Loading...
HomeMy WebLinkAboutBLD2009-00236 �� litUILDING PERMIT APPLICA!!G MLA09-00247N Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD09-00236 Received Date: 7/23/2009 SITE ADDRESS: 121 COOK AVE PORT TOWNSEND, 98368 OWNER: THE POINTE CORP PHONE: 360-301-0102 PO BOX 610 PORT TOWNSEND WA 983680610 TIBBALS LAKE PARK SUBDIVISION: Block: 39 Lot: T 86 PARCEL NUMBER: 999003901 Section: 4 'Township: 30 N Range: 01 W CONTRACTOR: SEVEN BRIDGES PROPERTIES LLC PHONE: (360) 301-0527 PO BOX 1953 PORT TOWNSEND WA 98368 Contractor's License SEVENBP983JD Expires 6/24/2010 REPRESENTATIVE: KEVIN COKER PHONE: 360-385-2739 814 GARFIELD ST PORT TOWNSEND WA 98368 PROJECT DESCRIPTION NSFR W/ U/G 500 GAL PROP TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 2,155 VALUATION 350,000.00 ADD'L: 361 HEAT TYPE: PRO CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: 5N GARAGE: 920 SHORELINE: CONST TYPE: DECK: 478 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: CITY BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 3 Prop: 3 Total: 3 Total: Routing Date: `— Type Amount Paid By: Date: Receipt: Approved/Date oPermit $2,393.75 LYK 07/23/09 108834 APPR Plan Check $1,555.94 LYK 07/23/09 108834 vEn State Building Code $4.50 LYK 07/23/09 108834 AUG1 2009 Potable Water Application $62.00 LYK 07/23/09 108834 Jefferson County Plannin Total: $4,016.19 & Buildinn Department E Jefferson County Building Dion Permit Num BLD09-00236 Applicant: THE POINTE CORP BUILDING PERMIT INSPECTION APPROVALS %pplicable 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 8/11/2009 Erosion Control Foundation Footing 8/11/2009 P;, Footing Drains Foundation Stem Wall Underground Plumbing 4000- Ftur-Ivr--rulio:',L.:?( - Under Floor Framing Straps(hold downs) Ext. Shear Wall Nailing Rough-in Plumbing 1-5-01 Framing 1-t1 "C`t (6' .c �.►� w� Blocking Airseal t- °ci 9c, Insulation: Walls t n Insulation: Floors Q'l -Dq ''R-ko scA4 Insulation: Ceiling Int. Shear Wall Nailing ( , L\-Cj-(�v Wallboard Nailing Gas Line: Interior Gas Line: Exterior t2)ll Or, 3-C./Propane Tank "� Heat/Chimney Clearance Br-ywe I/Alt'Draitrdge Address Posted . 6'L0 FINAL INSPECTION a'G 'G�lv j}� FINAL INSPECTION MU BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD09-00236 1.) 2005 DOE STORMWATER MANUAL DRYWELL DESIGN CRITERIA ALL INFILTRATION SYSTEMS SHOULD BE AT LEAST 10 FEET FROM ANY STRUCTURE, PROPERTY LINE, OR SENSITIVE AREA. FOR SITE WITH SEPTIC SYSTEMS, INFILTRATION SYSTEMS MUST BE DOWNGRADIENT OF THE DRAINFIELD UNLESS THE SITE TOPOGRAPHY CLEARLY PROHIBITS SUBSURFACE FLOWS FROM INTERSECTING THE DRAINFIELD. DRYWELL BOTTOMS MUST BE A MINIMUM OF 1 FOOT ABOVE SEASONAL HIGH GROUNDWATER LEVEL OR IMPERMEABLE SOIL LAYERS. EACH DRYWELL MAY SERVE UP TO 1000 SQUARE FEET OF IMPERVIOUS SURFACE FOR EITHER MEDIUM SANDS OR COURSE SANDS. TYPICALLY DRYWELLS ARE 48 INCHES IN DIAMETER (MINIMUM) AND HAVE A DEPTH OF 5 FEET (4 FEET OF GRAVEL AND 1 FOOT OF SUITABLE COVER MATERIAL). FILTER FABRIC (GEOTEXTILE) MUST BE PLACED ON TOP OF THE DRAIN ROCK AND ON TRENCH OR DRYWELL SIDES PRIOR TO BACKFILLING. SPACING BETWEEN DRYWELLS MUST BE A MINIMUM OF 4 FEET. 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.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water quality degradation. The submitted proposal does not require additional aquifer protection measures. However, during construction the project shall follow the Best Management Practices (BMPs) and facility design standards as identified and defined in the Stormwater Management Manual for the Puget Sound Basin. 4.) 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. 