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HomeMy WebLinkAboutBLD2009-00210 JILDING PERMIT APPLICA•N MLA09-00227 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00210 Received Date: 7/8/2009 SITE ADDRESS: PORT TOWNSEND, 98368 OWNER: KEITH HANSEN PHONE: (360) 379-1416 CINDY HANSEN 970 BECKETT POINT RD PORT TOWNSEND WA 98368 BECKETT POINT FISHERMAN'S CLUB SUBDIVISION: Block: Lot + PARCEL NUMBER: 932200801 Section: 23 Township: 30 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NEW GARAGE - UNHEATED AND NO PLUMBING Lot- 15 4 I In C q1b �P rLe.4-4-- T6u �.D TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION 18,030.00 MAIN: CODE EDITION: 2006 ADD'L: HEAT TYPE: UH OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: GARAGE: 672 SHORELINE CONST TYPE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 0 Prop: 0 Total: 0 Total: 0 Routing Date: Type Amount Paid Bv: Date: Receipt: proved/Date Permit $307.25 KAS 07/08/09 108752 APPROVEDPlan Check $199.71 KAS 07/08/09 108752 State Building Code $4.50 KAS 07/08/09 108752 DEC 2009 Total: $511.46 Jefferson Countye t Ruilr#tne pi nni►�A tleaartme►, Jefferson County Building •sion Permit Nu*: BLD09-00210 Applicant: HANSEN BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. 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 r- . .0 Minimum setback from Beckett Point right-of-way shall be zero feet. Minimum side and rear yard setbacks shall be 5 feet. Erosion Control I_y, tO SEE CONDITIONS I, 2, & 3 Foundation Footing 1_LI_ It Footing Drains / Foundation Stem Wall 1 J Straps(hold downs) Ext. Shear Wall Nailing Rough-in Plumbing Framing Address Posted -24'(O CU-WI # ql —/T7, 'c71( FINAL INSPECTION FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD09-00210 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 SPLASH BLOCK. A SPLASH BLOCK 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.) A SILT FENCE IS REQUIRED TO BE INSTALLED BETWEEN THE WETLAND BUFFER AND GARAGE PRIOR TO ANY LAND DISTURBING ACTIVITY. APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO MAKE SURE THAT SILT DOES NOT ENTER THE WETLAND. 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. • 4.) APPLICANT IS REQUIRED TOVE AN ARCHAEOLOGIST ON SITE TO MONITOR AND EVALUATE THE EXCAVATION OF FOOTINGS. 5.) 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. 6.) 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. 7.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 8.) 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. 9.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. Pre-existing legal lots of record less than one acre in size in rural residential districts are subject to the stormwater requirements in Chapter 18.30 JCC and must meet the "Area of Impervious Surface Coverage"to the maximum extent practicable as determined by the administrator. Lot coverage is defined as amount of impervious surface, which includes rooftops, driveways, concrete, etc. 10.) The building height is not to exceed 35 feet. 11.) Minimum setback for the garage from Beckett Point right-of-way shall be zero feet. Minimum side and rear yard setbacks shall be 5 feet. 12.) 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. 13.) 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. 14.) PRIOR TO FINAL BUILDING INSPECTION, PROPONENT SHALL PROVIDE THE DEPARTMENT WITH AN ORIGINAL "FINISHED" CONSTRUCTION" FLOOD ELEVATION CERTIFICATE THAT HAS BEEN VERIFIED BY A LAND SURVEYOR, ENGINEER, OR ARCHITECT AUTHORIZED BY LAW TO CERTIFY ELEVATION INFORMATION IN THE STATE OF WASHINGTON. 15.) Flood hazard reduction measure to be used as required by the Jeffersor>liunty Flood Damage Prevention Ordinance 07-0515-06 (Jefferson County Code Chapter 15.15). 16.) Construction Materials and Methods of Construction to Reduce Flood Hazard (i)All new construction and substantial improvements shall be constructed with materials and utility equipment resistant to flood damage. (ii) All new construction and substantial improvements shall be constructed using methods and practices that minimize flood damage. (iii) Electrical, heating, ventilation, plumbing, and air-conditioning equipment and other service facilities shall be designed and/or otherwise elevated or located so as to prevent water from entering or accumulating within the components during conditions of flooding. Locating such equipment below the base flood elevation may cause annual flood insurance premiums to be increased. 17.) Fully enclosed areas below the lowest floor that are subject to flooding are prohibited unless designed to automatically equalize hydrostatic flood forces on exterior walls by allowing for the entry and exit of floodwater. Designs for meeting this requirement must either be certified by a registered professional engineer or architect or must meet or exceed the following criteria: a. A minimum of two openings having a total net area of not less than one square inch for every square foot of enclosed area subject to flooding shall be provided. b. The bottom of all openings shall be no higher than one foot above grade. c. Openings may be equipt with screens, louvers, or other coverings or devices provided that they permit the automatic entry and exit of floodwater. 