HomeMy WebLinkAboutBLD2013-00024 BUILDING PERMIT APPLICION MLA13-00016
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD13-00024 Received Date: 1/22/2013
SITE ADDRESS: 5593 PARADISE BAY RD
PORT LUDLOW, 98365
OWNER: DAVID C CARBAUGH PHONE: 206-851-4278
KAREN J SCHOLZ
19700 NE 169TH ST
WOODINVILLE WA 98077-9484 BRIDGE VIEW ESTATE TRACTS
SUBDIVISION: Block: Lot: 5
PARCEL NUMBER: 821355005 Section: 35 Township: 28 N Range: 01 E
CONTRACTOR: OLYMPIC RIDGE INC PHONE: 360-302-0156
15940 LINDSEY LANE
POULSBO WA 98370
UA
Contractor's License OLYMPRI986NA Expires
REPRESENTATIVE: E.J. KLINKER PHONE: 360-302-0156
15940 LINDSEY LANE 360-598-3992
POULSBO WA 98370
PROJECT DESCRIPTIOI NSFR W/ATT GARAGE & A/G 500 GAL PROP TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 3,575
VALUATION 600,000.00 ADD'L: 223 HEAT TYPE: HTP
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 1,960 SHORELINE:
CONST TYPE: DECK: 1,486 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: 02043
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 3
Total: 3 —�
Routing Date: --
1—aa:1
Type Amount aid Bv: Date: Receipt: Approved/Date
Permit $3,281.25 LYK 01/22/13 139916 APPROVED
Plan Check $2,132.81 LYK 01/22/13 139916
State Building Code $4.50 LYK 01/22/13 139916 MAR 2 0 2013
Potable Water Application $66.00 LYK 01/22/13 139916
Jefferson County DCD
Total: $5,484.56
Mirlomor4\rlofe\fnrmo\C RI n Ann Ri- m1 1/99/0C11
JF -'hrson County 9 Buildin vision Permit Iber: BLD13-00024
Applicant: CARBAUGH
BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2009 International Building Codes
To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed.
Requests received after 3:00 PM will not be scheduled for the next 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 Minimum setback from Paradise Bay Road right-of-way shall be 20
feet. Minimum side&rear yard setbacks shall be 5 feet. The site plan
identifies a 50 foot setback from the top of shoreline bank per the
reocrded subdivision.
Erosion Control 4/24/? SEE CONDITION 2
Foundation Footing 1� (2) ,n ( ) _
Footing DrainsCO �Pt.
Foundation Stem Wall 15—c ..-(
Underground Plumbing
Under Floor Framing bl8.i2
C-J
Straps(hold downs) 9 L4 !3
Ext. Shear Wall Nailing // /ig
Rough-in Plumbing EL fl
Shower Pan 17- r
Framing p. i 13
Airseal 1 t l C3
Insulation:Walls 9 i3
Insulation: Floors
Insulation: Ceiling Iss.opep dari.ivc 6,.6117 goou OA // /q/d3
eCILI•ss 4,-rms gag_ MMSTER gat, done
Int. Shear Wall Nailing
AYrae,ve_ OS 6 5f4cr1_ W4cLS Or-, Q/za/r3
Wallboard Nailing 17i1r2-(13
Gas Line: Interior L / (-;
Gas Line: Exterior I 13
Ffm
Propane Tank01)
Heat/Chimney Clearance y 13
Mechanical Systems .i l , 1 3 y,
Duct Test Cert ecZ
'O L
Blower Airtight Test ( rg
Smoke&CO2
Drywell/Alt Drainage /9/l/ /)LS�CONDITION 1 FOR TRENCH
Address Posted 1/(/ 7
FINAL INSPECTION t\_'�
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD13-00024
1.) THE FOLLOWING MINIMUM LENGTHS (LINEAR FEET) PER 1,000 SQUARE FEET OF
ROOF AREA BASED ON SOIL TYPE MAY BE USED FOR SIZING DOWNSPOUT
INFILTRATION TRENCHES:
COARSE SANDS AND COBBLES 20 LF
MEDIUM SAND 30 LF
FINE SAND, LOAMY SAND 75 LF
SANDY LOAM 125 LF
LOAM 190 LF
MAXIMUM LENGTH OF TRENCH MUST NOT EXCEED 100 FEET FROM THE INLET
SUMP.
MINIMUM SPACING BETWEEN TRENCH CENTERLINES MUST BE 6 FEET.
FILTER FABRIC MUST BE PLACED OVER THE DRAIN ROCK PRIOR TO
BACKFILLING.
A VEGETATED FLOWPATH OF AT LEAST 25 FEET IN LENGTH MUST BE
MAINTAINED BETWEEN THE OUTLET OF THE TRENCH AND ANY PROPERTY LINE,
STRUCTURE, STREAM,WETLAND, OR IMPERVIOUS SURFACE.
