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HomeMy WebLinkAboutSEP2014-00089 li " tl 0.Jefferson County Department of Community Development �0 + vt 621 Sheridan St,Port Townsend WA 98368,(360)379-4450 1I p R � �_ SEPTIC PERMIT APPLICATION •!` ;L. PROPERTY OWNER 1K01;3ERT er K A TU LEN LoQ U E.: s' i 1% °5100259 � �� MAILING ADDRESS 4& Y C L Of .: ,r :P l ERICSEN �I. PD'T T• NS N a ` S GS' N$a .. ,c: 'i o PHONE ( 3 40 ) 385- 3a 5 3 a 4 _*r s s, 11 `i SYSTEM DESIGNER t C 4 E N I E J M Designer Phone# 360-361-63 LEGAL DESCRIPTION: Section .27 Township 30 n1 Range I J PARCEL# qq S t ®6 i 3' f4': Subdivision Name lom PO t 13 T Division Block Lot(s) 1 14 h Site address/Dinections to site ' 2 rj A Y C L I F F PR. - See at t ar-h -L 7144 mei) SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential )( New Tank/s only Private Residential ADU Modification Public P V I Commercial Expansion Community Upgrade Repair_____ SITE SIZE I g} 104 SYSTEM TYPE Partial Repair-(tank) (drainfield) X Previous Evaluation Conventional x Designate Reserve Area Yes#561› Q -.381 Alternative Redesign 1( No SYSTEM DETAILS Number of Gallons/day .Z 4O Soil type 4 (attach soil evaL) Application Rate .57 gal/sq.ft.iday Drainfield Length 140 ft Trench Width .3 ft. Trench/Bed Depth .24- 34 in. Septic Tank size EX. Itg® qal. Pump Chamber size gal. TYPE of system REPt.AGE FAlLab *D'Rk1N ftEt..i) _ C-01 19-ew.At LQV\t.'1 By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner 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 requires prior notice. Inspections shall occur during regular business hours. Initial here if you require notification before entry Appeal–A person aggrieved of a decision of the Health Officer may appeal.Appeals shalt be submitted to the Health Division in writing within fifteen days after receiving written notice of the decision. DISCLAIMER-This application is for an on-site sewage system that meets the state and county standards in effect on the date of application. This application for an onsite sewage system DOES NOT assure you of any other County approvals. For example, it DOES NOT GUARANTEE that you will later obtain permission to build a permanent residence or other structure on this parcel Any future applicatio ill •- l•. tely udg d i the rules and laws in effect at that ti e# t `- ry _ --; 7/4 Property nature Date OSS /4 I R OFFICE I l 11 4 PARTIAL`0 t( ASBUILT� Ft I I APPROVED INSP/PUMP TEST C C�)CL a//T i ALL HOLD REQ.MET i Q J� Date 7 r 2I I 'I Fee 2-`7°a Rec# 1 5®LIB t f Check# ) 0 l�L Case#St P 1 t — 0008 H:\WEB\PDFs\Septic\septic_permitapp_2008.DOC * : JEFFERSON COUNTY PUBLIC HEALTH = 615 Sheridan Street•Port Townsend•Washington •98368 `sts,uuia" www jeffersoncountypublichealth.org Nnone MU-373b-3444 Fax ;i(iU-3/9-448/ ON-SITE SEWAGE DISPOSAL PERMIT %t, PERMIT#: SEP14-00089 Date Received: 07/07114 Date Issued: 08/03/14 SITE ADDRESS: 462 BAYCLIFF DR Date Expires: 11/04/14 PORT TOWNSEND, WA 98368 APPLICANT: ROBERT R LOGUE PHONE: KATHLEEN M LOGUE 462 BAYCLIFF DR PORT TOWNSEND WA 98368-9513 LEGAL DESCRIPTION: KALA POINT#5 LOT 251 PARCEL#: 965000139 Section: 27 Township: 30N Range: 1W DESIGNER: BERNT ERICSEN PHONE: 360-301-0324 293 PINECREST DRIVE PORT TOWNSEND WA 98368 SYSTEM DESCRIPTION: CONVENTIONAL TRENCH No. of Gallons per Day: 240 Type of work: REP Drainfield Trench Septic Tank Length: 140 feet Width: 3 feet Depth: 24 inches Size: 1,150 gallons DISCLAIMER-This approval is for an on-site sewage system that meets the state and county standards in effect on the date of application. This approval for an on-site sewage system DOES NOT assure you of any other County approvals. For example, it DOES NOT GUARANTEE that you will later obtain permission to build a permanent residence or other structure on this parcel. Any future application will be separately judged by the rules and laws in effect at that time. All construction and development activities must comply with all permit conditions, state and local