Loading...
HomeMy WebLinkAboutSEP2014-00074 , , �� or I ✓s •it Jefferson County Department of Community Development $ :`'��.j• 'V 621 Sheridan St,Port Townsend WA 98368,(360)379-4450 „ ac A u e`0 20 4 SEPTIC PERMIT APPUCATION I' ,' -- �� .`k, • P R O P E R T Y O W N E R I ht 44 R A M 4 NI/Vg:T N A F LE M t N -t say‘ l 00259 SE i .f of MAILING ADDRESS "Pb ''�O$. 673 ,.... ... 4� • E*.Si_o ilea "_. 'R, -1-• , k • .. 8 .••∎►a∎sa.i.���.....'e.\.�o PHONE ( 360 ) V10 - 6478 1/ ,,tt 9-it S Y S T E M DESIGNER E�t elo DE t El W Designer Phone# 360 - 301- d 3 214 LEGAL DESCRIPTION: Section a7 TowrEchip.30 N Range {W PARCEL# q '7 Q q etO t 1 3 Subdivision Name W b O's)L.A t t 1 H LLLS 4z1,1rt t Division�_ Block Lot(s). l a _ Site address/Directions to site l57 S a. 111 DDT)LANb WR. 1)01 T To NSEtti WA. cig 36S SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential ( New Tank/s only Private Residential ADU Modification Public PUT) Commercial Expansion )( Community Upgrade — Repair SiTE SIZE 4,Q U S SYSTEM TYPE Partial Repair-(tank) .(drainfield) Previous Evaluation Conventional Designate Reserve Area Yes# SEP 04- 14$ Alternative 'l. Redesign No SYSTEM DETAILS Number of Gallons/day Soil type 4 (attach sod eval.) Application Rate .$(.. galisq.ft./day Drainfield Length sT uift. Tench Width 3 it Trench/Bed Depth 'n. Septic Tank size EX. 1150 gal_ Pump Chamber size Et. t150 gal. (i`rQ TYPE of system MA.k, b 1 t 0 TO 4 5ED K.00 M S By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowl edge. 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 shall 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 application will be separately judged by the rules and laws in effect at that time. 1 (6_0 VYI l/46 G/i0/2-6/y.Property Owner Signature ` ate 'Wan/ FOR OFRCEtISEONLY 3l ��31 76 j � PARTIAL ASBUILT e 31/I Fl 1 S APPROVED INSP/PUMP TEST-3f 06/19) der 3\776\1 ALL HOLD REQ.MET s� , Date (410 /11 Fee `T o u Rec# /�„ A O c-Check# #61/ Case#sEi ;t -�� - 1 H:\WE$\PDFS\Septic\septic_pexmitapp_2008.DOC ar f, Nk" JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street•Port Townsend•Washington •98368 www.jeffersoncountypublichealth.org Phone 3bU-36b-9444 i-ax MU-3(9-4461 ON-SITE SEWAGE DISPOSAL PERMIT PERMIT#: SEP14-00074 Date Received: 06/10/14 Date Issued: 08/22/14 SITE ADDRESS: 1582 WOODLAND DR Date Expires: 08/22/17 PORT TOWNSEND, WA 98368 APPLICANT: INGRAM M FLEMING PHONE: 360-770-5678 MARTHA M FLEMING 1582 WOODLAND DR PORT TOWNSEND WA 98368 LEGAL DESCRIPTION: WOODLAND HILLS#2 PHASE 1 DIV 2 LOT 13 SUBJ TO OPEN SPACE PARCEL#: 999900113 Section: 27 Township: 30N Range: 1W DESIGNER: BERNT ERICSEN PHONE: 360-301-0324 293 PINECREST DRIVE PORT TOWNSEND WA 98368 SYSTEM DESCRIPTION: PRESSURIZED TRENCH No. of Gallons per Day: 120 Type of work: EXP Drainfield Trench Septic Tank Length: 66 feet Width: 3 feet Depth: 12 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-Sit ewage Sy tems, codified in JCC 8.15 as amended. This permit may not be renewed. *<- (-//4 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.: SEP14-00074 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.) H - AS PER WAC 246-272AAND JEFFERSON COUNTY CODE 8.15 ALL ONSITE SEWAGE SYSTEMS REQUIRE THAT A 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 246-272A AND 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 4.) Health Dept. required to observe pressure test with system designer when system fully installed/complete, 48 hours notice to be provided for scheduling. 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.) MAXIMUM TRENCH DEPTH 12 INCHES 11.) Drainlines are to be installed along the natural contours. 12.) Dose counter and elapsed time meter are required in the control panel for all system components. 13.) 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. 