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HomeMy WebLinkAboutMLA07-00211 JEFFERSON COUNTY ribk-NN:s\itfii, D EPARTMENT OF COMMUNITY DEV 1T�. ,'' l 621 Sheridan Street • Port Townsend 'V11athjngtor : is*• _ ,�' 360/379-4450 . 360/379-4451 Fax AD www.co.jefferson.wa.us/commdevelopment '14611INOP _, Master Permit Application MLA: Y_al Project Description(include separate sheets as necessary): _,. ...,m f" NEIN MAN UFAcAR.E' NOn Tax Parcel Property z Number: qO( 341Z 09(2? Size: 5 3 7I goon. (acres/square feet) Site Address and/or Directions to Property: 3750 W, V'4GLY OA-D MA -C-0M/W A 9R 37.-5 Property Owner(s)of Record: C41 AR Lcr7 6 UMM E2S Telephone: 2Q0 335 86721 Fax: email:Sum Me_, Afit^L h'fMt+4#4 Mailing Address: 3f(o W, OLYMPIC 91. 0-4 rEk7TZf, (/vii. 94E3f(q Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) )d;Building I Variance(Minor,Major or Reasonable Economic Use) I Demolition Permit I Conditional Use[C(a),C(d),or C]** I Single Family I Discretionary"D"or Unnamed Use Classification I Garage Attached/Detached I Special Use(Essential Public Facilities)** XI Manufactured Home I Boundary Line Adjustment I Modular . I Short Plat** I Commercial* I Binding Site Plan** I Change of Use I Long Plat** I Address I Road Approach I Planned Rural Residential Development(PRRD)/Amendments** '>4 Propane I Plat Vacation/Alteration** I Allowed"Yes"Use Consistency Analysis I Shoreline Master Program Exemption/Permit Revisions""' I Stormwater Management I Shoreline Management Substantial Development** I Site Plan Approval Advance Determination(SPAAD)* I Shoreline Management Variance I Temporary Use I Comprehensive Plan/UDC/Land Use District Map Amendment I Wireless Telecommunication* I Jefferson County Shoreline Master Program Amendment I Forest Practices Act/Release of Six-Year Moratorium *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's 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 application that he or she wants prior notice. f l, Signature: d:!.LMC_' `�ia.La.►-a► Date: . /_ The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable responsibility for adhering to and co lying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: �a,✓r!f 11., Q¢_ CAA- Gt hQ.,0 Date: ■ fr,. G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 07-14-2006.doc , r s. 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 General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: j KD$-e-L.)51Qf5 ROME- 5ERv(C ( ) ads 32i5- ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ,$ New XT.Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank Community System ❑ Alteration/Remodel ❑ Concrete Total: _ Hei ht: ,.,Individual System ❑ Repair 0 Masonry (VGA SEP Permit# ❑ Demolition o Other: Bedrooms: Water Supply: Existing: Setback:___,„5___ Type of Heat: Proposed: ifN Private well 0 Two Party ❑ Public pro pa,y1.2, Total: / 6 lA Name of System: If this is a Commercial Proiect 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: l Underground Tank 5(Above ground Tank Size of Propane Tank: /00 C7i1-L. i Heat Stove i Cook Stove i Woodstove t Fireplace Insert 1 Hot W. er Tank t Pellet Stove i Other Ftl(RNAc& Is this appliance being installed in a Manufactured/Mobile Home? 451(47n 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 (f p , i - , _ ,; ,; ,p Main Floor Heated EH Bld App Review: 68 .00 2M Floor Heated Consistency Review: Other Heated , ` _ , ( ��' �© Base fee: Mezzanine , 4 Additional Section: Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: q3.00 Garage/Carport SUBTOTAL 411, od Decks ° 911/Rd Approach fee: Other � — TOTA $ 477 Receipt Number: (31 4, ''i Cash/Check Number: . H;:: 49 i1q-7423 ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish A,_j, Initials: 4 � G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 07-14-2006.doc , coo, JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT `a 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax ECEIVEU P Master Permit Application M of c 7 Project Description(include separate sheets as necessary): 7et Tax Parcel Property t,avthat . OD Number: Size: (acres/square feet) Site Address and/or Directions to Property: Property Owner(s)of Record: Telephone: Fax: email: Mailing Address: Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Building ❑Variance(Minor,Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]" ❑Single Family ❑ Garage Attached/Detached ❑ Discretionary"D"or Unnamed Use Classification ❑ Manufactured Home ❑ Modular ❑ Special Use(Essential Public Facilities)** ❑ Commercial* ❑ Boundary Line Adjustment ❑ Change of Use ❑ Short Plat** ❑ Address ❑ Road Approach ❑ Binding Site Plan** ❑ Home Business ❑ Cottagelndustry ❑ Long Plat** ❑ Propane ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Sign ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance ❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetaion Request *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's 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. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the ap lication that he or she wants prior notice. / Signature: (��'1,a.4449- to, 56(.01 yi2.# Date: q/{2/ o 7 The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: (i/iQii'�'0 sexp,f?l.O'5 Date: / //2 A,7 G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc 4. 