5.) Outdoor residential storage shall maintained in an orderly manner and shall Ste no fire, safety, health or sanitary hazard. 6.) 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. 7.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 8.) 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. 9.) The building height is not to exceed 35 feet. 10.) Minimum setback from Cook Avenue right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. 11.) 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. 12.) 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. 11- • • "E°'°EN""'°"' DWAIN SY' KC MAIN FLOOR COKER DESIGNWORKS, U.C. 1:42.0 TEE POINTE coIR}' DAIL 1400* PLAN 121 COOK AVE •ate 'µ �� PORT TOWNBEND, WA 98368 © eaM +'c+••I9co*Nil I IF� r-7 r-1 I I D1 1 • • I / j PATIO j JUL 2 3 2009 O ; L_J L_J *— I I i j I 1 JL------------.---- -1 II,W,I - j i � V 4 I . LIVING ROOM — 1 � .'d,rrd op im � IKE; • "".. Ai _III MASTER - BEDROOM ~ ) DINING BEDROOM ' 1 L I f�p��y r D y7TIll77////!!llrl�i i. 0 �„• OD 1 . `� Ii' !OO J f i Ilk P . Klwi •COURTYARD 0 i X s / n I is o M.� • l �i DRESSING 1� RDDAI 1A BEDROOMi II r JeATM j==== se FOYER Rd,ad • d0litCs I WALK-IN 0 hr . sthrLE I E. CLOSET PA I r.',rd ` / COVERED PORCH . �►�tt1 j STORAGE i .: l , 1 j -1 ] j COURTYARD j o1 ra ] J I i j 1 °n°IC 9-ii ] II �� , " i i 12'-flt" / :#0, ........ ..... .4 Jtil_ 2 3 20 9 , / # oat *. N 1 0------'' •,, '.. .../4111111111111 i 1.10 tit. II IA IF,,PA . 1 1- 11-0" 10 BONUS ROOM VG- 4-9 ..--\ 1- I --t- _ =9 I( 1 I VG_____ ...11(A ......---,r------, ---- 5,47,1 2'49" 2'-&' 16'-ou UPPER FLC)C) PL-41\1 JEFFERSON NTY DEPARTMENT OF COMMUNITY DEVELOPMENT zaleiiko, ` 621 Sheridan Street• Port Townsend •Washington 98368 ,e# 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopmentjUL 2 3 2009 BINS Master Permit Application MLA: Cr-1- 3`T i Project Description(includn �separate' � sheets as necessary): N k is/0V Tax Parcel Number: 119'„003 -6 F Property Size: .(14 s (acres/square feet) Site Address and/or Directions to Property: Property Owner(s)of Record: 1e 7en ti e 1-4 e,,l,.a v S / • Telephone: 5 < ' / /7 Fax: email: Mailing Address: Applicant/Agent(if different from owner): (�2u�ti G,lca.,i Telephone: °�� Z�3 �� 5 I Fax: email: Mailing Address: Si Z•� What kind of Permit?(Check each box that applies 0 Lot or Road Segregation 74,:wilding 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) ❑ 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 ❑ Cottage Industry 0 Binding Site Plan** 0 Propane ❑Long Plat** ❑Sign - • 0 Planned liurai 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** ❑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 0 Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: 4 D ' IGNATION OF AGENT I hereby designaternfy- 4/ y ¢ rttlie. to act as my agentin matters relating to this application for permit(s). OWNER SIGNATURE / vv �r•�V` �* r Date: �7 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 o entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any require er inspection Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applicatio the or she is prior notice. ti/P !4 /►a r� �� r g Signature: fi !�' Date: The action or actions pplicant 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 yo "a in compliance the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfer,p responsibility f hering to and complying with he E LL b�_A_ pplicant has read this disclaimer and signs and dates it below. Signature: / � V Date: �-�'— a 7" G:\PennitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Macrer Permit Annlirat:rm 5_90_nu,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 OR MANUFACTURED HOME INSTALLER: /� PHONE: FAX: _ tvi S Qv e _ ( ) 37f 3r"IS ( ) • MAILING ADDRESS: e 1�5. EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: S Li v(�I\ E P1'Q 33.