14.) Approval of this sewage disposal permit does not preclude the permit holder from complying with the Unified Development Code for other/future development on the site. SEP14-00074 Page 2 of 2 \\tidemark\data\forms\F_SEP_Permitmod.rpt 8/22/2014 • JEFFERSON COUNTY PUBLIC HEALTH, 615 SHERIDAN, PORT TOWNSEND WA 9$368. ASBUILT INSPECTION REPORT For RECORD DRAWING 9 Designer ER ICS E N Dr S 16 K) Permit# SEP /4 - 74 1;3D Installer I C_S F/J tX. (TO13E( ]{I I.H k M') Parcel# g 4 Q 9 01011 Electrician CA$CAD i C Design Flow 48o Property Owner 1 N ia'RA M 4 NI f3TtTl-) El E M I)�1 C� Site Address I $2 1n(bbt7LRIZ DR. TORT T M / NSE'Nbi WA• Answer all questions or indicate NA PATE, Tanks. Pumps and Controls INSP. Tank (manufacturer, size, baffles) EA. FRED H I LL. 1 150 E AL COO c tETE 3—.26-1 Pump chamber(manufacturer, size) l' • Screen(s)and/or Pump Shroud (type, location) OUT LET S A F F L E l L T ER 3-.74-/ IN SEPTIC- T/■ V Bi0TU 'De EASY PACK iii! PJNP TA01: Were Tanks tested onsite for water tightness? Yes CQ EMS Ti NC-� Panel Model EX, AQUA W cJRY. Sri; i 104-100 -- 67-5. Pump 1 - Man./Model UREA)rip ?C 5005 Flow Rate 41 apm t Pump Location (i.e. garage, treatment unit, basement) Po M? T4N k Float/transducer settings Inches Timer from bottom of tank- On/off- i 7 in. Functions: On I ; I /min 15eG Veto - 41 in. Off- Z #.1.0 c/minl • Alarm - 4 I in. Veto On - I ,i 5 :/mini${C, Storage Above High Water Alarm 360 gal. Veto Off- 1&0 /min Dose Counter Reading g L g 5 V D06 fob #gallons/dose 60 gal. Elap. Time Meter Reading (q; psi; 34 hK/minSE. Pump Throttled? Yes/1 Dose Drawdown (in inches) 1/g in. AT H I;Alj l? Pump 2- Man./Model Flow Rate qpm Pump Location(i.e. garage, treatment unit, basement) Float/transducer settings Inches Timer from bottom of tank- On/off- in. Functions: On sec/min Veto- in. Off- sec/min/hr Alarm - in. Veto On- sec/min Storage Above High Water Alarm gal. Veto Off- sec/min/hr Dose Counter Reading #gallons/dose gal. Elap. Time Meter Reading min/hrs Pump Throttled? Yes f No Dose Drawdown (in inches) in If additional pumps-complete the info In this table for each and attach. Other Timer functions & settings (e.g. override on/off) ZPj 0 C Au TD CLEAR = , tos" H:IWEBIONSITE1Asbuill_Report Form.doc 04/28/10page i of 2 Pre-Treatment. Date Insp Sandfilter basin high water alarm shuts down pump to Sandfilter Yes/ No • Sandfilter Basin size/location Sand Fill met design spec? Yes/No ATU (manufacturer; model) Alarm tested Yes 1 No Disinfection Unit(manufacturer, type, model) Independent Alarm Yes / No Drainfield ri Transport Pipe size, schd, diameter EX. ch 200 Manifold size/schd Orifice size rg Lateral Size/schd 111 Barrier Material G160 TEX TI LE Cover Material/Depth 4) 3-62-G'- I 5 ii Residual Head (lat.#&ft. Head) I' h-�OJi SW GIPS The laterals/pods were balanced Ye / No it 1' Source/Manufacturer of Drainrock/Gravelless chambers SI-1-0L-D Drainrock Clean? Cs / No if no, what action taken? — Mound/Glendon Site Prep Drainfield Length 44'ADDED a270 To-lat ft Width 3 ft Depth i:L-I3 inches Caps for measuring residual head stored (location) COMMENTS (inspection notes, changes from design or deficiencies in installation) Attach additional sheet(s) if necessary oL" 33' C,IFTE13-LS /CM l=am TO EX. SEP 0 i- / g ALL NEW 11ANIFOL1D 4 04-- eRi-LS ARE i"' SCE+ 4-0. Health Department Inspection issues resolved Yes/No/0 If yes how? • Users Manual Provided to Homeowner /A)C-lRA 11 1 LE M 110 6 Date, 3-2q-15 Tank/component Decommissioning Report Attached Yes/ No I is Installer Certification attached/signed Yes/ No ATTACH RECORD DRAWING stamped/signed by Designer or Licensed Professional Engineer I CERTIFY THEE INFORMATION PROVIDED 4$OVE WAS VERIFIED BY INSPECTION, Tf#£ SYSTEM WAS INSTALLED AS DESIGNED AND APPROVED by JEFFERSON COUNTY 2-22-14- (DATE) OR Tf#ATCffANG£s ftAVEBEEN NOTED AND 'ME SYSTEM IS IN COMPLIANCE WITS WAC 246-272. 1e CI^ . 3`02R-i5 600 Z59 Designer Signature Date License# H:IWEBIONSITE\Asbuilt_Report Fonn.doc 04/28/10page 2 of 2 . . 1 -nm $9 �i •3 Ni Cy. i�ar�i i rtn -4 ED cp m u9 Iv o �,• m rn z .st z.• R CO C9. -1 DJ O. =.am ® `—w:_ x. 01 AA m �. �' cn NC - " 1\/ C-o bm n m a o e XI N m o m oi r • N N.<Q No Ux cm /°° i .,.� 0° D CD SD 9' > 0 7'6" n; 0 c_.-- -3— o °- 0 0 0 0 O co Dry m mmz toco o m � D -0 * �, 5 � N •t. co v W m mED x w a > -13 (14 41, x • � � w p � 0�3� w -% mw > 2 *. < 0 -4 D 0 0 � omr Co (,,..1 N o " m Z cn K m 2 0 1 m 0 � � cnwvc 6 o m 3 D m -i m z ce a) -< 107' z 1 L1" r - - - - O — — — — — 6 1 778.72' (31 — ' — — — N 4°32'21"E V klip 74R.93,.93, 0 '9.26,00" 14/ ,,� I‘‘1,\ 1 A hy 0S `�®-^ cm " co -n G)co m d °0m. .ir ' -4 j;y�� . 