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BLD2014-00249
WILDING PERMIT APPLICAIN B Review 0249 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00249 Received Date: 7/18/2014 SITE ADDRESS: 60 MAPLE DR PORT TOWNSEND, 98368 OWNER: LARRY DAVIS PHONE: 209-743-3923 60 MAPLE DR PORT TOWNSEND WA 98368 9408 SUBDIVISION: Block: Lot: 18 PARCEL NUMBER: 940800018 Section: 13 Township: 30 N Range: 2' CONTRACTOR: BUY RITE HOMES PHONE: (360) 681-0777 259403 HWY 101 SEQUIM WA 98382 Contractor's License BUYRIH`084OB Expires 5/10/2015 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION New Manufacture Home TYPE OF WORK MOB SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 62,995.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: 11050 BEDROOMS: BATHROOMS: Exist: Exist: 0 Prop: 2 Prop: 2 Total: 2 Total: 2 Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $532.00 SRE 07/17/14 151260 State Building Code $4.50 SRE 07/17/14 151260 APPROVED Potable Water Application $67.00 SRE 07/17/14 151260 Total: $603.50 SEP 0 8 204 Jefferson County DCD 1ltidemark1data\forms\F_BLD_App_Bld.rpt 7/18/2014 Nst'N co DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street,Port Townsend,WA 98368 Tel:360.379.4450 I Fax:360.379.4451 } Web:www.co.jefferson.wa.us/communitydevelopment -q,s,f/1 Nv,cpr E-mail:dcd@co.jefferson.wa.us CERTIFICATE OF OCCUPANCY PERMIT #: BLD14 002 4 9 APPLICANT: LARRY DAVIS PHONE: 209-743-3923 60 MAPLE DR PORT TOWNSEND WA 98368 SITE ADDRESS: 60 MAPLE DR Issue Date: 09/8/2014 PORT TOWNSEND, 98368 Final Date: 11/14/2014 SUBDIVISION: 9408-CAPE GEORGE VILLAGE#4 Block: Lot: PARCEL NUMBER: 940800018 Section: 13 Township: 30 N Range: 2W PROJECT DESCRIPTION: New Manufacture Home THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 11/14/2014 \\tidemark\data\forms\F_BLD_Occupancy.rpt 9/24/2015 EDGES OF EXISTING ., f -LVI- ED ( T -L P PAVEMENT SEE SITE PLAN DETAIL SHEETS ■ ■ EXISTING // -r o \ CULVERT r� 7, � V �� � - - - Ocs. - O�Oa �� 1'I^ 1 7 �1 4�.• I I ' r / . --- 'N. : ,t. a160-,;COONEY 5 l i 40 / / f COPT OF CC' JN11Y DPIELDPMFNT X30 / EXISTING STORMWATER '0' / / i!2 ` `� , DITCH ' / 3 '�/�'�^\�`\� \ \ \. L 19 I / < > \N 1 r.I / ! ! — . N\ \ 1 EXISTINI ' ( ! ! /� o R; '\', \ CULVER I i . NI\ NL `I / ` \ \I \ I 4 , #\• N , � � T � % i :o N 1 I 1 / TOE OF FILL \ - ./ OR1JEfr \ NL \ J 11�p�\ — �;\ ORI� \ j8I tr,-*M? I ° 7 wjo-0a f' / II i ! ,. \ TOP OF FILL) Na 4" PVC (BACKFlLLLO PRIOR TO UNSEAL;ION \ - LOCATION PER INSTAL .\ _ \ \ \ .r-� ,1 -z. 60 MAPLE DRIVE �y \ 0" C k / 1Lra I I 1 8" E '(1i APPROXIMATE -... �gd35 �'' - PROPERTY LINES I / N 'DO� LOT 18 ZI 0 30 SGV-EOO IN FEET' APPROXIMATE OF IC TANK ABANDONMENT T FROM LANDMARK EXCAVATING. 