HomeMy WebLinkAboutBLD2009-00284 • •
CERTIFICATE OF OCCUPANCY
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451 (800) 831-2678
Al Scalf, Building Official
PERMIT #: BLD09-00284
SITE ADDRESS: 392 E MIDDLEPOINT RD Issue Date: 10/13/2009
PORT TOWNSEND, 98368 Final Date: 4/29/2010
APPLICANT: CHARLES CORTELYOU PHONE: 360-379-1606
JESSICA HUNTTING
727 JACKSON ST
PORT TOWNSEND WA 983684503
SUBDIVISION: Block: Lot: T 68
PARCEL NUMBER: 001052011 Section: 5 Township: 30 N Range: 01 W
PROJECT DESCRIPTION: NEW DETACHED HEATED GARAGE NO PLUMBING
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING
CODE 2006 EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes o -9
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 4/29/2010
I:\F_BLD_Occupancy.rpt 10/29/19
Jefferson County Building •sion Permit Nu, : BLD09-00284
Applicant: CORTELYOU
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 t) a F6 Minimum setback from East Middlepoint Road right-of-way shall be 20
ll feet. Minimum side and rear yard setbacks shall be 5 feet.
Erosion Control SEE CONDITION 2
Post Holes
Foundation Footing:e' 4/4-4 11 -°4
f. S1ii1�
Footing D11rains
Straps(hold downs)
Ext. Shear Wall Nailing _9 i.,1L N pb 1\iI►-1
Framing '5 0
Blocking
Insulation:Walls
Insulation: Floors Slab R-10 Rigid at perimeter
Insulation: Ceiling
Wallboard Nailing
3-8-co
Drywell/Alt Drainage SEE CONDITION I FOR DRYWELL
Address Posted
FINAL INSPECTION
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
•UILDING PERMIT APPLICA N ML .283
Revviewiew Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD09-00284 Received Date: 8/24/2009
SITE ADDRESS: 392 E MIDDLEPOINT RD
PORT TOWNSEND, 98368
OWNER: CHARLES CORTELYOU PHONE: 360-379-1606
JESSICA HUNTTING
727 JACKSON ST
PORT TOWNSEND WA 983684503
SUBDIVISION: Block: Lot T 68
PARCEL NUMBER: 001052011 Section: 5 Township: 30 N Range: 01 W
CONTRACTOR: STAPF CONSTRUCTION PHONE: (360)385-3199
2727 HASTINGS AVE
PORT TOWNSEND WA 98368
Contractor's License STAPFC*249J8 Expires 8/12/2009
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP NEW DETACHED HEATED GARAGE
TYPE OF WORK GAR SQUARE FOOTAGE::
TYPE OF IMP NEW MAIN: 864
VALUATION 68,067.00
CODE EDITION: 2006 ADD'L: HEAT TYPE: WOD
OCCUPANCY: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: 144 BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM:
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 $776.75 LYK 08/24/09 110814 APPR OV EPlan Check $504.89 LYK 08/24/09 110814
State Building Code $4.50 LYK 08/24/09 110814 OCT 3 2009
Total: $1,286.14 Jefferson County Planning
& Building Department
• •
CONDITIONS for Building Permit# :BLD09-00284
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 shalmaintained in an orderly manner and shalate no
fire, safety, health or sanitary haz• d.
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.) 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 East Middlepoint Road right-of-way shall be 20 feet. Minimum
side and rear yard 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.
44r44 JEFFERS.OUNTY •
DEPARTMENT OF COMMUNITY DEVELOPMENT
►d 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
<ys (#i•zrnsip www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: (X (96 3
Project Description(include separate sheets as necessary):
Ocziac_I e X Cc COY o �
Tax Parcel Number: 00 ( O62_6( I Property Size: c4 clues (acres/square feet)
Site Address and/or Directions to Property:
•
3412 Sys' %1A oL•-%t Rid
•
Property Owner(s)of Record: e cA
Telephone: 3f00- 3741- i(oOCe Fax: email: Glevivcnr-kr of pn.c at
Mailing Address: 7 Z•7 S,Lc.[Csat ' Ve v' Teus 14se u..1 4 3362
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address: _
What kind of Permit?(Check each box that applies
uildin ; t
�B g ❑Critical Areas Stewardship Plan _
❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use)
❑Single Family Garage Attached,q:letached ❑Conditional Use[C(a),C(d),or C]**
❑ Manufactured Home 0 Modular ❑Discretionary"D"or Unnamed Use Cla (43ti 4 2009
o Commercial* 0 Special Use(Essential Public Facilities)
CIIChange of Use ❑Boundary Line Adjustment
❑ Address 0 Road Approach ❑Short Plat** ,
❑Home Business Cl Cottage Industry 0 Binding Site Plan- \_ J
❑Propane 0 Long Plat'"
❑Sign ❑Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed'Yes"Use Consistency Analysis ❑Plat Vacation/Aiteration**
❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions**
❑Site Plan Approval Advance Determination(SPAAD)* El Shoreline Management Substantial Development**
❑Temporary Use ❑Shoreline Management Variance
❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment
❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment
*May require a Pre—Application Conference ❑Tree Vegetation Request
**Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal,if known:
DESIGNATION OF AGENT
I hereby designate 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.