3 w s� m g ..., rnw •, W xi 110 �, .Y a"ss = D 2; 4;m -'.; f. —I D z N m • m G) Q n -. V) co p o m 3 D mimz c---iSE=2--ro T co e ?y o ac'G�a \ J ss a m S o co /2 m `96440 n w J �A. m w R � 41, XI m I ' I ' mm l< 50' >■ P. CD m mr.,, X .i > -9 w per) ONr 402 A' N Ui X w .p X ... 107' co c,2 > 778.72' I i N 4°32'21"E CP • cci CN T N ,.,,�+ 519• > �. rn — orw 4�� 743.93;_,-------1,..`1), ' ,,, mil co# /r,, j I O0 z w �, rn m :,S \, G� ili. :d K �% 4 to Va, O Furl 4 . . i i� \r • '''':/\e..-,,,///,.�,,,,..s."7", v. ill . ....., ..... ..,," c5- , --' N ?\ 9 4.* „ r , ,,,,/ 44. k\I \'" / NAtitillr-7,'N-(y, >,„,/ .--dA• ° � y � ai '� rn 20, / \f 170:VI si� / ,;a i0zeG) 0 z ""•1 I1p 778.72 tl& rn Z --k Crl 7432` - -_ ,` / ° i d f Imo` `'- _ i� / P --____ _ Q1Pl?'-- ' / KP Q .#N z . +sir//r,�A,rp 11,, 2, R'i -1 O '%0 3. t ._ -!11ls Cli V, (� W L-7.- Ingram & Martha Fleming ,l�,y, 999900113 (,4 Project Description: Expand existing 3 Bedroom system ( SEP 04 — 148 ) to 4 bedrooms, make alterations to pump tank and add additional drain field. Existing Septic Tank Existing 1150 septic tank with outlet baffle filter to remain. Pump Tank: Existing 1150 pump tank to remain. Modify by removing existing pump and shroud and installing an "Aqua Worx" EasyPak Pump Package by Orenco. Pump Need pump capable of 41.8 GPM @ 38.4 TDH. Use Orenco PF5005 ( 115 volt ) included in EasyPak . EwAGE p Ap.riP'i f.�'�'SAL D reN Control Panel •- _/4 °�' ruction The , existing Aquaworx control panel is to remain. p ate Existing Header Modify as follows. Add two 2" tees, 2" x 1" bushings and 1" gate valves for 2 new drainlines. Install 1" flapper style check valves on lines 4 and 5. Drain field Install two new 33' l s. Trench depth 12'.L4 S e detail page for trench and inspection port details. Lateral 5 ( 33' x 3' ) 11 — 1/8th orifices, 3' on center © 12 o'clock Lateral 6 ( 33' x 3' ) 11 — 1/8th orifices, 3' on center @ 12 o'clock All laterals end with long sweep 90, with screw on caps inside valve boxes to grade. Enclose additional caps with 1/8th" orifice inside baggie in valve box. The first and last orifices shall be approximately 18" from the beginning and end of each lateral. Install orifice shields after pressure test. Cover with filter fabric before backfilling. Install inspection port to trench bottom 10' from beginning and at end of each lateral, as shown on trench detail page. Dose 45 gallons, 8 times per day ( 360 gpd ) 75% of peak or its+ 5' min. residual head required. s r Inspections irtz,` ) V. s ' ERN1` ! LEM• . .�' CENStb'bE IGNEa.. Qt SEWAGE DISPOSAL DESIGN Appro��•r f �on ctioct Contractor to contact designer prior to const u . • • e• • • struction meeting, and inspection schedule. Contractor to flush a era's prior to contacting designer for pressure test. General Construction Notes 1. The work described herein consists of ®r, 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. 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. Transport pipe and laterals shall be Schedule 40 PVC, unless otherwise stated in design, solvent welded joints. All fittings shall be Schedule 40. All transport pipe in traffic areas shall be Schedule 40. 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. Double case in traffic areas as described in plans. 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-15501. 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 drainfield/reserve areas. 6. The bottom of the trench or bed may be inspected by the designer prior to placing sand fill or drain rock and shall not exceed +/- '/2" from level. 7. Notify designer 48 hrs. prior to pressure test, after permanent power has been connected to panel and L. and I. inspection complete. Any deletions from plans, or necessary adjustments, shall be completed by installer. 8. 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. 9. Setback from the building foundation wall shall be 10' minimum to drainfield, 5' minimum to tanks and 2' minimum to non-perforated sewer pipe* 10. Setback from property lines, easements lines, and driveways shall be a minimum of 5' for both drainfield and reserve areas. 