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 General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: 0 Private well ❑ Two Party Type of Heat: Proposed: 0 Public Total: Name of System: If this is a Commercial Proiect 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: Underground Tank I Above ground Tank Size of Propane Tank: Heat Stove Cook Stove Woodstove i Fireplace Insert j Hot Water Tank Pellet Stove Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size, distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed '�ceU se O ._«,,,-. q '„k N Re ri _ 4 ,, Main Floor Heated = EH Bid App Review: 2"°Floor Heated Consistency Review: Other Heated � Base fee: Mezzanine Additional Section: Heated Basement <•< Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks `' 911/Rd Approach fee: Other TOTAL: $ Receipt Number: xt Cash/Check Number: ESTIMATED COST(REQUIRED) Date: .Fair market value of all labor and materials foundation to finish Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc BUILDING PERMIT APPLICATION MR A07-00211 vi wT pe:I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00184 Received Date: 4/30/2007 SITE ADDRESS: 3756 W VALLEY RD CHIMACUM, 98325 OWNER: CHARLOTTE SUMMERS PHONE:206-335-8621 PO BOX 654 CHIMACUM WA 983250654 SUBDIVISION: Block: Lot: TX10' PARCEL NUMBER: 901342009 Section: 34 Township: 29 N Range: 01 W CONTRACTOR: KOZELISKY'S HOME SERVICE INC PHONE: (360)385-3215 1112 S JACOB MILLER RD PORT TOWNSEND WA 98368 Contractor's License KOZELHS027C3 Expires 1/6/2009 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI NEW M/H -CORONADO (SER#0321073) TYPE OF WORK MOB SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: CODE EDITION: 2003 ADD'L: HEAT TYPE: PRO OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL �j ) J� BEDROOMS: BATHROOMS: ,/ l V Exist: 0 Exist: 0 &r..?t'6Vti Prop: 1 Prop: 1 Total: 1 Total: 1_ V >�JO�V'` a :.>� ' Routing Date: 1--,, - 1 0 1 (- ------- ----_ e --LT.r - 0- R Type `�74rrt6uT1"t Paid Bv: Date: Receipt: Appr ve t "- Manufactured Homes $163.00 LYK 04/30/07 89920 �� Potable Water Application $58.00 LYK 04/30/07 89920 ' v r_ pP Total: $221.00 j2--'6"- 1 I CASES, FINDING, CONDITIONS, PERMISSIONS FOR Parcel 901342009 Printed: May 14, 2007 Cases Name Review Type Status Planner BLD07-00184 MLA07-00211 SUMMERS I P Application Received: 4/30/2007 Permit Issued/Case closed: Case Finaled: NEW M/H -CORONADO (SER# 0321073) 1.) Building application will utilize a minimum of 240 gallons per day for the septic system. Existing septic permit SEP94-29 is for three bedroom, there is no additional capacity for an ADU on this septic system. SEP94-00029 SUMMERS F Application Received: 2/4/1994 Permit Issued/Case closed: 2/17/1994 Case Finaled: 3/3/1995 1.) MAXIMUM TRENCH DEPTH 12 INCHES 2.) Drainlines are to be installed along the natural contours. 3.) Divert all sources of drainage away from septic tank and drainfield area. 4.) Maintain a minimum of 100 feet from individual wells and 5 feet from property lines with the drainfield areas. 5.) All components of the septic system are to be completely protected from vehicular traffic or mechanical disturbance. Protective barriers are required around drainfield areas. 6.) Contact designer prior to installation for staking of drainfield area. 7.) When/if designated reserve area is utilized an alternative system may be required. USR07-00025 SUMMERS F Application Received: 2/27/2007 Permit Issued/Case closed: 5/10/2007 Case Finaled: 5/10/2007 3756 West Valley Rd No findings, conditions, or permissions found. Page 1 of 1 lofl Parcel Print Page 9xvc Parcel Number: 901342009 07/26/2006 Owner Mailing Address: CHARLOI ii:SUMMERS PO BOX 654 CHIMACUM WA 983250654 Site Address: Section: 34 School District: Chimacum (49) Qtr Section: NW1/4 Fire Dist: Chimacum (1) Township: 29N Tax Status: Taxable Range: 1W Tax Code: 211 South Planning area: Chimacum/Inland Valleys/Center(6) Sub Division: Land Use Code: 9100 - VACANT LAND Property Description: S34 T29 R1W I TAX 10 TR 3 OF SURVEY V7/P70 httn://vnvw.00 jcfferaou.rvaus/aaocosora/»uzoeknuzcc|pciu{.asp?yABCEL N[)~~401342009... 5/I4/2007 Map Output Page 1 of 3 Features not surveyed 711,1 44":+t 90134202 901342027 101342001? 901342001. ("7"14 901342003' ,1342016, 901 ,';` 901342007!' • r/r i �•/fir 90134201 901342017 90134202 jri / :f f fF r(r : :``r' /' 901341004 .40134202' 901342006f / 90134c �f ysf•` r``J.%`: r { 901342023 fe,2 !-•'i' :r`r'' ' ',: rFr 901342019 .941342011`:. 9013420101: '901343002 �y Uaps Granted M lCYGtS01 Cauny CaY�ss S Q fu[a5 t�S 9 901344001 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.... 5/14/2007 3> -I )E X fi 0) co -1 -13 x -I --I CD O1 -. _. 0) v C) 01 X a C7 r+ X 0) C) -3 -a 0) 0 - -O -3 -3 C) CO < 0.. CD CO 0 (D U) CC -- CD CC CD CD C CD r+ C) CD - O 7C X -3 E -S .. CD 3 0 0 # C C N CD C7 CD y - ") 0. C o 01 41. _+ C) • C) CA) C • ---` CO CO • C C C 3• • 3 W • -A • C ro CD C C:l1 C < CO o CD O r+ - CO U) C) -0 C) C) r+ C -1 Cl) G) = C) = C) -0 C 3 3> CA) CD H D X 0) () 3 X - o X CO 70 13 CO m a o r r co -I 70 -I C) 73 co, X co m X Cl) o ro o_ m C) C --I -4 - CO 3> 3 X rn -I m ro r o uI m -1 C7 -I 7o CD -P. D D = 70 -� o -o C Cf) o \ X D x -. X M C C7 3> 70 CO C,J C) a X 73 CO r - v m 3 rn I- C) o ro rn = m Cl) m -I T C 73 CL CD 7o C.0 -I CA -I CO Cl) m CO ry -< M w M c -. N H xi C) 3 O C Z E 3> Q- I C C7 r Ill Cl) o C o 0) -< -1 E rn M c o rn CrI a 70 -P y o c CL CO v CD CD -.1 0 CO 0 Cows. o -I -I 3 worms v v r O O n 3> C7 C) C) cr D C) ? _ = C 3> CO CO hi a r+ 1 Z C 0 m -I c o c) 7 N r+ ca. m 3 O. r 0 0 7 •-•-3 n -r' - a o Z 7C D) N - CD -I, t Cl m co .. .. r — CO r CD H O - I1 Z C - T .o co C CO I-I .P. 7C) Ual �lvg -10 t RECORD OF SURVEY 1 of a portion of the NORTHWEST I,4section 34. township 29 north, range I WEST .w m. jefferson county, washington. for FREDRICK 81 CORDALAYNE VAN DYKE 27 NW%4COR.SECTON34 r� .33 ,34 d 5■ GB.Si N89'47'/O"W 22/2.9/ ) I I 582./4 -..- \ 469.96 -�' 492.30 r� NO'/9'4,�E 30 e /0.50 0 \ o f 0 z�\ h S �, /)) 1, V O. _% TRACT 3 ti'9 S J^ 9.23 ACRES C 5.0/ ACRES N TRACT RD 2 �0 t90o n .O Ha Z tiR P o It 4 ha. D 6 2 31 ` �..."""'_--- '10. - 4 363.30 \ R- 3/44 %- b /06.66 \1 "F---- 4 /D 6 p " 5 N89.47'//'WY 786.40 51.0, t t,s4lb ry i; �- .59'-54-5.4 5/ 679.1$ Q �, TRACT l OP a -s—— 663,8 , o \ -'\ l \ NB9'S4'54"W /341.05 /S__ ' I 5.63 ACRE-5(EO RD. c4,Ni% 'V /j ' d Ael•13 (�0 1 N / L . SCALE /""l00' 2 3 S44 WALLOP Of SECT Y#t4-r4-ccwc NR//. I ` v i Q b j ! ,-.:.../ / / vgr y J lit' C CD LEGEND N / '� •_SE 7' 3/8"RE6AR W/713 1.5 206 41.