f further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorneys 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 r uire r in c' n S fts access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the appl that o taro — a I
Signature: Date: �yJ f g/O Q
The action or actions Applicant will undertake result of the issuance of this permit may negatively impact upon one or more threatened or
endangered species and could lead to a poten ral"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 are in mpl ce Je rson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transfers�,- on r a d complyuig with the ESA. The Applicant has read this disclaimer nd sig and dates it below.
Signature- �� Date: G/
G:\PemtitCenter\###FORMS###\DRD FORMS\M ermit Application 5-29-08.doc
1111 BUILDER STATEMENT i
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:
R� Sia.P ( ) ( )
MAILING ADDRESS: ' j . S ( � R�* DF� EMAIL: e ! eay bs„ �ealn�es0!'tc�,a ow
CONTRACTOR'S LICENSE i1 i WAINS
NUMBER: $l'A Pc Iq 4 c NUMBER
ARCHITECT/ENGINEER: L.4u,r�t Si�e�.,+,rfi PHONE ( ) FAX:( )
MAILING ADDRESS: (6 b 4 °AA 4+1(Lk Sit
Project Type: 2 P 1 T
EMAIL SiewsM'i S Z CA(e speed.r au-.
New Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
Wood Existing: n Sewer
rI Addition ❑ Steel Proposed: Bank ❑ Community System 4,)4
[:H Alteration/Remodel ❑ Concrete Total: 0 Height: 0 Individual System
LI Repair 0 Masonry SEP Permit#
❑ Demolition ❑ Other. Bedrooms: Water Supply:
Existing: Setback: X Private well ❑ Two Party
l I ype of Heat Proposed: 0 Public
l_t~X ).7 Total: cD NA Name of System:
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Current Proposed: Number of ADA Pirking Spaces:
Number of occupants(includes owners,tenants,employees,etc) Current Proposed ,, I '..
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: AUG 2 4 2009 "i
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 fora permit to install a propane tank you must also submit a site plan showing all of the buildings,ad property,
lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components—
including the reserve area. cc��
a t r {sI.
S uare Footage Current . „::,..- r': 1 s..'''c'i L.u.4.--:' 4, -4 l'.2,--, 4.I-,”:;r1.,.1;+�"i.`. ...f. r4 r.0
Main Floor Heated t EH BId App Review:
2"°Floor Heated a�- ;4', : T3,
( - fL
t r�s t Consistency Review.
�r4 �-' SF
Other Heated k14h z .� Base fee: ���r F /
•la S
Mezzanine 'If,:ir .c p ;, Additional Section:
Heated Basement F, - Plan Check fee:
39
Unheated Basement SurchargeNipy �
,F at: ,k State fee:
pry .
e t�`v
Other Unheated ,.,Y j'.n't Pot Water Review fee: 100 R
r-1 ` r .
Garage/Carport
1� t,x `i SUBTOTAL `
:1ckAe4 864 �: ' Ia b IL
Decks l,,»., ,- 911/Rd Approach fee: ex
I lL} �', 4f I-Si�)0C1
Other c�/�' TOTAL: $��U Y�
C -4,:::;.:1;n4614 Receipt Number. I
,-. Cash/Check Number 1 3� �-,
ESTIMATED COST(REQUIRED) p a 0 I Date: /C Ial
.Fair market value of all labor and materials foundation to finish
44.1
`J d06 Initials:
G:\PennitCcnter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc
• •
4 °N C
�� °,,�, JEFFERSON COUNTY
�'I DEPARTMENT OF COMMUNITY DEVELOPMENT 2009 `
AUG 24
� 621 Sheridan Street • Port Townsend •Washington 98368
O 360/379-4450 . 360/379-4451 Fax
`�BINO http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN. SUBMITTAL TEMPLATE
MLA# CCI - a PROJECT/APPLICANT NAME:
Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the
applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a
separate stormwater site plan map.