11. Water saving appliances, fixtures, and practices are to be used. 12. The septic and pump tanks, drainfield and reserve areas are to be protected from vehicular traffic or mechanical disturbance. 13. The installer is to verify pump requirements at the time of installation. 14. The designer is to provide the " Record Drawing " and letter of certification. 15. This system has been designed in accordance with WAC 246-272 A 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. A � DIS�'DS �`d AL DE Co, truction� Date I to G \ cD ca, ,`o v .Q o b u/ 0 • pR(CStA) -EGiC � /i 'D c O // r ii � / ;I CD C O J O// y • TS CO / N , / N%/ N 76 // /J/ ■ j / / C.1 , r • it / Ii LOT 14 /1/I 111010 `�' MOSTLY WOODED ' J As'' LOT % 0 1 • / 044 .11 / / Lo POR> / / , , 7;f... ..'1-.., . ��o %/ NEW GUEST - E s` / y . / ,' BEDROOM se?e4.���ss/, , / 100 , p �_ I s�'BERNT PAUL ERICSEN'.. 1 1�t / /<ry F. C i b•C ••I 'Eft.. 1, / / / J EXP b' 11= '.r.:* / / q-1�- 4 / /SS I / TIE IN SEWER TO -�.� / 9g „ , ,J , :fir s+4 j . EXISTING HOUSE LINE . Et, --�,� i '� s/� \o,. %I��' ''1°' EXISTING / I TO SEPTIC TANK �� TAN cl"� ....,:l\'' \ '\ \ TRANSPORT I / ROSURE 13 SIDE YARD SETBACK G\ 4s%ISS/55 A •� LINE /rir/Pe1i� \/ � I J %/ fAh�' �, • 'j • PRO'POSE }i21 D 5'.-0)(i -----l •ie rA 0 .o,14T-G" I I I ; „, / „.... , , 2 / �l0'v10+ r f 9 ►t/G /, , cn /� A�� %10,��o+ I J , dv_ 6� % `� , /„,,,, ,l 11 i, �6 104 8„ l„,,,,,AK %�� �' „0' /� \I/ I JI SIDE YARD SETBACK / I ` — I/ ll I + ��, EXISTI G ,' EXISTING GARAGE //i// SFR PAR IONGPED %/ 1 /I LOT 13 SPACES IN I / �% I / GARAGE / / TYPICAL �, /` ' I OVERHANG / %// @ NEW& -I %Z l EXISTING / CONSTRUCTION ', I / / I / 12'2,� %I, \'�. EXISTING GRAVEL i% _ % CONSTRUCTION DRIVE ' / / J ' %� / LOT 12 /1' I / / J , / I / / l Z I r ' leli / , jI&....,c) 4.,...,---- / / FRONT YARD / / ` u // SETBACK I `�' ”' -.. --— — —__ II ---- __-__ i WOODLAND DRIVE NORTH - - - S T= PLA\ 1.. SCALE: 1" — 50' • 250.00' ., S 88'19'33"Vd 4" 1" 4 ., `--0," cm 1 Existing Fence , a, 0, co- 6 v. c, & - cc, Pi cb ,... co — Proposed Expansion -...., ■ t NN,..., Existing SEP 04-148 itio,4414 A• SEWAr:,..-v.•z flic_,-n ,trDESIGN ' 0 ,. ir, _ 0,,, 4..■ / 1.... D e 00,:ir. 71410 4116 1 a t N 41 Atcf 4• 4 101,A .Ips; f,ds,4_ Ir. • roc. 4 .... z 5100259 AT jri:BERNT PAUL ERICSEN. h of‘r LICENSai DE NER li alionowwwwwwwlomom.......To 31 S ie 11 NO building site, driv: ay, access =o---- or other appurte Le has been reviewed • approved by Jeffe .•n County staff. 0 40' NM Ell mil mil CP4 A (-FILE NAME -N Ingram&Martha Fleming.TRV i rirtzr ks SCALE DATE DRAWN BY 7i0"` w Cl. uk`-- 14, 40 Ft/In 6-9-2014 Bernt Ericsen P'GrA JOB REVISION SHEET ..999900113 1/1 1/1 ..1 This map drawn with TRAVERSE PC,Software . . Existing Fence 0 (.--/- ke, —C)-- r-1 (W_E NAME Ingram&Martha Fleming.TRV ,\ SCALE DATE DRAWN BY 20 Ft/In 6-9-2014 Bemt Ericsen 0 20' JOB REVISION SHEET I= NM 999900113 1/1 1/1 MI MN i This map drawn with TRAVERSE PC,Software S Date w t.. N ca -, Existing''Hand Dug" t■ r r. v Test Hole S/L lA z \43 Proposed of Expansion ----...........,.. 0 q (See Detail Page) -0 of 4 of 1 63 0 Proposed L 6 (33'x 3') st: '... 0 ! .0, .,,Nor. . Ar ** - 1 • '''',P4 ' I /10,.',',. i ''' ,,i , Zo Proposed L 5(33 x 30) i 1, i 0 L 4(51'x 3') • , 0 ' 0 ,r ,.p-- ( ' s• BERNT PAUL ERICSEN Existing 0 L 3 51 x T)-. 44. SEP 04-148 UC NSait_• .•Piti T„- -0 .gottotmo■IweiNemetoto•Abitomit.yob:IF, L 2(51'x 3') r 0 L 1 (51'x 3') i Reserve Area 40' x 80' NO building site#driveway, access or c/ther appurtenance has been ?eviewed or approved by Ex. Shed Jefferson County staff. 10'x 12' oe ='C ' I i 4r-;70t_.‘ '.. ,V .,\ 71 ,. a R�g3�. . vfm (-4 c.) IkNil o. c • SEWAGE DISPOSAL DESIGN O _ -or) X m x x x W I- '- - co Lo in d- G. Ij/ _i J L CV X X J 0 _x CM _ ^0 CO -.03 r u) 0_ `� U ao �x W tO ' U) J ,ca a- _o W 0 o C Q Q ; 0 o O w i c a Q fi a x To W y i n = IV 0 1 °T °,:. 2 . ill o � � a , � i Ui — l f F-- z < a.v.... _W N 0 L OC m O -0_. Y ri)_- < In - 3 o c 0 LJ 0 - a o CO a' r 3 0- w a°)i X `) rn.F- O O m Q Cu 1.F. L x to W a-' r n aW.