�/ / o NYLON/DENT/F/CAT/ON CAR ' A- Q=EASEMENT FOR ACCESS ANO ur/L/r/ES. J \IIII /"O RN/JED .o-ac-es Q .e, �,• auditor's certificate. auditor's"' zazssv surveyor's certificate .F"sw;AR co TAA S„ . z....,.... '�ti ����Q aa...aasasaa ?14d far hoard Mle �LdaY o} n°G^"�� .19a�: at this map corrsctly rpnsantn a�urvay.mad.Dy ma or o y .. ..2 P m. In Dookof eurveye at pope_70 under my dinotlon m con}armanoe with iM naWremenri ^' '1 �]ss�ciatQS at the request of ALAN S. CARMAN. of the SURVEY RECORDING ACT at t request of t° bwn' c k'd I FREDRICK 4 CORDALA/NE VAN DYKE r a•+� .-/of l C.✓W 'Asc. , naL�A.�L/yppJrA In JUNE .Ifi6i�. o dole.J(////,/935 County audlfor by y alas e"carman.certUloari no. Map Output Page 1 of 1 ArcIMS HTML Viewer Ma ., ;:t 901342021 slrr 90€3420)4 901342001 1 901341002 Min 1 901342001 —Hi 1---- -- i:" 901342005 901342003 Legend n Selected Feati -- _ ET Parcety H �I I 1111 Wetlands 9013420'5 , ! ? FE MA FIRMS 901342'0/6 9ft09 901342024 - 901342007 , ZI rim phll i . 901342014 --_i I Mr- . . 4tvs 90134201? Boundaries 901342025 '34'00.4 El ss:nioily 901342021 901342022 0 '.vim 901342013 I-1 901342008 ,fir Castes I 901342018 X901342023 9013420901342019 1941342411 1 901342010 — 901342012 _— _ 901343003 90134'M-05 343002 901343001 90 211.1'' 'Ao,:raw 4=d try.r`+:rc�:'1Cuac>. -r3 ..... .>t5 r}— FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respec correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Tue May 08:21:15 2007 14)13.A \i\itr(" r (l' i 1 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.0... 5/1/2007 Map Output Page 1 of 1 FEATURES NOT SURVEYED -BLD07-00184 olit 1 N- t — w i ' t t 1 411 ill. 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Mon May 14 14:41:25 2007 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.0&Form=True... 5/14/2007 ., � ° JEFFERSON COUNTY E x DEPARTMENT OF COMMUNITY DEVELOPMENT �,[4� , 621 Sheridan Street•Port Townsend•Washington 98368 L. ..a"�� 360/379-4450.360/379-4451 Fax httpJ/www.co.jefferson.waus/commdevelopment/ Stormwater Calculation Worksheet I ra.n# _a.I I PROJECr/nPPUCAwr NAME: GHRRI -Cam MERE I DETERMINING STORMWATER MANAGEMENT REQUIREMENTS:This stormwater calculation worksheet should be completed first to classify a stand-lone lras"small,"Inectum,•or large." The size determines whether a Stormwater Site Plan is required in conjunction involves stormwater review. The asic information will also be helpful for permit application, or other land use approval application that completing a Stormwater Site Plan,if required. PARCEL SIZE Q.E.SITE) Size of parcel acres An acre contains 43,560 square feet. Multiply the by this acreage y figure. sqffl Size of parcel in square feet 217 600 Land-disturbing activity Is any activity that results In movement of earth, or a change in the existing sod cover(both vegetative and non-vegetative)and/or the existing soil topography. Land disturbing activities include, but are not limited to dean excavation,and compaction associated with stabilization of structures and road construction, n9, grading,filling, Native vegetation is vegetation comprised on plant species,other than noxious weeds,that are indigenous Pacific Northwest and which expected to naturally is the coastal region of the Douglas fir,western hemlock, could have been a raNy occur on the site. Examples include species such as and Douglas herbaceous �'wester red cedar,alder,big-leaf maple,and vine maple;shrubs such as willow,elderberry,salmonberry, plants such as sword fern,foam flower,and fireweed. LAND DISTURBING ACTIVITY.CONVERSION OF NATIVE VEGETATION.AND VOLUME OF CUT/FILL Calculate the total area to be excavated for compacted f proper sthe f native two questions related to project in this calculation the area to be cleared for. conversion of native vegetation: r Construction site for structures O O Does the project convert%acres or more of NM native vegetation to lawn or landscaped areas? Drainfeld,septic tank,etc. EX/5T7 NCB sg4t Circle: Yes No ) Well,utilities,etc. 00 sq/ft Does the project convert 234 acres or more of Driveway,parking,etc. :3(X 2O native vegetation to pasture? Lawn,landscaping,etc. 0 Circle: Yes sgift CIO Other compacted surface,etc. U sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance 41000 sq/ft Cut Fill (cu/yd) [over) atommater calc worksheet—REV.1On/2003 l • Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow from the flow present under natural conditions prior to development. Common impervious surfaces include,but are not limited to roof tops,walkways, patios,driveways,parking lots or storage areas,concrete or asphalt paving,gravel reads, packed earthen materials, and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater. STORMWATER CALULATIONS—IMPERVIOUS SURFACE NEW EXISTING Structures(all roof area) 6241 sq/ft Structures(all roof area) 21 sq/ft Sidewalks 0 sglft Sidewalks 0 sq ft Patios 0 sq/ft Patios 0 sq/ft Solid Decks sq/ft Solid Decks 0 sq/ft (without inliiltrahon below) (without infiltration below) Driveway 30 b D scvft Driveway 0 sq/ft Other 0 sq/ft Other 0 sq/ft Total New 3 6 Z 1 sq/ft Total Existing 2/(ter sq/ft TOTAL NEW+TOTAL EXISTING" 3 e 30 sq/ft *This amount will be used to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v.REDEVELOPMENT „Divici9.1.neletel sgamirepandous surface.above by the size of the parcel and convert to a percentage: /..7-(=;? Does the site have 35%or more of existinq impervious surface? Circle: Yes (NO) FURTHER INSTRUCTIONS: If the answer is yes,the proposal is considered redevelopment and the attached Figure 2 should be used to determine the applicable Minimum Requirements. If the answer is no,the proposal Is considered new development and the attached Figure 1 should be used. At this juncture,the applicant should refer to the applicable Flow Chart to determine the Minimum Requirements for stormwater management. DCD staff will help verify the classification of.the project and the application requirements. For proponents of "smalr projects who must comply only with Minimum Requirement.