HomeMy WebLinkAboutBLD2010-00273 •
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 #: BLD10-00273
SITE ADDRESS: 231 A COYLE RD Issue Date: 01/5/2011
QUILCENE, 98376 Final Date: 11/29/2011
APPLICANT: RODGER J BIASCA PHONE: 206-913-9266
STEVEN G LLORENTE JTWROS
4335 THACKERAY PL NE
SEATTLE WA 981056122
SUBDIVISION: Block: Lot: T 15+
PARCEL NUMBER: 801334004 Section: 33 Township: 28 N Range: 01 W
PROJECT DESCRIPTION: NEW ADU W/ UNHTD SHOP
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009
EDITION.
OCCUPANCY GROUP: R-3
TYPE OF CONSTRUCTION: 5N
SPRINKLER SYSTEM yes no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON11/29/2011
I.\F_BLD_Occupancy.rpt 10/29/19
.',fferson County Building Derision Permit NuPr: BLD10-00273
Applicant: BIASCA
BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2009 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 J(4 I t /9-A- Minimum setback from Coyle Road right-of-way shall be 20 feet.
Minimum North and east setbacks are greater than 250 feet from the
commercial forest lands. The western boundary shall be no less than 40
feet.
Erosion Control SEE CONDITIONS 4&5
Foundation Footing 3( i t , ) _
Footing Drains 5- , if it V
Foundation Stem Wall '�// 11)/ pii:
Underground Plumbing
fill !l 't-1 -r I.7 t i 11
Under Floor Framing 7
Straps(hold downs)
Ext. Shear Wall Nailing
Rough-in Plumbing
S31 - 1 i47:-
Framing pal—t
Blocking O
Airseal --3 i_i l cl—
Insulation:Walls G 8__ it re
Insulation: Floors q /ll t t F--0
Insulation: Ceiling 9_P_ l( 1--�
Int.Shear Wall Nailing C �L.. t _1 l
Wallboard Nailing 1 _( -It
Gas Line: Interior tr-s3 - t I _ r
Gas Line: Exterior
Propane Tank
Heat/Chimney Clearance
Drywell/Alt Drainage +1 l l SEE CONDITION 3
Address Posted
Hydrostatic Test
GORIC-1._ Herat_ 14pE•s MO
t OcrAtteb p,- --:..., }- I t.S.t�u
FINAL INSPECTION i t_Let-t+ 5k____FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
MLA10-00296
UILDING PERMIT APPLICAON Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD10-00273 Received Date: 7/28/2010
SITE ADDRESS: 231 A COYLE RD
QUILCENE, 98376
OWNER: RODGER J BIASCA PHONE: 206-913-9266
STEVEN G LLORENTE JTWROS
4335 THACKERAY PL NE
SEATTLE WA 981056122
SUBDIVISION: Block: Lot: T 15+
PARCEL NUMBER: 801334004 Section: 33 Township: 28 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: KEVIN COKER PHONE: 360-385-2739
814 GARFIELD ST
PORT TOWNSEND WA 98368
PROJECT DESCRIPTIOI NEW ADU W/ UNHTD SHOP
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADU MAIN: 720
VALUATION 175,000.00 ADD'L: HEAT TYPE: PRO
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3
OCCUPANCY: UNHEATED: #OF STORIES:
OTHER: 0
CONST TYPE: 5N GARAGE: 200 SHORELINE:
CONST TYPE: DECK: 332 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 1 Prop: 1
Total: 1 Total: 1
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,413.75 LYK 07/29/10 119859 APPROVE,'
Plan Check $918.94 LYK 07/29/10 119859
State Building Code $4.50 LYK 07/29/10 119859 JA,; 5
Total: $2,337.19 Jefferson County Planning
&Building Department
• •
CONDITIONS for Building Permit# :BLD10-00273
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 TARBOO SUBBASIN IN A DESIGNATED RESERVE MANAGEMENT
AREA; AS SUCH, CONSERVATION STANDARDS APPLY AS FOLLOWS:
1. A PERMIT-EXEMPT WELL SERVING AN INDIVIDUAL USER SHALL NOT EXCEED
A MAXIMUM OF 500 GALLONS PER DAY (GPD) OR AN ANNUAL AVERAGE MORE
THAN 350 GPD, FOR ALL PERMIT-EXEMPT USES AUTHORIZED UNDER RCW
90.44.050. (WAC 173-517-120(1)(B))
2. A WELL SERVING A GROUP DOMESTIC SYSTEM SHALL NOT EXCEED A
