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HomeMy WebLinkAboutBLD2009-00221 BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD09-00221 Received Date: 7/14/2009 SITE ADDRESS: 20 A BLUE SKY DR Issue Date 9/30/2009 PORT TOWNSEND, 98368 Expiration Date 9/30/2010 OWNER: DONALD GREGORY PHONE: (707) 642-6902 PATRICIA GREGORY 248 W CAROLYN DR AMERICAN CANYON CA 945031066 SUBDIVISION: Block: Lot: TX13i PARCEL NUMBER: 001194003 Section: 19 Township: 30 N Range: 01 W CONTRACTOR: J H CONSTRUCTION PHONE: (360)681-0871 670 PARRISH RD SEQUIM WA 98382 Contractor's License JHCON**033BF Expires 1/27/2010 PROJECT DESCRIPTION: NEW GARAGE & BREEZEWAY NEXT TO TO M/H (adu BLD09-220) TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION 20,000.00 MAIN: ADD'L: HEAT TYPE CODE EDITION: 2006 UH OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE 672 SETBACK: DECK: 48 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PUBLIC Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $321.25 LYK 07/14/09 108749 Exist: 0 Exist: 0 Plan Check $208.81 LYK 07/14/09 108749 Prop: 0 Prop: 0 State Building Code $4.50 LYK 07/14/09 108749 Total: 0 Total: 0 Total: $534.56 Directions to Site: SEE DIRECTIONS & MAP IN FILE HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. Request must be received by 3 pm the day before inspection is needed. Monday Inspections must be received by 3 pm on Thursday before inspection is needed. Office Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY -SEE ATTATCHED BUILDING PERMIT APPLICA•N MRLA09-00p233 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00221 Received Date: 7/14/2009 SITE ADDRESS: 20 A BLUE SKY DR PORT TOWNSEND, 98368 OWNER: DONALD GREGORY PHONE: (707) 642-6902 PATRICIA GREGORY 248 W CAROLYN DR AMERICAN CANYON CA 945031066 SUBDIVISION: Block: Lot: TX13i PARCEL NUMBER: 001194003 Section: 19 Township: 30 N Range: 01 W CONTRACTOR: J H CONSTRUCTION PHONE: (360)681-0871 670 PARRISH RD SEQUIM WA 98382 Contractor's License JHCON**033BF Expires 1/27/2010 REPRESENTATIVE: VELLA TUDOR PHONE: 360-681-7559 PO BOX 246 (360) 681-3242 BRINNON WA 98320 PROJECT DESCRIPTIOP NEW GARAGE & BREEZEWAY ATTACHED TO M/H TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 20,000.00 ADD'L: HEAT TYPE: UH CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: SHORELINE: GARAGE: 672 CONST TYPE: DECK: 48 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: OTHER BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 0 Prop: 0 Total: 0 Total: - 0 --- Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $321.25 LYK 07/14/09 108749 APPROVED Plan Check $208.81 LYK 07/14/09 108749 State Building Code $4.50 LYK 07/14/09 108749 SEP 2009 Total: $534.56 Jefferson County Planning &Building Department Jefferson County Building Dion Permit Nun : BLD09-00221 Applicant: GREGORY BUILDING PERMIT INSPECTION APPR.. `. .. i applicable Code: 2006 International Building Codes 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 /0-21-0( 3g Minimum setback from Blue Sky Drive and Cape George Road �U rights of ways shall be 20 feet. Minimum south and east property line setbacks shall be 5 feet. Erosion Control SEE CONDITIONS I &2 Post Holes Foundation Footing /P—. f_C(( mono slab Straps(hold downs) /c:).1)/D j4---1 2,- Ext. Shear Wall Nailing Framing Blocking Address Posted FINAL INSPECTION (- C 074 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD09-00221 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.) 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. 3.) 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. 4.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 5.) Not more than 2 unlicensed vehishall be stored on any lot unless totally stilled 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. 6.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 7.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 8.) The building height is not to exceed 35 feet. 9.) Minimum setback from Blue Sky Drive and Cape George Road rights-of-ways shall be 20 feet. Minimum south and east property line setbacks shall be 5 feet. 10.) 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. 11.) 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. o • -3 • � o i.Y , i 3 hZ ' �' Al v r fo � 1 , 1 1 1 i a i A s -IS 41 O V c d %, , t k,3 , 0 a u. l a 3f Cr 0 C5 0.1 Jj in NI 4i1 _ � vJ s a I t I 0j P-1 1 TI o ., 0 U.