Loading...
HomeMy WebLinkAboutBLD2010-00074 f S 1 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 #: BLD10-00074 SITE ADDRESS: 1903 DUCKABUSH RD Issue Date: 05/13/2010 BRINNON, 98320 Final Date: 5/16/2011 APPLICANT: WILDERNESS NORTHWEST PHONE: 360-796-4968 JODY WEED 1903 DUCKABUSH RD BRINNON WA 98320-9623 SUBDIVISION: Block: Lot: TX 10 PARCEL NUMBER: 502083013 Section: 8 Township: 25 N Range: 02 W PROJECT DESCRIPTION: NEW RESTROOM / SHOWER FACILITY & LAUNDRY THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2006 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes o l THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 5/16/2011 I:\F_BLD_Occupancy.rpt 10/29/19 Jefferson County Building øsion Permit Null: BLD10-00074 BUILDING PERMIT INSPECTION APPROVALS Npplicable Code: 2006 n ernatio all Building C 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 Miimum setback from Duchabush Road right-of-way shall be 20 fee Minimum side and rear yard setbacks shall be 5 feet. Minimum setb; from the northern parcel designated commercial forest shall be 250 II Erosion Control SEE CONDITION 2 Foundation Footing Footing Drains Foundation Stem Wall Underground Plumbing Straps(hold downs) Ext. Shear Wall Nailing (( i ?f 1 /a 0 i tISL NA-t Rough-in Plumbing 7 f I, ( I° "—�Framing `-7-g-10 ✓ . ►min' Airseal 9-erb Insulation: Walls Insulation: Floors Insulation: Ceiling Gas Line: Interior t° Gas Line: Exterior Propane Tank Mechanical Systems Fire Protection Landscaping exisitng vegetation; additional planting not required. Sign Drywell/Alt Drainage SEE CONDITION I FOR SPLASHBLOCKS Exterior Lighting Exterior lighting for residential uses shall not exceed twenty feet(20') ii height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. Address Posted SEPA Mitigation FINAL INSPECTION -/1 .-// (Q�T.-p- FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR MLA1 0-00091 LDING PERMIT APPLICATII Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00074 Received Date: 3/16/2010 SITE ADDRESS: 1903 DUCKABUSH RD BRINNON, 98320 OWNER: WILDERNESS NORTHWEST PHONE: 360-796-4968 JOD 1903 DUCKABUSH RD BRINNON WA 98320-9623 SUBDIVISION: Block: Lot: TX 10 PARCEL NUMBER: 502083013 Section: 8 Township: 25 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI NEW RESTROOM & SHOWER FACILITY TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL: TYPE OF IMP NEW MAIN: 864 INDUSTRIAL: VALUATION 46,080.00 ADD'L: HEAT TYPE: RAD CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT NUMBER OF EMPLOYEES: WATER SYSTEM: PWELL BATHROOMS: Exist: 0 Prop: 2 Total: 2 Routing Date: r_7—1 Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $613.45 LYK 03/16/10 114016 APPROVEr Plan Check $398.74 LYK 03/16/10 114016 Jefferson State Building Code $4.50 LYK 03/16/10 114016 MAY C oun�� 1U3U Potable Water Application $98.00 LYK 03/16/10 114016 ty Planninc Total: $1,114.69 & Building Department CONDITIONS for Building Permit# :BLD10-00074 • i 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.) 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 be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 6.) Not more than 2 unlicensed veh shall be stored on any lot unless totally ned from view of neighboring dwelling and rights-of-way. Such screening shall m t 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.) Miimum setback from Duchabush Road right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. Minimum setback from the northern parcel designated commercial forest shall be 250 feet unless an administrative variance is requested and approved by the Administrator. 