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HomeMy WebLinkAboutBLD2009-00170 • I CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 (800) 831-2678 Al Scalf, Building Official PERMIT #: BLD09-00170 SITE ADDRESS: 244 NICKELBUSH LN Issue Date: 08/10/2009 QUILCENE, 98376 Final Date: 8/23/2010 APPLICANT: CATHERINE MOTTELER PHONE: 360-765-3226 PO BOX 756 QUILCENE WA 98376-0756 SUBDIVISION: Block: Lot: 1+ PARCEL NUMBER: 701061018 Section: 6 Township: 27 N Range: 01 W PROJECT DESCRIPTION: NSFR W U/G 500 GAL PROP TANK THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2006 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 8/23/2010 I:\F_BLD_Occupancy.rpt 10/29/19 AIME Jefferson County Building 'ision PerrniVNu - r: BLD09-00170 BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 International Building Code To schedule inspections, call (360)379-4455 : ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks Min ' Minimum setback from Nicklebush Lane right-of-way shall be 20 feet. Erosion Control rom the stream shall be 155 feet. SEE CONDITIONS 2& 3. Foundation Footing Footing Drains Rao �,.•f— `` � Foundation Stem Wall M t— 1111111111111 Underground Plumbing 11g / IIIIIIIIN Under Floor Framing Straps(hold downs) ro!1/11111 Ext. Shear Wall Nailing 0_,• _oci Milli. Rough-in Plumbing IM Framing NMI6Wi4.,c ,R? i It/D Blocking AirsealamiiIIIIM Insulation:Walls i- 1-1- 10 MINIIIIIII Insulation: Floors Insulation: Ceiling NM MErnifiz Int. Shear Wall Nailing Wallboard Nailing IIMMI �.. Gas Line: Interior IIIIIIIIIIIIIIIII Gas Line: ExteriorMIS—�— I Propane Tank MIA Heat/Chimney Clearance Z3-(© 1 SS Drywell/Alt Drainage 1� SEE CONDITION I FOR SPLASHBLOCKS Address Posted '�� -23 -l o FINAL INSPECTION ah� —23-10 �` FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD09-00170 1.) DESIGN CRITERIA FOR SPLASHBLOCKS: A VEGETATED FLOWPATH OF AT LEAST 50 FEET SHOULD BE MAINTAINED BETWEEN THE DISCHARGE POINT AND ANY PROPERTY LINE, STRUCTURE, STEEP SLOPE, STREAM, WETLAND, LAKE, OR OTHER IMPERVIOUS SURFACE. SENSITIVE AREA BUFFERS MAY COUNT TOWARD FLOWPATH LENGTHS. A MAXIMUM OF 700 SQUARE FEET OF ROOF AREA MAY DRAIN TO EACH SPLASHBLOCK. A SPLASHBLOCK OR A PAD OF CRUSHED ROCK (2 FEET WIDE BY 3 FEET LONG BY 6 INCHES DEEP) SHOULD BE PLACED AT EACH DOWNSPOUT DISCHARGE POINT. NO EROSION OR FLOODING OF DOWNSTREAM PROPERTIES MAY RESULT. FOR SITES WITH SEPTIC SYSTEMS, THE DISCHARGE POINT MUST BE DOWNSLOPE OF THE PRIMARY AND RESERVE DRAINFILED AREAS. 2.) IF NEEDED, A SILT FENCE SHALL BE INSTALLED EAST OF THE CLEARING LIMITS OF THE HOUSE SO AS TO NOT CAUSE DEGREDATION TO THE STREAM AND ITS ASSOCIATED BUFFER. APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO MAKE SURE THAT SILT DOES NOT ENTER THE STREAM. THE MINIMUM HEIGHT OF THE TOP OF SILT FENCE SHALL BE 2 FEET AND THE MAXIMUM HEIGHT SHALL BE 2 1/2 FEET ABOVE THE ORIGINAL GROUND SURFACE. THE SILT FENCE SHALL BE BURIED IN A TRENCH TO A MINIMUM DEPTH OF 5 INCHES BELOW THE GROUND SURFACE. THE TRENCH SHALL BE BACKFILLED AND THE SOIL TAMPED IN PLACE OVER THE BURIED PORTION OF THE SILT FENCE, SUCH THAT NO FLOW CAN PASS BENEATH THE FENCE AND SCOURING CAN NOT OCCUR. ANY DAMAGE TO THE SILT FENCE SHALL BE REPAIRED IMMEDIATELY. SEDIMENT DEPOSITS SHALL EITHER BE REMOVED WHEN THE DEPOSIT REACHES APPROXIMATELY ONE-THIRD THE HEIGHT OF THE SILT FENCE, OR A SECOND SILT FENCE SHALL BE INSTALLED. 3.) CONSTRUCTION ENTRANCES SHALL BE STABILIZED WHEREVER TRAFFIC WILL BE LEAVING A CONSTRUCTION SITE AND TRAVELING ON PAVED ROADS OR OTHER PAVED AREAS WITHIN 1,000 FEET OF THE SITE. THE ENTRANCE SHALL BE CONSTRUCTED ON A FIRM' COMPACTED SUBGRADE. QUARRY SPALLS (OR HOG FUEL) SHALL BE ADDED IF THE PAD IS NO LONGER IN ACCORDANCE WITH THE SPECIFICATIONS. (BMP C105, 2005 DOE STORMWATER MANUAL). ANY SEDIMENT THAT IS TRACKED ONTO PAVEMENT SHALL BE REMOVED BY SHOVELING OR STREET SWEEPING. THE SEDIMENT COLLECTED BY SWEEPING SHALL BE REMOVED OR STABILIZED ON STIE. ANY QUARRY SPALLS THAT ARE LOOSENED FROM THE PAD, WHICH