MAXIMUM USE OF 500 GALLONS PER DAY (GPD) OR AN ANNUAL AVERAGE MORE
THAN 350 GPD, FOR EACH RESIDENCE, AND SHALL NOT EXCEED A TOTAL USE
OF 5,000 GPD FOR THE GROUP. THE DESIGN AND CONSTRUCTION OF GROUP
DOMESTIC SYSTEMS MUST BE CONSISTENT WITH APPLICABLE STATE
DEPARTMENT OF HEALTH REQUIREMENTS AND APPLICABLE JEFFERSON
COUNTY OR CLALLAM COUNTY REQUIREMENTS. (WAC 173-517-120(1)(C))
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.) The applicant SHALL IMPLEMENT THE MITIGATION PROPOSAL as described in the
HABITAT MANAGEMENT PLAN (dated May 2010) prepared by WESTECH Company
that was submitt to Jefferson County on July 29, 2010.
3.) 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.
4.) A SILT FENCE SHALL BE INS•ED LANDWARD OF THE 117.6 FOOT *AM
BUFFER AND AS CLOSE AS PRACTICABLE TO THE CONSTUCTION AREA OF THE
ADU PRIOR TO ANY LAND DISTURBING ACTIVITY.
APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO MAKE SURE THAT SILT
DOES NOT ENTER THE STREAM.
THE MINIMUM HEIGHT OF THE TOP OF SILT FENCE SHALL BE 2 FEET AND THE
MAXIMUM HEIGHT SHALL BE 2 1/2 FEET ABOVE THE ORIGINAL GROUND
SURFACE.
THE SILT FENCE SHALL BE BURIED IN A TRENCH TO A MINIMUM DEPTH OF 5
INCHES BELOW THE GROUND SURFACE. THE TRENCH SHALL BE BACKFILLED
AND THE SOIL TAMPED IN PLACE OVER THE BURIED PORTION OF THE SILT
FENCE, SUCH THAT NO FLOW CAN PASS BENEATH THE FENCE AND SCOURING
CAN NOT OCCUR.
ANY DAMAGE TO THE SILT FENCE SHALL BE REPAIRED IMMEDIATELY.
SEDIMENT DEPOSITS SHALL EITHER BE REMOVED WHEN THE DEPOSIT
REACHES APPROXIMATELY ONE-THIRD THE HEIGHT OF THE SILT FENCE, OR A
SECOND SILT FENCE SHALL BE INSTALLED.
5.) 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.
6.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the
Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the
Landslide Hazard Area.
7.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated.
Should buffer disturbance occur during construction, the Unified Development Code
(UDC) Administrator shall require replanting with native vegetation. No alterations shall be
made to the Landslide Hazard Area or its associated buffer without prior authorization by
the UDC Administrator.
8.) Prior to and during approved construction activities, the perimeter of the landslide hazard
area buffer shall be marked with a temporary sign. The sign shall be placed in such a
manner that it can be directly observed from the construction area. The sign shall contain
the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter
Existing Vegetation."
9.) All construction activities shall not encroach upon the stream and landslide hazard area
buffers. This includes the storage or preparation of materials.
10.) The applicant shall permanently•arate the boundary of the Landslide HazSrea
Buffer from the remainder of the subject property through installing logs, trees, a hedge
row, or any other prominent physical marking approved by the UDC Administrator.
11.) 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.
12.) The identified Fish and Wildlife Habitat Area (Type F Stream), shall maintain a vegetative
buffer setback of 112.6 feet(plus 5 foot buildling setback= 117.5). The setback shall be
measured horizontally from the Ordinary High Water Mark (OHWM) to the proposed ADU.
13.) An additional setback of five (5) feet is required from the edge of the stream buffer area to
the proposed ADU.
14.) 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.
15.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
16.) 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.
