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Home My WebLink AboutBLD2013-00171 MLAI 3-00082 Review Type;I MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00171 Received Date: 6/4/2013 SITE ADDRESS: 1500 WAHL LAKE RD PORT LUDLOW, 98365 APPLICANT: POPE RESOURCES PHONE: 360-697-6626 C/O OLYMPIC RESOURCE MGMT 19950 7TH AVE NE#200 POULSBO WA 98370 SUBDIVISION: Block: Lot: PARCEL NUMBER: 801361001 Section: 36 Township: 28 N Range: 01 W CONTRACTOR/ TBD PHONE: DEALER: REPRESENTATIVE: MILES SAND&GRAVEL CO PHONE: 253-833-3705 PO BOX 130 AUBURN WA 98071 PROJECT DESCRIPTION: Manufactured home for security personnel. TYPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: r,.3 M 'l SETBACK: VALUATION YEAR: �, SIZE: (A°' BANK HEIGHT: LABOR& INDUSTRIES APPROVAL? SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: A�' Apxo D State Building Code $4.50 CJZ 06/04/13 142145 I!- t"66,.� Manufactured Homes $228.00 CJZ 06/04/13 142145 Potable Water Application $66.00 CJZ 06/04/13 142145 Total: $298.50 Jefferson County DCD \\firicmer4\rloM1fnrme\G RI Il Ann Mnh• 4 A/A mil CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 Carl Smith, Director/Building Official PERMIT#: BLD13-00171 APPLICANT: POPE RESOURCES PHONE: 360-697-6626 C/O OLYMPIC RESOURCE MGMT 19950 7TH AVE NE#200 POULSBO WA 98370 SITE ADDRESS: 1501 WAHL LAKE RD Issue Date: 04/10/2014 PORT LUDLOW, 98365 Final Date: 6/17/2014 SUBDIVISION: Block: Lot: PARCEL NUMBER: 801361001 Section: 36 Township: 28 N Range: 01 W PROJECT DESCRIPTION: Manufactured home for security personnel. THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009 EDITION. OCCUPANCY GROUP: R-2 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes o THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 6/17/2014 \\tidemark\data\forms\F_BLD_Occupancy.rpt 6/19/2014 ,.._,:_‘ , I. _ - 5) <I I_•-----i- . , 1 ' 4 ' ----7 _ {l�We ( ____i JEFFERS► •4INTY JP EPT.OF COM ' f' ►EVEIOPME ! lip:_ ,. P SITE �' AP 014 JEFFERSO '• TY G 9 ibi /, ' .•4.. INZvb ve/ ,� SIGNA , ��...,1 ��: �'R�TI '1. St�� ►�wa - •and for oGV \�i Q th_ \ 1 Q I' �•a \\ BL -293,.„ . . .„.„ ..-:No , , a , „----\ „t, • . - \\ .., „ ..... , y , \ \ Expansion �, ea for- , �- �� Stormwater nfiltration ,!�, �� /�\ ` pending C Approval co. 4. . �,d \ \ �., _..J• --� 1i< \ '\' �\ i— \,,, . 14,,,,kiet ' * ‘10.‘ •' --> ) .,-)t- TAN '.--- N ,•'# V‘ \ • \ t V> 1 'S) \ \A �\ I� } / ■\ \ P�0` m \\ \ \\ / \ \ \� E��RK1 I \ 1 y-' .�- ; A k .. w? 't, \ iii �■ itt. \ \ / i- r' 1 1 1 1 :.!:. \� .4-------- , SCALE 1"=61'�' '= = ) 1 ' / n .MILES- �,!” ' \ ` , SAND & GRAVEL COMPANY / � l /`,�f�✓ " ` RevisechSite P an , �, � BLD 12-293 /0:�� \- Fe\brry 2013 rtee orili \\ • eY 17 P&emsnu.m rg*C3',' 1 6/6/2013 a" EL •onditions Associated With a 2:37:59PM " Case#: BLD11-00063 &! F 19 = 2001 C-CONDITIONS OF APPROVAL-MDNS None NOT MET 5/11/2011 MKF Based upon the documents admitted into the record,and the above Findings of Fact and Conclusions of Law,it is hereby the decision of the Administrator that the Stormwater Permit application by Miles Sand&Gravel Company be APPROVED subject to the following conditions: The following conditions are incorporated into this permit from the MDNS issued on May 11,2011 for this proposal. A. If contamination is currently known or observed during construction or removal(placement),sampling of the potentially contaminated media shall be collected. If contamination of soil or groundwater is readily visible,or is revealed by sampling, Ecology shall be notified. Contact the Environmental Report Tracking System Coordinator at the Southwest Regional Office at 360-407-6300. For assistance and information about subsequent cleanup and to identify the type of testing that will be required contact Mr. Chuck Cline. If contamination is identified,this issue may be referred