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HomeMy WebLinkAboutBLD2008-00099 0-SON ro6, DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street,Port Townsend,WA 98368 Tel:360.379.4450 Fax:360.379.4451 Web:www.co.jefferson.wa.us/communitydevelopment sc,,.cp E-mail:dcd@co.jefferson.wa.us CERTIFICATE OF OCCUPANCY PERMIT#: BLD08-00099 APPLICANT: WEI ZHOU PHONE: 360-531-0609 200 W KINKAID ST PORT HADLOCK WA 98339-9660 SITE ADDRESS: 130 JOHNSON AVE Issue Date: 10/15/2009 PORT TOWNSEND, 98368 Final Date: 4/15/2015 SUBDIVISION: 9615 Block: 1 Lot: 1+ PARCEL NUMBER: 961500101 Section: 18 Township: 30 N Range: 1W PROJECT DESCRIPTION: NSFR THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2006 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes lno THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 4/15/2015 \\tidemark\data\forms\F_BLD_Occupancy.rpt 4/15/2015 Jefferson County Building Elision Permit Nudr: BLD08-00099 Applicant: ZHOU BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2006 International Building Codes To schedule inspections, call (360)379-4455 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 Foundation Footing I) 1. Footing Drains Foundation Stem Wall i�31 L Under Floor Framing" Vit,//3 Straps(hold downs) Ext. Shear Wall Nailing ID _ - 13 Rough-in Plumbing r.;//7/13 J Framing Blocking Airseal Insulation:Walls Insulation: Floors Insulation: Ceiling i(,T i 1,4 Int. Shear Wall Nailing Wallboard Nailing 41 Gas Line: Interior /..1/ .7/,3 Gas Line: Exterior (V//1 Propane Tank Heat/Chimney Clearance Drywell/Alt Drainage t\+ Address Posted S)y, ti. Miscellaneous 4/15/2008 DONNA TO DO WETLAND INSPECTION PRIOR TO ANY LAND DISTURBING ACTIVITY OR FIRST BUILDING INSPECTION. FINAL INSPECTION /05/i5 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR IUILDING PERMIT APPLICON MLLA08 00p123 Review Ty I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD08-00099 Received Date: 3/12/2008 SITE ADDRESS: 130 JOHNSON AVE PORT TOWNSEND, 98368 OWNER: WEI ZHOU PHONE: 360-531-0609 200 W KINKAID ST PORT HADLOCK WA 983399660 INGERSOLL'S ADDITION SUBDIVISION: Block: 1 Lot: 1+ PARCEL NUMBER: 961500101 Section: 18 Township: 30 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NSFR iev '13C-1 Oa in 7:3-1 21 -CP TYPE OF WORK RES SQUARE FOOTAGE: —� TYPE OF IMP NEW MAIN: 560 VALUATION 88,701.00 ADD'L: 560 HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N SHORELINE: GARA0 CONST TYPE: DECKLE' 204 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: CAPE GEO BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: 1 Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,772.15 LYK 03/12/08 97105 APPROVED Plan Check $1,151.90 LYK 03/12/08 97105 State Building Code $4.50 LYK 03/12/08 97105 OCT 1c2009 Potable Water Application $59.00 LYK 03/12/08 97105 Jefferson County Planning Plan Check $284.00 LYK 03/18/09 105582 &Building Department Total: $3,271.55 CONDITIONS for Building Permit# :BLD08-00099 1.) PRIOR TO FINAL PROJECT APPROVAL, THE PROPONENT SHALL PAY ALL COSTS RELATED TO THE DEPARTMENT OF COMMUNITY DEVELOPMENT'S APPLICATION REVIEW AND INSPECTIONS. IN ACCORDANCE WITH THE JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT FEE SCHEDULE, ORD. NO. 12-1209-96, AS AMENDED PER ORD. NO. 02-0223-09, THE DEPARTMENT'S REVIEW FEE IS CURRENTLY $71 PER HOUR. 2.) PRIOR TO FINAL BUILDING CERTIFICATE OF OCCUPANCY THE PROPONENT SHALL CONTACT DONNA FROSTHOLM, JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT (DEVELOPMENT REVIEW DIVISION, 360-379-4450) TO ARRANGE FOR AN INSPECTION TO VERIFY COMPLIANCE WITH THESE MITIGATION PLANS. 3.) Silt fencing shall be installed along the eastern edge of the Wetland B buffer prior to beginning any construction-related activities. Orange barrier fencing shall be installed along the outer edge of the wetland buffers for both Wetlands A and B prior to beginning construction on the property. 4.) The proponent shall contact Donna Frostholm, Jefferson County Department of Community Development(Development Review Division, 360-379-4450)to arrange for an inspection of the silt fence installation and an inspection of the silt fence and orange barrier fencing locations at least 72 hours prior to initiating any ground-disturbing activities. 5.) Permanent fencing installed post-construction along the outer edge of the buffer shall be split-rail fencing. Any fencing, such as chain-link, that would preclude wildlife access into and out of the wetland buffer shall not be used. 6.) The trees to be retained (as stated in the Mitigation and Monitoring Plan) shall be clearly marked as 'DO NOT CUT' prior to beginning any ground-disturbing activities. 7.) Trees species planted as mitigation shall not be installed over utility lines. 