- i '�- ; P; cT p 0- 6 v Jf S ( i A -_9 j 'N, m x I 1 1 1 I , 1 1 _ i 1 i i • (Y') • • 4w �Nc��, JEFFERSON COUNTY 4.r' ' 4' DEPARTMENT OF COMMUNITY DEVELOPMENT 'W A, 621 Sheridan Street • Port Townsend •Washington 98368 >$ 360/379-4450 • 360/379-4451 Fax N� www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: 09 a33 Project Descri tion(include sepa rate sheets as necessary): fti' LL -3ACkt i. r) , t. Agri � ttr4 n� N- Tax Parcel Number: Property Size: (acres/square feet) Site Address and/or Directions to Property: adL4 gLAJA —Olt 02— '---R0-1-k 2(A.0,3`. .___ WA qt (191K . Property Owner(s)of Re rd:)ck_A- 4.- 7q,J (1 r c ,� JUL 1 4 2009 Telephone:OLD(. � 1C3 14 3-5 Faxi j(AI — t c email: Mailing Address: vr`l ,\]e . Applicant/Agent(if different from owner): QA to. —1-6,,6 0 il..__ Telephone jl,VI-- .�1 Fax Skl nt RI- 1 email:Pi 49FS32 C�0 C a,kao, owl.Mailing Address & a o T -i t✓1 yl o Vl 16,1 �3 3ZQ • `! What kind of Permit?(Check each box that applies 0 Lot or Road Segregation " uilding 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) ❑ Single Family Garage ached/ etached 0 Conditional Use[C(a), C(d),or C]** O Manufactured Home .0 Modula - �F 0 Discretionary"D"or Unnamed Use Classification O Commercial* 0 Spedal Use(Essential Public Facilities)** O Change of Use 0 Boundary Line Adjustment ❑ Address ❑ Road Approach 0 Short Plat** ❑ Home Business 0 Cottage Industry ❑Binding Site Plan** ❑ Propane 0 Long Plat** 0 Sign - 0 Planned kurai Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** 0 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 0 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 to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE r7v7e-Z2 /_.../-e7/s2 . .e Date: (.0 --�7 5 9 By signing this applicati n form,the owner/agyt attests that the infofmation 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 toprovide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any quired later inspectio . taffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the ap I tion that�or sh wan rior notice. Signature: Date: /— -2 - The action or ctions Applicant wit' n ertake 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••ssued will not violate the ES . Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even iI ou are in compliance wi e. efferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfer ble responsr li ,for h to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. -yn Signature: l � � Date: l:-, f I • • BUILDER 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: Date: GENERAL CONTRACTOR R MANUFACTURED HOME INSTALLER: PHONE: FAX: STL 0 ( ) ( ) MAILING ADDRESS: ` t EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: El New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank CI Community System ❑ Alteration/Remodel ❑ Concrete Total: _ Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party T qf Heat: Proposed: ❑ Public Jn�,l Total: 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 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 1 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 a site plan showing all of the buildings,all property 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 Current Proposed FsrOfftce l) 43n1Y Amount ovjsion Main Floor Heated EH Bld App Review: LU/ (11/H 2nd Floor Heated Consistency Review: LC)/ MA+ Other Heated Base fee: I Mezzanine Additional Section: ^— cY� Heated Basement Plan Check fee: — �� .B1 Unheated Basement State Surcharge fee: 'S7- Other Unheated Pot Water Review fee: Garage/Carport b0/ nit 1 SUBTOTAL , /n 911/Rd Approach fee: � 1/4 �" Decks PP 1ST Other'-_ 71%I,t. � - 1 -Mti TOTAL $ �3(.4 Receipt Number: ( o rl4-lq — Cash/Check Number: ESTIMATED COS IRFOUIRFD Date: _ .Fair market ue of all labor and mate ' Is foundation to finish (X Pa_ - Initials: C APPROVED STORMWA R PLAN °.4.4e JEFFERSON COUNTY $)404q. ,: DEPARTMENT OF COMMUNITY DEVELOPME Tr 621 Sheridan Street • Port Townsend •Washington 9:36 , JEPFERS. a' 360/379-4450 • 360/379-4451 Fax OF•• UNf7'i► E NO`)' http://www.co.jefferson.wa.us/commdevelopment/ NONA : i .ITY•" • `tt 4 STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# U—233 PROJECT/APPLICANT NAME: ( 0 r 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 sizq tikprcip4senTrovements on the site map. C o -Iry • ti% 0. 