to Jefferson County Health Department as a solid waste concern. B. Visual inspections of all Erosion and Sedimentation Control BMPs shall be conducted at least every seven days. BMPs shall also be inspected after any stormwater event that results in greater than 0.5 inches of rainfall within a 24-hour period. An inspection log shall be maintained which includes the date,the name of the observer and any pertinent observations. C. The procedures in the Technical Memorandum and Unanticipated Cultural Resources Discovery Plan dated February 26, 2010 must be followed in the event that cultural resources and/or human remains are identified. D. Prior to operation,the applicant shall obtain from the Washington Department of Ecology Water Quality Program a national Pollutant Discharge Elimination System and State Waste Discharge General Permit(NPDES)for process water, stormwater and mine dewatering water discharges. All activities within the Wahl MRL overlay shall be subject to the standards of the latest edition of the Department of Ecology Stormwater Management Manual for Western Washington. E. In an email dated April 20,2011,WSDOT does not need to see the annual Rock to Go Road Traffic Impact Analysis (TIA)from Miles Sand&Gravel Co.as conditioned on the Fred Hill Materials now Miles site that currently uses Rock to Go Road. Since negotiations are occurring between Miles Sand&Gravel Co. and WSDOT,that would move the operation and new access(T-1000 Road)to west of SR 19,preparing a new TIA would most likely just be wasted time and effort and money. However,this postponing the annul TIA is only for this year as those negotiations continue. 2001 C-FPA COMPLIANCE None NOT MET 5/11/2011 MKF A FPA(Forest Practices Application)complying with the requirements of WAC 222 Forest Practice Rules)will be required for the removal of trees. It is anticipated that mineral extraction within the Wahl Lake MRLO will commence once a Conditional Use Pemit has been approved. Harvested areas should be replanted with trees within three years,then that area is not considered converted from timber use and may be processed through a Class III FPA. Jefferson County has limited authority to regulate FPAs that do not involve a conversion to non-forestry use or is not adjacent to shorelines of statewide significance. If an activity would result in trees being removed and the area not reforested within three years,then this activity would be considered a"conversion," since the area is not reforested in the required timeframe for a FPA. The County is provided additional authority over conversions to non-forestry use and ensures that conversions meet all JCC requirements(such as Environmentally Sensitive Areas,performance&development standards). After the County's review is completed,the conversion is implemented through a Class IV General FPA processed through WA State DNR. Mineral extraction is a use that is consistent with forestry use as outlined in the Jefferson County Comprehensive Plan. The Jefferson County Code(JCC)is the implementing development regulation for the Comprehensive Plan,which states that mining is a permitted use in Commercial Forest Designations with a MRL. The subsequent use of the area to be mined is timber production with other uses allowed in the underlying Commercial Forest Designation. 2401 BMPs None NOT MET 5/11/2011 MKF The project shall adhere to the Best Management Practices(BMPs)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. 2402 Stormwater Plan None NOT MET 5/11/2011 MKF Page 1 of 3 CaseConditions..rpt 6/6/2013 C C CEL •onditions Associated With • 2:37:59PM Case#: BLD11-00063 y 9 4444 B i F§ d 444 447 44 04:444444;4010444.4 4 34%.44;414. 44,4.44 444 44444-744434444 44W4/4 4414441e4 4411:1444k :444';4::4 J.' 4:44 .444'4 4T414Z.44:444ag''4;44ikaO44',:f;L;443:4:41414. 