-T NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: 0 New DY Wood Existing: ----- ❑ Sewer O Addition ❑ Steel Proposed: Bank 11 Community System ❑ Alteration/Remodel ❑ Concrete Total: Heig t: ,(3 Individual System O Repair ❑ Masonry SEP Permit# Bg- 22 ❑ Demolition ❑ Other: Bedrooms: ,Z Water Supply: Existing: -� Setback: [1 Private well 0 Two Party Type of Heat: Proposed: [I Public r Total: Na a of S stem:A2___ 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: nderground Tank i Above ground Tank Size of Propane Tank: I Heal Stove i Cook Stove i Woodstove replace 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 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 For Office Use only *�`izzAinount Revision Main Floor Heated �l 1 J J Z 1 707ZcEH Bid App Review: �3 0,Floor Heated ?.� ?(jam Consistency Review: 03 Other Heated Base fee: ( Mezzanine Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: .1. Other Unheated Pot Water Review fee: 1 On qa Garage/Carport ���`3314,c� SUBTOTAL Decks 911/Rd Approach fee: Other 1 . L.�6.' �' 6 1 �t I TOTAL $43 , VI Receipt Number: I L ray ZO y� sh/Check Number: 10 1 , ESTIMATED COST(REQUIRED) Date: _ •Fair market value of all labor a fermis foun o� finish J J` , DO o Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc • • sTo pPIOV (' -ioRMwq TERED iiiNI °�v JEFFERSON COUNTY PLAN DEPARTMENT OF COMMUNITY DEVELO' ENT AUG 7 2 2009 621 Sheridan Street • Port Townsend •Washing •n %368 JEPEE .,qs OHO 360/379-4450 • 360/379-4451 Fax s/6-.\.AT of cb.NSON CouNTy 87N http://www.co.jefferson.wa.us/commdevelopment/ _ 4 t'1) .�� Mrp4T1 STORMWATER SITE PLAN SUBMITTAL T MP �`�`�- MLA# Qq-C947 PROJECT/APPLICANT NAME: / vrr1` -- / y — Please answer all of the following questions to the best of your ability. Where the questioi n ca'tts-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. JUL 2 3 Project Overview L.�r,Li:..,. i 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed impraypiients on the site ma ,,[ J/J ("y� 1 • �//� / 1Lt'S1 YKE/� R �i i l!0 S1 s£ SEGA"+-C 4"A Q -III cc-t a-P si+'c . ` , ;,. cy�►-tw 5'S•O s e t 7,,c) st. o Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site ap. [Loa +kifolazft...4 rk, 0- polt - . n-`r rn 1 , 3. Describe the existingvegetation. Indicat native vegetation areas or the site map. Y lI , LJ1/4k. wit sirzet dvi st- f rr "f rwa 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 appl' ble,and indicate acreage of each. ( _ + _ c. _ -,, .,,, „^„.„.___c 0 ,wf-P,..z,_ L --te...„.._, 6. Describe any excess levels of noise generated by the proposed use or activity: stormwater site plan template-rev.10/21/2008 5 0• 7. escribe[ `significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep to es, 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,/ /d lakes,steep slopes,etc.). / L I=r�` . /`f�-e. �ah.,e Co P /=" / • si(-ts rv-a� f , ,6 -4oiti..._ W4Y►. '----•e Permanent Stormwater Control Plan 'tits 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 sit Locate t se facilities on thelsite plan and differentiate proposed acilities from existing facilities. 77) 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.] (14 11. Describ the performance goals and standards a ble to the proje - s � sus , :eP _ L "<..,,),---te, at ---it•At- 12. Describe flow control sistel. A Q -:L c `� ` trret ho- L t, ..e c7rT` stormwater site plan template—rev.10/21/2008 6 • • 13. Describe the water quality system. ^ 41, 14. Describe the conveyance stem analysis and desig 4x.A04.. G.,.