HomeMy WebLinkAboutBLD2009-002031
0UILDING PERMIT APPLICAIN MRLA09 0eview 0p225
e: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD09-00203 Received Date: 7/7/2009
SITE ADDRESS: 294 SNOW CREEK RD
QUILCENE, 98376
OWNER: STEVE MAC DONALD PHONE: (702) 210-2428
TWYLA MAC DONALD
PO BOX 776
PORT HADLOCK WA 98339
SUBDIVISION: Block: Lot: 2+
PARCEL NUMBER: 802243003 Section: 24 Township: 28 N Range: 02 W
CONTRACTOR: H G C PHONE: (360)477-9643
GREG HUDSON
91 STONE FARM RD
SEQUIM WA 98382
Contractor's License HGC****951J2 Expires 3/11/2011
REPRESENTATIVE: GREG HUDSON PHONE: (360)477-9643
91 STONE FARM ROAD
SEQUIM WA 98382
PROJECT DESCRIPTIOI NEW SFR W/32 SQ FT COVERED PORCH
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,280
VALUATION 133,000.00 ADD'L: HEAT TYPE: EEE
CODE EDITION: 2006 HEAT BASE: HEAT TYPE: WOD
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: SHORELINE:
CONST TYPE: SETBACK:
DECK: 481
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: 2 Prop: 2
Total: 2 Total: 2
Routing Date:
7l1lb1
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,178.55 KAS 07/07/09 108693
Plan Check $766.06 KAS 07/07/09 108693 APPROVED
State Building Code $4.50 KAS 07/07/09 108693
Potable Water Application $62.00 KAS 07/07/09 108693 SEP 3 2009
Total: $2,011.11 Jefferson County Planning
& Building Department
Jefferson County Building Div3'fon Permit Numb . BLD09-00203
Applicant: MAC DONALD
BUILDING PERMIT INSPECTION APPROVALS %pplicable Code: 2006 International Building Codes
To schedule inspections, call (360)379-445E .
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 S
Erosion Control
Foundation Footing 1AMk
y F'
Footing Drains
Foundation Stem Wall
Underground Plumbing
Under Floor Framing IQ_ii_O G
Straps(hold downs) ti_oil
Ext. Shear Wall Nailing t0,4__0 a m
Rough-in Plumbing 1o._f?/ -o 7 R
Framing iSalif./D FA
---Bfeekillg_
Airseal to•dq-oq
Insulation: Walls r 1— 2 v
Insulation: Floors4.
Insulation: Ceiling
Int. Shear Wall Nailing
Wallboard Nailing 1) - '(J
1 ;1p.E:
Gas Line: Interior g0`(w0 9,
Gas Line: Exterior l
Prepay_ -6)-(t,Heat/Chimney Clearance .1 it 'l U `�_(
Drywell/Alt Drainage
Address Posted
FINAL INSPECTION 3 it; V V-k:c>
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
110 •
CONDITIONS for Building Permit# :BLD09-00203
1.) Septic tank location shown in this building permit application is not approved. See septic
permit SEP08-78 and or contact the septic system designer.
2.) 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.
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.
4.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the
Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the
Landslide Hazard Area.
5.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated.
Should buffer disturbance occur during construction, the Unified Development Code
(UDC) Administrator shall require replanting with native vegetation. No alterations shall be
made to the Landslide Hazard Area or its associated buffer without prior authorization by
the UDC Administrator.
6.) Prior to and during approved construction activities, the perimeter of the landslide hazard
area buffer shall be marked with a temporary sign. The sign shall be placed in such a
manner that it can be directly observed from the construction area. The sign shall contain
the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter
Existing Vegetation."
7.) All construction activities shall not encroach upon the wetland or landslide hazard area
buffers. This includes the storage or preparation of materials.
•
8.) The applicant shall permanently separate the boundary of the Landslide Hazard Area
Buffer from the remainder of the subject property through installing logs, trees, a hedge
row, or any other prominent physical marking approved by the UDC Administrator.