END UP ON THE ROADWAY SHALL BE REMOVED IMMEDIATELY. UPON PROJECT COMPLETION AND SITE STABILIZATION, ALL CONSTRUCTION ACCESSES INTENDED AS PERMANENT ACCESS FOR MAINTENANCE SHALL BE PERMANENTLY STABILIZED. ThUILDING PERMIT APPLICA)N MRLA09-00p191 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00170 Received Date: 6/10/2009 SITE ADDRESS: 244 NICKELBUSH LN QUILCENE, 98376 OWNER: CATHERINE MOTTELER PHONE: 360-765-3226 PO BOX 756 QUILCENE WA 98376-0756 GOV LOT 1(N 1/2) SUBDIVISION: Block: Lot: 1+ PARCEL NUMBER: 701061018 Section: 6 Township: 27 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: JOHN EWALD PHONE: 360-877-5814 PO BOX 207 LILLIWAUP WA 98555 PROJECT DESCRIPTION NSFR W U/G 500 GAL PROP TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,260 VALUATION 220,000.00 ADD'L: 600 HEAT TYPE: WOD CODE EDITION: 2006 HEAT BASE: HEAT TYPE: EEE OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: 120 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: {r (6- II - Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,665.75 LYK 06/10/09 108546 APpRc \/ED Plan Check $1,082.74 LYK 06/10/09 108546 State Building Code $4.50 LYK 06/10/09 108546 AUG IO 2009 Potable Water Application $62.00 LYK 06/10/09 108546 Total: $2,814.99 Jefferson County Planning &Building Department 4.) SEP03-299 as well as SEP09-81 must both be finaled prior to final 5.) PRIOR TO FINAL OCCUPANCY WATER QUALITY TEST FOR CHLORIDE, FOLLOWING TREATMENT CHLORIDE, MUST BE SUBMITTED THAT SHOWS LEVEL MEETS DRINKING WATER STANDARD AND THE TREATMENT UNIT IS ADEQUATE. 6.) The identified Fish and Wildlife Habitat Area (Type F Stream), shall maintain a vegetative buffer setback of 150-feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to the proposed single family residence. 7.) An additional setback of five (5) feet is required from the edge of the stream buffer area to the proposed single family residence. 8.) A permanent physical separation along the boundary of the stream buffer area shall be installed and permanently maintained. Such separation can include installing logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC Administrator. 9.) Stream buffer perimeters shall be marked with temporary signs at an interval of one per parcel or every one hundred (100) feet, whichever is less. Signs shall be in place prior to and during construction activities. The signs shall contain the following statement: "Buffer - Do Not Remove or Alter Existing Vegetation." 10.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP) Elements#1 through #12 of the Department of Ecology's Stormwater Management Manual for Western Washington to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 11.) A Stormwater Site Plan has been submitted and approved by the Department of Community Development. Once the subject permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. 12.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 13.) Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the requirements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor vehicles be stored in a critical area. 14.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 15.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 16.) The building height is not to exceed 35 feet. 17.) Minimum setback from Nicklebush Lane right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. Minimum setback from the stream shall be 155 feet. If an ESA is present, then the more stricter setback(s) shall apply. w 18.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 19.) Lighting fixtures shall be designed and hooded to prevent the light source from being directly visible from outside the boundaries of the property. The intensity or brightness of all lighting, during construction and after project completion shall not adversely affect the use of surrounding properties or adjoining rights-of-way. K4,,infri%6SoNc JEFFERSO LINTY40 DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax www.cojefferson.waus/commdevelopment 9'krING Master Permit Application MLA: O -- n 1 Project Description(include separate sheets as necessary): �i Alice ic;iyn%/y Z5;D ./ Tax Parcel Number: 'ya/DC/O/3 Property as / roperty Size: wva41059#1. (acres/square feet) Site Address and/or Directions to Property: ay5/V1C.