� w Z Cr co CO - OS C/ I-H-n W M H N to d N E O. = > N O Z 2 c p ~ �)m;� W u_ W is < s m rn >15 _t rn W P_a o L = tn � O� Wm: ' iN�'RAM 4 MA-RTNA cLEMtNfa gRgqao II"j FINISH GRADE 24'0 RISERS WITH LIDS I NATIVE FILL -.AL-- .� 1 */>>/;\i\�$ ///fl i• !/!/,,//!/f!/< /f///!!f f!/! •!!/! 1, N.,.//..\ \N. / / r- . 1. l I i •l 1. i 1 /, / / = well./////I//I/lll ‹' `�,` = i 1* OUTLET 1% :7 IN FROM /\ TO PUtV? TANK BUILDING MW_- --m- ` . . I d EFFLUENT LE M_ I < < -.- SLOPE �� . s T } i �, `� 3 STAINLESS STEEL > - i CLAMP OVER _-•- /I o'- 4,15 PVC OUTLET NEOPRENE RUBBER \ ; — / -a- _ BAFI•LE (NO SCREEN) BOOT (T R) :::e/ \ ]]] `y : >/1-..---1 \4°¢ r-vB :: .\(:_......:.:k INLET BAFFLE 11/1 I --I NEW 2000 GAL 2 - 0 1 COMPARTMENT ;1 C O N C R E IE S E P T I C >� E X t s T Wei i t 50 4 A L. - TANK FROM 1 - PENINSULA TANKS s / - -„-./ BACKFILL AROUND - : / K.:::: E - \ TANK MTH PEA �, •- / / GRAVEL TO TOP OF / -':: ////J//»//!!//f//.r//I.�/ �// .40.12.1// 1 ; z< TANK ;�\\jf\mil`/ \\7j `-V/:'\Z> Zl ..\\,/ /\\ s ItW TANS 5E Q .r.„_,4..4..:8,A:.,,--,..=?. NOT TO SCALE v1 A i I nst FCC "�l �j i h s Iti 4 acQ tt Fib_d .. F ' SI ELECT. CONDUIT FINISH PVC SPLICE BOX l-.•w Date Le TO AQUAWORX GRADE KITH CORD GRIPS ,24"0 PVC RISER & LID [ t S 2 �� CONTROL PANEL 2 21a - 1-1 4- \ // // // // // // // // !/ !/ // // !/ /! // ////,! !!/!�\ i\\n/1-fJ.I1./�.1�./�./� //-� _. . rims=:t_11=, !,•/, /, !, 1, ', f ! /,, \j`\�� '% ::;' //I/.l�IIII/ 1� �.%.t,�/'1/I�//III ::-. / IN FROM f>\\f •_- -' — ► SEPTIC PVC UNION A Z- I TANK 0-�---� I � Fi1Gr! = ■.� ti w �/'-•- 1S MIN. / - t` I ALARM� - '—BALL VALVE st / I•SLOPE \\. -_-k ALARM. N j - :- TRIGGER Lai- A. `-2'0 TRANSPORT STAINLESS STEEL \! -::-: t \/LINE TO DRAINFIELD CLAMP OVER t/ -= --G Lrc MI _ .> NEOPRENE RUBBER /s.:=- BELL i BOOT(1W)`\i- -•i ASSEMBLY `i ' a CHECK VALVE ;1f 4'0 PVC `� •. II A ' TRANSDUCER �/ INLET BAFFLE READS 0.0 % .,1 - ��1t. PUMP IN AQUA Wd ; -.-• ` BACKFILL AROUND 1 EASYpAK Pump TANK WITH PEA ffi PUMP TO at PAcM E BY Mob) . _ p GRAVEL TO TOP OF NEW A 000 GAL Ns/ : -__ _s TANK �\ REMAIN _ SINGLE , -SUBMERGED : k< COMPARTMENT<</:\ .•� , - CONCRETE PUMP y/\ : _ CHAMBER FROM >!. •: Lf/rl:hr.# /rlAI/f/J1A A%oo /// /.�//�%% \� PENINSULA TANKS ! -•' .'-" • :may _ '/�j f\ mil\\/' s_f-- A " '.L \/>, > NOT TO SCALE EXIST i Mei i,to Q�. Pump Selection for a Pressurized System -Single Family Residence I', roject Ingo & Martha Fleming Parameters ' ro. Discharge Assembly Size 2.00 inches 160 Transport Length 300 feet PF5015 ' i 1 i ; j ' 1 [ 1•i Transport Pipe Class 200 ` i i j i ; Transport Line Size 2.00 inches Distributing Valve Model None 140 ` 1 1 Max Elevation Lift 12 feet • ( ! � € 1E ! i I 1 Manifold Length 90 feet j i ' i� Manifold Pipe Class 200 i I } Manifold Pipe Size 1.00 inches Number of Laterals per Cell 6 120 1 I i1 � I s, ! Lateral Length 45 feet i PF5010 _ ? Lateral Pipe Class 200 Lateral Pipe Size 1.00 inches ' Orifice Size 1/8 inches iv 42 .Orifice Spacing 3 feet is.. 100 Residual Head 5 feet S PFSee7 i I 'I Ippr_ Flow Meter None Indies — --r–, i• Add-on'Friction Losses 0 feet -t— CO r I I 2 80 i I , t � Calculations v , ' � Minimum Flow Rate per Orifice 0.43 gpm m ? I I .,_ Number of Orifices per Zone 96 >, � �\ i ' L_ ; I ! Total Flow Rate per Zone 41.8 gpm a PF5I I � ` I I ; To 60 ii i ; Iii ! I li !� l � { ; I Number of Laterals per Zone 6 O I i i '`, %Flow Differential 1st/Last Orifice 2.3 % t— -- 1 ' ' i i I ! ! ; 1111111111111111 }.I I – — Transport Velocity 3.7 fps �p ' 4 I _ 1 ,i ; i i Frictional Head Losses _ _ 1 i ` Loss through Discharge 3.5 feet 11111 �� ' I =i Loss in Transport 7.1 feet ' 1 ! I.//11 1 i i I " I !_L Loss through Valve 0.0 feet i j 1 ! I 1 I I i : ; ! -;- j I i Loss in Manifold 10.6 feet , 1 1 � I i i i ` Loss in Laterals 0.3 feet 20 I C I I I I i � I Loss through Flowmeter OM feet m fr. � � I I i I I ) , Add-on'Friction Losses 0.0 feet I- IIIIIIIIIIINIMIIIIIIIIIIIIIIHII � � i i I l � Pipe Volumes 0 ! i l I II ! 