744 444 An Engineered Stormwater Drainage Report dated March 2011,prepared by Team 4 Engineering was been submitted with the application that assess the site,proposed activities,and proposed stormwater management strategies and facilities. The Report and Plan Sheets address the erosion and sediment control and stormwater treatment and flow control. Runoff from new impervious surfaces is proposed to be infiltrated on site. DOE regulates erosion and stormwater runoff from construction sites greater than one acre and from surface mining operations. The proposal is subject to the requirements of a Construction General Stormwater Permit and a Sand and Gravel Permit. it DNR regulates compliance with surface mining reclamation plans. The proposal is subject of the requirements of a Reclamation Permit. Construction of SR 104 access is subject to plan review and inspection by DOT. 7001 F-BACKGROUND INFORMATION None NOT MET 5/11/2011 MKF Background Information: An application(MLA03-00377)for a stormwater permit w/SEPA within the Wahl Lake MRLO was received on July 3,2003. The case was placed on hold to wait for the issues related to the Comprehensive Plan Amendment (CPA)for a MRL(MLA 02-235)to be resolved. On October 14,2004 the Western Washington Growth Management Hearings Board determined that the CPA for this MRL was in compliance with SEPA and the Growth Management Act. The application was taken off hold after the Hearings Board decision. The application was routed on December 23,2004 to agencies with jurisdiction and interested parties. A Threshold Determination of a Mitigated Determination of Non-Significance(MDNS)was issued on March 30,2005. Based on comments received regarding impacts to the hydrology to Thorndyke Creek,the SEPA Responsible Official withdrew the MDNS in a Memo dated May 12,2005. This in effect put the application in the position of having to issue a new Threshold Determination. The May 12,2005 Memo also indicated that the current proposal would result in probable significant adverse impacts to groundwater movement,quality,and quantity,which would result in a Determination of Significance. WAC 197-11-350(2)&(6)indicates that an applicant should be informed that a Determination of Significance is likely and be provided an opportunity to change a proposal to address the issues that would warrant a Determination of Significance. On June 1,2005 an on-site meeting was held with DCD,The Port Gamble S'Klallam Tribe,WA State Department of Fish& Wildlife and the applicant to examine issues related to impacts that mining would have on the hydrology of Thorndyke Creek and unnamed tributary. Part of the concern expressed was that there was no site specific data that documented the relationship between surface and groundwater to in-stream flows. Also,there was no field documentation on how long it took water to pass through the material found within the Wahl Extraction area. In addition,although the MRL was 500 feet from Thorndyke Creek,mineral extraction was proposed approximately 200 feet from its riparian zone of an unnamed tributary to Thorndyke Creek. The applicant modified the application to re-sequence the areas to be mined by starting near the center of the MRL at the eastern edge instead of the southeastern corner(See Reclamation Sequence Map dated June 17,2005). This would move the initial mining areas from 200 to over 500 feet from the riparian fringe of the unnamed tributary. In addition,Group 3 (the area closest to the unnamed tributary)has been changed from the first to the last area to be mined,contingent on the results from monitoring data.Group 2 is not part of this stormwater permit and would not occur for at least five years. This would allow the review of groundwater monitoring data that will be developed per