#2—Construction Stormwater Pollution Prevention—an additional submittal Is not required. The proponent is responsible for employing the 12 Elements to control erosionlfnd prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwater Pollution.Prevention(SWPP)Best Management Practices(BMPs) Packet. Proponents of"medium"projects—those that must meet only Minimum Requirements #1 through #5—and for large" projects—those that must meet all 10 Minimum Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan, principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance In the Stonnwater Management Manual. APPLICANT SIGNATURE By signing the Stormwater Calculation 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. ?� E 4111 Jo7 (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) • (DATE) stomMIatercalc wolksheet—REV.1W112003 - 2 IRE CEIVElj " JEFFERSON COUNTY AFR 3 e 2r:(7 _ DEPARTMENT OF COMMUNITY DEVELOPMENT r 621 Sheridan Street • Port Townsend •Washington 98368 �I HS $I 3111111 OC 360/379-4450. 360/379-4451 Fax http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# Ore-) 1 PROJECT/APPLICANT NAME: G F-, R Lv777 st 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. pirio ctre a_ 5 lie -far a /Yl am cc fetCJUP.ce how.'3 L ( 6"-&,o 2 on et 5`a crepaste4 prod se-oldrt v. / wet!(b,c appko) • 25TH 'X /2' w Lolz Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. terrain IS Y4-'1'eo( eyt 5 O u//d fir% /S p rev posed oei Gt £ z I idYf7ol _ , 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. o r e • vie to �'�✓' ceda4e a lacfcG�e, r no 4. Describe the existing soils. Indicate soil type on the site map. MAY 14 3 Goaen a 4 b e ceea/ns w-et •Oi r, 5. Describe the existing site hydrology i.e.,drainage;behavior of water on the site—a: existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on "no- applicable,and indicate acreage of each. �Q-id(h ` h Or Weld- COrner- t�5-d.2- as _ - 6. Describe any excess levels of noise generated by the proposed use or activity: 4 b e x c55. no/se 1e t-e€.e c . S JZ#i,:es f,"! e ce.... von t rafinl 647y- Fe4,0 dt-aice stomawater site plan template—rev.10/1/2003 5 • . ., . 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. pP21.00,1 PAL /1/1 -ii 1/44A ae,Yiner 5141.,C /Ora/44,41r 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.). rn yr,,{ ' / (C. OL med ko rij- Wilt 12-6 OY) Ui s V / r YCArrYLG144� CorrivWt.M - kV rS kils rata/ I (74 kAks,/ 2 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. ALL :57'1°)R,t4 G(/r'7t I'NliL SSE nispgieser G7- 7c (A/1174 tdwAisfoolirt Gpo/Nc, tye.y s /,iJ f L Z. 7>IS.127eS STX,R44 WA-re-se pi2.e w+ /mss 14 FA- - - • 141.2✓1✓t 1 4, ' .1 I r-•u e •= se • stormwater treatment facilities,describe the types of stormwater treatment facilities proposed •r :"g 4, i• : the : facilities on the site plan and differentiate proposed facilities from existing facilities. [This is �� •••• s= pr.= or p •jects that involve the potential for dispersion of contaminants.] vimiy3 0100131111:0) tots VW 'escri s_ II •._:.=.us ti mes d standards applicable to the project. tthWr .11) 7451-1/4 7-14 C.•4/0) AK L-177z "45 Pass/ea., waif i.e. $/17/v£7 TF/"E /144/VGt K47,nee'f_)11-0 E. 12. Describe the flow control system. G /t efictAz ova S W(L L LI t s P82.5 E 0}-[4.1/'ATER. stormwater site plan template—rev.10/1/2003 6 t� 13. Describe the water quality system. iV/4 • F rN 1 . 11 1 9 Y 14. Describe the conveyance system analysis and design. �n urrEPS l,S774 - Gv/LL t 3Paw-rs 6o9rNCa fio t,R.ywVZ..cs F -) 51-D le,/1/l.wAr -0r UcV l-M, M (,ftO05 R- iJ + •b/Atm -ca✓' 36/ tt�-tf SID& OP A AAJ uc-Ac-nt a Fso M E' f✓V S7Llk1� o� &i tAIM��3� 2t' ID Rif VV 15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material. ANy AQ1ieWA-Y Ov2. 5 ITe Ci-14/VC) (A/7L-L '4 (,i) )fl - friS 1-7/n1C ?fit 12.)- 01teGei'r f -ie 12,4- A wN 7Z D 21 VE -/ 2 D/) 12 ' 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. D ofrettjory .J/L1- 6B t°12,4s 14-60 kvc g. m M.E> W I i1 E 'PLACED ON A- S Lpr6 .e Gi Jc1ec er 17. Describe the proposed surfacing material. KiRAMEZ- On) b,k.1 V WAY Gi cS' I A) fl4 18. Describe`methods for restoration of the site. R.E-Pt,4,1' C rEs !n7 c a--At 461 C4. Al up C9ASr rccrrc AJ )EB,eit,s 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. 4V/A"-- 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 1V/A- 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. 7tfl1 S 1`57 / 4 r iR,4-rnq'1(Zf stomnwater site plan template—rev.10/1/2003 7 V. 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 section 2.5.2 of the Manual(beginning on page 2-15). 12 Required Elements—Construction SWPPP 1. Mark Clearing Limits. {� rkw Aiewmi IA i Wii,L 6E- ,,44o(1151) To PA-c11.47-ppre- e-c2A)s-rieuuseiv 2. Establish Construction Access. 4'5 4a 2vr (9QA10 eX1575 3. Control Flow Rates. �f fr�f AAl $ ON YA-ND 4. Install Sediment Controls. ?-( C( 44«5 5. Stabilize Soils. A-PreR, GQvsri ucrion) L 6¢gs1CCovER 7 (o vie cc 6. Protect Slopes. 51 y- is T z 4-fAJG AHL1-1 Lv/1i-7-P s ,cie1.c P / aivsF_' (artu Albr 7A-lc€ u l° 4N'i11&pm TD S 7. Protect Drain Inlets. (.OMO- CQv(-&5 /N7v77 Paw) A armire. Rgbizs i&ss. stormwater site plan template—rev.10/1/2003 8 12 Required Elements-Construction SWPPP(continued) 8. Stabilize Channels and Outlets. N7A- /- ,I I S 9. Control Pollutants. POSH b3 L- WATER. Lou_ s 6 ON S CTE- 10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site). / boAf t--11'- Otis wi+Lt_ A 1✓ A-pie o L-e:AM 11. Maintain Best Management Practices(BMPs). 12. Manage the Project. WILL 8e oau 5f7j AND/ Jetku.n Ec azEZ.tsk.y W I L L ese S (-rte b(.ck(NG, 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). NOttejg th✓V r/--e EAST .S'iDE lc/DJ/Fe-a/0- 7a Pke PERsir J, 77 2 pre-oeer 2-7 z tore A-CAW/ =ipx�.ln 4 C41 01-1 f 1174-g b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). AN'y (NotA.Lb JGew 40 - WM T V 7= 131",ILISH s tre Ss 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. stormwater site plan template—rev.10/1/2003 9 b. Description of special requirements for working in or near environmentally sensitive areas. /11/A- 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). 