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HomeMy WebLinkAboutBLD2010-00161 lib UILDING PERMIT APPLICN MLA10-00188 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD10-00161 Received Date: 5/17/2010 SITE ADDRESS: CENTER RD CHIMACUM, 98325 OWNER: KURT T WAGGONER PHONE: 360-340-5723 PO BOX 248 PORT GAMBLE WA 98364-0248 SUBDIVISION: Block: PARCEL NUMBER: 801161003 Section: 16 Township: 28 N Range: 01 Wt: TX 2+ CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: KATHERINE MORGAN PHONE: 360-930-0537 22461 MILLER LANE POULSBO WA 98370 PROJECT DESCRIPTIOP NEW DETACHED GARAGE/SHOP W/STUB OUT FOR FUTURE BATHROOM - UNHTD TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION 12,000.00 MAIN: CODE EDITION: 2006 ADD'L: HEAT TYPE: UH OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: CONST TYPE: GARAGE: 1,050 SHORELINE: DECK: SETBACK: SEWAGE DISPOSAL: ALT BANK HEIGHT: WATER SYSTEM: 2WELL BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 0 Prop: 1 Total: 0 T Routing Date: Type Amount Paid By: Date: Receipt: a. • e....I t Permit $421.55 LYK 05/17/10 117705 AP _ • E Plan Check $274.01 LYK 05/17/10 117705 State Building Code $4.50 LYK 05/17/10 117705 AUC4 21J10 Total: $700.06 Jefferson County Planning &Building Department Jefferson County Building •Ision Permit Nuar: BLD10-00161 Applicant: WAGGONER BUILDING PERMIT INSPECTION APPROVALS applicable 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 Erosion Control Post Holes Foundation Footing if-t- 10 Footing Drains Foundation Stem Wall Straps(hold downs) Ext. Shear Wall Nailing Framing �;�. l re; ?"-- Blocking Wallboard Nailing Drywell/Alt Drainage splashblocks see condition #2 Address Posted IA)E r (e--2-J` 10 9 FINAL INSPECTION a-'21_ Colif FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD10-00161 1.) THE PROJECT IS SUBJECT TO COMPLIANCE WITH THE DEPARTMENT OF ECOLOGY IN STREAM FLOW RULE OF WRIA 17. THE PARCEL IS LOCATED WITHIN THE CHIMACUM SUB-BASIN; AS SUCH, THE FOLLOWS IS REQUIRED: 1. WATER USE SHALL BE LIMITED TO DOMESTIC USE ONLY, AND SUCH USE SHALL NOT INCLUDE OUTDOOR IRRIGATION. "DOMESTIC USE" MEANS USE OF WATER ASSOCIATED WITH HUMAN HEALTH AND WELFARE REQUIREMENTS, INCLUDING WATER USED FOR DRINKING, BATHING, SANITARY REQUIREMENTS, COOKING, LAUNDERING AND OTHER INCIDENTAL HOUSEHOLD USES, INCLUDING POTABLE DOMESTIC WATER REQUIREMENTS ASSOCIATED WITH COMMERCIAL AND INDUSTRIAL PURPOSES. (WAC 173-517-150(8)) 2. INSTALLATION OF A WATER METER, MEETING DEPARTMENT OF ECOLOGY SPECIFICATIONS, IS REQUIRED FOR ALL NEW USES THROUGHOUT THE WATERSHED. (WAC 173-517-180) BROCHURES WITH SPECIFICATIONS ARE ENCLOSED WITH THE PERMIT. REFER TO ENCLOSED DOCUMENTS FOR MORE INFORMATION OR CONTACT ECOLOGY AT 360-407-6300. 2.) 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. 3.) All construction activities shall not encroach upon the stream and wetland buffers. This includes the storage or preparation of materials. 4.) A setback of 60-feet, measured perpendicularly from the wetland edge, shall be permanently maintained as a buffer. No filling, grading, clearing, or other alteration of the wetland or its buffer is allowed. 5.) Buffer perimeters shall be marked with temporary signs at an interval of one per parcel or every one hundred (100) feet, whichever is less. Signs shall contain the following statement: "Wetland & Buffer- Do Not Remove or Alter Existing Vegetation." 6.) A permanent physical separation along the upland boundary of the wetland buffer area shall be installed and permanently maintained. Such separation can include installing logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC Administrator. 7.) The identified Fish and Wildlife Habitat Areas (Two Type N Streams), shall maintain a vegetative buffer setback of 75-feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to the proposed residential development including driveways. 8.) An additional setback of five (5) feet is required from the edge of the buffer area to the proposed residential development. • 9.) A permanent physical separation along the boundary of the buffer area shall be installed and permanently maintained. Such separation can include installing logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC Administrator. 