A SETBACK OF AT LEAST 5 FEET SHOULD BE MAINTAINED BETWEEN ANY EDGE
OF THE TRENCH AND ANY STRUCTURE OR PROPERTY LINE.
NO EROSION OR FLOODING OF DOWNSTREAM PROPERTIES MAY RESULT.
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.) The kennels and grooming area in the home is approved by health for personal use only
and by a reasonable number of animals. The septic system is not designed for this type
of activity on a commercial scale.
4.) 10' minimum separation required between the water line and any onsite sewage system
components including sewage transport lines.
5.) Existing wells on site is not approved for potable water for this project. If the well is
unusable (as defined by WAC 173-160-381) it shall be decommissioned in accordance
with WAC 173-160-381 and comply with Jefferson County Health Department Policy
Statement 96-02.
• •
6.) To help prevent seawater from intruding landward into underground aquifers, all new
development activity on Marrowstone Island, Indian Island and within 1/4 mile of any
marine shoreline shall be required to infiltrate all stormwater runoff onsite.
7.) The property owner shall comply with Water Conservation Measures (per list maintained
by the UDC Administrator).
8.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the
Landslide Hazard Area for those areas located outside the 200 foot shoreline jurisdiction
as measured from OHWM landward. All buffers shall be measured perpendicularly from
the top or toe of the Landslide Hazard Area.
9.) A Geotechnical Report prepared by Craig White, Inc. dated October 6, 2005 was
submitted in conjunction with a SPAAD application (ZON10-2). An updated geotechnical
report prepared by GeoResources, LLC dated August 16, 2010 was submitted on
November 1, 2010 in conjunction with the SPAAD application.
10.) 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.
11.) 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."
12.) All construction activities shall not encroach upon the landslide hazard area buffer located
outside the 200 foot shoreline jurisdiction. This includes the storage or preparation of
materials.
13.) The applicant shall permanently separate the boundary of the Landslide Hazard Area
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.
14.) The site plan as submitted with the building permit application on January 28, 2013 has
been reviewed for consistency under the UDC, and has been approved by Jefferson
County Department of Community Development. Any modifications, changes, and/or
additions to the stamped, approved site plan dated March 20, 2013 shall be resubmitted
for review and approval by Jefferson County Department of Community Development.
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.) This parcel is within the Paradise Bay no shooting area per JCC 8.50.
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.
20.) 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.
21.) Minimum setback from Paradise Bay Road right-of-way shall be 20 feet. Minimum side &
rear yard setbacks shall be 5 feet. The site plan identifies a 50 foot setback from the top
of shoreline bank per the reocrded subdivision. Minimum setback from top of shoreline
bank is as follows:
The standard setback for residential structures, including common appurtenant structures
such as garages and workshops, shall be thirty (30) feet or one (1) foot for each foot of
bank height, whichever is greater. This setback shall be measured from the bank's edge
when the bank's height exceeds 10 feet. When the bank's height is less than 10 feet, the
setback shall be measured from the ordinary high water mark. The setback shall not
exceed 100 feet.
22.) The building height is not to exceed 35 feet.
23.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
24.) Maintaining ground cover will help reduce erosion from surface runoff. Any bare areas
that develop should be revegetated. Native low growing vegetation that requires little or
no irrigation would be the most beneficial.
25.) Tree limbs, lawn clippings, etc. should not be thrown over the bluff because these piles
have a tendency to damage/kill the underlying vegetation which in turn increases the
erosion potential of the bluff soils. These piles also add unnecessary weight to the bluff
soils, especially when saturated with water.
26.) Silt fences or other sediment control devices may be needed during construction such that
sedimentation off site does not significantly exceed predevelopment conditions. Standard
erosion control best management practices (BMP's) should be utilized as necessary to
prevent erosion and off-site runoff. Temporary stabilization might include silt fences
and/or hay bails or straw waddles staked with rebar. Permanent stabilization might
include replanting, mulching or gravel.