//e 10A 2c0 O1J)= QA 7 I �cFNt- GL>A. Property Owner(s)of Record: C ��,el ni 'o Telephone: 34.O '76 " 3aa Fax: Mailing Address: 'P6 aak . -6 email: LlApplicant/Agent(if different from owner): aphirk �L,Wei Telephone: 3rpO—$77 .-- g kq Fax: Mailing Address: p, email: What kind of Permit?(Check each box that applies %Building 0 Critical Areas Stewardship PiiM 0 ZOOS ❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economicse)/ Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]'"` j❑ Manufactured Home 0 Modular El Discretionary"D"or Unnamed Use Classification,: ,IT ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment ❑ Address 0 Road Approach ❑Short Plat** ❑Home Business 0 Cottage Industry 0 Binding Site Plan** IR Propane 0 Longflat** ❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use 0 Shoreline Management Variance 0 Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference 0 Tree Vegetation Request "Reqres a Pre-Application Conference Please identify any other local,state or federal permits required for th s proposal, if known: I hereby designate Toll's) EWA l� DESIGNATION OF AGENT. to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE J / Date: //o 9 By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the a ication that he or sh wants prior notice. Signature: Date: 3-(--O ck The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act'or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual Ind non-tran rabl respons�ity for c hering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. gnature: Q� A1 ( p _ Date: 3- (- O rmitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc NNW AOBUILDER STATEMENT The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. (� Signature: /VIRJU,IY eDfYYt Date: 3— I,-0- l GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: A 1 E4 6e. A 3rikot:,S f PHONE (3(0)69a 3022 FAX:( ) 5;9/rn MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: Itt New X Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: 0. Bank t 1 Community System ❑ Alteration/Remodel ❑ Concrete Total: 3- Height: )( Individual System ❑ Repair 0 Masonry SEP'Permit# 03 - d 61 g O Other: Bedrooms: MWater Supply: ❑ Demolition Existing: Setback: i Private well 9 Two Party Type of Hea : Proposed: 01 ❑ Public u)ooC�l �P rtr iC- Total: a Name of System: If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No 1,4 If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: --- Underground Tank) 1 Above ground Tank Size of Propane Tank: 5 0n as5 CHeat Stove)( Cook StovOC Woodstove) ► Fireplace Insert (1 Hot Water Tank 1 Pellet Stove I Other Is this appliance being installed in a Manufactured I Mobile Home? Yes I o When applying for a permit to install a propane tank you must also submit a site plan sho all�of the buildings,all property lines,tank location and size,distances from the propane tank to all property lines,tt. tinls`gn{�g nd septic system components, including the reserve area. Square Footage _ Current Proposed For Office Use Only Amount Revision Main Floor Heated I EH Bid App Review: -2 Floor Heated 6� f Consistency Review: doll - Other Heated Base fee: I J Mezzanine Additional Section: Heated Basement Plan Check fee: • IU'a 1721 Unheated Basement State Surcharge fee: + Other Unheated Pot Water Review fee: I CD Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other ,3 2 TOTAL: $ 3 i couci.eb rOre•A /o7 3219K) Receipt Number: 16S (cra Cash/Check Number: if ESTIMATED COST(REQUIRED) II Date: /� •Fair market value of all labor and materials f undation to finish Co" h )-0 // Initials: / `— 7Lwo �1uNdrFd �C, N�� OOVA)h `/ ._.._______ -D-- G:\PennitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc t 1 0 0 ���.gsoly °°�v JEFFERSON COU NTY q DEPARTMENT OF COMMUNITY DEVELOPMENT _ 621 Sheridan Street • Port Townsend • Washington 98368 �� �O� 360/379-4450 • 360/379-4451 Fax LNG` http:I/www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE IMLA. oq ` lei I PROJECT/APPLICANT NAME: C Q'CY\erlV�� LTC\-L-5tr-ei-e!(' Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a separate stormwater site plan map. Project Overview 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site map. 1 5r ..o •e t (-)- - . h-C �-r. �` --e___\c k c) he dyoc�v� 1n o v S e ��t d i f Ut wtd� �nar11 J ___— Existing Conditions Summary :1 2. Describe the existing topography. Indicate contours on the site map. I ��e-v� I�ue.l t,. .‘?to cA, (rot�v�\ Sow eve S\� e_ Ji_'�� 1 u J P 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. rc I�JC Ie F S �PP�x\ cknd Mary T o ave h a\ iyt� ny�� hrry try to C„ �, F- — C�dGrr a� fYlnr,l� ,U t5 cav-Ij gevn1Dc. S-F ik ,/�� 6 IJL� CI[l 04 -lY S l Y 1 Ora(' 4. Describe the existing soils. Indicate soil Y VA lNI Mil r r�1 ���} type on the�ite map. 0 v\e- --to -h_d.2Q -sP -1-o4=, `-)o k \-h r 0, t i cC� rycxoe \ �iX_kee \ �sY\ C �A�( rSY�o � ?��� ) Jrfl�SGh`� 5. Describe the existing site hydrology(i.e., drainage; behavior of water on the site—above, below, and on the ground). Indicate existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if applicable,and indicate acreage of each. (.(\clie r ne_u e r. -t-av-tok 5 on i-Qne irtau e_— 4nyue_ off- -k-Pn.,2_ 1rwv-1 mr)s-klt ovt -rt c kt� l--O y_r cxnd„ low ct an_45-And a .,* a1a` ( ear. ' pig ._ 6. Describe any excess levels of noise generated by the proposed use or activi AP r ROVED N STOR114WATFR 1 AN • AUG . 3 2009 JEFFERsoN/ `UN stormwater site plan template—rev.1021/2008 SIGNATUR DE PT.OF CO, �'��A'L I ENT • 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes, etc.)on the site. Indicate location on the site map. 1 Q—��►� �JsR'�r t.��L L�S�� to rlk� C�O.v e � r Q D1Nt Atn 4V1.2_ -° 8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads,and sensitive/critical areas (streams,wetlands, lakes,steep slopes,etc.). _ f ham_ ;s 10(017E4 hPttt19-e n woe-- Wnr104.0 aet4 tZ orb C Q - ckyNa r'ura d tea°St'd.P t a‘ Permanent Stormwater Control Plan This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs and facilities to remain in place after construction of the project is completed. "Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control facilities are not exceeded. g. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed (i.e., per BMP T5.30 in the Manual)or, if not,what types of stormwater flow control will be utilized for the site or specific threshold discharge areas within the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. o.to hviIat‘06,5it-P - Tirt 'p- houe iue 1 ekt)9 V1. J)( S e_- -v1 5--ct v\c1 vt'c� t Ja -etr O ion 1.0.._ '7 0,c_v 10. If the project requires the use of stormwater treatment facilities, describe the types of stormwater treatment facilities proposed for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is normally for large"projects or projects that involve the potential for dispersion of contaminants.] ` • C it� wi(( re_ tr.e no ITe_ttmewnT i t�-te5 11. Describe the performance goals and standards applicable to the project. we_ t t( t th'i&th; �rP s ex i sty. - c rasr&j, ��p� \ s e s t (re__ ��-e� n `CXIo m o� Q. VI 12. D cribe the flow control system. -r I is 1M0 � `mil �v -tO `t"Vl`� -- t cct-Qt e ©ems 6 rx - UP t,!1-1 t`0'V stormwater site plan template-rev.10/212008 6 41110 13. Describe the water quality system. ��>✓ -�r� - � ((it (-tu o + textrA ch-tc. '+ l S V-Im)t�� be!s.P VV1 LA 'f'.e(d -Qc)w t S r v e d in'r f —52,t W� �c�c1 e— c v '5 j e ' 4:14— _ ‘d c-J 14. Describe the conveyance system analysis and design. cFcaot r corn 1 4a tt sU Li rfaVrai ne cQ 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. e_tc of 4 ictt , f,r(( vlc r 1lr'' 'c 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. 