10.) Buffer perimeters shall be marked with temporary signs at an interval of one per parcel or every one hundred (100) feet, whichever is less. Signs shall be in place prior to and during construction activities. The signs shall contain the following statement: "Buffer- Do Not Remove or Alter Existing Vegetation." 11.) 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. 12.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 13.) 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. 14.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 15.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 16.) The building height is not to exceed 35 feet. 17.) The setback from the ingress/egress easement is no less than 20 ft., the setback from Center Rd.right-of-way is no less than 30 ft., the setback from SR 104 right-of-way is no less than 50 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. 18.) 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. 19.) 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. ' ' (7 JEFFERSCOUNTY41, I DEPARTMENT OF COMMUNITY DEVELOPMENT �^ ^' 621 Sheridan Street•• Port Townsend •Washington 98368 4 beA.,,,..„. 360/379-4450 . 360/379-4451 Fax '' 4; www.co.jefferson.wa.us/comrndeveiopment Master Permit Application MLA: l 0 .1 C,O Project Description �M sheets as necessary): - _�. IF. ( )nh-Fz-i. (Iv .�-hi a t h rn)1- Tax Parcel Number. 60 I (a I 003 Pr Size: I (o,S 9 6.L. (acres/square feet) ) Site Address and/or Directions to Property: IPS c k- C-Q--C1 =e-Ar R...G.a.�) - 6-yttace. norm e(s 104 1 nk- c: , 6 0 Ob c Property Owner(s)of Record:_ �t)Y4- On .� Telephone: 300 , 3 LI b. 57 Z 3 Fax email: k-u r+t,v& ..c-+re,I .oS Mailing Address: PO, 5t 2-4$ r* gym h t e'_ to A- 98S 01 Applicant/Agent(if different from owner): KL -{r)or L.n e IL-Co K-'C_,t�, Telephone: 3(eC� . G(Z 0 , 0 S 3 1Fax y email: Mc)roexn 1 ka_A-c�3gfrierg., (�k' Mailing Address: ZZLi to ( 1(-Qt- Ln KS6- -�?vu 1s to Ar "t e63-Z e.: rh What kind of Permit?(Check each box that applies iffewilding 0 Critical Areas Stewardship Plan ❑ Demolition Permit 3 Variance(Minor,Major or Reasonable Economic Use) ❑Single Family rage Attac d/Detacne.9 0 Conditional Use[C(a),C(d),or C]** Qllanufactured Home 0 Modular 0 Discretionary'D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑change of Use 0 Boundary Line Adjustment ( 1 7 .,, . ff Address ❑Road Approach ❑Short Plat** ❑Home Business 0 Cottage Industry ❑Binding Site Plan** ❑Propane 0 Long Plat** ❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑9llowed`Yes'Use Consistency Analysis ❑Plat Vacation/Alteration** LStormwater 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 ❑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 Sr 1Ito act as my agent in matters relating to ap ication for permit(s). 1 OWNER SIGNATURE "--- Date: ) JO By signing this application form,the owner/a that the information provided herein,and in any attachments,is true and correct to the best of his,her or its knowledge. Any material false 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 attomey'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 requi ter inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applicati h 'r she wants prior / Signature: ---� `� Q'"� Date:5// i / /0 The action or actions Applicant will undertake as a result of the iss ante of this endangeredpernpermitmay negatively impact upon one or more threatened or 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-transfera pgrtsibility for adhering tQ;and ying with the ESA. The Applicant has read this discla" r a signs and dates it below. Signature: l !`�•Gf'1 - — �{/ Date: 5//, r'! • • 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 assumin the res nsibility of the General Contractor for the proposed project. �� P �_ Date: ,5//7 l� �CSignature: / _._� GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAx: ( ) • ( ) . MAILING ADDRESS: EMAIL: CONTRACTORS LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAx:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: p -Alew PC.Wood Existing: 0 Sewer 0 Addition ❑ Steel Proposed: Bank ❑ Community System Total: ❑ Alteration/Remodel ❑ Concrete I Height: ❑ Individual System SEP Permit# ❑ Repair ❑ Masonry 0 Other: Bedrooms: Water Supply: ❑ Demolition Existing: Setback: 0 Private well ❑ Two Party T o Hea : Proposed: /s. d Public YOn Total: II/ Name of System: • If this is a Commercial Project you must answer the following: . Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed - IBC Occupancy: IBC Type of construction: Will you have FoodSenrice? Yes / No if this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: 1 Underground Tank 1 Above ground Tank Size of Propane Tank: 1 Heat Stove 1 Cook Stove 1 Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 Pellet Stove 1 Other Is this appliance being installed in a Manufactured/Mobile Home? Yes I No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildin 9s,ali 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 tg rtig. t`. f.- I -<,ti Main Floor Heated F, EH Bld App Review: x r Floor Heated n r fi r; Consistency Review: 1 J ' � ` Base fee: Other Heated a l , -15.,. s p ati> Mezzanine v _ s. ; Additional Section: Plan Check fee: �,( I Heated Basement ,� �x `f Unheated Basement i t ce State Surcharge fee: ,4 ...9 Other Unheated 3t r7 Pot Water Review fee: ;..4,,V ` �`( e-r t' SUBTOTAL " l - _ Garage/Carport 0 1 . N > Decks 911/Rd Approach fee: k 4� Other TOTAL: $ OE, " XY« -:".:AL,-, a Receipt Number: I i T 7cf �" y'"" ' r Cash/Check Number. ESTIMATED COST(REQUIRED) Date: �_ .Fair market value of all labor and materials foundation to finish Initials: < • APPROVED STORMWATER PLAN 4`�'45oN °6� JEFFERSON COUNTY JUL g 2010 4� ti DEPARTMENT OF COMMUNITY DEVELOPMENT JEFFERSON COUNTY DEPT.Of COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend • Washington 98368 SIGNATURE: �qs ,gyp 360/379-4450 • 360/379-4451 Fax FI7NG http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# Or g3 PROJECT/APPLICANT NAME: ,J[.`C G'Y��t� 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 improve/rents on the site map. -�nz w t I ]`'�= Lt ,1 twirl t� C_tz� 'te'c hoa vi-E.. CRLn ck C& f .e-�<L o 1 1'G [ t t't 1 E'(1 �tX -1)c'£_' (t7 D(Yl e' c'-S i..o ill be I i Yfl r -feet fiv -5_1171A.L/ It � G��c� ( `tf�e `rfi ,�� C � cry ._ 1�55 y-1 W /� - Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map." rAra, hei 4.4461E:)Iai_ c S.kp - ,/5- j 3. Describe the existing vegetation. Indicate native vegetation areas on the site map.f f'/4- ll lLC� lii 1-> L� [ C- -- ??'E,v/ic05/L IG<l y{1 j> �Lc, r 7cc-1-. d� i( CZ ✓e<<.s care, nafi r vac 4. Describe the existing soils. Ind Cate soil type on the site map. ,*15 e �� f�. lc f � rc�c� I c:, rc..0(-11, >c� ��<( l� r J V? L`c.ill SL /1L(y �f L, t 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. I1 L.'L_lilc1 Cv(i/ii C, rir,✓L'. /t y 'trL.1 Lief"' fed 6. Describe any excess levels of noise generated by the proposed use or activity: stormwater site plan template.doc—rev.10/12/2003 t= % , i"A 7. Describe significant geo aphic fe tures and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes, etc.) on the ite. Indicate location on the site map. f)v(I. *LA crAolp; 614+ �/I-r , ',(�Q,,rr.�t ,ei. L - , � 't`l� u4 yaalrwUi..VMl.�14,40444J; 4: lYPi �. . .%dot Ltn . - (1_t/)- i(.-1 CU2tr refer?} i Lew.)it /1 13 -b e C 8. Describe the general vicj 9fthe site, including adjacent land uses and structures, utilities, roads, and sensitive/critical areas (streams, wetlands, lakes, steep slopes, etc.). `�c-f-t' Ly I2bUh6 e U-, - 0 ?-/.. over iv -F /4ic-ii. /C_x- l ezvc,�7fl/ i-r. 4--r �•-�= i s l U Dc-coz�i' be;-tl.�.e n -t 1,Ls z e 4i.,Ad (`i>G �- ► ,4 trek- ��LZ��' /S �f7,, 'f 1..ce 106,AT 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. '.iq1.)&irtilcvs roc$ )621Gz — WI-(I be 4/l7 diS x.r( C-fc, 1 't'- T 5. f v L u cu m S "A- A,e pa.44(10)-1 -tz- r ki-(,-r- t,•-•( L`e -r i k yy��,,, lye, / /� /��� ,�Q, /'�/ j�/ /e .J ))/fit t +\ ; {�j i►-pe Y r 4)�-& A K{Y L. Lam_`-'"' )-P4F'-„—t.t-�1 C.v YI(\ �G.K.�-L, Lc t 1'6L. �—X a L<.) ' `�^7 ve: c 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.] 11. Describe the performance goals and standards applicable to the project. I L lc,,t I/1 L;'Lu Zc_- cc tSt;tr�:e_t tC-� D it 6 h v VUc c._. i:,r-t :t._Ji pc:-r- .. e).K) e> 12. Describe the flow control syst m. ) [ [ ,..L,1 0 t 6 ru i 1( at 5.p e i-- L a J�L n echj c al i i.e C y T�Z f l C ,'i tor" C )41 I.) / ,yl I,rYY1 l), 5 0 ' i c;V e - 0)a.,(:17 .e. 0 C -� (j et L ,24 7 c-'`r 7 -t7"re 1?c It tip,r -Pe7�J- Q J stormwater site plan template doc-rev.10/12/2003 • • 13. Describe the water quality system. ,. 