\\tidemark\rtata\fnrmc\F RI f) Parmit Rlrin rnt 71/7n/9(11R
tormwater;�MP's
Re uire ;,
.. r-(fUvt'i li if s 14004'0 „ Hood Canal p q _
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M' N � \\ DrirT.OF cG►MMUN1TY DEVELOPMENT •
'n \ 100' SIC ATUREt _ ,
°ape \_--., " L\\ \ O0 . _
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Top of slope =` \ �\�
50 ft geo setback --, �
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' 1EFFERSOi:COUNTY
'� NTT.OF COMMUN!TY DE�'FtPMENT
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�fNew Drive -
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[site verify] - - 4 '(Y
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20 Access easement '-'-' -_�� Co
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Paradise B Road __
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Property extends both sides of road
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Bridge View Estate Tracts
Lot 5
Address: 5593 Paradise Bay Road ®�G
Jefferson County Tax ID:#821-355-005 co�� ,e
Refer to Geological Report for set-back&construction information �4® ®®�
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Schematic Site Plan ®®��l�a3� . 'emack''°
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Scale: 1"= 100 ft ;y �
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(:-I-TS
. -OL JEFFERSON COUNTY
' ', `rA DEPARTMENT OF COMMUNITY DEVELOPMENT
W � � ' —
"' C 621 Sheridan Street • Port Townsend • Washington 98368
itop360/379-4450 • 360/379-4451 Fax
j www.co.jefferson.wa.us/commdevelopment
1`riiIN
Master Permit Application MLA: I
Project Description(include separate sheets as necessary):
.Al '4 i /10-n-e-
Tax Parcel Number: C - jS-x-- ., 5.) Property Size: .. 'Z v ,,,,,,. (acres/square feet)
Site Address and/or Directions to Property:
•S-cc,1 r�cAt .u_Qld ra c 1 p .-ct. J (�(- C,,�Q(ut.J
Property Owner(s) of Record: .0,CZ,� c 'O, IQ ntu S,L i ,c vivr a:l .rail p j Z
Telephone: . c'J'(0 •- 1R-C-( - -r)_ ?' Fax: email: p,i- Q 1,,7„,..; Al.(, watt
Mailing Address: 1C000 ,l,r.�_ /6c' -` s'-i- (A.)00,9, i.,./i. , tfr, . 44-d77-y 'eq
Applicant/Agent(if different from owner): Y. ,[.e/L e,,,„ - 04/14: ,ri* 71,:_
Telephone: 770 " a - Dtr-G Fax: 76o-G2C,--/c17 to email: PJ w CXy4,,�,c 1�3 .ca...
Mailing Address: P 7/ 4/• - i-Z/swot Acy.. 1 u lrLn ex)w _ Y ' o
What kind of Permit? (Check each box that applies 0 Lot or Road Segregation
(Ai iilding 0 Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance asonable Economic Use)
(a'Sin nu Family ❑Garage Attached/Detached ❑Condition I; � ec �YL 0 Manufactured Home .0 Modular • - ❑ Discretio I
❑ Commercial* 0 Special U et(,E sential Pub—ITc FacT le I
❑ Change of Use 0 Boundary Line Adjustment
❑ Address 0 Road Approach 0 Short Pla ** •: ,/ ,' ` 1
❑Home Business 0 Cottage Industry 0 Binding ite Plan** 11
0 Propane ❑Long Pla ** U i i 1
❑Sign 0 Planned)-turai Resr RRD)Amendments**
❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/R ter4Krpi%il,;,,n t,•l,,. np,, n
❑Stormwater Management ❑Shoreline Ma`sferPro lam Exerttpti� visions**
❑Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Substantial Development**
❑Temporary Use 0 Shoreline Management Variance
❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment
❑Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment
*May require a Pre—Application Conference 0 Tree Vegetation Request
**Requires a Pre-Application Conference
Please identify any other local, state or federal permits required for this proposal, if known:
_o
DU IGNATION OF AGENT
(
I hereby designate i•. V .0(Ct 'Olt.,,,j,..c /l.' to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE - / Date: Yoft ao!2--
By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet
may result in this permit being null and void.
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 a entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any required la spections. St s access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the applicati h r e wants prio notice.
Signature: -! Date: /— i c.— /2_,
The action or action licant will ake 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 viola efhe FSA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you are in co lance with the fferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transferable respo sibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: Date: /—7 te—i Z
, . 1
• • •
BUILDER STATEMENT
The signer of this statement does cb ify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the onsibility oft General Contractor for the proposed project.
Signature: Date: f—ig —i.)
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
MAILINGAbD ss - -1(-- `/ 760 ) ^0? —o/r�,r� -Pr�c) ) G.24- r61,C,
a 7/ lfl=- J z4irGri7 /)i. AI 44) Ewa: `VC Vl yi.i lI.r4-,c ;ri.by,.