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. 1. (4�c�N Cod,. JEFFERSON COOTY • W f \v DEPARTMENT OF COMMUNITY DEVELOPMENT 1, v ' '4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 1`S$IN0' Fax p' www.co.jefferson.vva.us/commdevelopment Master Permit Application MLA: (C) - 6 Project Description,(include separate sheets as necessary): a�x t gym+stouJe,) �t, - sep• rc, Syst vr, Tax Parcel Number: 50a Og'3 ©( 3 Property Size: 9.8 gGl'e5 (acres/square feet) Site Address and/or Directions to Property: 1903 .77Ucgici.gu E1 Rd • 13 RInirNCAO Property Owner(s)of Record: W i 1 el,r hP is /v 0 r •),iA t j+ Telephone: 3 60 7 9k 4 S*55 Fax: email: Tel 0(9 WA.CO I g Gf)2*J.l1A Mailing Address: 1906 b o GMekb Vs 2, Ike! g ,g r I»ntftr, L1..I6• 9 P3.10 Applicant/Agent(if different from owner): Telephone: Fax: email:_ Mailing Address: . What kind of Permit?(Check each box that applies gBuilding ❑ Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance (Minor, Major or Reasonable Economic Use) ❑Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home ❑ Modular 0 Discretionary"D"or Unnamed Use Classification ❑ Commercial* f$ Re .+roavti ❑Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment O Address ❑ Road Approach 0 Short Plat** ❑ Home Business 0 Cottage Industry ❑ Binding Site Plan** ❑ Propane 0 Long Plat** ❑Sign ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** ❑ Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination (SPAAD)* ❑ Shoreline Management Substantial Development** ❑Temporary Use ❑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: ��d Weed DESIGNATION OF AGENT I hereby designate y to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE ---)- .( v Date: r )2,^o9 By signing this application fo , he owner/agent attests that the information provided herein,and in any attachments, is true andl 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 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 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 applicati that he or she ants pri notice. Signature: Date: IP ' v 9 The action or actions pplica t will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable esponsibility trZhering to complying with the ESA. The Applicant has read this disclaimer.and'signs and dates it below. ` Signature: 72. J Date: )._O — D V G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc . • • 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 responsibi ity of the General Contractor for the proposed project. Signature: 1 pre.dt ( WNW Date: S' Z 0- O GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: 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: j New X Wood Existing: 121— ❑ Sewer ❑ Addition 0 Steel Proposed: Bank ❑ Community System O Alteration/Remodel ❑ Concrete Total: Z Height: %Individual Sysjq ! ❑ Repair 0 Masonry.. SEP Permit# �{ ❑ Demolition 0 Other: 'Bedrooms: Water Supply: Existing: Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: ❑ Public IRaz14fa rio Total: Name of System:VA 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:-- il rgretni&Pank XAbove ground Tank Size of Propane Tank: a5Z7 i Heat Stove I Cook Stove I Woodstove I Fireplace Insert XHot 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 For Office Use Only Amount Revision Main Floor Heated EH Bld App Review:60+' _ l 14(r V n0 Consistency Floor Heated Review: --_G� � Other Heated Base fee: 6)13.457 "f5 - Mezzanine Additional Section: ---_-- Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: •.4 �q .5D Other Unheated Pot Water Review fee: `'t Garage/Carport SUBTOTAL CI Decks 911/Rd Approach fee: Other TOTAL: 4 L5 1 (.