4U iC 2.1- A.A.A.4A 4A-tea 1 -owl C .k Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. a- 42j..4. -_ . ,�e -&& tn't Cior._o_ -Ci-5\ Q) isi-i It (AAN-Ci- Ti).rQposa SAC- S 4. Describe the existing soils. Indicate soil type on the site map. tdtsnyrtI Q S0i1 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. e ( J Lib Stti.rndJi 1�o kx- J2A,-c.-,r; 1,-0 Q Al �Nw\ .WILL (Lt w TSi —0rc..:. r�o.�e v„ 4� (Q,v.._ 1.+ - i.,i..4... "5Qd` A w,03&.- -P'cl . 6. Describe any excess levels of noise generated by the proposed use or activity: FFFUUSON LOONEY OCI stormwater site plan template—rev.10/1/2003 5 i1,1 � ....�. .... ' 7. Lescripsignificant geo raphic fea, res and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steet+. es,etc.)on the ite. Indicate location on the site map. 0.z Lay- . on Tim7, S: 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.). 0411r041 00 St(pi% 0 ir w S. 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. . S1Z1►u 1/60.—-e_r IA. 'l,L lQ c ,A-701 S YoD 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.] K10 K.1 . 11. Describe the performance goals and standards applicable to the project. :lA Q vvi par 4- /} osSi bLe ea-v. pro')�e n SCc� ivy 1A)tlk b./ CQ ©moo Cn✓,froC ti,'c)S a Dt`l 12. Describe the flow control system. W ' ik Jac kJ 0 S 13c,,✓I CJL 0e VA'1 S4- ✓ - j��o►A S- '`mil.-c Sifp �A �v� - C�,Ac - Ue�� c1 �1 stormwater site plan template—rev.10/1/2003 6 • • 13. Describe the water quality system. o-0 o_-) • 14. Describe the conveyance system analysis and design. v �+ -Clink a IrlavA Q . S 1t'' u ���� t�1 IDS b arS (AJl /l h 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. tit o 'tL kit,Lasufk— ,'ti �) ;,o LQ,� • 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. 1 - • 3 - �eQ - ' `��e,lr, - o v� i -- i c� �� 1 �Ue9 '_ , 14.Arac,, �ID 17. Describe the proposed surfacing material. - Car e Q__ Gvo iv) C)u_aur � 18. Describe methods for restoration of the site. Jt� liklaiL an i Fif 1 ttr i vt - cu s , L`'t,c i 2c 1 A fi►,t S i c N 4J1 n �?e.L , 1 La:+ld.Sckp t r� 0 1� C o vvl e 0.- ear CI)v,5-1-v- '0 r 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. IA— • 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 00 21. List other necessary permits and approvals as required by other regulatory agencies. If those permit *app v Jude conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditionsJ or restrictions here. • ifis stormwater site plan template—rev.10/1/2003 a ti Ir 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 section 2.5.2 of the Manual(beginning on page 2-15). 12 Required Elements—Construction SWPPP 1. Mark Clearing Limits. 2. Establish Construction Access. XJI�I c �DC1V _kk.A-tom . W .i►.5� Qj-__ or,St e t ohS f e r1 c-�QS L w * vc_ 3. Control Flow Rates. ja r o.;,•��g, t.3 -11 0 ro P-12A -, 4. Install Sediment Controls. � -0e-A\CQ �QJ\ A Wl \ — U� `V SIXl v21L 1-10 — L.1.e n..tt_o& • (� 5. Stabilize Soils. 1-A- 6. Protect Slopes. -- �' {e-n l:e v Q• 7. Protect Drain Inlets. I Ot�1e__ - • , . stormwater site plan template -rev.10/1/2003 8 • • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. op, 9. Control Pn111'tants. 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). ` tee w LQ 6 1 j n ki P - 11. Maintain Best Management Practices(BMPs). 12. Manage 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, roads). kJ° • 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. J U L I 1 2009 uuuni stormwater site plan template—rev.10/1/2003 9 • • 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). 5. Construction Phasing. a. Construction sequence Sr�-e_ �r e.p t 9 Jc-)r �9 t�, fl v� q-Or�/ _v��e-tn o r - �,;s� off- 110 w-� r 1� .�- C Q. r . a- Leoftd.S Q pi . b. Construction phasing(if proposed)' t 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. LL wpo W,►� 0 Isst,u_� • II. Wet Season Construction Activities. a. Proposed wet season construction activities. t.)0 . b. Proposed wet season construction activities for environmentally sensitive areas. t3oK1e_ . 7. Financial/Ownership Responsibilities. a Identify the property owner responsible for the initiation of bonds and/or other financial securities. -Do,n C1r9-C . b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts EA (-)i-\a 0 p (Is; b4 I 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations stormwater site plan template—rev.10/1/2003 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 affected property. 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