codes, and Recommended Standards and Guidance documents in effect when the permit is issued. The property owner is responsible for the accurate location of all property lines.Any removal of or major disturbance of soil in the primary or reserve drainfield area may create site conditions that are unacceptable for the installation of a sewage disposal system. Any change in drainfield or tank location may invalidate this permit unless prior approval is obtained from the Jefferson County Environmental Health Division. If during excavation or development of the site an area of potential archeological significance is uncovered, all activity in the immediate area shall be halted,and the UDC Administrator shall be notified at once. Permit issued to CONSTRUCT, ALTER, REPAIR OR MODIFY AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM IN JEFFERSON COUNTY, WASHINGTON This permit is issued for a period of three years (unless otherwise stated above) in accordance with Jefferson County Rules and Regulations for On-Site So age Systems, codified in JCC 8.15 as amended. This permit may not be renewed. Jefferson County Environmental Health Specialist This permit with conditions must be onsite during all phases of construction HEALTH DEPARTMENT MUST BE CONTACTED FOR FINAL INSPECTION. SPECIAL CONDITIONS APPLY - SEE ADDITIONAL PAGES CONDITIONS OF APPROVAL - PERMIT NO.: SEP14-00089 1.) Approval/issuance of a sewage disposal permit does not guarantee the approval of other development or a building permit on this site. Compliance with other Jefferson County and Washington State Codes is required. 2.) All construction and development activities must comply with all permit conditions, Washington State and Jefferson County Codes and Recommended Standards and Guidance documents in effect when the permit is issued. 3.) This permit was issued to correct a violation of WAC 246-272A. The permit must be completed within 90 days of the date of issuance. 4.) H - AS PER WAC 246-272AAND JEFFERSON COUNTY CODE 8.15 ALL ONSITE SEWAGE SYSTEMS REQUIRE THATA RESTRICTIVE COVENANT REGARDING THE MONITORING OF THE ONSITE SEPTIC SYSTEM BE RECORDED TO THE PROPERTY TITLE. THE PROPERTY OWNER SHALL ASSURE THAT MONITORING IS PROVIDED BY AN APPROVED ENTITY AT THE FREQUENCY DEFINED PER STATE WAC 246-272AAND JEFFERSON COUNTY CODE 8.15 AS ADOPTED OR AMENDED. A COPY OF THE RECORDED OPERATIONS AND MONITORING AGREEMENT IS REQUIRED PRIOR TO FINAL APPROVAL OF THE SEWAGE DISPOSAL PERMIT 5.) Designer must be contacted prior to start of construction and for inspections during installation. DESIGNER IS REQUIRED TO DO A PRECOVER INSPECTION ON ALL TYPES OF SYSTEMS. 6.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 7.) H -An asbuilt drawing and certification of completion by the Designer is required prior to final approval. 8.) Before final approval is given, the designer shall provide an operations and maintenance manual to the property owner and the Health Department. The manual must instruct the owner of the on site sewage system on the ways to properly operate and maintain all components of the system. 9.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. 10.) When/if designated reserve area is utilized an alternative system providing an additional level of treatment may be required and must comply with code at the time of application for use. 11.) A 30' setback shall be maintained from the disposal component and reserve area to any downslope footing, curtain or interceptor drain or drainage ditch. 12.) Contact designer prior to installation for staking of drainfield area. 13.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 14.) Risers are required to grade with secured lids over both compartments and over the outlet of the septic tank for inspection and maintenance/monitoring. Minimum 20" riser over inlet. 15.) Distribution boxes shall be fitted with a riser to grade, constructed of durable materials and a secured lid, adequately sized to allow visible inspection of the liquid level in the box. 16.) 