9.) The proposed single family residence is greater than 400+ feet from the edge of the
wetland. Therefore, a wetland delineation report was not required for this project.
10.) 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.
11.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
12.) 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.
13.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
14.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
15.) The building height is not to exceed 35 feet.
16.) Minimum setback from the north property line (rural forest lands) shall be 100 feet.
Minimum setback from the west property line (commercial forest lands) shall be 250 feet.
Minimum east property line setback shall be 5 feet. Minimum setback from SNow Creek
Road right-of-way shall be 20 feet.
17.) 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.
18.) 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.
19.) The applicant shall fully adhere to all conditions and requirements of the eagle habitat
management plan as signed by WDFW on Junbe 23, 2008 and the land owner on June
24, 2008.
• •
/� ON
C06 JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
'‘� `.4 621 Sheridan Street • Port Townsend •Washington 8368
360/379-4450 • 360/379-4461 Fax
Ny�p www.co.jefferson.wa.us/cdmmdevelopment L_��!t
Master Permit Application JUL - 7 2(0) MLA: pct-.906
Project Description(include separate sheets as necessary):
% ►.(tlt F6.,.,..1A L 60 , SUld CUUNT ]CD
Tax Parcel Number: $O Z Z\5 00Y3 Property Size: 3\ * C (acrj/square feet)
Site Address and/or Directions to Property:
cac1'i SNc... Geed; CZtcL 1 (),.;\�� e. ;,J A cig376
Property Owner(s)of Record: 'S�e.)z } 'Tw`1 \ck ,('\,:.` )1/4 o,ti 0._ \ a
Telephone: 10 2. -210 2k o g Fax: email:
Mailing Address: 'PO LcX 11 L7 Qc.r r ' c A 1 t c1, W A ci$33°
Applicant/Agent(if different from owner): Gresasc f.:
Telephone: 3i D -4.11 -ab`13 Fax: email:
Mailing Address: q 1 kcn;e. F4,c,,,,t kz�.� �,vw. (A) A, cj q `
Mat kind of Permit?(Check each box that applies ❑Lot or Road Segregation
Building 0 Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use)
)it'Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]**
❑ Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification
❑ 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 ❑ Binding Site Plan**
❑ Propane 0 Long Plat**
❑ Sign - 0 Planned Rural Residential Development(PRRD)/Amendments** '
❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration*"
❑Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions**
❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development**
❑Temporary Use 0 Shoreline Management Variance
❑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 ❑Tree Vegetation Request
"*Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal, if known:
` DESIGNATION OF AGENT
I hereby designate ` c� •mil to act as my agent in matters relating to this application for permit(s).
•
OWNERSI URE / t 1 t2/ Date: - Z99
By signing this application form,th caner/agent attests that the info ation 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 inspection Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the ap that h o hew s prio o' .
Sig ure: ,2`{449dell, Date -Z-d` '
The action or actions Ap cant will undertake as a result of the issuance of this
n one or more threatened or
endangered species a could lead to a potential'take"of an endangered species as those terms ermit may vare defined inely impact othe 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 , I the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-tran - .••Je responsi''lity for V herin.V to :nd co plying with th; ...A. T Applicant has read this disclaimer and signs and dates it below.
`_`� Date: Z
mmil 0 4111
BUILDER STATEMENT .
The signer of this me oe' ereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assu nsibility of the General Contractor for the proposed project.
Signature:
` Date: t `2-1 - ° 1 GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: .
(,r VT`^,(1 ra C.Sr ( (-3CO) 411 -ti k,y 3 ( )
MAILING ADDRESS: q I A EMAIL:
CNC `Grh1 -GQ�� , W
CONTRACTOR'S LICENSE /" ((A-53 L WAINS (V A i L
NUMBER: 1'��c. 4 # 1 G 5I S z. NUMBER CA\SUU SS ' J1 ZOG .