(0q Receipt Number: ) I(40t Cash/Check Number:• I cr, ,r ESTIMATED COST(REQUIRED) Date: _, r .Fair market value of all lab materials foun ' n to finish —t{� Initials: ��o.-s��-I ylIjo8 r G:\PermitCenter\###FORMS###\DRD aster Permit Application 5-29-08.doc • • (-.re,osON-6.c."-ie4, JEFFERSON COUNTY ti DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 �q�, �O�\N......... 360/379-4450 . 360/379-4451 Fax STING http://www.co.jeffersori.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# I q I PROJECT/APPLICANT NAME: IPi kkr( .cs kl('tk(yo-J- 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. pj (j lv'Oc71- CA,*1-(09 S. teci-rwrn iShoukrkoo , 4 c li hj y1� . an Ck C�- 1ri flq 11.ill r vh C Ai tQ ) i l 7-p_ J2 i s-i--in d tv f O 13(aVe i l( S 9 Sif s t: v,ctte t�v t ? ct r�s� ccJJ Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. e Y'ons et4 Side- OC ?iroOP4+ - 1e is O SYn U Stop-e CQnc& , of -r -( do 1h '1 I` (Lc Ok. fo . S ( ills ec ` V 3. Describe the existin ve etation. Indica a native ve etation areas o the site ma . Wv,e.re S 00L),.9 1 C ,�L�i ' r y _ M t-t• CANC.(' 'ine Pr p 4-,, i a maiuv'e ‘- r'i -{-_ die. ,rou ndi Comer i s sad A. ,Sck1o1 , Sow .ic,ayvivo bent/ c, • rkode cten -arcs . 4. Describe the existing soils. Indicate soil type on the site map. `fl e PvLz1 Ar i s ri cL i n Loam c d dark- perme_c Oole. So' l u cj 'Npcts-t -W-s+ c4"; , gavel . 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. leas+ a50 4 . a 4urn b. 1d1rr si} ()nil rums W-rSederc4 I s i n 'fie i.v i `� I APPROVED 6. Describe any excess levels of noise genera.ed by r ti itAN 001. G oc mra,..l n o► O C STORn c� Suc O 1 on Sir G{i uo, stormwat MAY 1 2 Require JEFFERS• �U TY DEPT.OFCO 1'EV•i OP NT stormwater site plan template—rev.10/21/2008 SIGNATURE: i • • • 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes,etc.)on the site. Indicate location on the site map. is o- n . `b ��prok. 5-(0670 . "(ke,tre i���.tu oc � (ecru 0.CIZAe. d eXl ' _ (Cf.S-� O f t D)sc-ci 94- C pcONC. a5.0 ran Si4 .Wk C � rhf i s Ccsed4-arcs • f t 5 ci_k, IC S..rnh lCcJ'.. "pn -re- case__ ,no Wetiot s 8. Describc-(he general vicinity of the site, including adjacent land uses and structures, utilities, roads,and sensitive/critical areas (streams,wetlands, lakes,steep slopes,etc.). b r`��re. .. tOw� J -�`o fi-e 'lgw.re C 9 c cc Ilia, s•4e Qpson AVec►ve t'a 1\r►.e _D-o ckr,t_ . COcd CvnS 6Y(�L`e� 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. tX'�1 e Is u-Ck- k C�-t S Pej d" .Th.is j S ,CtA P_ (.Lo CtCX" \ �►�e T CL �CrC c1� `+ P•d scd 5i ke -Ca iS Well L flsi de. -h, , 3 5 0 rnax-cnu/wl (Acker-J.::r-) On15 .S r 0 O.e te-icyt-Q1 St T r 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.] tk-C •sac;Lf Y)eise_A ullj C�� rr,r� plcoq 4/7/-e,r,� CC,�Q /0a,g. 11. Describe the performance goals and standards applicableto the project. W . l�l -e-nd � 11 n cd± as Li tie.le. QS cU Sit hie — eve sterc•►wake_c c'a4 le-e -- cig.,.je(o ff r1 CGS►Chi fi�rl . 