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. SEP14-00089 Page 2 of 2 \\tidemark\data\forms\F_SEP_Permitmod.rpt 8/3/2014 CONVENTIONAL SYSTEM ASBUILT INSPECTION REPORT INSTALLER fR tC-GE 1( . (o hei k i I ha km) PARCEL# q 416 o 00 q Permit Owner 'RD bex&2 4 a,-th ken Lel U_ Permit # Se 1 q '–O-7 ABSORPTION AREA: DRAINFIELD TRENCH TRENCH TANK #OF #GAL/ LENGTH l 0 WIDTH 3 DEPTH .-4• 31 SIZE(.l I Sv BEDRMS DAY o2 Tank Shroud/ IF PUMP AND PUMP CHAMBER REQUIRED: Size — Screen Float Arrangement High water float–distance to top of tank/emergency storage Dose drawdown (#of inches) #Gallons/Dose "'- Timer/Dose Counter info Pump Size/Manufacturer — I CERTIFY THIS ONSITE SEWAGE SYSTEM WAS INSTALLED AS DESIGNED, PER PLAN APPROVED a - 3 - t�- ,0 r 11 to-i4 DATE APPROVED Jr zSIGNATURE DATE MQk 9 i / / L / c Y / INI 0 / 0 , / N / O O m / `9L —' LO Q� f f ~ � _� 9�f9 2 ,4/ / f f ~ Xj� %Od 110/), a o °,° '-./J tL O L v / / o e�,�3� , �9taS, adsv/ 0 m� / f 5--0,. x,.31 ',,� _�L •�_ ti /// -- / • 1, ,.'a COQ��Z``L,, �gl Z m 0 / 'J6., im ,,,'0-' W / k / 4 > < 45 1 ` (1) / 44/ / 5 w Ct0m cnN- w / / w / / r� ai w c O v Z / / \ o Q z N :C.4) t / b ° wh' ,- I N XO J Q r w v- c / CO om = o .- Wry / ea i < * . 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Y Ne Y GI) *i...' a c---------- w / , Aryl SEWAGE DISPOSAL DESIGN ,p dp C.nstruction 4 off ..: � " Date ;�;_ `"'��'` Robert & Kathleen Logue 965000139 4Aoo1/ 3 ms`s a����� a .�►a��o��� v, Project Description 02" Replace failed drainfield ( SEP 93 — 389 ), remove 7 trees, extend existing transport line and install new "D" box and drainfield. Septic Tank Existing 1150 gallon two compartment septic tank appears to be sound, and may remain. Existing risers to remain. Install outlet baffle filter ( Orenco FTiPW 0418 -= W ) or equivalent. Transport Line It is imperative that minimum grades are used for effuent line to "D" Box. Install 4" 3034 sewer pipe from existing "D" box (approximately 20' ) to new "D" box @ 1%. Tightline from "D" box to drainlines to be 1% min. "D" Box Install 6 hole "D" box on poured in place concrete pad on undisturbed soil with riser to grade. Install speed-levelers and water level prior to designers inspection. Drainfield Remove seven trees from drainfield area and install 5 ( 28' x 3') laterals as shown on plans, Lines 1 and 2 will require removal of up to 1' of soil to meet maximum 36" depth, Line 3 - 5 to be 24" depth ( Gravelless Chambers are recommended because of lack of access ). Install inspection ports ( inside 6" round valve boxes ) with risers to grade within 5' of each end of lateral. Install Digger's 20 Gauge, Hot dipped galvanized wire mesh with 3/4" hexagonal openings over entire trench bottom under chambers. Water Lines Maintain a minimum of 10' separation from septic components. Water line appears to enter on southwest side of house, no conflicts anticipated. Inspections Designer needs to be contacted for a pre-construction meeting prior to construction to discuss details and to set up schedule for inspections. Designer is responsible for submitting "Record" drawing, and must be called prior to back filling system. SEWAGE DISPOSAL DESIGN Apor es o C•nstruction �► ..� y General Construction Notes 1. The work describleatEherein consis q construction of an on-site wastewater system. 2. The contractor shall be knowledgeable and experienced in the construction of this type of wastewater system and shall hold a valid certificate from Jefferson County Division of Environmental Health. "Approved" septic plans must be on site during construction. 3. If during the installation of the system the contractor finds soil conditions that may lead to premature failure of the system, construction shall be terminated immediately and the designer notified. Such soil conditions may include groundwater, fill, clay, highly compacted soil, bedrock or excessively permeable soils. 