ARCHITECT/ENGINEER: VoAt�G�p;� a ``. ' PHONE (36c)ja/3 $Ls,s FAX:( )
D,�.1C1 '1 y;S•cvV
MAILING ADDRESS: P(•,3,, 1 pi CZ.C>A;,v.;% A c1i 5 LY EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
Wood Existing: ❑ Sewer
New ❑ Steel Proposed: 2 Bank t7 Community System
❑ Alterati
❑ Additionaion/Remodel ❑ Concrete Total: 2- Height: Isf Individual System
— SEP Permit# �-��
❑ Repair ❑ Masonry
❑ Other: Bedrooms: Water Supply:
❑ Demolition Existing: _ — Setback: �;'Private well ❑ Two Party
Typeof Het: Proposed: C.- ❑ Public
Total: Z Name of System:
If this is a Commercial Project you must answer the following: T
Number of Parking Spaces: Current: Proposed: Number of AD17A F44400 V j ?� T
employees,
Number of occupants(includes owners,*pants, etc) Current Proposed 'i
have Food Service? Yes / No
IBC Occupancy: IBC Type of thnstruction: Will youJUL
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: J
i Underground Tank i Above nd Tank_ Size of Propane Tank:
i Heat Stove i Cook Stove i Woodstove)i Fireplace Insert i Hot Water Tank i Pellet Stov 1
tl � rt.'y
Is this appliance being installed in a Manufactured/Mobile Home? Yes / to A • UJLJ„I T
permit to install a propane tank you must also submit a site plan showing all of the buildings,alrpr
When applying for a operty
lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components,
including the reserve area.
Square Footage I Current Proposed For Office Use Only '� �t Revision
Main Floor Heated EH Bid App Review: 3 r10
2n0 Floor Heated Consistency Review:
tv\A Q) 3. U
Other Heated Base fee: I I 5N V\
Mezzanine Additional Section: _______ ___.._
N��
Heated Basement Plan Check fee: r w
Ni1A Jl1)
Unheated Basement State Surcharge fee: /�
NIA b
Other Unheated Pot Water Review fee: I OO
? �A l
Garage/Carport SUBTOTAL
N`A • a 3"65:_.( 1
Decks 111/Rd Approach fee: __.__--__
Other nr�'h`` ; L .5C TOTAL: $ a 3. 5.
Covtrc� � _
Receipt Number: 10 S19
- �. Cash/Check Number: z--104
ESTIMATED COST(REQUIRED) Date: L�� 'U_I
I
•Fair market v of andinaterlls foundation to finish Initials:
b 13 DCb C---l--
. .. . ._ ,..uu.-�nr,.fcH1+44\ilA Tl vrIRMC\:,,,-,-.,t DRTI EcumclliastA.,.,1:.•ot:r.-5raigl,d...-
! . , 6 iir
0 J10'► r�, ���V��� ly7ON
1, JEFFERSON COUNTY
,i:� Ali; DEPARTMENT OF COMMUNITY DEVELOPMENT JUL - 7 2009
\,,.....
qq 621 Sheridan Street• Port Townsend •Washington 98368C[[ j��I (' N O� http/3/7www co.efferrson.wa.s/ommdevelo ment/ JEEFER�� COUNTY 11 0��
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STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# Qct'• _a Ol PROJECT/APPLICANT NAME: )\-c-JG \u-J - L ` ,o.c NA)A0,
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. ` ,L D a
1 e CotiS+csn6\ q aiC: 5r.,.11/� S.,ink( C&,.... i 2es'. ekc.,,L( ov n e�'.�,�'.`� Clcac'.�„1 oorl o P ro4.