14. Describe the conveyance sys em analysis and design. 15. Describe the source of fill material, physical charactef istics of fill material, and deposition of excess material. nu �i(� lt) i,�FCJZf�U 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. 17. Describe the proposed surfacing material. 9 ro. '-e-K.18. Des ribe methods for restoration of the,site. r—cu., 1 h,), L:),c 4, CIL:',1 t,tc C(2()_0-rL,:C t� c;•-\ Ltii 11 & ...'ee .ie%1 ( (- al lJ 1 C 6 : ACC 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. nit-, _ 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.l -r i l l ! c-,_k_ C: , c C. .\ ( ( ',. 1 T C 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. t r(c.. stormwater site plan template.tloc—rev.10/12/2003 • i CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN (SWPPP) The Cc -truction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the templs.:: gnat 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 BM Ps used to satisfy the required element. If an element is not applicable to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual (beginning on page 2-15). 12 Required Elements—Construction SWPPP 1. Mark Clearing Limits. , • n 2. Establish Construction Access. k/licsi 3 6- � I i zed C.a vkA1�v cA--1 c:Y, -,►'`(�-Yl�e . -1E v,S_ (c-ed 3. Control Flow Rates. E'k .1,n,t- C.h �U �ltt6 n v(1 -r'�...F r�( L``E� C. CAC 41 n(--? 4. Install Sediment Controls. ,� V w o l ( be. p/(c.,P te L.r-) c fzi t [.iaan • 5. Stabilize Soils. r l i. j t lei ( b 1. C l pl/Lt ') 6. Protect Slopes. n o S(6 l( L)12__ C stt.°44c 44i -O-/LpoSe.6k 7. Protect Dr in Inlets. (� (1, /‘ (e-1- . stormwater site plan template.doc—rev.10/12/2003 8 • • 12 Required Elements— Construction SWPPP(continued) 8. Stabilize Channels and Outlets. Ct o r ifl 9. Control Pollutants p6/1 t) Dr-) Cl e Lh) Lt/) (( f es LJ)Wi e)ri p ►v-re.e L groundwater or stormwater away from an active construction site). 11. Maintain Belt Management P actices(BMPs). 3t t i..&j 1 (l �?-e l - d C (p - ck ►1�E'Ct.(C 12. Manage the Project. I CY] YV.Lk (o ) I,(,%UYLam ; lI C<<<x-- i r svm rv)8--- . 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). 1 ;Qr1 , 1A,ri/1 rt.1rta/c.r- b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. 1 ( roc= -�� -� -�- m t : 4)ec_f-- s/ /'c stormwater site plan template.doc—rev.10/12/2003 9 • • 0 b. Description of special requirements for working in or near environmentally sensitive�p areas. .4el rS i t v� et- et..-", C1/rr_ a '> �S Qh z CCl S r %t (/'t,Y'l�i-C-Ct e' 4-1/1 L'u'L.:t t t')C 1 Cc-� -O'.--` J t 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). ) . L.1--- ce'-v-t. c Q CcAr'a�. ?k,i.>p-ei.e.-e -ev ► al\*,,e v e- t- ( t i 1) ' (7 E J S I'i" .)LL , E O '*- CO r!1' .. ( ci -o it\ L.,D 1(A.•t _cam e 4f? v r. po ,�rb ,` �r iA . -cL m cam, AA 5. Construction Phasing. 1 rcL , ro 61..q Construction sequence , 1 a. -El..:_- r V S hex+- C o nSAYUCkTh /- Loy)A�u - C X .l�'a5r b r i.nC b e us k ��c�; n�� sl�->os LLt1e 1�17C, � YY b1Ct� -en h G t' _ C.X �Jr 1 b. Construction phasing (if proposed) • ry 6. Construction Schedule. Wet season is October 1 through April 30 (page 2-21 of the Manual). I. Provide a proposed construction schedule. cvi — Jun-e_. II. Wet Season Construction Activities. a. Proposed wet season construction activities. 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. b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. 1 i./e 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.doc-rev.10/12/2003 H • • 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. 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.doc—rev. 10/1212003 11 • • Stormwater Site Plan Changes 4f the das. t, .lake 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 Const uction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to t best of y knowledge. I also certify that this application is being made with the full knowledge and consent of all owne s oft, affe ed roperty. .011 (LAN!OWNE- �' • THORI�EPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: stormwater stte plan template.doc—rev.10/12/2003 12 ' 4 CD r- . —, i ©� i° •.• rr . O • • O,,trC/ S gSns.i.vh13 1 ct Q m M. m CD Ili r0 v XO O r 't 0 U. 0 r .> ..ti.. is•. 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