8.) Young native trees, up to 2 years in age, that have established within the building footprint may be transplanted to the buffer planting area. 9.) Setback from Johnson Ave right-of-way shall be no less than 20 feet, Setback from "O" Ave shall be no less than 20 feet, setback from adjacent properties shall be no less than 5 feet from parcel boundaries If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 10.) Stormwater shall be retained and infiltrated on site. The owner shall control all sedimentation and erosion on the property. 11.) All construction activities shall not encroach upon the wetland buffer. This includes the storage or preparation of materials. 12.) As shown on the approved site plan, a setback of 35-feet, measured perpendicularly from the wetland edge of wetland B and a setback of 50-feet, measured perpendicularly from the wetland edge of wetland A shall be permanently maintained as a buffer. No filling, grading, clearing, or other alteration of the wetland or its buffer is allowed. 13.) Buffer perimeters shall be marked with temporary signs at an interval of one per parcel or every one hundred (100)feet, whichever is less. Signs shall contain the following statement: "Wetland & Buffer- Do Not Remove or Alter Existing Vegetation." 14.) A permanent physical separation along the upland boundary of the wetland buffer area shall be installed and permanently maintained. Such separation can include installing logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC Administrator. • 15.) The project shall adhere to the Best Management Practices (BMPs) to controgt'ormwater, 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. 16.) A Stormwater Plan has been submitted and approved by the Department of Community Development. Once the subject permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. 17.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 18.) Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the requirements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor vehicles be stored in a critical area. 19.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 20.) The building height is not to exceed 35 feet. 21.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 22.) Lighting fixtures shall be designed and hooded to prevent the light source from being directly visible from outside the boundaries of the property. The intensity or brightness of all lighting, during construction and after project completion shall not adversely affect the use of surrounding properties or adjoining rights-of-way. 23.) 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. 24.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP) Elements#1 through#12 of the Department of Ecology's Stormwater Management Manual for Western Washington to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 25.) THE PROJECT PROPONENT SHALL COMPLY WITH THE MITIGATION PLAN (JANUARY 2009)AND THE MITIGATION AND MONITORING PLAN ADDENDUM (JUNE 2009). �,��.¢'So1v c06, JEFFERSO COUNTY • W r,. DEPARTMENT OF COMMUNITY-plVE`.Q���P�VINT � \ ~' 14 621 Sheridan Street • Port Tov�rnserScl fW, shingtnll'�8�368 360/379-4450 • 360/379-4451 Fax .qS NG�p www.co.jefferson.wa.us/commdev r nejnt 2008 Master Permit Application (( (# MLA: 12 l �j5 Project Description(include separate sheets as necessarAFFERSON C(�UU�(ETY OD Neu.) S'` tc'" ,vnl j._r c(eA,k i„a k a-H-a.Lie& Tt;rrY,e Tax Parcel Property r , Number: 'I I j i tJ Size: 27 i 000 7 �t- (acres/square feet) Site Address and/or Directions to Property: �1 Property Owner(s)of Record: IA;P,1 ?J,pirt. Telephone: ,3ti1) -53I — Gbt9 Fax: email: ynOhr,-ciV1Q YGhcf),(GJ►l, Mailing Address: 200 l&) VI LA St, 1701..±- Ho6It&k il�,i4i /k339 Applicant/Agent(if different from owner):, Telephone: Fax: email: Mailing Address: What kind of Permit? (Check each box that applies %Building ❑Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** I Single Family V Garage Attached_ /Detached 0 Discretionary"D"or Unnamed Use Classification 0 Manufactured Home ❑ Modular 0 Special Use(Essential Public Facilities)** ❑ Commercial* 0 Boundary Line Adjustment ❑ Change of Use 0 Short Plat** ❑ Address ❑ Road Approach 0 Binding Site Plan** 0 Home Business 0 Cottagelndustry 0 Long Plat** 0 Propane 0 Planned Rural Residential Development(PRRD)/Amendments** ❑ Sign 0 Plat Vacation/Alteration** ❑Allowed "Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ Shoreline Management Substantial Development** 0 Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Variance 0 Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment 0 Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment 0 Forest Practices Act/Release of Six-Year Moratorium ❑ Tree Vegetaion Request *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save, indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he or she wants prior notice. Signature: (A)0.,t ZA(91 t Date: 21)7/0 D The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual, group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: L,JCi C't Date: 2/i7 /n G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc 0 BUILDER STATEMENT • The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: )i'�I�nQ 1-Lame-5 (. 