12. Describe the flow control system.r L)L- +do n0+ 1 '�\"'� ?O c� ,PCc--ACC C,�1rt1 0.� �`�S'� T 1c WS _ ►e. ff -i ka• ?G S S cam, t e -01 '(1�' Gchct?ve. 11 � J 1 stormwater site plan template—rev.10/21/2008 { ' ' A 6 • . 13. Describe the water quality system. Inc too i.\d;--41,- Si{� �s c-r 0.nc' nvi- a ec k n�: s-is r t j Q w r, -\ c-�v reftwate _ VS 0 e,rQ Z Or\ Q( Se c1;( W.C4 4 s e x:C r(et( 1 - O 1r-j‘r i s {,fir 4k a.d. -Ve-seActii or) • 14. Describe the conveyance system analysis and design. .4e OQSe- -to n Aou-nscioL s;d totit\ n 5r,O-ad. tt-.4 +0 nr.�- a.1\J a'tKh 0-1-0 � 1O\Ji c.ceck.c- ' suc�ru,s 15. Describe the source of fill material, physical characteristics of fill material, and deposition of excess material. t oc1' need G.r)j 1 , Si}e ' s \-e,V P, c cA tnQ XCAi - • 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. Oink 0,0pAi cc.,bk. ci}c1/4„8c,1 o 1 c\. be "Me, L Sc 0- kne c&4L .0 -ed LA d.�(lr,�` fvP -C»1c-.�-4, s\c k e�n c{ axvi( c,-1-e � �-o cc,c4-e 1 17. Describe the proposed surfacing material. 000t focr_. � S(Dc t t \oc. sc a rl el A IO CX�C Ql S o l o(7fl V O-F UT afCE:r e 18. Describe methods for restoration of the site. ,/�/� t'- c- c et c cc iet_ rows i• ire _ r1feC a rr. e( \\-e V,L t ► d,�,J ()aka c r/-n e $ ec s 1 v w 11 Ind s(�e mod. elcL� nc . -c ,3, 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. P 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include conditions that affect the drainage plan or contain more restrictive drainage-related requirements, describe those conditions or restrictions here. c, S eev cnd cS -c is 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 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. ( 1rl'tCA,�& ciec<ct `�, by-� \c � site 'frees as Wet O-5 to - e, ` v.?-CS �tl�e chin � ,� 11, "I t CcintielA _ 2. Establish Construction Access. �`� tkW c.L 'e)►SAS, TL,�U C�.Cct ,rocArls `00t of (1116 Covet c nd 11— �(�nc: n--cA.ne A A . A\\ C s Ck-;on \[�4) cA-e g 190 IA 1 4 w C CP S 5 5'i�e b\, �YYie Se -e K; n9 roc s J 3. Control Flow Rates. 'Tne e)Gi c-k- c n cove.4- 1ric4S -Me 0.i'ure-ti C��jt tv ct bSo-r 1n an �� - - and -11.1e_ Con-6-la I -4io L (4_1 t.S S4,Clu ld J lie nee,1 c � co 4. Install Sediment Controls. WV-IAA 'Me Srn.c01 t 6:me4 t4cd is P fop o a. ) erg 9nould Yee np se.dirt'-ten ssve s 5. Stabilize Soils. �vly 0 �(e c4e ci acec .s W l l soe t c nd SccLp�d W i rtCC A/C. P end' &Inco b S -te 4 S o f ► CA24-le.r s Coon 0.e,4e_c-k 6. Protect Slopes. 1�11 5: ,n.cf cc.nL cAn9e 5 are. i47V01ved 7. Protect Drain Inlets. () - sc e S ex Ve-c,+s ►\\ be I t -Zed- stormwater site plan template—rev.10/21/2008 8 • 12 Required Elements-Construction SWPPP(continued) 8. Stabilize Channels and Outlets. (OW I %S 0.Vc l cL b 1 e t o the e ve r-rf c9 F e )cc're m e cfre i rx dur:r,s con sty-0 in . 'n - . hcti� never cLo„iyi °Lin iticMS in v�" t4St' 9. Control Pollutants. wct s c.,r► d Irc,k.s.i 1oaLP s Crd �- c�vGitab1P 1 n Cc*Se.. T e_,re i s ra t e d o f ap, (tea W k.-0Ln+ Cc n;4Ar-v 1. • 10. Control De-Watering (the act of pumping groundwater or stormwater away from an active construction site). `Tve c irecA.. e„.r si;_-k e s eytre rvwP 1. cxn d. cL (Leo..i n � r-c,.I cj (-1,r-►d Over ' e cc cl� toIit. avc,�lahle t � �r,y pvo11e.v,r, kd rtic4S4) 11. Maintain Best Management Practices(BMPs). n c e Cke,n cc. l Cov+ c,.. - L311_ d vri n ci C S4w c i���, 5v c� �1-,e S; t-t s e ru 1-e c Att..d (Anev cnctin-6 to 12. Manage the Project. "'Sl7C�� 11.1 e c-I Or' c.L 7\ e. 