1H ! I I I , 1 I i WI I Vol of Transport Line 56.5 gals 0 10 20 30 40 50 60 70 80 Vol of Manifold 5.2 gals Net Discharge(gpm) Vol of Laterals per Zone 15.6 gals Total Volume 77.3 gals Minimum Pump Requirements PumpData Legend Design Flow Rate 41.8 gpm PF5005 High Head Effluent Pump System Curve:— Total Dynamic Head 38.4 feet 50 GPM,1/2HP 11 5/230V 10 6(H z,2 00'23 0V 30 601-1z Pump Curve: PF5007 High Head Effluent Pump Pump Optimal Ranger 50 GPM,3/4HP 230V 1060Hz,200/230/460V 3060Hz Operating Point() PF5010 High Head Effluent Pump Design PointO (a 50 GPM,1 HP Air r ,l! 230V 10 60Hz,200/460V 30 60Hz ' 0 , \ li PF5015 High Head Effluent Pump f� �;,�' 50 GPM,1-1/2HP Ca �` ,,,4„, A in:.'4I-.1i.': 230V 1060Hz 200V 3060Hz Orwnoo 9ystema" 6� w . j. Incorporated 1 _ ,,y 3 s - .; avenging rrrciVSry r3 if 1. It-w d Dorf I trr rvn' 0 9 - �$ of,i r.3.ti:z, i,, ;c, -" 1 Div®w���www.>e*,..,acv..►...m Dr ar• --'",4'1 _ C.1-f'- Technical Data Sheet --.---,' Biotube® g Eas PakTM Pump Packa a Y 60-Hz Series Pump Packages General �'L Riser lid Orenco`s Biotube®EasyPar Pump Package is the first 6 I lete (not f - Internal I included) pump package specifically for filtering and pumping efflue"`!ym 1! splice box i pump tanks.The EasyPak pump package makes it easy to se ect .� (External t and install the correct pump package for the pump tank.(U.S. r . splice box i_Riser(not Patents#4,439,323 and#5,492,635.Additional U.S.and international { Ili " optional) i included) patents pending.) ,r. This document provides detailed information on the EasyPak pump Lam j Discharge vault effluent filter cartridges,4-in.(100-mm)60-Hz turbine effluent ! = �` assembly pump,and control panel.For more information on other EasyPak - 1 1 components,see the following Orenco technical documents: I i L •Roat Switch Assemblies(NM-AV-AV-1)I •Discharge Assemblies(NTD-HV-HV-1) a •Splice Boxes(NTD SB SB 1) •External Splice Box(NTD-SBEX-1) 1 1 Float bracket I I Applications I g Float stem The Biotube EasyPak pump package is designed to fitter and pump I I effluent from a pump tank to gravity or pressurized dispersal. i a The unique low profile,submersible design of the pump vault 1. i i makes it well suited to applications where large reserve volumes I ! are required,or when pumping from near the bottom of the tank. Lifting strap ' I 1 • Complete packages for on-demand dosing or timed dosing at 10, 30,and 50 gpm(0.6,1.9,and 3.2 ljsec)and 50 Hz or 60 Hz are avail- II I able. Float collar 1 --4:`': { �? � Standard Models 1 ( (a BEPIODD,BEPIODDCW,BEP30TDD,BEP30TDDCW, lr I : :i(,,,,� Floats BEP50TDD,BEP50TQDCW Flow inducer t _„ (2 or 3) r 11 Nomenclature► r-r i'4- j,`f Filter Pump liquid end ; - ° ' cartridge handle Discharge assmbly:4-in.{100-mm) e � Blank =Standard i :t DB =Drainback turbine effluent ' _ )( Flter CW =Cold weather pump — i cartridge 1 Panel:DD = De mand dosing Pump motor �; TDA = Timed dosing,analog vault TOO = Timed dosing,digital j Pump flow rate(nominal): 10= 10 gpm(0.6 Usec)with 4-in.(6-mm)flow control 30=30 gpm(1.9 L/sec) Biotube EasyPak®pump package components 50=50 gpm(3.2 L/sec) (Control panel not shown:see p.4.) Biotube EasyPak' pump vault,15-inch(380-mm)vault i ©2012 Orenco Systeinsa Inc. A1TO-BEP-1 Rev.1.4,©01/12 Page 1 of 4 Biotube® EasyPakTM Pump Package (continued)• �ak Pump Vault Biotube®Filter cartridge Materials of Construction Materials of Construction Vault body PVC Filter tubes Polypropylene c-® Vault top ABS Cartridge end plates Polyurethane Vault base Fiberglass Handle PVC Flow inducer PVC Dimensions,in.(mm) Lifting strap Hollow-braided poly A-Cartridge height 12(305) Dimensions,in.(mm) B-Cartridge width 10.3(262) A-Overall height(adjustable) 64(1625) Performance B-Vault height 15(380) Number of filter cartridges 3 C-Inlet hole center height 12(305) Biotube®mesh opening 0.125 in.(3 mm) D-Vault diameter 15.75(400) Total filter flow area 4.5 ft2(0.4m2) E-Inlet hole diameter(8 total) 1.38(35) Total filter surface area 14 ft2(1.3m2) F-Flow inducer diameter,nominal 4(100) Maximum flow rate 75 gpm(4.7 L/sec) F 4.1 Filter cartridge handle • t Filter //\•Q• Nitm � . 