„9,4 15. Describe the sourc of fill aterial, physical characteristics of fill material, and deposition of excess material. /14 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. �4� ca� 17. Describe the proposed surfacing material. 18. Describe m hods for restoration of the site. �� 5 4 /^/c �t a . 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. A 20. List here and i lude any special reports or studies conducted to prepare the Stormwater Site Plan. ~�J� /41 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 ntain more restrictive drainage-related requirements, describe those conditions or restrictions here. • stormwater site plan template—rev.10/21/2008 7 0 • 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 dev SECTION I—CONSTRUCTION SWPPP NARRATIVE 1 'o .4.t i ctwn 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 Clearin Limits. . Zl 2. E ablish Constructiop A %ess. ¢)GIC� (zcll_ 4u4_, 3. Contro Flow Rates. n X e.-7f 1-.0. 4. ISaIl Sediment Controls. `hrc.. ,s of .,,s2z.- 5. Stabi" e Soils. ` g 6. Pro '.Slope<K' O 7. ProtecctrDrain IIn-l_et�s � ^ r1 cOr...v......_ 8 storrnwater site plan template—rev.10/21/2008 • 12 Required Elements—Construction SWPPP(continued) 8. Stabil. a Channels an Outlets. rr b2 9. Control u4 nt 10. Control De-Watering (the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best M • anagement Prs(BMPs). ���/• frel sin? s 12. Manage thp Proj t. 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential are roads). b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards),, Grb 5 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. „I U L 2 3 2009,(174-t'L- OM 00 stormwater site plan template—rev.10/21/2008 9 • 0 • b. Description of special requirements for working in or near environmentally sensitive areas. 4// 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils (e.g.,errJJodii Jbility, sett/)e�ability, permeability,depth,texture, soil structure). ///�,4.( ( 'e DM 5. Construction Phasing. a. Constructipn sequence "L"--4-,-/ 104.---S-53rcl° • `1' (:::.C-R- eibte /-"f1 / . -64----BI }-11-in ' b. Construction phasing (if proposed) g. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed c struction schedule. II. Wet Season Construction Activities. a. Pr posed et season construction activities. al b. Proposed wet season construction activities for environmentally sensitive areas. /1/F)."2- 7. Financial/Ownership Responsibilities. a. Identify the property own r 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. e"(� I g. 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 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 construe 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. (0 0 7 (LANDO ER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: 12 stormwater site plan template—rev.10/21/2008 N 2°23'45" E 111,9-15' la • r-. - —..—..— .—.— —. .—.—.—•— — — —•— —. EAR SETBACK 1 rfl -1 •• . • ___ ,i. ,, .______. RESERVE Q 1-1 P Rq (AE�Y t AREA _ 0) DRALALFIELD d1i f-I h 3 2009 APi NZ / 1 I r-.—.—•—.—._.r.__.—. .i_..�.—.—.—.—.—.—._...—.—.—. y. J _ A fl I -� _vJ r-O" -9 / la —•—•—•— —...PR9��IELP ACK _ — PUMP l 'I "'""-'SEPTIC — E TANK 0 1 C. TANK O I I" ._I_ ti� -1 "ol " 0 0 _ a' Si w pi -1 u� i_ 1. co 21 ,,r CO433 03 N 2144sF HA IN) m ; _ ; qZo GeRc- s a i32t-I IL . /0 PROPANE r. Q TANK J-17' U 111 W ./\\ iz Y FRONL S 'CK 12-1 g 1 J a u 6 N 0 -C9i I 0 3 . . LU a_ / "-----1. ( if)i-7 PRO`S �oF_ SITE PLAN 4 ad- o Q �� AUG 12 2009 D- E DR�YE DEFT,p JE+FERSO COUNTY SIGNATO.E. �' TY DEV M• WATER �" '� = METER COOK AVE, RIGHT OF WAY CENTERLINE ------0 iii.-- COOK AVENUE (EXISTING) Pig "g # B I JEFHHDSUN COUNTY DCD