17.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
18.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
19.) The building height is not to exceed 35 feet.
20.) Minimum setback from Coyle Road right-of-way shall be 20 feet. Minimum North and east
setbacks are greater than 250 feet from the commercial forest lands. The western
boundary shall be no less than 40 feet.
21.) 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.
22.) 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.
•
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,, o�1 JEFFERSON COUNTY
1 ao-
DEPARTMENT OF COMMUNITY DEVELOPMENT
lk
1' '.4 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
�N�foS. www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: (C -cX(tp
Project D scription(include separate sheet as necessary):
U L�) Li0 her *19 P
Tax Parcel Number: Sol 3'3 le7-c) Property Size: �7`Qw,e‘ (acres/square feet)
Site Address and/or Directions to Property: / ,.a?
3 y Q4,lit l ,6376
Property Owner(s)of Record: / B cm S c". 4 '12g.taLir yu,H1L,„
Telephone: Ze Fax: email:
Mailing Address: u-.. f/ ),JI N JJ j!D/o
Applicant/Agent(if different from owner)] /G,„,;,,, Co te.,/
Telephone: 3 FS 2739 Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies 0 Lot or Road Segregation
$uilding ❑Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use)
❑ Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or CI**
❑ Manufactured Home .0 Modular ❑Discretionary"D"or Unnamed Use Classification
❑ Commercial* 0 Special Use(Essential Public Facilities)**
❑ Change of Use 0 Boundary Line Adjustment
0 Address ❑ Road Approach 0 Short Plat**
❑ Home Business 0 Cottage Industry 0 Binding Site Plan'"
❑ Propane 0 Long Plat**
0 Sign 0 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)* 0 Shoreline Management Substantial Development**
❑Temporary Use 0 Shoreline Management Variance
0 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 AL_Jildmq___4 it —> P4.,z.Zi// r-1 Date: /tt1YlD Pt 2 01 d
By signing this application form,th wner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet
may result in this permit being null and void.
I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and
expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to provide access and right 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 cation that or he4ants prior notice.
Signature: Qr.., , ae", Date:A KKA 1 Y, 2 01 a
The action or actions Appli nt 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-transfer a responsi ity f adheting to and complyin zzESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: pP,., .. Date: 4/Aid,. Ai j.Z of i}
ill
• BUILDER STATEMENT
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the responsibility of the Genera ntractor for the proposed project. f
y� s G-�� /f Date: 4 v C, 2 A!G
Signature: 1 V Q 1
GENERAL CONTRAC R OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( ) `
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: /41,1e. -tYce PHONE ( ) 5av5"(0/ 0 FAX:( )
MAILING ADDRESS: EMAIL •
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
tyNew W Wood Existing: _ 0 Sewer
O Addition 0 Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel 0 Concrete Total: .1 Height: Ait,Individual System /
o Repair 0 Masonry SEP Permit# 10 --(OOP')
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: /9 Setback: A) Private well 0 Two Party
Type of Heat: Proposed: ❑ Public
p a
v oe- Total: Name of System:
If 1thisis 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: ` ?
T Underground Tank i Above ground Tank Size of Propane Tank:
i Heat Stove i Cook Stove I Woodstove i Fireplace Insert 1 Hot Water Tank i Pellet Stove i Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No c
When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all prope
lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system compon ,, i
including the reserve area. IP
;s$ r t , . , ,, i grn-,a E ,1s a , Y J f
, g` r7, x x 'i 21z... s .k,„- . Fi4 i
Square Footage Current Proposed ; 6 s _ 41 r :: A:., , `; g .] 1 'Main Floor Heated 720 EH Bld A.pp Review:
2 ' Floor Heated ,1 = Consistency Review:
Other Heated .' 1 Base fee:
H/3° 9
Mezzanine "`'" '' Additional Section:
•),,,
Z.
