HomeMy WebLinkAboutBLD2009-00270 MLA09-00275
BUILDING PERMIT APPLIC ON Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD09-00270 Received Date: 8/13/2009
SITE ADDRESS: 83 HAZEL POINT CT
QUILCENE, 98376
OWNER: NORMAN F JOHNSON PHONE: 206-842-5485
SOL CHUA JOHNSON
8563 NE DAY RD
BAINBRIDGE ISLAND WA 981101395 HAZEL POINT LARGE LOT
SUBDIVISION: Block: Lot: 8
PARCEL NUMBER: 501025008 Section: 2 Township: 25 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: SCOTT SHELTON PHONE: 360-620-8883
PO BOX 245
SILVERDALE WA 98383
PROJECT DESCRIPTIOr NSFR
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 768
VALUATION 101,663.00 ADD'L: 473 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: 352
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 2 Prop: 2
Total: 2 T,otaL--- 2 —
Routing Date:
8—i1—cq
E)
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,004.94 LYK 08/13/09 110736 APp�Plan Check $653.21 LYK 08/13/09 110736 E
State Building Code $4.50 LYK 08/13/09 110736 1
Potable Water Application $62.00 LYK 08/13/09 110736 OCr I �09
Total: $1,724.65 Jefferson County Planning
& Building Department
fa
Jefferson County Building •sion Permit Number: BLD09-00270
Applicant: JOHNSON
BUILDING PERMIT INSPECTION APPROVALS 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
Setbacks 10/6/2009
Erosion Control 10/5/2009
Erosion Control
Foundation Footing
Foundation Footing 10/6/2009
Footing Drains
Foundation Stem Wall
Foundation Stem Wall 10/6/2009
Underground Plumbing
Under Floor Framing
Straps(hold downs)
Ext. Shear Wall Nailing _ ,,
Rough-in Plumbing
Framing 414C)
CIJ" o, r)
Blocking
Airseal
Insulation: Walls 1491 to II.I
Insulation: Floors �1 tb t0II
Insulation: Ceiling �1 `� I 0 "i
Int. Shear Wall Nailing
Wallboard Nailing , ,p %I
Gas Line: Interior '22\40 — c JIS. Z TO sr4-pw ?R,p *
Gas Line: Exterior -__\ OVO
Propane Tank
Heat/Chimney Clearance (`` ii 1 _if;
Drywell/Alt Drainage 1
Address Posted ,
FINAL INSPECTION 0. ..ii_ tc /(,,
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
i
CONDITIONS for Building Permit# :BLD09-00270
1.) The applicant shall fully adhere to all conditions and requirements of the eagle habitat
management plan.
2.) Water lines shall be located a minimum of 10' from all onsite sewage system components
including transport lines, tanks and drainfield/disposal area.
3.) 1. DRYWELL BOTTOMS MUST BE A MINIMUM OF 1 FOOT ABOVE SEASONAL HIGH
GROUNDWATER LEVEL OR IMPERMEABLE SOIL LAYERS.
2. IF USING DRYWELLS, EACH DRYWELL MAY SERVE UP TO 1000 SQUARE FEET
OF IMPERVIOUS SURFACE FOR EITHER MEDIUM SANDS OR COARSE SANDS.
3. 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).
4. FILTER FABRIC (GEOTEXTILE) MUST BE PLACED ON TOP OF THE DRAIN ROCK
AND ON TRENCH OR DRYWELL SIDES PRIOR TO BACKFILLING.
5. SPACING BETWEEN DRYWELLS MUST BE A MINIMUM OF 4 FEET.
6. DOWNSPOUT INFILTRATION DRYWELLS MUST NOT BE BUILT ON SLOPES
GREATER THAN 25% (4:1). DRYWELLS MAY NOT BE PLACED ON OR ABOVE A
LANDSLIDE HAZARD AREA OR SLOPES GREATER THAN 15% WITHOUT
EVALUATION BY A PROFESSIONAL ENGINEER WITH GEOTECHNICAL EXPERTISE
OR A LICENSED GEOLOGIST, HYDROGEOLOGIST, OR ENGINEERING GEOLOGIST,
AND WITH JURISDICTION APPROVAL.
4.) To help prevent seawater from intruding landward into underground aquifers, all new
development activity on Marrowstone Island, Indian Island and within 1/4 mile of any
marine shoreline shall be required to infiltrate all stormwater runoff onsite.
5.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ:
Water conservation measures:
1. Roof and other intercepted precipitation shall be routed to on-site detention ponds
and/or other approved means and allowed to be released to the soil slowly.
2. Water collected from Storm water and roof catchments may be used for watering
lawns and gardens. Unless catchment water has been treated to meet drinking water
standards, there shall be no cross connections allowed between the potable supply and
impounded water.
3. Water withdrawn from wells on each property shall not be used for watering of lawns
and/or gardens.
4. Ground water withdrawn from each property shall be restricted to a rate of three (3)
gallons per minute.
5. Installation of water conserving fixtures such as low flow toilets, faucets and shower
restrictors and other water saving plumbing fixtures.