3) 8 --(NI ( ) MAILING ADDRESS: • , I A„Q. ) p y 3 EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: Cr.©1341 LII' _Ig\C3 J NUMBER Ha-the-h u� �� PHONE ( ) FAX: ( ) MAILING ADDRESS: �� �� ' ` EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: New X Wood Existing: _._ ❑ Sewer ❑ Addition ❑ Steel Proposed: L - Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: K.Individual System ❑ Repair ❑ Masonry SEP Permit# 11-000(o ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: ' X Public .7IP.,Ctr . ., Total: Name of System: If this is a Commercial Proiect you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: i Underground Tank i Above ground Tank Size of Propane Tank: 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 Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed :For-Office Use Only Amount ' Revision Main Floor Heated / � t555,�71(C EH Bid App Review: 0 • rCI)'f0 2na Floor Heated 7fl3 7 * � Consistency Review: 1J� Other Heated _ -- - Base fee: --7 I Mezzanine _______------ Additional Section: Heated Basement ,__-----""- Plan Check fee: t�(� t 131 - Unheated Basement State Surcharge fee: A. Other Unheated �_..� . Pot Water Review fee: "15 °I) Garage/Carport 1309144 SUBTOTAL Decks 12 911/Rd Approach fee: Other TOTAL: 2� Covr��,e�r� Receipt Number: q'7 105 5 15 �� Cash/Check Number: >iT c 3 ESTIMATED COST(REQUIRED) Date: 2-` y� •Fair market value of all labor and materials foundation to finish J G-0v 1'51 1 927, Initials: C,'. ... -, J GAPermitCenter\###FORMS###\DRD FORMS\Master Permit Application 12-19-2006.doc r L'Nei, r:sON JEFFERSON COUNTY ti DEPARTMENT OF COMMUNITY DEVELOPMENT 626 Sheridan Street • Port Townsend • Washington 98368 JUL 2 1 2009 � �,q p 30/379-4450 360/379-4451 Fax �IIN http://vvvvw.co.�efferson.wa.us/commdevelopment/ STORMVVATER SITE PLAN SUBMITTAL TEMPLATE MLA# _DcI" 12-3 _ PROJECT/APPLICANT NAME: L).e1 2.11 o1A Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a separate stormwater site plan map. Project Overview 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site map. Cam, i e - I�I -&cf- I:-S 2 0 x2Z` o A_ cat o o S1 .ix- 1it4n Tnl�vt /-fie _ .S Cr.e -I-D Trop ..I- �-r n`LIP LA A rod 0I r_ • c,. — Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site ma oc�h� i ( � - — 3 Describe the existing vegetation. Indicate native ve etation areas on the site map. f 1d.Qit1a (-1,- -- .DofL e i 4 Describe the existing soils. Indicate soi ype on the site map. 5. Describe the existing site hydrology(i.e.,drainage; behavior of water on the site—above, below, and on the ground). Indicate existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if applicable,and indicate acreage of each. dr7 Q L5a (' w&i '1 � -� r.�.�k►1.>, �>n (ni— r .rA•-yvs wen . _ 6. Describe any excess levels of noise generated by the proposed use or activity: STORMWATER PLAN O n I zY YYIR Y►o w'�3-e— t�r► Cvs,6-r-ct,C rave �. SEP 1-8 MX JI FF NTV VW.OF OIEV SIGNATURE: stormwater site plan template—rev.10/21/2008 �� ) ram+ lilk • 0 , i. 7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, stele slopes,etc.)_ on�the `site. Indicate location` on the site map. 9 `_ on 1� Q INflri `X k eA4 f''CXt_ c,-. S i Q - cf ( ti_,,. S-CK Vinci i Q d- 16 . f 8. Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads, and sensitive/critical areas streams,wetlands, lakes,steep slopes,etc.). """�"` i (fir.✓ r 15�� toy.) E ✓ r�&W€ ds 1 �'E1� & �� ��i1 . Permanent Stormwater Control Plan This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs and facilities to remain in place after construction of the project is completed. "Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control facilities are not exceeded. g_ Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed (i.e., per BMP T5.30 in the Manual) or, if not, what types of stormwater flow control will be utilized for the site or specific threshold discharge areas within the site. Locate these facilities o the site plan and differentiate proposed facilities from existing facilities. .--A kOrsv'VL S i v� Y-2 tMt r 't l' O i Z� c' "1 e TAU 8 4e . 