Condition 15 of Ordinance 08-0706-04. The final area to be mined(Group 3)would be the area closest to the unnamed tributary and would not be reviewed until approximately 10 years of monitoring data has been collected. The groundwater monitoring would include establishing rain gauges,groundwater monitoring wells,stream monitor/water elevation stations in areas where flows are low (unnamed tributary),and flow meters near the confluence of the unnamed tributary with Thorndyke Creek and the downstream portion of Thorndyke Creek where the flows are perennial. A new SEPA threshold determination will be conducted as part of the stormwater permit required for Groups 2 and 3. The existing environmental documents completed for the Comprehensive Plan Amendment for the 690 MRL and the 165 acre Wahl Extraction area will be utilized as deemed appropriate. The new threshold determinations will examine the specifics impacts associated with mineral extracting within Groups 2 and 3 and will examine surface and groundwater monitoring data collected in the Wahl area. By 7001 F-SEPA None NOT MET 5/11/2011 MKF Page 2 of 3 CaseConditions..rpt 6/6/2013 CEL.-A? •onditions Associated With • 2:37:59PM Case #: BLD11-00063 (mm Reviewed under the State Environmental Policy Act(SEPA)by Jefferson County acting as lead agency. Notice of Type I Land Use Application(MLA11-00054)and Preliminary Threshold Determination for a Mitigated Determination of Non-Significance(MDNS)utilizing the optional process(WAC 197-11-355)was published in the April 6,2011 edition of the Jefferson County Port Townsend Leader. On March 29,2011,a notice was sent to agencies,the applicant/representative,and surrounding landowners. The site was posted on March 31,2011. 7202 F-Confirmed ESAs None NOT MET 5/11/2011 MKF The application was reviewed by the Jefferson County Department of Community Development staff on March 24,2011 for the potential presence of Environmentally Sensitive Areas(ESAs)under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection,the following ESAs were confirmed to be present on the subject property: SUSC aquifer recharge area. 7751 F-Site Plan Changes None NOT MET 5/11/2011 MKF The site plan as submitted with the stormwater permit application on March 21,2011 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 11,2011 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 7752 F-Approval for Only None NOT MET 5/13/2011 MKF This approval is to grade and construct improvements within the 18-acre MRLO AND a stormwater permit for construction of the T-1000 Road from SR 104. 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. Page 3 of 3 CaseConditions..rpt 60 is -- 1 -7 r 411 . �3 . c''c JACK WESTERMAN ID Jcitcrson C.antt r..rtboose ASSESSOR PO I$.x 1226, Port Towwsead.101'A 0*368 (3660 3834103 MOBILE HOME INFORMATION FORM OWNER'S NAME/MAILING ADDRESS: NAME: I 4(342{ - ADDRESS: tZ € . 0 .111117; 1..64)k3 �� ir 41/1- PHONE NO. 3 -3o I -.554 The purpose of this questionnaire is to obtain information regarding either the current location of a mobile home or the previous ownership and location of a mobile home. This will help our office determine whether the mobile home is already on the tax rolls in Jefferson County or if it has been moved to this county from another area. l)MOBILE HOME DATA: (A) MAKE NASO (B MOD 1�-i. 1 Mr-1-116e-,c)YEAR 2-C2 (D)LENGTH l/! , (F)WtDTN ' , (F)SERIAL# WI( 31 2- 4G)YOUR PURCHASE PRICE(Do not indeJe sales tJ 59,OCO PURCHASE DATE 3'2b02. 