31 y1 1 j 1 1
Existing Conditions Summary JEFFERSON COONIY IICt
2. Describe the existing topography. Indicate contours on the site map. r t 11,,(�fill L66
Lo� b;;,,. ••.,•fie e rJ i�.e11 Qr1) C'r.s troy �l oct'hweai •-o 4-V.c ``� nivr s7V1 . (i J c.rii` C
),.. 1,4-0 1wt(t Qrs 45tS I�Z .S (.`f.Ar 1 AK L1 4 S (l •t C N 1'{ '`jl b 1 e `11) Q"nt 50.4e1 CQ S-
qA V.6..6 ut �� i
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
Qwne to ,A ►c -ID ,,,\e•.s5 �.c, ``.. . &\cker 5a�-e So•-\a\ v^ .0Sk %.\ 0VCCciryw1‘)
1-1
4. Describe the existing soils. Indicate soil type on the site map. /
O /o' art-'pry Cf,,,4 / S 4 / (�.. 6....,,/ f -
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, ` I
and indicate acreage of each. j n
(LrrCJ S.f c i S Clr'1 i #'&tr -1 / Seders re_;$45 rc_ J 3 t.L.r+ - e.FT
b .4 o. ti•e- eo ei d l,Y Col
APPROVED
6. Describe any excess levels of noise generated by the propos d use or activity: STORM WATER PLAN
J1pr►,.,,, I for 6,4 64rK ;o.1)
SEP — 2 2009
•
JEFFERSON COUNTY
pwlyiwiy.‘,
stormwater site plan template—rev.70l27/2008 DEPT.OF CO pF E
SIGNATURE:
•
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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. 11
�riv ,1 S1e�es rri•.. �w ‘to 5t LI...4, Iv. G�en1t ' ' ,t,,Sr Ouer tODr
e.tt1 g 0,1/4. l acet. eF WftA1c.,a,,t. T. IQ (...trtcc- M4.rke c' Ow 5At e,1A,...)\,,fide ?61-"i.cw Oc t 1)Qz1i %S /rrsGj .L U1cl 'et-0
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).
aA k ?r,1. i Cho,.;t_p_lr rum t W t irt- m ul vc cl hi ()v r (Z .wrce.,
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 facilitiesc on the site plan and differentiate pro?osed facilities from existing facilities.
C 40,,,,0c i c v.) ,\` 4c C14AV.. c�5111.a-54� L f i 6*,2e e) f '2 4�srce 3
ULti2.l , CA f/ C le are GI c re_z,S iia:l , i p%$11 60.-t,F,S. ecru to s 5 4'fuc J / ('`)o 4 is 0
10. If the project requires the use of stormwater treatment facilities, describe the types of stormwater treatment facilities proposed
for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is
normally for"I r]qe"pr jects or projects that involve the potential for dispersion of contaminants.]
540..J 4 6Z iveces e..e—!
11. Describe the performance``goals and standards applicable o the project.
4-4,e 4rec1 i b�, u5ec> Xc- /11 se/a, / ca /Ore✓.ri.a f� r �re4
d Alp ve,4 c/t,av, ;S// 6a,f':., [{er, o cc�/I sirl�Ve, �aus�rwc c.i Seec:1 w. /7
e p
1a c.r c 4.- t r' -Sy-f c w tor 6-4 s.on/
12. Describe the flow control s. �t rn,..1_, 'A /
._ . _ ,...; iVoT d yFa b; .i �,1l .t F,Lbos t�'/!cr c /l L' -ruff
i Sr_... ..,o/�!. . t Q �. d r i ;L. It' ,✓.
Y.ik,in s
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JUL — 7 2009
_._.� ' EFERSIH COUNTY OH
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storm4iatef s�l�'ptah'�A�{pla�ej-fAv.`fOV21'200$ � ' .a $
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13. Describe ther quality system.
n FF /
LlAfr S� .r i 3 11. 44.ri w. /rf a o i 4 {� � �e�:% �1`� ��ar;� /
There :5 cJer Sz v - eXi5�ti'�y i-rees .f ✓2f�.Tw/l+'o.✓ for F l4rw1,'avJ
14. Describe the convect ancfe�Lssysttem analys/Is and desig .
K i/ ^441 oTT 1 Too. dowNSJ J /-ve" 44. a;1 4 41€ /;41 41ere
4 Aere i 3 ertrrCJLi T.,ee 5 r- ri/ / / �e.1 Idai.e Pv , tire.. 1 w,%/
fro,;:de ,yore *iia� ael yJe Dr,.." te.,i4
15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material.