6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation).
Please NOTE that the above listed measures are not intended to be exhaustive, but rather
is intended to be illustrative of the types of water conservation measures.
6.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ:
1. Installation of a flow meter.
2. On-going well monitoring for chloride concentration.
3. Submittal of monitoring data to County.
7.) MANDATORY MEASURES FO AT RISK SIPZ: 4111
1. For proof of potable water on a uilding permit application, applicant must utilize
DOH-approved public water system if available.
2. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water or an individual well may be used as proof of potable water subject to the
following requirements:
a. Chloride concentration of a laboratory-certified well water sample submitted with
building permit application.
b. Installation of a flow meter.
c. On-going well monitoring for chloride concentration.
d. Submittal of flow and chloride data to the County per monitoring program.
3. If public water is unavailable, a qualifying alternative system may be used as proof of
potable water.
8.) 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.
9.) The project shall adhere to the Best Management Practices (BMPs) 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.
10.) A Stormwater 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.) Setback from Hazel Point Court right-of-way is no less than 20 ft., side and rear setbacks
are no less than 5 ft. If an environmentally sensitive area (ESA) is present, then the more
restrictive setback shall apply.
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.) Stormwater shall be retained and filtrated on site. The owner shall control all
sedimentation and erosion on the property.
(liTSO
06. JEFFERSO OUNTY •
` ) DEPARTMENT 5F COMMUNITY DEVELOPMENT
• 621 Sheridan Street • Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
/4,9 Cs`.,,0 www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: — g15
Project Description (include separate sheets as necessary):
Ste
Tax Parcel Number: 5o I U 1....5 L)v Property Size: (acres/square feet)
Site Address and/or Directions to P
83ZEC_ 6-
cor tt..t..(c1z ne L.
Property Owner(s)of Record: NIoR tviA N 014 N So N
Telephone: (Z ) ) 842.- 54 3 Fax: email: S.,AA S 1 51 E3 ens Sn.c•o-.
Mailing Address: g 63 Nji; DAY AD RAi 2,•R,D Le I sC.AN . WA `I PA l0
Applicant/Agent(if different from owner): S L c 1-7 S r-1 e•c.ro NI
Telephone: (3(,,e) 6 ZO - 136 i 3 Fax: email: Sc(,1 here,-70;r>1 c,,ir,cc--
Mailing Address: T.0 i3.`r 24 5- 31 LVE R D a Lz- W q_ , if 3E 3
What kind of Permit?(Check each box that applies
tgiBuilding ❑ Critical Areas Stewardship Plan 1 3 2039
❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use)
j2ii 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 ❑ Road Approach 0 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**
0 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* ❑ 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:
DESIGNATION OF AGENT
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 gent Rests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or its knowledge. Any material falsegial 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 appli ienthattee h wants nor notice. _ C
Signature: ?9� "'SJ� ScTcr'EG.r Date: �'/57o
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 lake"of an endangered species as those terms are defined in the federal law known as the
"Fnriangered 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-transferablspo ibili f adh ' g to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: cC'l` Date: g
G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
• BUILDER STATEMENTIP
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 rgspon ibilit th General Contractor for the proposed project. /
Signature: Date: 63/l/3/ V/
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE:I FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
1L New l4 Wood Existing: I I Sewer
❑ Addition [7 Steel Proposed: Z Bank ❑ Community System
❑ Alteration/Remodel Li Concrete Total: 2- Height: Individual System
20
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: k Setback: pq, Private well ❑ Two Party
Type of Heat:
Proposed:
(Q c, Total: Z.- t I-S u t Nameu of System:
If this is a Commercial Protect 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 ood Service? es / No
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply:
l Underground Tank I Above ground Tank Size of Propane Tank:
I Heat Stove i Cook Stove I oods l Fireplace Insert I Hot Water Tank I Pellet Stove i Other
Is this appliance being installe in a anufactured/Mobile Home? Yes / No
When applying fora 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.
_ M,�y,G�w.4 � r,� - ... �, F Mop at ;
Square Footage Current Proposed For,„QffiC Use{)nly,, Amount :�a ROyision
Main Floor Heated r;. EH Bld App Review:
7&0 5703P=off; 73
2nd Floor Heated z `t` Consistency Review: 13
t .,
Other Heated ;;, � Base fee: I 0
0
4'G1(`1
I
Mezzanine . Additional SiP )(fly L{C1-1 "
Heated Basement Plan Check fee: (p 53 Z
Unheated Basement State Surcharge fee:
Other Unheated Pot Water Review fee:
10(—) --
-
Garage/Carport SUBTOTAL
Decks 911/Rd Approach fee:
Other G 2C N 3 Z-S t 119 TOTAL: $ a753 .(c5
4> ., Receipt Number: I t0��/
Cash/Check Number:
ESTIMATED COST(REQUIRED) Date: '1.