1. Any inconsistencies, errors, or omissions that, in the opinion of the installer, would compromise the quality of the wastewater system shall be reported to the designer prior to construction. 1. Backfill in traffic areas shall be pitrun gravel and compacted. All gravity pipe shall conform to ASTM D 3034. All gravity and transport pipe shall be bedded, using native or imported material free of rocks, debris and sharp objects. 2. All exposed soil shall be seeded and mulched prior to the final inspection. Seed shall be spread at an approximate rate of 10 lbs. per 5,000 sq. ft. 3. The installer shall be responsible for constructing the system according to plans and conditions of permit and shall be responsible for its proper operation and function for one year. The owner shall be responsible for operating and maintaining the wastewater system in accordance with WAC 246-272A-0270. 4. Any changes, substitutions, or deviation from these plans shall be approved by the designer and by the Jefferson County Environmental Health Department. 5. The installer shall grade to divert all surface water runoff away from tanks and drainfieldfreserve areas. 6. The bottom of the trench or bed may be inspected by the designer prior to placing drain rock and shall not exceed +1- %" from level. Place filter fabric over drain rock prior to backfilling. 7. Setbacks to all known water lines shall be a minimum of 10'. No crossing of water lines with any septic component shall be allowed, except as included in septic design approved by Jefferson County Health Department. 8. Setback from the house foundation wall shall be 10' minimum to drainfield, 5' minimum to tanks and 2' minimum to non-perforated sewer pipes. Water saving appliances, fixtures, and practices are to be used. 9. The septic and pump tanks, drainfield and reserve areas are to be protected from vehicular traffic or mechanical disturbance. 10. The designer is to provide the as-built and letter of certification. 11. This system has been designed in accordance with WAC 246-272-A- 0270 and the most current Department of Health "Recommended Standards and Guidelines for Pressure Distribution Systems," and has been approved by the Jefferson County Health Department. Nevertheless, negligence or improper action on the part of the users could result in the premature failure or malfunction of the system or its components. !( ` 9�. DG to • JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 SHERIDAN ST., PORT TOWNSEND ,WA 98368, 1360) 379-4450 • . _ __.. SOIL EVALUATION /i- PROPERTY OWNER Ro-3Ei T 4 KATHLEEN tO G U E J SYSTEM DESIGNER ER icsE.f) - &SiQ0 fI9' LEGAL DESCRIPTION: Section 17 Township 300 Range (tJ Parcel # qG c©bp 13 q Subdivision Name k�}L�1 PQIi1 Division 5 Block Lot(s) .251 Date Logged: 1- I- N.. Logged By: P ER m? E R l G S E N Include son textural characteristics and the depths at which significant changes occur. Be sure to include depth where mottling or impermeable layers occur. SOIL LOG #1 SOIL LOG #2 0 tom in G.S. ,/r;y o to ,, in. L. S. 1/4 r .jb _to_tjg in. TAO FIIJE 5A1b a° �� fa to � in. TAN FINE S h t �f8 to `��F in_ Si. LtPT`Zj FIIJE sat:. 1 to in. to in. go # i to in. s. •.A1 Anticipated water table>5q in. - ` • Anticipated water table>S6 in. Roots to Get inches „!,. ,,r wnsq• '14+ . Roots to GO inches Health Dept. Comments :.-� `� jt�,`1r 0 Health Dept. Comments ice' Y/�1 ! 'b. t� j= 100259 �, SOIL LOG #3 i p BERNTRUL ERICSEN to SOIL LOG #4 .i LICENS b. l-NER 1 to in �o��►om�mmool►wimotmo�, to in. EXPIR 8 02/11 to in. to in. l t S c_ AKT 1i to in. I to in. to in. / dal 14 to in. - Anticipated water table in. Anticipated water table in. Roots to inches Roots to inches Health Dept. Comments Health Dept. Comments SOIL LOG #5 SOIL LOG #6 to in. to in. to in. to in. - to in. to in. to in. to in. Anticipated water table in. Anticipated water table in. Roots to inches Roots to inches Health Dept. Comments Health Dept. Comments H:IINFOHLTHISOIL.FRM 1100 • ONSITE SEWAGE DISPOSAL (05 Coe) 13 SYSTEM DESIGN Date Property Owner R10 Ei T 4 K 14_T H C.EE A/ (.