Project Overview
1. Describe the proposed developed conditions of the site. Indicate positipn and relative size of proposed improvements on the
site map. I1re, ,e ttkiln/cl' . 1465 'h .�/a k cc14m J �5�ewce 444 pt 720
Q f. �r f. T4 c t t O h_ ekt�s]., c 1Gm b i.� dPf ) 5 q A M C 4 / JaiI l�l c
/O1.) 1�c I t►Q"4Q� Iv 4s*e /$ c 441.4- „ DP'Lfc� is /P4NC/ 1';'taltkc ',b' iOMt .
JJ ✓ J
Existing Conditions Summary
2. Describe the existing-topography. Indicate contours on the site map: ' "T � %tz A l r sd1 r.
• T •�
�w1110. ` G .ir2 % • pr,M�4.1 het,44. Sic a ;WIru ie f ssact feye01�J
I , Csv 4.1 a„#Lt 2.441 putu *4 f fC$*4a,.A sly rwb5. /
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
All Dwt 1L eit4✓coCn Vy 460t All Li4 4Fewija_ UOttItsf FlN //jIJty hoesf
Lo;#14 e1d€✓he ) s ibs u t✓s payJ .
4. Describe the existing soils. Indicate soil type on the site map.
Prepcdi I's 4tts..c.e.P 1.4.4 Hit s46t.01) LAW Mkt-. 1lJ41I lea ys L S ,/ s4
Se;/5 61-e jog4J 386 '.
5. Describe the existing site hydrology(i.e., drainage; behavior of water on the site—above, below, and on the ground). Indicate
existing stormwater drainage to and from the'site on the site`map. Depict separate drainage basins on the site map, if
applicable,and indicate ecrea a of each.
+$cC4t•Jt 42l t4c def., 54,401 sod sodA toe s,ic e01<c vc.. we ► —
4ib.f.eillto etv_ii„fistraillt Ii.frieplArinr%ev. 4...i2jore jes .3.;:rlie if.k. , Ils..Li deti$al ,e/MA IL 416.1____
APPROVED
6. Describe any excess levels of noise generated by the proposed use or activit':
tax kmwit.d h4;44_ Ater 1 dctisl Ch45 tAtl` 101".ATER PLAN
OCT - 6 2009
Starmwat i"
aired II� ��•�•_J/ . EFFE Req � izs U r
Ilw Oh DEPT.OF CO Fl`
stormwater site plan template-rev.10/21/2008 SIGAATuR . 5
•
• •
7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
stee slopes, etc.),on the site. Indicate location on the site map.
o 4P/tittle.1 A 1,0445 , 7-4..e. pnyhek, >/yes (....2._44 71.0 tee do....g....L. _
8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads,and sensitive/critical areas
(streams,wetlands, lakes,steep slopes,etc.).
7 1ti. 4cAue.4 ®re� f�rs t r e forts ir'� A a�e$.�7�5, F' l q,•41 rrplo L
'41-
Loa Klii ie t_'sj us.�' lc, Tic toe sf a re toy` . Y
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. L
fill �j foMws.kPtl it It,t1 i b ( f j''s.4 5, I1 'vie�" ikt t 14-41 4, e J i/.
bGiva. tkc ID' i0vietit i,(L l --. 2. re TI.VCc 4,c/ weds 44.c ,pert
Of '>'"�t to . w L y c 0IA. .S.4c Ii . 7— _cm,' lt.Ws,c i .fa - -e`'e`I"�
i‘lotit . ® ,
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.]
TA tote 01 N) w(/l,,S. — .I'o e K sile P It
11. Describe the performance goals and standardsc applicable to the/ project. 'Ile
.
aek. i:tie 4 Act e.:K d S I'Ile 44 poSS LW- — a. hl I.c
f- A. e dev .� � w44. 1-44 f - e deIAt/.i.a Zdi4/;i',ew. .