.Fair market value of all labor and materials foundation to finish 5���"--` ,---",
i7 vra a Initials:
G:\PcrmitCcntcr\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
•
• *WAWA E'ER PLAN
SEP 2 3 2009
It� JEFFE•SON C t U
-
,i„..so. ...,6� JEFFERSON COUNTY SIGNATURE:F•';u Yo'�r* ,,, .
,.4 DEPARTMENT OF COMMUNITY DEVELOPM ` Air .
621 Sheridan Street • Port Townsend • Washington 98368 IP AU
� 1 3 2039
.q�, �O� 360/379-4450 . 360/379-4451 Fax
87NG http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# _Z13 PROJECT/APPLICANT NAME: J 0lit•K NI C "1)1V
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.
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Existing Conditions Summary
/
2. Describe the existing topography. Indicate contours on the site map.
52-0/ V 4 to T Rio nti lW CST 7`a EAST,
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
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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.
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6. Describe any excess levels of noise generated by the proposed use or activity:
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^ton,rrrtn.; , -.n:orv'2'?• -::v. )l`'I;:";iJ
4
• •
7. yitescnbe Vplificant,gbographic featuras and rriticil areas ally sensitive areas such as wetlands, streams,
tee 1 iii5'e5 atc a nti lie Site. Indicate location on.`he site mac.
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3. 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.).
NEB AA) of C V'C-� ---
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.
Try c_PrezthN Lot CL M�✓� �i)r 2� Wed -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.]
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11. Describe the performance goals and standards applicable to the project.
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12. Describe the flow control system.
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13. Describe the water quality system.
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14. Describe the conveyance system analysis and design.
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15. Describe the source of fill material,physical characteristics of fill material, and deposition of excess material. • .
No (/- FCL
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
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17. Describe the proposed surfacing material.
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18. Describe methods for restoration of the site.
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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.
APPC
20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
N4c
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.
N p<
7
• •
';OON a RUC]ION 5T-IRMWATER POLLUTION LPPR-VEN'l?ON PLAN (SWPPP)
The Construction SWPPP addresses >ediment and erosion control :luring con ytruction. 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.
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2. Establish Construction Access.
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3. Control Flow Rates.
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4. Install Sediment Controls.
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5. Stabilize Soils.
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6. Protect Slopes.
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7. Protect Drain Inlets.
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12 Required Elements-.Construction SWPPP(continued)
3. Stabilize Channels and Outlets.
9 Control Pollutants.
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10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
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11. Maintain Best Management Practices(BMPs).
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12. Manage the Project.
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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 that are on or adjacent to the site.
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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).
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5. Construction Phasing.
a. Construction sequence
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b. Construction phasing(if proposed)
6. Construction Schedule. Wet season is October 1 through April 30 (page 2-21 of the Manual).
Provide a proposed const ction schedule.
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II. Wet Season Construction Activities.
a. Proposed wet seas n construction activities.
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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.
n/orA J o+*AisO ,J
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
Pa- c'/ l 5,0 sl&LI
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.10/21,2008' 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 affected property.---
gfr3/0
(LANDOWNER OR Ar RIZEI.RE RESENTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
stormwater site plan template—rev.10/21/2008 12
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rains e and o e
-� asemen
Kim
LEGEND
®
10' No Build
Soil Log
Setback
Existing Septic
Component
Tree
(A)
Clean Out
(B)
Septic Tank
(C)
Filter Sock
(D)
Pump Tank
(E)
Manifold
lik
SL
L
100% RESERVE ARE S� \
3200r
I r v
F 2PROPOSEG CABIN
7
o B �—
W �
w C
Z)
i �t4
U%
a 4" Gravity Sewer
3 Line
8455'17- W �!
457.51, --
Access Easement
MI_
�I _O
20 N
L-�
0o A of.
o�
0
.� 2" Transport
Line
wlth
water
Notes:
—Install a Cleonout eve 100' in 4" sewer line
—Place a Check Valve e ery 100' in the 2" transport line next to
clean out in 4" sewer line.
—The 4" sewer line and 2" transport line are along side
the driveway and need to be bedded in sand for protection.
DRAWN BY:
PETER BERTERMANN
REVIEWED BY:
SCOTT SHELTON
360-620-8883
P.O. BOX 245
SILVERDALE, WA W383
DATE: OBAO/09
SCALE: I' : 40'
NORMANJOHNSON
HAZEL POINT SUB LOT 8
PORT LUDLOW, WA
(PARCEL' 501-025-008)
"PROVI.._ --
SITE PLAN
SEP 2 3 2000
DEPT. OF
100% Primary
Area
267' 6-9' O.C.
atchetin
Valve
Approved SP
(see Approved SPAAD
I A
I
1
1 0'�z
1
NIA A
zcI� B—
1�
I A
1
I
�. 5
L N_ 82'42 58" Wa
69'
----- 469'
10
N
SCALE: 1 "=40'
THIS IS NOT A SURVEY
i
,r
N
Ni �Le
Open Spa h�R
water line
- — _ _ N 82'42'59" W \�
455, _ \
Affthsij�w GUUNly Oct