-D ezog System Designer 1IGSEA) 'b si ri Legal Description: Section ..? Township ,3o A) Range I vi Subdivision Name lc kt,A ?Qt MT Division 5 Block Lot(s) -251 i. CALCULATIONS If for residential use: Number of Bedrooms: .2 x 120 G.P.D. = .24O total G.P.D. If for non-residential use, attach calculations used to determine G.P.D. Soil texture waste water application rate . 57 G.P.D./ft. squared (see page 214 of the EPA Design Manual) DRAINFIELD SIZING: Absorption area: 420 square feet (total G.P.D. _G.P.D./ft. squared) Trench or bed width 3 feet Trench or bed length /L/-0 lineal feet (sq. ft. 4.trench or bed width) II. APPURTENANCES Septic Tank Size a 1150 gallons Pump Requirements (If Necessary) Elevation difference in feet Friction loss Pump capacity should be — G.P.M. at -- T.D.H. Number of doses per day Dosing volume -- gallons Pump chamber size — gallons / ovs rte .-ACA/ 00259 '1 067 BERNT PAUL ERICSEN 1� H:`homelpincntr\intohithlsewcisn EXP S 002(111 III. DRAINFIELD CROSS SECTION //// r-I/TZ/ a" Dram hack ( MATE SOIL A B C 3E 1 CHA • St'3..,."RAi.3, A. Trench Depth .2t4.- 31- inches Lin 42 36"de,o f L-Iru �l s 3 -4 2� deriA B. !o inches of drainrock below pipe t✓N EFM 8ER5 -RECO M iti JDED C. > 3G inches of vertical separation from trench bottom to impermeable material;seasonal saturation D. inches of fill (if needed) E. Trench width 3(, inches NOTES: ATTACH DETAILED DESIGN OF SYSTEM Robert and Kathleen Logue Repair ( 07 — 03 — 2014 ) 965000139 Current drainfield ( SEP 93 — 389 ) is severely "Ponded" with effluent level at top of"D" box. No surfacing effluent noted. Owner has pumped tank several times over last year. EES was done at time of sale ( 05 — 02 — 2014 ) Landscaping and "hard scaping" ( concrete slabs and water feature ) were installed 5 years ago over drainfield area which may have adversely affected drainfield. Daughter was recovering from brain surgery and required baths over last year ( has recovered and no longer living there ). Have spoken with owners concerning ways to reduce water usage. Respectfully, Beret Ericsen ( Ericsen Design ) weta toi Vii, `*wA • b� .- ®o. BERNT '1100259 UL ERICsEN #1 CE Stf)"• . ;, o���.oforwm►y►oC rool tr►tw . ' L.w vvi ko 1-1-1-1* . . . --.... --:, , KALA POINT DIVISION NO. 5 - PORTIONS OF SECTIONS 26 & 27 IN T.30N.,R.1W., W.M. JEFFERSON COUNTY, WASHINGTON ----_____ - - a: - -• 249 ,t2. 4. .• .14-J4,, 2' i 4 4441- -4,;1, -',... N. e ,.... •-4Z:77ATP 268 . ;,,,.. ... „ zov .„ ii;c.a... Ie. Al -0-- .--- 247 -17...,, ;21 e69 F:I, e• ii•--71-0-1-• --------. . --f-..q''''. /f 0 -0" '. 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PROJECTAPPIICAPIMAte 'jeil6C1'?7 I lct}THLEEA) LOOur DETERMR ING STORMWATER MANAG T REOIMIENIENT&This stormwater calculation wolicstsset should be corwleted first to-classify the proposal as'small;'madam:or b" The size detemtres whether a Stormwahnr She Plan Is recethed hn conjunction with a' management p FORM appricalion,or other land use apps val application that involves stormwater review. The basic kllormation will also be helpful for completing a Stonnwater She Plan,If reed, PARCEL SIZE 8.E7-SCh'EI Size of parcel ,4-3 acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet is',710 sq/ft Land-disturbing activity is any activity that results in movement of fit,or a change kt the existing cover(both vegetative and non-vegetative)and/or the existing soil topocwhy. Land disturbing include,but are not limited to clearing,gradng,filling, excavation,and compaction associated with stabfrzation of structures and road construction. Native vegetdion is vegetation compdsed on phut species,other than rexkius weeds,that are kvigenous to the coastal region of the Pacific Northwest and w�hichh r y have been expected{ to naturally occur on.the site. Examples� species such as ��fir,western Ie• oM western cedar,alder,big-leaf maple,Cn d vine maple;shrubs such as valaw,eklerbeny,salmonberry, and salal;herbaceous pleas such as sword fern,foam flower,and firmed. LAND DISTURDNIG ACTIVITY.CONVERSION OF NATIVE VEGETATION.AND VOLUME L.