4/e E rages-v Sod is 412-E 'p, y 5. Construction Phasing. a. Construction sequence 5' p-R.eR � ovo512 v � �e SET mAivu t=A au�e e,ffeivtc 10,6 -S S -0-7`C r b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction schedule. j tN /I40Ey ¢4 J ttiv 7,Z977 COM.PL W 009e 31)• II. Wet Season Construction Activities. a. Proposed wet season construction activities. / b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financlal/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. l2l-0 S u44e-s 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. b. Diversions. c. Waterways. d. Runoff/Stormwater Detention Calculations storm water site plan template—rev.10/1/2003 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 controVrestrictor 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.10/1/2003 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. 611a41,6&SIZAWW—PS (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)Wr/46,/°7 THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,IF NEEDED: r- stormwater site plan template—rev.10/1/2003 12 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT UNIFIED DEVELOPMENT CODE TYPE I LAND USE PERMIT APPLICANT: CHARLOTTE SUMMERS PO BOX 654 CHIMACUM WA 983250654 DATE ISSUED: IKA r ?�70' DATE EXPIRES: APi.( 1`I ,2..x54% MLA NUMBER: MLA07-00211 PROJECT PLANNER:Mo-chi Lindblad PROJECT DESCRIPTION: NEW M/H -CORONADO (SER#0321073) PROJECT LOCATION: Parcel Number 901 342 009, Section 34, Township 29, Range 1W, WM, Located at 3756 W Valley Road, Chimacum, WA 98325 CONDITIONS: 1.) Building application will utilize a minimum of 240 gallons per day for the septic system. Existing septic permit SEP94-29 is for three bedroom, there is no additional capacity for an ADU on this septic system. 2.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP) Elements#1 through#12 of the Department of Ecology's Stormwater Management Manual for Western Washington to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 3.) A Stormwater Site Plan for a medium project 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. 4.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 5.) 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 autormobile 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 requriements 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. 6.) Minimum setbcak from the edge of the ingress/egress easement is 20 ft. Minimum side and rear setbacks are 5 ft. 7.) 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. 8.) 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. 9.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 10.) The building height is not to exceed 35 feet. 11.) A minimum of two (2) on-site parking spaces are required for the single family residence. FINDINGS: 1.) The Administrator finds that this application complies with applicable provisions of the Unified Development Code,all other applicable ordinances and regulations,and is consistent with the Jefferson County Comprehensive Plan and Land Use map. 2.) The application was reviewed by the Jefferson County Department of Community Development for the presence of Environmentally Sensitive Areas(ESAs). The Department conducted a review and has concluded that the property DOES NOT contain Environmentally Sensitive Areas. However, future proposals will be subject to a new ESA review and conditions may be added if new ESAs are found on the property. 3.) The applicant is proposing to create or add 3624 square feet of impervious surface and 4000 square feet of land disturbing activities. JCC 18.30.060 and 18.30.070 require the project applicant submit a stormwater plan meeting Minimum Requirements#1 through#5 of the Department of Ecology Stormwater Management Manual for Western Washington. The stormwater plan shall address measures to control stormwater, erosion and sediment during construction and shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 4.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act(SEPA) pursuant to WAC 197-11-800(1)(b)(i). 5.) The site plan as submitted with the building permit application on April 30, 2007 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 May 14, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 6.) This approval is for installation of a manufactured home only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 7.) Jefferson County has determined that the use of real property for agriculture and forestry operations is a high priority and favored use in the county. The county will not consider to be a nuisance those inconveniences or discomforts arising from such operations, if such operations are consistent with commonly accepted best management practices in compliance with local, state, and federal laws. If your real property includes or is within five hundred (500)feet of real property designated as Rural Residential 1:10 or 1:20, Rural Industrial, Rural Commercial, Agriculture, or Forestry, you may be subject to inconveniences or discomforts arising from such farming and forestry operations, including but not limited to noise, tree removal, odors, flies, fumes, dust, smoke, the operation of farm and forestry machinery during any 24-hour period, the storage and disposal or manure, and the application of permitted fertilizers and permitted pesticides. One or more of these inconveniences may occur as a result of agricultural and forestry operations which are in conformance with existing laws and regulations. 8.) This parcel has been designated as Rural Residential 1:10 under the Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998. 9.) A septic permit(SEP94-00029)was finaled on March 3, 1995 for a 3 bedroom system. 10.) W Valley Rd (C514109) is a local access road. The road approach is existing and an address of 3756 W Valley Rd has been assigned to the parcel. 