2)PREVIOUS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE TO QUESTION 3) (A)FROM WHOM DID YOU PURCHASE MOBILE ADDRESS (B)WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR?Yes No It Yes,Previous address of mobile. It No,What County was Mobile assessed in last year. 3)WHERE MOBILE HOME IS TO BE LOCATED: (A)WILL THE MOBILE ROME BE IN MOBILE HOME PARK? Yes eft° (B)IF LOCATED IN MOBILE HOME PARK: NAME do ADDRESS OF PARK Lot/Spate# (C) IF NOT LOCATED IN MOBILE HOME PARK: NAME OF LAND OWNER: LOCATION ADDRESS REAL PROPERTY PARCEL#/DESCRIPTION sgnatnre of applicant THANK YOU FOR YOUR HELP! ejt SS Q SC Q_ JO COSSELL,Property Technician i i` O JEFFERS COUNTY �� / ``-ADEPARTMENT OF COMMUNITY DEVELOPMENT � ;I 621 Sheridan Street• Port Townsend •Washington 983611 ' 360/379-4450 . 360/379-4451 Fax ;Th) 4 www.co.jefferson.wa.us/commdevelopment JUN 4 2013 Master Permit Application ML R �- .ON w . 1' Project Description(include separate sheets as necessary): Install Security Person's Manufactured Home Tax Parcel Number: 801361001 Property Size: 624 acres (acres/square feet) Site Address and/or Directions to Property: 1500 Wahl Lake Road, Port Ludlow,WA 98365 Property Owner(s)of Record: Pope Resources/Olympic Resource Managment Telephone: 360-297-0570 Fax: 360-297-0580 email: PRaymond @orminc.com Mailing Address: P.O. Box 7, Port Gamble,WA 98364 Applicant/Agent(if different from owner): Miles Sand&Gravel Company Telephone: 253-833-3705 Fax: 253-833-3746 email: mikes @gravelpits.com Mailing Address: 400 Valley Avenue NE, Puyallup,WA 98372 What kind of Permit?(Check each box that applies Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) X Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]** X Manufactured Home ❑ Modular ❑ Discretionary"D"or Unnamed Use Classification ❑ Commercial* ❑Special Use(Essential Public Facilities)" ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach ❑Short Plat" ❑Home Business ❑Cottage Industry ❑Binding Site Plan" ❑Propane ❑Long Plat** ❑Sign ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions" O Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development" ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: N/A Miles Sand & Company OF AGENT I hereby designate p y ct 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 its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later i spections. S -- s acce and right of entry will be assumed unless the applicant informs the County in writing at the time of the ap•'d,o/ =t( •r she tsiror nor,,'. / r�' Signature: ` ,/ /./� _ (/ i/i/, 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 actions)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 responsitf for adher'••to a•• complying with the ESA. The Applicant has read this disclaimer nd ns and dates it below. /. Signature: 1i/. ,i , . , Date: S 3/ /3 G:\PemvtCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc BUILDER STATEMENT The signer of this s_...igiiyuk nt does hereby ..� that they are the Owners of the parcel referenced hit that they are not licensed contractors and that they will be assu 44W- responsibility of General Contractor for the proposed protect. Signature: I _*- rir_L, _ ■ Date: l^0 it-t-77 GENERAL CONTRACTOR OR 4117 RED HOME INSTALLER: n PHONE: FAX: Miles Sand &Gravel Company lkw. 4e. 1_C , p;4,.4 (254 833-3705 (253 833-3746 MAILING ADDRESS: 400 Valley Ave NE, Puyallup,WA 98 EMAIL: mikes @gravelpits.com CONTRACTOR'S LICENSE WAINS NUMBER: N/A NUMBER ARCHITECT/ENGINEER: Team 4 Engineering PHONE ( 360 297-5560 FAX:(360 297-7951 MAILING ADDRESS: 5819 NE Minder Road, Poulsbo,98370 EMAIL berni @team4eng.com Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ix New 0 Wood Existing: 0 ❑ Sewer ❑ Addition X Steel Proposed: —2-- Bank 0 Community System D Alteration/Remodel 0 Concrete Total: — He__igght: al Individual System ❑ Repair ❑ Masonry N/A SEP Permit# SEP12-00104 ❑ Demolition ❑ Other. Bedrooms: Water Supply: Existing: 0 Setback: X Private well D Two Party Type of Heat Proposed: ❑ Public Total: z _L LA Name of System: • if this Is a Commercial Protect you must answer the following: Number of Parking Spaces: Current