'JocA,rd \rvl e. n' r k.40 ry 2M �, 1.•i iv, 0-0 5O ,i‘,5;Yl e rtV"e- rci,niYet- N 6 u v.-tln 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). mere_ c,re t-,o rn5 l s oCL lC J s C� O L' Un `t xQ ✓ �c cc�� � e c2 4- SYU r rc_c.�c�S b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). 0 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. CArc NCI o ex►v i ravn,Men4c kA Se nd H \ram eXre CA-5 Oil Of CA diCt-62-e4 tl) IVO stormwater site plan template—rev.10/21/2008 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. I 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,r permeability,depth,texture, soil structure). tJDYl. e=Sr en . S.c io wi i L VA,. O crG a.2. / 'Mt,'1i.evict eXC(-AU CL# On LA)MA. tr.c e.-4-'CA-or ?CI-4 CA cL\ . 5. Construction Phasing. a. Construction sequence Si-it Pre - )u-ClcrcL-ti On - cLrn t s1G , NC0© 0 f j -e,r;ye b. Construction phasing (if proposed 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction schedule. 10( tn. ,A. -v 1- co.r e t� Se-p-tic, r., av- ;e IA 'n \c OcAvber 1 cst-'7 cj,}c?rr ifUwtidc ivn ? "KC—,c,, d-ra.in-fi�etd CU a r— S� ..C�t)Fv-�cYvi c C .ncj ,C ct II. Wet Season Construction Activities. m�i tx"h�‘'s1��°u,s, c1-��'^c i �.��r�n, � i�o (� a. Proposed wet season construction activities. � `c �Y,q C(e,G- O g, -Pi-,,r-r,,.. rcO rr��, "tsN-�.r;rx -Fni<J.. tandScc pT b. Proposed wet season/A— . construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify the prope y owner responsible for the initiation of bonds and/or other financial securities. A- b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable. Nif a. Sediment Ponds/Traps. b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations stormwater site plan template—rev.10/21/2008 10 • i SECTION II—EROSION AND SEDIMENT CONTROL PLAN Sediment and erosion control measures may be depicted on the master land use application plot plan, a stormwater site plan,and/or a separate Construction SWPPP site plan. This is a checklist to ensure that the following are depicted on a site plan: 1. General. a. Vicinity Map b. Jefferson County Approval Block c. Erosion and Sediment Control Notes 2. Site Plan. a. Legal description of subject property. b. North arrow. c. Indicate boundaries of existing vegetation (e.g.,tree lines, pasture areas, etc.). d. Identify and label areas of potential erosion problems. e. Identify FEMA base flood boundaries and Shoreline Management boundaries(if applicable). f. Show existing and proposed contours. g. Indicate drainage basins and direction of flow for individual drainage areas. h. Label final grade contours and identify developed condition drainage basins. i. Delineate areas that are to be cleared and graded. j. Show all cut and fill slopes indicating top and bottom of slope catch lines. 3. Conveyance Systems. a. Designate locations for swales, interceptor trenches,or ditches. b. Show all temporary and permanent drainage pipes,ditches, or cut-off trenches required for erosion&sediment control. c. Provide minimum slope and cover for all temporary pipes or call out pipe inverts. d. Shows grades,dimensions, and direction of flow in all ditches, swales, culverts and pipes. e. Provide details for bypassing off-site runoff around disturbed areas. f. Indicate locations and outlets of any dewatering systems. 