11.) Development Review staff conducted a site visit of the parcel April 13, 2007. The site visit confirmed the wetland as identify on the GIS mapping system is a manmade pond and there is no stream on site. NOTICE: This permit does not excuse the proponent from complying with other local, state, and federal ordinances, regulations, or statutes applicable to the proposed development. Development pursuant to this permit shall be undertaken subject to the applicable development and performance standards of the Jefferson County Unified Development Code. If during excavation or development of the site an area of potential archaeological significance is uncovered, all activity in the immediate area shall be halted,and the Administrator shall be notified at once. The Federal Endangered Species Act rules to protect threatened Chinook and Summer-run Chum salmon became effective on January 8,2001. Bull trout have been listed as threatened since early 2000. Under the ESA,any person may bring lawsuit against any individual or agency that "takes"listed species(defined as causing harm, harassing,or damaging habitat for the listed species). In addition,the National Marine Fisheries Service can levy penalties. All areas in Jefferson County are included as"critical habitat"for a listed species. Development of property along any marine shoreline,freshwater shoreline,or floodplains could harm habitat if protective measures are not taken. To minimize the potential to damage habitat,all property owners developing adjacent to marine shoreline,freshwater shoreline,or floodplains are advised to do the following: -Set back buildings,utilities and roads as far as possible from surface waters(streams,rivers,lakes,marine waters),or at least 150 feet from the edge of the water -All development activities should avoid unstable slopes,wetlands,and forested areas near surface waters -Remove minimal vegetation for site development,especially large trees -Allow trees that have fallen into surface waters to remain there -Infiltrate stormwater from buildings and driveways onsite through drywells rather than discharging directly into surface waters or roadside ditches Any individual,group,or agency can bring suit for a listed species"taking,"even if you are in compliance with Jefferson County development codes. The risk of a lawsuit against you can be reduced by consulting with a professional fisheries habitat biologist,and following the recommendations for site development provided by the biologist. For more information,contact the National Marine Fisheries Service in Seattle at(206)526-6613,or the U.S.Fish and Wildlife Service at(503)231-6121. APPEALS: Pursuant to RCW 36.70C,the applicant or any aggrieved party may appeal this final decision to Jefferson County Superior Court within twenty-one(21)calendar days of the date of issuance of this land use decision. For more information related to judical appeals see UDC Section 8.5.2. -1 A. inistrator MLA07-00211 u\ •D . . 3 n • Z z illiiiiiiiiiii11111111111-71111111111111111110111111110117- iiiiiii- '.Fri !EflhiEiH!!! M - ; ' . ��a�II®C��ic, --I • •-•11INIME111511111111111111F_Ill •- , i--1111111111111111111111111111111111 • •'i -I i 1 I - •-71-• ' • l''''. .' • PI ' • . 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ITj-- t5cc°11 z• ° T11-.. 90 -g 1 1 a.1 4 t O 1 v .1Q* '7Fli i "eg 3 vg A -1 414 5 3 i • E 0 1 •l t c a - 8• 0 4 4 4 0 0 0 0 0 0 0 0 0 2 '2 1 a.'i DRAFT - NOT A VALID PERMIT JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT UNIFIED DEVELOPMENT CODE TYPE I LAND USE PERMIT APPLICANT: CHARLOTTE SUMMERS PO BOX 654 CHIMACUM WA 983250654 DATE ISSUED: 51 V4`O-) DATE EXPIRES:'S I t, /(0 MLA NUMBER:MLA07--00211 PROJECT PLANNER:Mo-chi Lindblad PROJECT DESCRIPTION: NEW M/H -CORONADO (SER#0321073) PROJECT LOCATION: Parcel Number 901 342 009, Section 34, Township 29, Range 1W, WM, Located at 3756 W Valley Road, Chimacum, WA 98325 CONDITIONS: 1.) Building application will utilize a minimum of 240 gallons per day for the septic system. Existing septic permit SEP94-29 is for three bedroom, there is no additional capacity for an ADU on this septic system. 2.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP) Elements#1 through#12 of the Department of Ecology's Stormwater Management Manual for Western Washington to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 3.) A Stormwater Site Plan for a medium project 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. 4.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 5.) 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 autormobile 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 requriements 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. 6.) Minimum setbcak from the edge of the ingress/egress easement is 20 ft. Minimum side and rear setbacks are 5 ft. 7.) 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. 8.) 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. 9.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 10.) The building height is not to exceed 35 feet. 11.) A minimum of two(2)on-site parking spaces are required for the single family residence. FINDINGS: 1.) The Administrator finds that this application complies with applicable provisions of the Unified Development Code,all other applicable ordinances and regulations,and is consistent with the Jefferson County Comprehensive Plan and Land Use map. 2.) The application was reviewed by the Jefferson County Department of Community Development for the presence of Environmentally Sensitive Areas(ESAs). The Department conducted a review and has concluded that the property DOES NOT contain Environmentally Sensitive Areas. However, future proposals will be subject to a new ESA review and conditions may be added if new ESAs are found on the property. 3.) The applicant is proposing to create or add 3624 square feet of impervious surface and 4000 square feet of land disturbing activities. JCC 18.30.060 and 18.30.070 require the project applicant submit a stormwater plan meeting Minimum Requirements#1 through#5 of the Department of Ecology Stormwater Management Manual for Western Washington. The stormwater plan shall address measures to control stormwater, erosion and sediment during construction and shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 4.