P �"
12. Describe the flow control system. • /
2 i
r
r
E tt
t: c
stonnwate site pl iisi ete'-:r6V 1 2f/2406 ` ,t(;') "' in tfl 6
x 1t- ',b
• •
13. Describe the water quality system. ! 1 /
A S� �/� 64 LOrC�'� AA,' // /4k.J c .u) r
r'r�0 �! ,S �1 .t �1 1 4 � l
pass 4r vC € L4/e izaL to 7 �L/-1 e-• ♦ 1 a.tai e f
14. Describe the conveyance system analysis and design.PF at o SA -40 1 r4.:, ,dew►s.sofe toL4-ft he 5A.? -
2 4 j 14 /i 1 C t s $id e e 4►a ve s/'u1 c i1-10 / d
15. Describe the source of fill material, physical characteristics of fill material, and deposition of excess material.
o� .� 2 .J J '/ b� ust' /e�1 timtt c S:) 51eI• r 11.7
4 J1 I3 re .s�� will at P< < .
S � 1 4
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code. / / ,l /
Qnt Mc w.'j( 44I. y.3J'j 4tiuccs b4 4/l ,pIt a col 4/7 f a e4ch .
�K..`� s k+r / I241v- ®)/ rit UP4) qN. 1 a SIL`j t4.. `'.01123 f,
aLIAIR a' ie itt
17. Describe the proposed surfacing material. t ••
�[
All 1,, )} .•1/ h/Mt, ✓4 " /Mt t t h•tSt/7t Ge4 b /(_hK[rk ••
Fp�t Tjdwf L✓4II ea iT �'K ✓.t , tv.1/ 4.atdca .' (5f4b7 l�v s / 4k)40 o4/40
18. Describe methods for restoration of the site. to/SO//c.,
1.4.L4d c v £I( e920-54-40 set h .
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.
4/0 iyo
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.
C •
2 4 -16.
stormwater site plan template—rev.10/21/2008 7
• •
CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN (SWPPP)
The Construction SWPPP.addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the
template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for
preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater
Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential
development.
SECTION I—CONSTRUCTION SWPPP NARRATIVE
1. Construction Stormwater Pollution Plan Elements. Describe how each of the ConstructionSWPPP 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.
lb, la e%1ea.�
2. Establish Construction Access. ,
e4',$h
•
3. Control Flow Rates.
.5;:g dr'A is(3. la, t,L.4--tiv eel, 6;6
4. Install Sediment Controls. •
L41.14glhc / it.7.1 V1L T C7&(dv
5. Stabilize Soils.
t
Lids 54•71 k,L Pe, a7ide...
6. Protect Slopes.
5le,,,A4 i _.ed/4 /--2./.
7. Protect Drain Inlets.
/VA 14 Pa I 'Ile7,5
stormwater site plan template—rev.10/21/2008 8
• •
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
0. 444 if /$
9. Control Pollutants.Akin 4
e / 1 Q/� ► I
I V d S L P t UeL V$. 1?h 0,sz y e.4 Gdre1 b C 4 rQ/
141
10. Control De-Watering (the act of pumpitr groundwater or stormwater away from an active construction site).
e. /
11. Maintain Best Management Practices (BMPs).
4/( •,. a r.jego,S w i// b . c Au,.cue o 8/tfrs .
12. Manage the Project. 1
Dr i t'M r G CN4.I 4041. 1-mat471erp-4ll �c Pal. 6i7-C 41" ezil
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). it/
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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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stormwater site plan template--rev.10/21/2008 9
• •
b. Description of sQe ja quirements 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).
WO41
5. Construction Phasing.
a. Construction sequence / f -. 1 , N
b. Construction phasing Ofpr`o)sed)
6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a propos d construction schedule. \ T
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)......4r„,.._, _ m., A. e,
II. Wet Seasgn C,dnstruction Activities.
a. Proposed wet season construction activities.ti /�
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b. Proposed wet season construction activities for environmentally sensitive areas.
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7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for the initiation of bonds and/or other financial securities.
6440 5 (-0r Lj c
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
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8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable. i IF
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.
0 1 AI
AV 1
2 ye if
(LANDOWNER OR AUTHORIZED REPRES:NT• E SIGNATURE) (DATE
THIS SPACE MAY BE USED I' • DDITIONAL NOTES, IF NEEDED:
stormwater site plan template—rev.10/21/2008 12
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