0,0 I cartridge ( Flow �f1. } inducer l\iU Q �Q Vault 'ir top X004�O i 3 Filter cartridges in vault top view a0[00 O O O I.,.1 • O r_., °ocoo :•oo°° 000 ooc i' °°o•i 5 OO •.00 ao a0[ • O° og 00 moo! , go O O O O O O It A o°O° 1OQ go goc ' ' °o/ { °c°o {;oo o U°c f- o°r °[°O .0O 00 00[ 1- , c o o o a c o oco°i oo'oo °oc i °°( c o a;- 0 0 �o° °o °°c - ' °o I f 1 O°O° '00 °O oo( • °B � t � °C°O!:°O 00 OC ' O C O O I•i ocoo y'oo 00 ooc i.•• 00 o° oo ooc ,• o 1 .. F� D ►I 1.•----B .1 EasyPak®pump vault Biotube®filter cartridge,front view NTD-BEP•1 ©2012 Orenco Systems®Inc. Rev.1.4,©07/12 Page 2 of 4 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 SHER(DAN ST.,PORT TOWNSEND,WA 98368. (360) 379-4450 - SOIL EVALUATION PROPERTY OWNER 1N4 R A M M A"KT t4 A F L E M I N i/4 SYSTEM DESIGNER e-R.le_5E10 D E S t �'i. & °eo/.. LEGAL DESCRIPTION: Section ,21 Township 30 N Range l\A( Parcel # (16?q q 00113 Subdivision Name WOODLAN'b I-LtLLS 2- Division .L Block Lot(s) I 3 Date Logged: 6- L - (Li. Logged By: 1) E R 4 T ER,((',S E N Include soil textural characteristics and the depths at which significant changes occur. Be sure to include depth where mottling or impermeable layers occur. SOIL LOG-#1 A 1 I S C"6 Clictj SOIL LOG #2 0 to g in_ -5R N LS / 61 to in. to (i in. � S 3 TN 4S/FS / to In. to in. ` N.._, ) to 'in. , to in. , i to in. it1 Anticipated water table 7%.ini o�� ��f Anticipated water table in. Roots to 4L. e, inches Al Roots to inches Health Dept. Comments • W le Health Dept. Comments �'��:. ' SOIL LOG #3• nnoco •. SOIL LOG #4 to in ss. `BERNTPAI ICSEN'. 11 w ' UC. :.gEb NOW- 4+ _ to in. woobw....emilbowiminekw Ti iv/.5 to in. to in. to in. to in. jp?cy:2Q \ !) to in. Anticipated water table in. ���/'^�-' J � � y� yAnticipated water table in. Roots to inches 1 .� /"' O toots to inches Health Dept. Comments ) ( q� _ l/ (. 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:1JMFOHLTHISOIL-FRM 1/00 r • ONSITE SEWAGE DISPOSAL SYSTEM DESIGN 449 '1 00 113 Date /6- 5 - 14 , Property Owner l Ill Cam,iR is 1i 4 11 A T F �r A L 1 N 0"4, se System Designer E1. I CSEN 'DE'S t Ei t Legal Description: Section a7 Township 30 p} Range t \ J Subdivision Name i%IOO'DLA N'b 141 LLS 41, Division a Block Lot(s) /3 I. CALCULATIONS If for residential use: Number of Bedrooms: 4 x 120 G.P.D. = 490 total G.P.D. If for non-residential use, attach calculations used to determine G.P.D. Soil texture waste water application rate ,4?,, G.P.D./ft. squared (see page 214 of the EPA Design Manual) DRAINFIELD SIZING: Absorption area: x'10 square feet (total G.P.D. - G.P.D./ft. squared) Trench or bed width 3 feet Trench or bed length 0170 lineal feet (sq. ft. =- trench or bed width) II. APPURTENANCES Septic Tank Size 1160 gallons Pump Requirements (If Necessary) Elevation difference in feet 12, Friction loss ,Zj,50 Pump capacity should be 41, 8 G.P.M. at 38.4 T.D.H. Number of doses per day 6, Dosing volume (,d gallons i 8 i Pump chamber size ( 1 '5O gallons !)? '% ;Q i � jf A' .* � s1 , o% #is 3EAtia AVIC s o I . H:lhometpincntrlinfohlthlsewdsn ar_-.r . S] ( 1-r0- • DRAINFIELD CROSS SECTION , ///7// a- tk,:., R,414 NAT JE SOIL A B C 77.21-1-27-447 a_BEE SEASCI A, , SA K.=,s='C: ts - Ia' — >n`odv. A. Trench Depth _ in hes B. 6 inches of drainrock below pipe C. > .24 inches of vertical separation from trench bottom to impermeable material/seasonal saturation D. 0 inches of fill (if needed) E. Trench width .3, inches NOTES: A " - ATTAC Y D . AIL4D,DESIGN OF SYSTEM f,.. 4. 1 gggq oo ct3 �J 4;2: JEFFERSON COUNTY if _ t1'.1, b, _ DEPARTMENT OF COMMUNITY DEVELOPMENT .1 /i:`1 r plot 0'ti o . 621 Sheridan Street-Port Townsend-Washington 98368 to - " - ' 360!379-4450 360/379-4451 Fax ��•' Sion -.:��t� hi#p flvaww.co efferson wa.t�,skomrndev t/ go. BERNT PAUL ERICSEN'•. 