-.. Calculate the total area to be cleared,graded,fftled, Answer the fogowiv two carixdkais related to - -excavated,and(or compacbsd for priposed development convendon of native vegetation: project. Include kithis calculaton the area to be cleared fm: Does the prciect convert%acres or more of Construction site for structures sq/ft native t to lawn or landscaped areas? Draurleld,septic tank,etc. Ir 400 sq/ft Circle: Yes Well,uts,eta sq/ft - Does the project convert 2z acres or more of relive vegetation to pasture? Driveway,parking,etc. sgdt Circle: Yes No Lawn,landicaphig,etc. agltt Other compacted surface,etc. sglft Indicate Total Volumes of Proposed:- Total Land Disturbance !I COO sq/ft Cut Q RV ®— (c ufYd) [over] stommater cat wa et—REV 11WUi2003 1 . • r Impervious surface is a hard surface that either prevents or retort's the entry of water into the sail mantle as under natural conditions prior to development. A hard surface area which causes water to run off the surface in greater quanblies or at an increased rate of flow from the flow present under natural concidons prior to development Carsrwn inipen4ous surfaces rulude,but are not kmlted to roof tops,walkway,paw,driveways,paring lots or storge areas,concrete or asphalt pang,gravel roads,packed earthen material% and oiled,Wraitirdatner other surfaces which skready ink the natural infEraton storimmater. STORMWATER CALULATIONS—IMPERVIOUS SURFACE NEW-4' EXITING Starclums 0414 ama): weft Structures(all roof area) soft deunralks ` ''�' sglft Sidewatcs sq/ft Patios sq!It Paws salt Solid Decks sgllt said Decks soft (walled kdlitraliat below) (without inn below} Driveway aglft Driveway sant Other sgfft Other Total Hew sglft Total Existing stint. TOTAL NEW+TOTAL EXISTING* sglft This amount wa be used trs check total lot c ov _ The following questions will help detennthe whether the proposed project iss ccorsidered development or went DEVELMIENT V REDEVELOPMENT Divide the total existincr impervious surface above by the size of the parcel and convert to a pexcestagm % Does the site have 35%or more of egg' impervious surface? Circle: Yes No FURTHER : If the answer is yes,the proposal is considered redevelopment and the attached Flgtne 2 should be used to determine the appltable Minimum Requsernents. If the answer Is no,the proposal Is consklered new development and the . attached Figure 1 should be used. At this jtsneme,the appitant should refer to the Flow Chart to determloe the ivbfinten Requirements for stormwater management OCD staff wN het verify the won of the project and the applicalion requirements. For proponents of 'small° projects who mast comply only with Methuen Requirement _ Stormwater Pollution Prevention—an addlional stthrnfttal is notrequired. The proponent is responsible for employthg the 12 Elements to control erosion and prevent sediment and other patents from leaving the site during the construcilon phase of the project. Pick up the Construction Stormwater Pollution Prevention(SWPP)Best Management Prate(BMPs)Packet Proponents of.° n"probe that must meet only Ilnmum Requirements *i through #5—and for lance° probe that must meet an 10 Minimum Requirements—are required to submit a Stormwater Site Pion_ DCD has prepared a sew ternplate of a Stoat-water Site Plan, principally for rural residenilal projects. Complete the termilate in the Stomarater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using gtdclance in the SbnnwaterManagement Manual. APPLICANT SIGNATURE By signing the Stormwater Calculation Worksheet,I as the wplicardlowner attest that the information provided.tom is true and correct to the best of my knowledge. I also cry that this application is being made with the full knowledge and consent of all owners of the affected property. (uAMowNERoR AUTHORIZED REPRESDITAME SMARMS) (DATE} 1 µ , ercacwo,ksheet—REV.1fl/1/2003 2