17. Describe the proposed surfacing material. 18. Describe methods for restoration of the site. 'V \ 19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for "large"projects only and only those for which facilities are required to control flow or treat runoff.] If included, list the Manuals here?, 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 6�O[ -i�.� — St rat u YYt c rpu e _" 36D- -i t`E--ck`i(� 21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include conditions that affect the drainage plan or contain more restrictive drainage-related requirements, describe those condition s off_ restrictions here. Sept` - �'' �nG�� 1;►nct� C'roucil • 1 U N 1 0 2009 stormwater site plan template—rev.1 0/2 112 0 08 7 • CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP) The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential development. SECTION I—CONSTRUCTION SWPPP NARRATIVE 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable to the proposal,justify in writing. Descriptions of the 12 Elements are found at Volume II Section 3.2.3 of the Manual(beginning on page 3-7). 12 Requimd Elements—Construction SWPPP 1. Mark Clearing Limits. luny c r l5 2. Establish Construction Access. xi st un -- '{-cam dY w e uja_Lx 5 3. Control Flow Rates. nSa -310. -. 4. I Install Sediment Controls. ►v 5. (Stabilize Soils. NU 6. Protect Slopes. Cat 5 U 5 c�utQp,2 -r\ S�c' I `7 J e.as(S 7. Protect Drain Inlets. JUN 1 0 2009 � stormwater site plan template—rev.10/21/2008 8 • 12 Required Elements—Construction SWPPP(continued) 8. S abilize Channels and Outlets. 9. Control Pollutants. NA 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). WA 11. Maintain Best Management Practices(BMPs). _145.4:64,ctuaLC try cf rz� 5.pc.ry-1 5;�n1� -- —rPi P i f et.O r C k-Pcu up av\, ji_r� M t„la,< <S 5 U e S 12. Manage the Project. Prcc3e_rt Nrtttis L.ti 1( by ern site cq( 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). R b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). - ravel �` lt�Sit\ 1arle_ "tr") C -Q t ro act('t(' k . 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. ?O(9 t LI stormwater site plan template—rev 10/21/2008 9 1110 • b. Description of special requirements for working in or near environmentally sensitive areas. U j e__ ui t kk. how 1c _ n c k i VI O i to r h,•e ex I- ct_n c\ enc.)it(fl1- 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils e.g.,erodibility,settleability, permeability,depth,' texture,soil structure). 'W (��.,241 '� p�C?bl,,C`45 4,5 S l`�Q l S <� Le i,1P 5. Construction Phasing. a. Construction sequence —wt_ i b. Construction phasing(if proposed) NA 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction schedule. Siik--4P--(ar 'p a r [L t►' �zt oC\ — 'rauAv ek c_tr ztr� i on f k u sv- cmL� aY II. t Season Certstruction Activities. I V\t Q�(I O i VZr 5� �pp rt CA a. Proposed wet season construction activities. R1pc b. Proposed wet season construction activities for environmentally sensitive areas. J v 7. Financial/Ownership Responsibilities. a. . Identify the property owner responsible for the initiation of bonds and/or other financial securities. b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. 8. Engineering Calculations. Provide DesignCalculations on a separate sheet for the following, if applicable. a. Sediment Ponds/Traps. N R -- b. Diversions. c. Waterways. 2009 d. Runoff/Stormwater Detention Calculations in 1 0 stormwater site plan template—rev.10/21/2008 10 411 Stormwater Site Plan Changes If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems,treatment facilities,flow control facilities,or structural source control BMPs (not standard on-site stormwater management BMPs),the applicant shall submit a final corrected plan ("as-builts")when the project is completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as constructed. APPLICANT SIGNATURE By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. (LANDOWNER OR AUTHOR! 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