18.) Utilities shall be designed as specified in 15.15.080(c) of Jefferson County Flood Damage Prevention Ordinance 07-0515-06 (Jefferson County Code Chapter 15.15)which states: (i) All new and replacement water supply systems shall be designed to minimize or eliminate infiltration of flood waters into the systems; (ii) Water wells shall be located on high ground that is not in the floodway; (iii) New and replacement sanitary sewage systems shall be designed to minimize or eliminate infiltration of flood waters into the systems and discharges from the systems into flood waters; (iv) Onsite waste disposal systems shall be located to avoid impairment to them or contamination from them during flooding. 19.) 1) All new construction and substantial improvements shall be anchored to prevent flotation, collapse, or lateral movement of the structure. 2) All manufactured homes shall be anchored to prevent flotation, collapse, or lateral movement, and shall be installed using methods and practices that minimize flood damage. Anchoring methods may include, but are not limited to, use of over-the top or frame ties to ground anchors. • III . ON C, �4� :6, JEFFERSON COUNTY ,�,� DEPARTMENT OF COMMUNITY DEVELOPMENT 1' 04 621 Sheridan Street•Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax �rqy*,66 www.co.jefferson.wa.us/Gp�mdevelopment Master Permit Application }? �, (� MLA: 061- as 7 Project Description (include separate sheets asJcesary43� ; I I L' B t Kph0 tM 6 Tax Parcel Number: q a 0.70 1 Property Size: (acres/square feet) Site Address and/or Directions to Property: at/MSS vh 9 ?C� �." ' ' e -e4,4 et ' )0 1- 1,19 d k s 4- Property Owne i)of Record: ( fir°. „ �N.- 'ni Cittho Telephone: Fax: email: Mailing Address: MO B.pi4 14" R1<ri�- � Por+ 1ooms0 LA- 9 (Oo Applicant/Agent(if different from owner): r a h`, r- C t.ic__ ?-0114vy\ Telephone: 3(Oi� '� 2q� I y O Fax: J email: kLe,111 C{nn ®r�hS 1,& v►^ Mailing Address: 990 13ec*e-i{- tR} lei) pP--r✓ Tcx,3l.,Y} gg3(p Y at kind of Permit?(Check each box that applies ❑ Lot or Road Segregation Building 0 Critical Areas Stewardship Plan Demolition Permit ---- ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family •irage Attached Detache) 0 Conditional Use[C(a), C(d),or C]** ❑ Manufactured Home .0 Modular 0 Discretionary"D"or Unnamed Use Classification 0 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 ❑ Long Plat** ❑Sign - • 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration** ❑ Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development'"` 0 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 ;— alto J—f G,,,-y--_- I hereby designate to act as my agent in matters relating to this application for permit(s). - OWNER SIGNATURE Date: 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 applica r that he r she want prior notice. _.Signature: //��/ Date: 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 and non-transferabbe respon ility fo adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: �� ' Q� --�_ Date: 7- 6-- -V • • BUILDER STATEMENT . The signer of this statement does hereby certrfy that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming t responsibility of a General Contractor for the proposed project. Signature: / / l -I, -1> ----k__ - Date: Fax:- GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTORS LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New 0 Wood Existing: —70L--- ❑ Sewer tion ❑ Steel Proposed: Bank Community System O Altera ❑ AlteraAlteration/Remodel ❑ Concrete Total: _ Height: 0 Individual System SEP Permit# ❑ Repair ❑ Masonry ❑ Other: Bedrooms: Water Supply: ❑ Demolition Existing: 0 Setback: ii Private well ❑ Two Party Proposed: 0 Public Type of Heat: Total: Name of System: w�� If this is a Commercial Project you must answer the following: A AD Parking Spaces: Number of Parking Spaces: Current: Proposed: Number of Proposed Number of occupants(includes owners,tenants,employees,etc) Current p .. IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes /(o If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: I Underground Tank i Above ground Tank Size of Propane Tank: I Heat Stove i Cook Stove i Woodstove I Fireplace Insert i Hot Water Tank i Pellet Stove i Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit bm itasite plan showing all of the buildings,all property lines,tank location and size,distances from the propane tank to all roe lines,buildings and septic system components, including the reserve area. }° � Square Footage i Current Proposed For Office Us l$r Amount Revisionion, Main Floor Heated ;� EH Bid App Review: L ; , 1_3 •i Consistency Review: 2 Floor Heated C9 1 '''' ter,,,-" Base fee: �C Other Heated JUL 6 L 1 3(}1 . 