Proposed: Number of 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 I Above ground Tank Size of Propane Tank: N/A I Heat Stove I Cook Stove I Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove I Other Is this appliance being Installed in a Mangfactured/Mobile Home? Yes I No When applying for a permit to Install a propane tank you must also submit a site plan showing all of the buildings,all property lines,tank location and size,distances from the propane tank to all property Ines,buildings and septic system components, including the reserve area. Square Footage Current Proposed ,a� _� _ 9 4 `:� F �� Main Floor Heated 0 1039 :s 4 i '; EH Bid App Review: r7 3 U 2"0 Floor Heated Consistency Review: Other Heated Base fee: •�Q S Mezzanine Additional Section: �( .:_; N PC Heated Basement = ' Plan Check fee: Nfk Unheated Basement t' a ' State Surcharge fee: O Other Unheated ;;.,..,:,Alt-- ., j ;A Pot Water Review fee: j CO Garage/Carport • 4 -*' SUBTOTAL Decks • x 4444 911/Rd Approach fee: N , r „, Other -1,,,,,,--, TOTAL: $ L/tj v 3» Rectal•t N mbec 4 ESTIMATED COST(REQUIRED) `1 Date: Weir et value of all labor and materials foundation to finish! 2013 I' ' —( $2000 ` low t GAP etnritCenter\###FORMS###\DRD FORMS\Master Permit A tan 1Ef MMUN COUNTY PPS 9{�@@Mh4UNlTY DEVELOPMENT II V. • • [ ICEOVEr) i gli Gil 0 I U • 1 I � It{ SUP,' t 2013 li I 11 JEFFERSON COUNTY t. ' ! I 1 DEPT OF COMMUNITY DEVELOPMENT N11111111.041 Willillimm . •I 11 11:.•.. IMa"" 41'.1'.r-C]-. s w I:::: ..... it i Y: L •..t 0 . T ii..Wa! p,)" . • \II _ i tr. 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The purpose of this questionnaire is to obtain information regarding either the current location of a mobile home or the previous ownership and location of a mobile home. This will help our office determine whether the mobile home is already on the tax rolls in Jefferson County or if it has been moved to this county from another area. l)MOBILE HOME DATA: (A) MAKE (B) MODEL (C)YEAR (D) LENGTH (E) WIDTH IF)SERIAL# (G) YOUR PURCHASE PRI(' "5 - PURCHASE DATE 2) PREVIOUS OWNER/LOCATION UL N!' W MOVE TO QUESTION 3) 'e,t1NCt (A) FROM WHOM DID YOU P c %C\ ADDRESS \` �((B) WAS MOBILE HOME ASSE, TN _ter COUNTY LAST YEAR?Yes No If Yes, Previous address o. mobile. If No, What County was Mobile assessed in last year. 3)WHERE MOBILE HOME IS TO BE LOCATED: (A) WILL THE MOBILE HOME BE IN MOBILE HOME PARK? Yes No (B)IF LOCATED IN MOBILE HOME PARK: NAME &ADDRESS OF PARK Lot/Space # (C) IF NOT LOCATED IN MOBILE HOME PARK: NAME OF LAND OWNER: LOCATION ADDRESS REAL PROPERTY PARCEL#/DESCRIPTION Signature of applicant THANK YOU FOR YOUR HELP! Lauralee Kiesel, Property Technician ', To schedule inspections, call (360)379-4455 no later than 3:00 PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next day's inspections. Office Hours 9:00-4:30 MONDAY-THURSDAY ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks Erosion Control 4b MH Foundation 011 di/3,4 9' Blocking&Tie Down Skirting&Ventilation `12o7/i Gas Line: Exterior Propane Tank /l� Pressure Test Drywell/Alt Drainage Address Posted (aI)7( Water Meter Inspection installed as part of the public water supply approval.No need for another inspection A final inspection will not be scheduled until all of the following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed off • Public Works Permit Final(where applicable) FINAL INSPECTION (4( ,.- FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR SPECIAL CONDITIONS APPLY-SEE REVERSE • • SPECIAL CONDITIONS CASE # BLD13-00171 1.) The project is located within WRIA 17 and thus is subject to compliance with the WA State Department of Ecology In Stream Flow Rule for that region. The parcel is located within the Thorndyke sub-basin in a designated Reserve Management Area; as such, conservation standards per state regulations require the following: 1. A permit-exempt well serving an individual user shall not exceed a maximum of 500 gallons per day(gpd) or an annual average more than 350 gpd, for all permit-exempt uses authorized under RCW 90.44.050. (WAC 173-517-120(1)(b)) 2. A well serving a group domestic system shall not exceed a maximum use of 500 gallons per day(gpd) or an annual average more than 350 gpd, for each residence, and shall not exceed a total use of 5,000 gpd for the group. The design and construction of group domestic systems must be consistent with applicable state department of health requirements and applicable Jefferson County or Clallam County requirements. (WAC 173-517-120(1)(c)) 3. INSTALLATION OF A WATER METER, MEETING DEPARTMENT OF ECOLOGY SPECIFICATIONS, IS REQUIRED FOR ALL NEW USES THROUGHOUT THE WATERSHED. (WAC 173-517-180). BROCHURES WITH SPECIFICATIONS ARE ENCLOSED WITH THE PERMIT. Refer to enclosed documents for more INFORMATION; see Ecology web site at http://www.ecy.wa.gov/programs/wr/instream-flows/quilsnowbasin.html or contact Ecology at 360-407-6300. 2.) See MLA12-210 for findings and conditions that apply to this project approval. 3.) The project shall adhere to the Best Management Practices (BMPs)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. 4.) The site plan as submitted with the Building Permit application on June 4, 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 April 8, 2014 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 5.) This approval is for a Manufactured Home for Security Personnel 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. • S 6.) 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, but consistent with RCW 90.58. Development pursuant to this permit shall be undertaken subject to the applicable policies and performance standards of the Jefferson County Shoreline Management Master Program and 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: -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 The Federal Bald and Golden Eagle Protection Act requires landowners within 660 feet (1/8th of a mile)of an eagle nest to consult with the US Fish and Wildlife Service. This Eagle Act prohibits anyone from "taking" bald eagles. This federal law defines the term "take"and describes the possible legal consequences when a"take"occurs. Among other actions, "take" includes a disturbance of bald eagles or their habitat. Under federal law a permit may still be required for activities that impact bald eagles or their habitat. Contact the US Fish and Wildlife Service(http://www.fws.gov/pacific/eagle/)to learn more about how this law affects your project. 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, or the U.S. Fish and Wildlife Service. 7.) Parking is approved per the site plan dated April 8, 2014 with at least one (1) parking space designated for handicapped parking with appropriate signage. \\tidemark\data\forms\F_BLD_Permit_Mobile.rpt 4/10/2014 • MANUFACTURED/MOBILE HOME INSTALLATION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD13-00171 Received Date: 6/4/2013 SITE ADDRESS: 1501 WAHL LAKE RD Issue Date: 4/10/2014 PORT LUDLOW, 98365 APPLICANT: POPE RESOURCES C/O OLYMPIC RESOURCE MGMT 19950 7TH AVE NE#200 POULSBO WA 98370 SUBDIVISION: Block: Lot: PARCEL#: 801361001 Section: 36 Township: 28 N Range: 01 W CONTRACTOR/ MILES SAND AND GRAVEL PHONE: DEALER PROJECT DESCRIPTION: Manufactured home for security personnel. MAKE: NASHUA YEAR: 2002 SIZE: 67x16 Directions To Site: k -S°� B� OO JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT e ' /l X1.0%: Thur. Fri. Date: Time Received: l7 2 am/pm Mon. S Date: BLD: /3 - /7/ Contact Name: Owner: Contact Number: 360 'Q,�pi Address: /CV / 44a/ tic 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block &Tile Ceiling