CONTRACTORS LICENSE WAINS
NUMBER: L 24'��� �7. N� NUMBER
ARCHITECT/ENGINEER: �� �� 6- lh PHONE
MAILING ADDRESS: O ,,5 ,e f"tic L7-(� ) yl5,r FAX:( }—
Z',f EMAIL 6"
Prole Type: Frame Type: Bathrooms: Shoreline: °f Type of Sewage Disposal:
ew mood Existing: —c- E Sewer
Addition ❑ Steel Proposed: 3 Bank Li ommunity System
❑ Alteration/Remodel ❑ Concrete Total: '3 _ Height: Vlndividual System
❑ Repair ❑ Masonry apn / SEP Permit# ,friou•)-(91 ?66_
Demolition ❑ Other: Bedrooms: Water Supply:
Existing: 0•— Setback: ❑ Private well C Two Party
Type of^He Proposed: Z ;'Public
1 (-J,. �„G� Total: 3 S'b Name of System: Akio (
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:
i Underground Tank above ground Tank Size of Propane Tank: Qy) --
i Heat Stove rJook Stove i Woodstove JjFireplace Insert OHot Water Tank i Pellet Stove i Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes /0
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 5 EH Bld App Review:
" C
"
7E3
2`a Floor Heated
�q Consistency Review:
a D 3 2Z Z2 -
Other Heated
Base fee: e"
—o 212_�
Mezzanine Additional Section:
Heated Basement Plan Check fee:
°— c9(3a SI
Unheated Basement State Surcharge fee: sc)
Other Unheated —�_ Pot Water Review fee:
Garage/Carport SUBTOTAL
Decks ��0 911/Rd Approach fee: _
act.1 sS 1 t$ EXt S-ri cci
Other c ve l(�S' 33�(US'� TOTAL: $
Receipt Number: 15gG 1
(40
Cash/Check Number: I
ESTIMATED COST(REQUIRED) Date: � --1.
•Fair m rket value of all labor and materials foundation to finish I�2;2
I( ) � rfk7 Initials:
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ON �,O6,4. JEFFERSON COUNTY
►•,rt
► DEPARTMENT OF COMMUNITY DEVELOPMENT JJ
1.
621 Sheridan Street • Port Townsend • Washington 98368 `
� 1rfrERST.:
1 O 360/379-4450 • 360/379-4451 Fax nr C '": :U^,STY'; v';T I
$7N http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# I --( `Q PROJECT/APPLICANT NAME: Can 6u,,.{iT — , ,_ Grp %2
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. l' ,/ Jr/{jam Kn fv 0.1 `lrV t /-2 , i,.., o _ C.v./-
Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
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3. Describe the existing
v_egetation. Indicate native vegetation areas on the site map.
,
4. Describe the existing soils. Indicate soil type on the site map.
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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 creage of each. /► �J
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6. Describe any excess levels of noise generated by the proposed use or activ ty: APPROVED
STORMWATER PLAN
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Stop u� r � M % 2013
Req ,
JEFFEP ON COL."TY
DEPT.OF CVO. ; FFY DE ELO MELT
stormwater site plan template—rev. 1N21/2008 SIGNATURE: 1 / 5
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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.<, , ..J4. , lc 6i,A. 7H.0 r-.- ) (9 ) ,
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.). r
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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.
9. 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./
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.]
—v -
11. Describe the performance goals and standards applicable to the project.
____ u___
12. Describe the flow control system.
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stormwater trite pVtemplate—rev.10/21/2008 6
3 •
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13. Describe the water quality system.
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14. Describe the conveyance system analysis and design.
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15. Describe the source of fill material, physical characteristics of fill material, and deposition of excess material.
—
16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code. Ja
17. Describe the proposed surfacing material.
18. Describe methods for restoration of the site.
19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for
"large" projects only and only those for which facilities are required to control flow or treat runoff.] If included, list the Manuals
here.
20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
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.
stormwater site plan template—rev.10/21/2008
7
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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.
2. Establish Construction Access.
3. Control Flow Rates.
-0-
4. Install Sediment Controls.
5. Stabilize Soils. (( /�,/ /�
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6. Protect Slopes.
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7. Protect Drain Inlets.
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411 .
12 Required Elements— Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
—U
9. Control Pollutants.
10. Control De-Watering (the act of pumping groundwater or stormwater away from an active construction site).
11. Maintain Best Management Practices (BMPs).
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12. Manage the Project.
2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas, roads).
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.
stormwater site plan template—rev.10/21/2008 9
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b. Description of special requirements for working in or near environmentally sensitive areas.
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4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site
soils (e.g., erodibility, settleability, permeability, depth, texture, soil structure).
5. Construction Phasing.
a. Construction sequence
b. Construction phasing(if proposed)
6. Construction Schedule. Wet season is October 1 through April 30 (page 2-21 of the Manual).
Provide a proposed construction schedule.
II. Wet Season Construction Activities.
a. Proposed wet season construction activities.
b. Proposed wet season construction activities for environmentally sensitive areas.
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7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for the initiation of bonds and/or other financial securities.
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.
a. Sediment Ponds/Traps. '"O
b. Diversions.
c. Waterways.
d. Runoff/Stormwater Detention Calculations
stormwater site plan template—rev.10/21/2008 10
• •
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.
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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
l—/4>—/2
(LANDOWNER OR AU ORIZED REPRESENT 516NATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
stormwater site plan template—rev 10/21/2008 12
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