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act(SEPA) pursuant to WAC 197-11-800(1)(b)(i). 5.) The site plan as submitted with the building permit application on April 30, 2007 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 May 14, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 6.) This approval is for installation of a manufactured home only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 7.) Jefferson County has determined that the use of real property for agriculture and forestry operations is a high priority and favored use in the county. The county will not consider to be a nuisance those inconveniences or discomforts arising from such operations, if such operations are consistent with commonly accepted best management practices in compliance with local, state, and federal laws. If your real property includes or is within five hundred (500)feet of real property designated as Rural Residential 1:10 or 1:20, Rural Industrial, Rural Commercial, Agriculture, or Forestry, you may be subject to inconveniences or discomforts arising from such farming and forestry operations, including but not limited to noise, tree removal, odors, flies,fumes, dust, smoke, the operation of farm and forestry machinery during any 24-hour period, the storage and disposal or manure, and the application of permitted fertilizers and permitted pesticides. One or more of these inconveniences may occur as a result of agricultural and forestry operations which are in conformance with existing laws and regulations. 8.) This parcel has been designated as Rural Residential 1:10 under the Jefferson County Comprehensive Plan Land Use Map effective August 28, 1998. 9.) A septic permit(SEP94-00029)was finaled on March 3, 1995 for a 3 bedroom system. 10.) W Valley Rd (C514109) is a local access road. The road approach is existing and an address of 3756 W Valley Rd has been assigned to the parcel. 11.) Development Review staff conducted a site visit of the parcel April 13, 2007. The site visit confirmed the wetland as identify on the GIS mapping system is a manmade pond and there is no stream on site. NOTICE: This permit does not excuse the proponent from complying with other local, state, and federal ordinances, regulations, or statutes applicable to the proposed development. Development pursuant to this permit shall be undertaken subject to the applicable development and performance standards of the Jefferson County Unified Development Code. If during excavation or development of the site an area of potential archaeological significance is uncovered, all activity in the immediate area shall be halted,and the Administrator shall be notified at once. The Federal Endangered Species Act rules to protect threatened Chinook and Summer-run Chum salmon became effective on January 8,2001. Bull trout have been listed as threatened since early 2000. Under the ESA,any person may bring lawsuit against any individual or agency that "takes"listed species(defined as causing harm,harassing,or damaging habitat for the listed species). In addition,the National Marine Fisheries Service can levy penalties. All areas in Jefferson County are included as"critical habitat"for a listed species. Development of property along any marine shoreline,freshwater shoreline,or floodplains could harm habitat if protective measures are not taken. To minimize the potential to damage habitat,all property owners developing adjacent to marine shoreline,freshwater shoreline,or floodplains are advised to do the following: -Set back buildings,utilities and roads as far as possible from surface waters(streams,rivers,lakes,marine waters),or at least 150 feet from the edge of the water -All development activities should avoid unstable slopes,wetlands,and forested areas near surface waters -Remove minimal vegetation for site development,especially large trees -Allow trees that have fallen into surface waters to remain there -Infiltrate stormwater from buildings and driveways onsite through drywells rather than discharging directly into surface waters or roadside ditches Any individual,group,or agency can bring suit for a listed species"taking",even if you are in compliance with Jefferson County development codes. The risk of a lawsuit against you can be reduced by consulting with a professional fisheries habitat biologist,and following the recommendations for site development provided by the biologist. For more information,contact the National Marine Fisheries Service in Seattle at(206)526-6613,or the U.S. Fish and Wildlife Service at(503)231-6121. APPEALS: Pursuant to RCW 36.70C,the applicant or any aggrieved party may appeal this final decision to Jefferson County Superior Court within twenty-one(21)calendar days of the date of issuance of this land use decision. For more information related to judical appeals see UDC Section 8.5.2. UDC Administrator M LA07-00211 4lA,Ick so(\ e- ES6o 3T`7 - 33S-7 1 _ c---- • o --2, fi-tel f r .c, 1 , .r0 I/ ,0 t f<1- f-42Z2S3rk- , it --=-.) Nor-1-14. Eekx.c.i. [_ _ 1 H /\\J i .(4.1..j. k,,c7)1.■ 'Oa CS — 1 s.c._---‘r . `I• LI_ ^ va ..... --_-\... ... :..tliN) )0110 fLO .. ------ 0 'it-) SPAAD Category and Intake Requirements BETA version Rev. 12/12/2006 Cat A Cat B Cat C Cat D (low risk) Potential Probable Mitigation and site constraints site constraints State review reqd *Special reports are *'`Special reports **Pre-application optional at intake. If required at intake. required to reports are deemed Could request determine submittal required, the 30 day waiver from intake requirements • timeline will not be requirements at pre- met. application. *Need to provide additional information on site plan >200 feet from (1)Shoreline (1)Shoreline parcel-boundary depicted less than property, and(2) Shorelines 200 feet away from proposal doesn't parcel boundary,or meet standard (2)shoreline on site . setbacks and/or • Streams .. . , proposing mitigation >155 feet from parcel (1)Stream depicted. Development boundary off site and less than proposed less than •Type T . 