4. Location of Detention Best Management Practices(BMPs). Identify location of detention BMPs. 5. Erosion and Sediment Control Facilities. a. Show the locations of sediment trap(s), pond(s), pipes and structures. b. Dimension pond berm widths and inside and outside pond slopes. c. Indicate the trap/pond storage required and the depth, length,and width dimensions. d. Provide typical section views through pond and outlet structure. e. Provide typical details of gravel cone and standpipe, and/or other filtering devices. f. Detail stabilization techniques for outlet/inlet. g. Detail control/restrictor device location and details. h. Specify mulch and/or recommended cover of berms and slopes. i. Provide rock specifications and detail for rock check dam(s), if applicable. j. Specify spacing for rock check dams as required. k. Provide front and side sections of typical rock check dams. I. Indicate the locations and provide details and specifications for silt fabric. m. Locate the construction entrance and provide a detail. 6. Detailed Drawings. Any structural practices used that are not referenced in the Ecology Manual should be explained and illustrated with detailed drawings. 7. Other Pollutant BMPs. Indicate on the site plan the locations of BMPs to be used for the control of pollutants other than sediment(e.g.,concrete wash water). 8. Monitoring Locations. Indicate on the site plan the water quality sampling locations to be used for monitoring water quality on the construction site. Sampling stations should be located upstream and downstream of the project site. stormwater site plan template—rev.10/21/2008 S 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. R. L0d ? (LAN O ER O HORIZED REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: stormwater site plan template—rev.10/21/2008 12 24' 1\ \ I �I 1 n e I m 1a D � i 1i 1 _< 1 A i3 1 3 ti...-----__ E >,E C ® LILi I co L " i Wz — r i mz 0 - 0 -_-_, El.gamil ) 1-1 1 I i 0moo -CO I� x -I w� 11 1'Hi = � O I 0 Lip Cili lu O �1 I it% ® co 82 ► ® SI OI tTh Po � O I (---- , = D n � o I ^� n /ord 02 cn N lu �I ° x IIO ....(71 * \ / I N...) • / \ 1 / ° _ Fc51, /°\ - n 0 m 4111z --I cr.! O �� I D II xz . 1 m cop 0 m w � v v -< v_ .! - - � - - - - � _ \ \I _ ' 1 4'6 ' 2'6 6'6 ' 4'6 --- F- > < >rC >E ------ 1 0' 14' 1 NI . ...... 1I 1` PROJECT TITLE DATE REVISIONS Sept 1, 2009 Proposed bathroom/shower house For Wilderness Northwest, 1903 Duckabush L ) R i2�A Rd, Brinnon, WA 98320 rL Contact Jody Weed 360-796-4855 _ Tax Parcel 502083013 DRAWN BY: Mark Pornerinke 360-774-6640 CA CD CD rr C w p o nat at at p H VI CZ O, O ~• ~ C b vt, 2 C4' g ra., A: r ,65, til Of:.,40 IZif o0o � a � o II p y ry c (ACp WC ►"ti .. 0 Pt Im Coo �� •. CD M--i .0 `p p 1 i eD pV 7.7z. 0 '•" 0 I'mf Of.14- '1 • . , ti„,, ,t. (....).R 'M - .• •.. . P • s -S prep. ownet-; ,J'e• eecc ' N 5.16 I • A.�•i , / N ,i — /' /..),,,....„ -g—• (5/ 6" / :41;), • F: h . -7-- ,el ,,,,,,, _ ,, tiit ( ', 4-. •• kiF,'"if/07 ' 4: '1M ;, a,-ft_ ' . \ . `/--- r. c, - \i''' ,., ,•'' v 1 / "� n ao 133,./ - (1), (..'\ tt .( — 1 ., .7, / ,. - .7 ,,, ..., (,,, r,: , , ,�, Ec. (/ \ •• t , p c: (...) N v Ci 1 /c h \i'leA\ ' . r r�1. o to° O N JC • . 4 • • ) •• • V •('' it — ‘cN L tr .L.._. ..... / ice' I rrn I 4°8 , - • \-\\N- 30 .