14 - ,i 'cEPitEb DE I ER t 4'- o2/111 I., Stormwater Calculation Worksheet 6.4i-I I( iau►# PROJECT/APPLICANT NAM: I146RAM 4 MARTHA FLEt1It\1C DETERMINING STORUWATER MANAGEMENT REQUIREMENTS:This stonnwater calculation worksheet should be coned first to classify the proposal as final,"`median,"or large.' The size d3tennkres whether a Storm water Site Plan is required in conjunction with a stand-alone stormwater management permit motion,building per"application,or other land use approval application that involves stormwater review. The basic ir#ornration will also be helpful for completing a Stormwater Site Plan,if required. PARCEL SIZE(LE.,SITE Size of parcel 4.q L acres An acre contains 43,560 square feet. IVkilliply the acreage by this figure. Size of parcel in square feet 2141 3 I sq/ft Land-disturbing activity is any activity that results in movement of earth,or a change in the existing sod cover(both veg ive and non-vegetative) and/or the existing soil topography:" Land disturbing activities include, but are not limited to clearing,grading,filing, excavation,and compaction associated with stabilization of structures and road construction. Native won is vegetation comprised on plant species,other than noxious weeds,that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as Douglas fir,western hemlock,western red cedar,alder,big-leaf maple,and vine maple;shrubs such as willow,elderberry,salmonberry, and said;herbaceous plants such as sword fern,foam flower,and fireweed. LAND DISTURBING ACTIVITY.CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Wallets the tom area to be cleared,graded,filled, Answer the following two questions related to excavated,and/or compacted for proposed development conversion of native won: project:" Include in this calculation the area to be cleared for Does the project convert Vs acres or more Construction site for structures sq/ft native vegetation to lawn or landscaped arm? Drainfield,septic tank,etc. MO sciat Circle: Yes (19 Well,utilities,etc. sq/ft Does the project convert ert 2 3i acres or more of - native vegetation to pasture? Driveway,parking,etc. sg/ft Circle: Yes No landscaping,ing,etc. sq/ft 1.J Other compacted surface,etc. sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance Roo sgitt Cut Q Fin 0 (c ulyd) [over] stomnwitercalc worksheet—REV.1W12003 1 nfflO "" , . 2. Impervious surfaiti a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions prior to developriantepft hard surface area Much causes water to run off the surface In greater quantities or at an increased rate of flow from the flow priscattdnder natural conditions prior to development Common krpervious surfaces include,but are not United to roof tops walkwaypahosveways,parking lots or storage areas,concrete or asphalt paving,gravel roads, packed earthen mderials, and oiled ndambr other surfaces which similarly impede the natural kifilhation of stonnwater. P*1,' k 4*, STORMWATER CALULATIONS—IMPERVIOUS SURFACE EXISTING Structures(al ropfama) sq/it Structures(all roof area) sciNt Sidewalks sq dewaks sq Patios sqlft Patios scifit Solid Decks 8q/ft Solid Decks sclift (without kifiltration below) (without Inflitralion below) Driveway sc/ft Driveway sqlft Other sclfit Other seift Total New split Total Existing =I/it TOTAL NEW+TOTAL EXISTING* sqlft *This amount will be used to ehedc total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v.REDEVELOPMENT Divide the total erdstka impervious surface above by the size of the parcel and convert to a percentage: Does the site have 35%or more of adding knpervious sudace? Max 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 detennkie the Minimum Requirements for stonnwater management. DCD staff will help verify the dassixndion of the project and the application requirements. For proponents of %mar projects who must comply only with trinknum Requirement #2—Construction Stormwater Pollution Prevention—an additional submittal is not.required. The proponent Is responsible for employing the 12 Elements to control erosion and prevent sediment and other pollutants from leaving the site(Mktg the construction phase of the project. Pick up the Construction Stormwater Pollution Prevention(SWPP)Best Management Practices(BMPs)Packet. Proponents of meckmf projects—those that must meet only Mini= Reqtdrements #1 through #5—and for large projects—those that must meet all 10 Minimum Requirements—am 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 Stonnwater Site Plan instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stems/rater 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. (LANDOWPER OR AUTHORIZED RS'REE.ENTAIDIE SI(NATURE) (DATE) stormwater calc worksheet—REV.10/1/2003 2