155'away from 155'from stream . . . . parcel boundary,or. . . . (2)on site . >155 feet from parcel (1)Stream depicted . . . Development : boundary . . off site and less than proposed less than . • 2 •: 1.55'away ' y ..from �155 from stream • •• parcel boundary,or . ry • • (2)on site >105 feet from parcel" (1)Stream depicted . Development boundary off site and less than proposed less than Type 3 '. 105'away from 105'from stream parcel bounds . ►Y,or • (2)on site . . >105 feet from parcel '(1)Stream depicted. ' . ' Development • . • . boundary off Site and less than . proposed less than . . ' Type 4 . 105'away from. • . . 105'from stream .. • parcel boundary,or • (2)on site. •• >55 feet from parcel (1)Stream depicted Development • boundary off site and less thin proposed less than • Type 5 55'away from parcel 55'from stream boundary,or(2)on • site • kilt 8z ' ' ' . none ' • • ' Depicted on site • • • Wildlife(other • **Include agency • thaa fie) packet with . application . . . Eagle(contact. none Depicted on site . . • DC to 0 **Include agency • determine) • packet with application • Page 4 of 5 • Cat A Cat B Cat C Cat D (iow risk) Potential Probable Mitigation and • site constraints site constraints State review reqd • *Special reports are **Special reports *'`Pre-application optional at intake. If required at intake. required to reports'are deemed. Could request determine submittal required,the 30 day waiver from intake requirements timeline will not be requirements at pre- met. application. *Need to provide additional information on site plan >225 from parcel Wetlands depicted Depicted on site Wetlands boundary off site and less than **Wetland 225'away*Wetland delineation required delineation.optional . • Depicted off site Depicted on site • Seismic *Geotechnical report optional none Low or moderate (1)High landslide hazard mapped on hazard depicted on site or within 30 feet site or within 100 Landslide from parcel feet of parcel • hazard area . boundary boundary, or(2) *Geotechnical report verified slides optional **Geotechnical report required none Intermediate on Site • Unstable,unstable or within'30 feet from recent landslide, : parcel boundary ' unstable old • Shoreline *Geotechnical report' landslide depicted Slope Stability optional on site or within 100 feet of parcel • boundary'** . • Geotechnical report required . . • none Depicted on site Flood • *Flood Elevation • . • .Certificate optlonal. >30 feet from parcel (1)Depicted off site • boundary and less than 30 feet . ' • •Erosion • - away,or(2)on site' . *Geotechnical report • . ' • optional Aquifer Any Recharge. Area ' (1)None,or(2) . High Risk SIPZ High Risk SIPZ - Seawater Coastal or At Risk depicted within 200 depicted on site . • Intrusion SIPZ on site feet of parcel **Hydrogeologic . Protection . • boundary Assessment •• • Zone . - *Hydrogeologic required • • Assessment optional . • • Page 5of5 UDC CONSISTENCY REVIEW Project Planner: Mvster#MJ.A07-00211 Review Type Proiect Description t BLD07-00184 I NEW M/H-CORONADO(SER#0321073) Primary: CHARLOTTE SUMMERS Site Address: PO BOX 654 3756 W VALLEY RD CHIMACUM WA 983250654 CHIMACUM WA, 98325 Project Location: Parcel Number 901 342 009, Section 34, Township 29,Range 1W, WM,Located at 3756 W Valley Road, Chimacum, WA 98325 Parcel Number: 901342009 S-T-R:34-29N-01W Total Acreage: 5 Legal Description S34 T29 R1 W TAX 10 TR 3 OF SURVEY V7/P70 Land Use: 9100 Flood District: Fire District: 1 Planning Area: 6 Flood Map(FIRM)Panel No: 5300690435B District: 49 Zoning: RR1:10 COMP PLAN DESIGNATION: COMMUNITY PLAN: UGA: MPR: WATER SUPPLY UTILITY: Service Area PUD: [ ] Plot plan states "property line" [ ] Assessor's Map(Property lin�bmitted plot pia must match the pro rtyide{�tified on h�� es s� sot's]t/4 m�q) [ ] Legal Access to Property i\ EESS NO di V lf_/^_,f/ [ ] Parcel Tags or Scanned Documents YES NO [ ] ESA's: Special Reports Nearby YES iS�O [ ] Designated Ag [ ] Shoreline Designation: YES ditimi [ ] Shoreline Slope Stab' ' : YES OF Stream Type:YES 1 • 9 f t r� (bl ranfilLSIMM eft--•—•11 Fish& Wildlife:YE %• Wetlands: YES! , i a . 6t _ .. Rare Plants:YES , • MI / wit '- 4 oillif 60 Seismic: YES O Landslide: YES Flood: YESaI • Erosion: YES • Aquifer Rechar e Area:YESS SIPZ: non At Risk i Risk Coastal Stormwater site plans • itted• ° � -;� tom, [ ] Forest Lands: YES tO `� Orr C�P 111.' r 1 r 7 LIP Adjoining Forest Lan.s: `�'L C ercial Rural/ Inholding [ ] Stormwater:New Impervious Surface (/5 L' bart istui ' g Activity t k00 ESA's Stormwater Req's: Min Req#2 c i Req#1 thru#5 Min Req#1 thru#10 Engineer [ ] Notice Provisions/Disclosure. Airport YES n MRL YES NO Forest Lands YES NO [ ] Landscaping Required: Yes - [ ] Parking Spaces R-•• -d NO Other [ ] Building Height: eir UBC Standard [ ] Impervious Surface coverage percentage: ` Resource Lands&Public: 10% Rural Residents ° Rural Industrial: Per UDC Sec 6.7 Rural Commercial: 60% Area of Building Coverage:60%in Rural Industrial Lands only [ ] Total Building(s) Size: --, RVC:20,000 SF CC:5,000 SF NC:7,500 SF GC: 10.D00 SF All others:subj se tic&wateLcrostraints/No pecified [ ] Setbacks: Front: 2A Left Side: S Right Side: Rear: Shoreline Setback: ', 0)( I' �' LSHA Setback: V1 VIAiltel 1 , r h C 1 [ ] Road Classification: VM 1(�f J Road ApproachxlsT NOT REQ'D RAP �. [ ] SEPA Required:YES M [ ] Flood Certificate: q 1�(� [ ] Existing Case(s)& on(s): `'I l l k t " r /3 1i,' Io t- " 1� i Violations: Yes • c [ ] Recorded Date of Subdivision: h(ite_ AFN Over 5yrs=UDC Plat Conditions: <5 yrs=Plat Conditions on at o Old Ordinance Lots/Require Declaratio • 'estrictive Cove ant YE NO, submitted: YES N . [ ] Site Visit conducted O 13 ( ficg [ ] Require Final Zoning Approval YES N [ ] ADMIN: Setbacks entered in Pe Plan c N/A New Parcel Tags entered i '- 'Ian YES Special Reports Scanned YES No parcel tags found for parcel Associated CASES status issued finaled description 901342009 MLA07-00211 BLD07-00184 P NEW M/11-CORONADO(SER#0321073) SEP94-00029 F 2/17/1994 3/3/1995 USR07-00025 F 5/10/2007 5/10/2007 3756 West Valley Rd II VIII II