95 Mezzanine Add TSaTSe ion: �C1 ;c• ' ,t f `- ,. Plan Check fee: a r1 Heated Basement j I 1, 1 1 Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: tcyto Garage/Carport it--- IS � a - --.N SUBTOTAL s27 — I ��}Ll •Lt(p Decks ---- 91'1/Rd Approach fee: Other TOTAL: $ l a l 4 •4., Receipt Number: I bS r J a Cash/Check Number: 50 ESTIMATED COST(REQUIRED) Date: ��a(; •Fair market value orf�all labor and materials foundation to finish Initials: "� , . . • *Ns N i� JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend • Washington 98368 qs 0 360/379-4450 . 360/379-4451 Fax KING http://www.co.jefferson.wa.us/commdevelopment/ JEFFERSON COUNTY UCO STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# 0 q,_ a-D,-1 PROJECT/APPLICANT NAME: J. A_e-4 1" / Keikile, r-- c,,,n Ail Nance->, 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 pos Ion and relative size of proposed improvements on the site map. c. �f`� A 2 " �'�- 6 7.D., Prr Existing Conditions Summary 2. Describe the existingtography. Indicate contours on the site map. 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. /r/071 ___ 4. Describe the existing soils. Indicate soil type on the site map. 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. APPROVED 6. Describe any excess levels of noise generated by the proposed use or activ ty: S 1 UKMWATER PLAN 4 flie NOV 3 0 2009 Sto r P Requir 1EFFERS i•U DEPT.OFC'O, PEV �'MEVT SIGNATU' I , �..,i-, 416. stormwater site plan template—rev.1 0i21/2008 V • • 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. 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.). garGf < 77 ,06 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. c� _Rer ChiVQ S 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.] 11. Describe the performance goals and standards applicable to the project. RECJ } 1L, 12. Describe the flow control system. � ♦.vJv t- ,�eE��r C ►4P�TY DCD i . 4 l I vt, stormwater site plan teinplate—rev.10/21/2OO8. ' • - -- • 6 • • 13. Describe the water quality system. REC Ell V' D 6 2tiu 14. Describe the conveyance system analysis and design. JEFFERSON CRIMP( HD 15. Describe the source of fill material, physical characteristics of fill material, and deposition of excess material. 6,1 i‘a0 oIre.— 3o t0 — Ito NO pi 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. n►a-- 17. Describe the proposed surfacing material. 18. Describe methods for restoration of the site. 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. 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. stormwater site plan template—rev.10/21/2008 i 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. 2. Establish Construction Access. 3. Control Flow Rates. O1- 4. Install Sediment Controls. hla- 5. Stabilize Soils. I\la, 6. Protect Slopes. V1 1GC_ l \v ) 7. Protect Drain Inlets. n JUL L .; tl,r t r iSON lrlrkit�i� [in _I i L�11t stormwater site plan template—rev.10/21/2008 8 i • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. 1\ 4-- 9. Control Pollutants. R .� ,�,� E EI VEJ b JUL - 26 10. Control De-Watering(the act of pumping groundwater or stormwater away from an activerpst yOp�is�I` 11. Maintain Best Management Practices(BMPs). t1)4-- 12. Managv the Project. 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, r+ads). It" n w land 4J24 ftr b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. 1 k.[ Po i f+ t�e la,� Iv;vti. stormwater site plan template—rev.10/21/2008 9 • • S b. Description of special requirements for working in or near environmentally sensitive areas. 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). ItL 5. Construction Phasing. a. Constructs n sequence -}ta)r Gak b. Construction phasing (if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction schedule. dign44 csti. Lika, Ut,Q. Q,E-p eim t C Asf r i� tit) 1 Qs s6la s -y_n I�- •�� cb_ II. Wet Season Construction Activities. a. Proposed wet season construction activities. b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. (\IQ - as1704S b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. ctvR `\,✓ E�� ) 8. Engineering Calculations. Provide Design Calculations on a separate sheet for theowing, if applicable. a. Sediment Ponds/Traps. 1 4- b. Diversions. tRl4 r DI-a c. Waterways. h d. Runoff/Stormwater Detention Calculations _ !110•.. j` C SIA t,UtJtV lI 10 stormwater site plan template—rev.10/21/2008 • • 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. -Yk (Of afib )-/ 2/li_- (LANDcJNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: ; �� ' ED 1111 .j...),_ stormwater site plan template—rev.10/21/2008 12 aemeeramenurapa J H - .... ; . . ...._ . ,. , , . , . 1 , . 0 ., v : • I 1 I I I . I I • i I 1 I I 1 . I i ''• 1 A i I • . . A . i t . t . i . . % 1 ..i ? i . : . • . F 1.. , . 1 , r 1 f 1 ; . A r A; . ;t‘ r... 1 1 4-• — --.4.- , '. . 1 'Ir ! 1 A A A 1 . A ‘114 1 — - , - —,-- ---- -...--- --..--- - ...-.,-- „ ; -—— - - -- -- ---..-,-_-- . A ' A A I 1 r . 1 ', • • A A A 1 A A • / . \ . i • \ • _r_ I \ , t ‘, ' . •, / r A A \ t A 1 r r • • . . • i t . -4, 1 I / i . -....r., C.... 14.. , 1 r-r-I , , 1 i /: / I ..1'..-- A : 4't L.41'1 I -....... r 1 <C=7, :..- 4....t....': I '.. . L...'.. , ... i Z7 1 1 ' i r / I 1 ...,..t.,:"........„ ; i ...... AA -.. 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