Wgil{ Plan Check fee: 9//T
State Surcharge fee: ,mil
Other Unheated '7' -.R ` # k Pot Water Review fee:
Garage/Carport �W�- '.fi SUBTOTAL
Decks ✓zJ 2 k ` .. 9)1 pprpa fee: /‘. 00
Other r s y l TOTAL: $ 3—�1• `q
y. ` 1 a
;;��,,,i Receipt Number:
t� Cash/Check Number:iftC
ESTIM ,. Date: _ )
•Fair ma Coet alue of all labor and mate ally ndation to finish �9
� �[j \ Initials:
G:\PemvtCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc
s •
146
JEFFERSON COUNTY
� DEPARTMENT OF COMMUNITY DEVELOPMENT
,. ,. 621 Sheridan Street • Port Townsend • Washington 98368
�s o 360/379-4450 • 360/379-4451 Fax `'= c;
ii7NG http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# 10 _(R(9 PROJECT/APPLICANT NAME: /24,4,4 /3 misc._
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 exis ing topo raphy. Indicate contours on the site map.
i/ / GArtlnl 1 4# $ S 4/ rl S.P /7oc xA-v�.S J s(2-3
3. Describe the exi tin vegetation. Indicate native vegetation areas on the si;e map.
s.s.. .1/4..
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, d indicate acreage each.
(a-r(rx,�, Gar • a
APPROVED
6. AADescribe any excess levels of noise generated by the proposed use or ac.ivity:STOR-MWATER ER PLAN
KV
InIii). JAN -5 am .
Required �1�� --. 41.
JEFFERSON COUNTY
DEPT.OF COMMUNITY DEVELOPMENT
stormwater site plan template—rev.10/21/2008 SIGNATURE: 5
• •
7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep slopes,etc.)on the site. Indicat location on the site map.
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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. .
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 site. Locate se facilitieson the site Ian a differentiate propos d faciliti from existing facilities.
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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" rojects or projects that involve he potential for dispersion of coggtami nts.]
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11. Describe the •-rformance a and standards a plicable to the r9jec
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12. D`e—scbe the flow con�tro'�glsyst� � � �� {-0
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stormwater site plan template—rev.10/21/2008 6
• •
13. Describe jhe water quality system.
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14. Describe the conveyance sy em analysis and design.r.epavo L;i:f2pctiAttAA.v t..,A,c...j....4.17,0 ,,,a1:11. 1 e-gt4c.,,,......_( "7015
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15. Describe the sou of fill material, ph ica characteristics of fill rr�teri , and deposition o excess material.
L42
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code
3/4 11A"-". ^..S LeS6Q+ C-Trt-r-j4
17. Describe the4proposrfaci material.
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18. Describe methods for restoration of the sit .
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. l V 4-
20. List here�a include any�specia�rep�studies conducted to prepare the Stormwater Site Plan.
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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
restricfoJ re. ?[sin,, r (94
r171uG42.1
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
develoi
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 .mits.
2. Establish Constr ction Access.
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3. C ntrol Flow Rates. 1
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4. nstall Sediment Contr s. e4,
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5. Sta rlize Soils.
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6. Protect Slopes.
7. Protect Drainln7let
srle146
stormwater site plan template—rev.10/21/2008 8
s i
12 Required Elements-Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
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9. Control Pollutants
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 Pr ctices aloof
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12. Manage the P���r�'jeIct. ,�,�,tT�'►�
2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas/ roads). /Gar / 1� //'LrsH-< Gn S ¢c k-_..�
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards). / t4 44
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3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive a as that are on or/adjacent to the te.
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stormwater site plan template—rev 10/21/2008
9
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b. Description of special requirements for wor ing inpr rear a vironmentally se 's 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. .,exodibility, sability, permeability,depth, ure, soil structure).
5. Construction Phasing.
a . ' . Lsc,
. Constru¢ctiion sequ��ce i
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b. Construction phasing (if proposed) •
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6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Ofide proposed construction chedu7 �.
II. Wet Season Construction Activities.
Proposed 1 t as seon co-Q- n/ .ve es/,
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/o other financial securities.
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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.
a. Sediment Ponds/Traps.
b. Diversions.
c. Waterways.
d. Runoff/Stormwater Detention Calculations
stormwater sate plan template—rev.10/21/2008 10
s •
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. J U L 2 9 LUIU
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 11
• •
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.
�- ✓ - 27- ib
(LANDOWNER OR AUTHORIZED REPRESENTATIVE 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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