10. If the project requires the use of stormwater treatment facilities, describe the types of stormwater treatment facilities proposed for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is normally for"large"projects or projects that involve the potential for dispersion of contaminants.] t l ►n n2� rrn t,xv! e -hne�-t ti,,v�—t-of u p -tom - t,o ► 1. 1-: t, 11. Describe the performance goals and standards applicable to the project.I t I V -``�e 1- (t \'-ec t2 as 1 7vlttvcd' a,S F055; D-k-e- . Sf? yry` L):L± 1 -c' e.- Describe the flow control system. • trit':}SAStLis.t:iV at4$iWt.+k:a...eF s;i rt'tt! 6 rmwater site Ian template—rev.10/21/2008y::1*.,i,,,,r,.t • • 13. Describe the water quality system. frcd h? Q,>� hela�l Iw,l�1 �2v ems(. , ✓1 O eXoS; pro6loyy6 14. Describe the conveyance system analysis and design. 2 1 J 4P I �u�y�5►�ra�l-5 5 � la�h�,k5 d v�e,✓� r I n 'h9 15. Describe the source of fill material,physical characteristics of fill material, and deposition of excess material. 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. o „O c- TM�e� e1..da$-IV.P..1 (n(-1 17. Describe the proposed surfacing material. aclu,-red 71,Lcvfev ( . l hast,t-- 3/4" lu . 18. Describe methods for restoration of the site. s 0 euIR - 1 `tvt sap . raVrleie 19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for "large"projects only and only those for which facilities are required to control flow or treat runoff.] If included, list the Manuals here. ?f\(0t- N 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan. 21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditions or restrictions here. storrnwater site plan template—rev.10/21/2008 7 • CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN (SWPPP) The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential development. SECTION I—CONSTRUCTION SWPPP NARRATIVE 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable to the proposal,justify in writing. Descriptions of the 12 Elements are found at Volume II Section 3.2.3 of the Manual (beginning on page 3-7). 12 Required Elements—Construction SWPPP 1. Mark Clearing Limits. 2. Establish Construction Access. (W1 Ck_UGUTII2LA cLec-e5 15 Pry?oS-k-d d e_w . 3. Control Flow Rates. (It T S S9 I eves... out PX.c.es5 4,Arne_dij -e_ . y_u-s.ext . cvJlu r1— a -A-- drive 4. Install Sediment Controls. tiA.L fiP Gtt <N kl o MLA ft .S a G%l a+ed . 5. Stabilize Soils. Rosi-o n t` ham"' Gt to 1 SS\k2 .I . 6. Protect Slopes. 7. Protect Drain Inlets. stormwater site plan template—rev.10/21/2008 • • • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. � 5�-f-�►5 -occ�L s;d e_ i/74.4fed 9. Control Pollutants. er fwMe-d Dh S:tp 10. Control De-Watering (the act of pumping groundwater or stormwater away from an active construction site). /\147/\- • 11. Maintain Best Management Practices(BMPs). n pn,p-er Gtr,,4-49-,ls J U L 2 ? 2009 12. Manage the Project. 5 Wy -e/r5 q cl (A)"t I Gt,G tines fie. 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). ` J o vL_ b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). ,o pcwc-40,c_. IJ-cu- -the w -la 4d - v�AAA-ktsvt sew-1-e_5 - ,rt l, P,- fiat e� Gtx o1A .c�. (v uu-e r a 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. te, LklPAq cLw )'?Jrf2.i,rf'5 . stormwater site plan template—rev.10/21/2008 9 i • b. Description of special requirements for working in or near environmentally sensitive areas. ctu -t -1Akwn -1-1) eI rtdv Fi•s;6le-- d.;S+U _�r(( \1 (s1s:ll h4 -6241 91,1 • 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodibility, settleability, permeability, depth,texture, soil structure). 5. Construction Phasing. a. Construction sequence InAl2Mlin^ft.n ;311_, b. Construction phasing (if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. CIA.,t, �-{- - rv►tee, ~ V AC - T-a-y t4-1-1nS� k) I \ c�i� J II. Wet Season Construction Activities. a. Proposed wet season construction activities. N b. Proposed wet season construction activities for environmentally sensitive areas. 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. ptz1rl-e F-e v aL ij; t f� 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following, if applicable. a. Sediment Ponds/Traps. b. Diversions. ,c c. Waterways. y -- d. Runoff/Stormwater Detention Calculations 10 stormwater site plan template—rev.10/21/2008 • • Stormwater Site Plan Changes If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems,treatment facilities,flow control facilities, or structural source control BMPs (not standard on-site stormwater management BMPs), the applicant shall submit a final corrected plan ("as-builts")when the project is completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as constructed. APPLICANT SIGNATURE By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. 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