`I`.,ctat ,t Ex-)
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code. —
7
2009
/l/p,ve ass JUL
FE ;1N CQINTY On
17. Describe thA proposed surfacing material. I . / / / /
(In,%twcwj 1-Xishi.I , U'S bevy So, l 'mod be SGt hc/
18. Describe methods for restoration of the site.
ti/A ( ;54`7 )
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.
N 1 4-
20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
NoN,t
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 conditions or
restrictions here.
; L SirLetAl 44 SLY o$ — oo618
stormwater site plan template-rev.10/21/2008 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 Required Elements—Construction SWPPP
1. Mark Clearing Limits.
Iv+-LGi):�'V�
2. Establish Construction Access.
fix, �```i
3. Control Flow Rates. ``n�
irc. Ure t; el 4-1 414
4. Install Sediment Controls. `-I
•Ae, 'Srcc.� cr cis IVzcc>7•v-ti okv Alt-d L4-4{
T 44 Seel, ;S A4 / ccn 40/Irl
5. Stabilize Soils.
eeci d raw
6. Protect Slopes.
5, e 5 fzVy f S/opes cirz (leg :
RECEIVED
7. Protect Drain Inlets. ��//
Il) Orn w r It
JUL - 7 2Q09
JEfffHSON CO(JNIY OCU
stormwater site plan template-rev.10/21/2008 t3
• •
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12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets. JUL — 7 rry
�WC�
J`Uf f,9SON CUUNTY DCD
9. Control Pollutants.
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W f tr 15 GL.d4...1Alt Co"' sr Te 61ro4L` t3 Qa:c_\OM< hjc,cassc....) 0Ja /a
10. Control De-Watering(the 9ct of pumping groundwater or stormwaterLU (Ipway/from an tiiye construction site).
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11. Maintain'Best/Management Practices(BMPs). /
II eo rac Or L.., I r (�4 ON 5,,tt T 14 S t 5,. Cb rA.e.14r j
w 'I rece...0 MSTIwd/I CWi
12. Manage the Project. 1
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2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas, roads).
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b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
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3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas thatare on or adjacent to the site. ,
p+�'.‘ '1 '( nt-' 0.0 f kk"ta•� :.r� evCCeYa,� d$ 8�v `t'� Ocrk'kwea Jct.
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stormwater site plan template—rev.10/21/2008 9
• .
b. Description of special requirements for working in or near environmentally sensitive areas.
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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). {iv
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5. Construction Phasing.
a. ponstruction se``q ence `- Q 1\ Fo.A.hc�d,;o�, \ `ca+M�c.` low \ sLcor Gr+w,,Q :c.
b. Construction phasing(if proposed)
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide alp oposedp` /cy\}nstruction schedule.�[ ry `` 4 1 1
NW\V' � a�lc(( C6M W'•I 6.v ♦lea\ •Cav.e ` `�GaN 1 4ti\Ci ,iZ (bkm1 ,
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II. Wet Season Construction Activities.
a. Proposed wet season co struction activities.
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b. Proposed wet season construction activities for environmentally sensitive areas.
P\, .
7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for the initiation of bonds and/or other financial securities.
Sir2.i t. \ t.\\G., r1 ac ch Al A eA1
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
`'ZC5 I RECE " E
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8. Engineering Calculations. Provide Design CaloAlos-o/anefirate sheet for the foll wing, if applicable.
a. Sediment Ponds/Traps.
b. Diversions. i�[C p�n j' COUNTY ill 4
c. Waterways. J t f R ` N ( OUN . ,up
d. Runoff/Stormwater Detention Calculations
stormwater site plan template—rev.10/21/2008 10
• •
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 a to
(LANDOWNER O AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
•
RECEIVED
JUL•- 7 2009
JEFFERSON COUNTY DUI
stormwater site plan template—rev.10/21/2008 12
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REVISION /a -- B O N D E S O N •DND••D CONSTRUCTED FROM
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