1 June 30, 2014 10:57:49 a.m. Drawing: KAY SEPTIC DESIGN (STAKING) RCD DWG.DWG.OWG © CREATIVE DESIGN SOLUTIONS 2009 PRELIMINARY SEPTIC SYSTEM, PAR REVISION I DATE SITE PLAN DRAWN BY: MICHAEL S. DEENEY FOR: SUSAN STOLTZ SHEET 1 OF 2 I DATE: 5/26/09 SE cd2Ack° ��% ..rev PAVEMENT OF EXISTING 01'WS Ictr e. 7,e1ctCc tt \0,- ØEXISTING///jJ�,ovy/��� �Q�9 J� 9 .� CULVERT Pa I l.0 '�#'�L!9/V gveci a"q"l/ N\ O � OW * fr1 n✓ dared' &777..e... i o N + / $itwp/urn �Jcf,'/1'i •�; arA �/ 101, '34-0- Fl-0777 5 T,d,7,1u i, / EXISTING s. / / i' i/2 l STORMWATER ' i n`� ` \ ', DITCH / 3 . � LOT 19 I / r "� ■ ( � , I „ 117/ -` v,, p \ EXISTING i CULVERT NL + & i 1 1... 44 '1 -I \., I\\ ' 4 r -� . `, \ / v ill* 1 � �>� 1 O p ` \ o TOE OF FILL \ \ 00 / NpL —. l z 1$'j N N j // TOP OF V I ' � a \�4" PVC (BACK' LED PRIOR TO INSPECT':+N > \ LOCATION PER INSTALLS' ` 9/yVA\ ' �d . X- ill _� � a yQ'b Z+� \ 60 MAPL£ DRIVE ��� .'" .. tl: L k E,N 1_, •• RTY LINES L. 8 `I r1)I J U L 1 7 2014 0 + / SCALE IN FEET APPROXIMATE LOCATION OF EXISTING .4Rg1�4L �YTANX. SEETTACHED CERTIFICATE OF SEPTIC TAN ABANDDN .Gbpv'�A�9k1TY4!.EDt]h4�-it - G. 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' / < 1 / 1 EXISTING •o N ' CULVERT ..._,Ni. 1I 1 N z 1 ' 4 r �' ` \ \ T 11 DI 1 4 o ''-.. I I i o i I L__ TOE OF FELL \ ` 1 vRN60 r ���s'j N ----, _ CEIN C-C=3 \), , sNL / oo 'e . -- : :044° ' AUG 2 5 w i �0 I / N l TOP OF FILL ! JEFFERSON COUNTY , ' o \- miff IF COMMUNI7 DTIJEWPMFNT 4" PVC (BACKFILLEO PRIOR TO INSPECT.+N `°` ` LOCATION PER lNSTALLE' \ Z 60 MAPLE DRIVE ' V / \l'..; I (AI�'"1 ©� i q �Q V ,,, 3y't 8 PPROXIMATE N ` t)ti4JL �66�0o PROPERTY LINES LOT 1 o Jo SCALE %APPROXIMATE LOCATION OF EXISTING ABANDONED SEPTIC TANK. SEE ATTACHED CERTIFICATE OF SEPTIC TANK ABANDONMENT FROM LANDMARK EXCAVATING. June JO, 2014 10:57:49 a.m. Drawing: KAY SEPTIC DESIGN (STAKING) RCD DWG.OWG.OWC © CREATIVE DESIGN SOLUTIONS 2009 REVISION DATE 'PRELIMINARY SEPTIC SYSTEM, PARC DRAWN BY: MICHAEL S. DEENEY SITE PLAN SHEET 1 OF 2 DATE: 5/26/09 FOR: + • • 4. 'oc JEFFERSON COUNTY L�o - ki , 1 DEPARTMENT OF COMMUNITY DEVELOPM v l L 4s, ,10. 0. .. . 621 Sheridan Street• Port Townsend • Washington 9 1 7 2014 '1Nce 360/379-4450 •360/379-4451 Fax J U L J http:l/www.co.jefferson.wa.us/commdevelopment/ I JEFFERSON COUNTY Stormwater Calculation Worksheet DEPT.OFCOi�MUNITYDEVEIOPMENT MIA# PROJECT/APPLICANT NAME: �,4i(.'(/ F'S Z'��S DETERMINING STORMWATER MANAGEMENT REQUIREMENTS:This stormwater (calculation worksheet should be completed first to classify the proposal as°small,`"medium,"or large." The size determines whether a Stormwater Site Plan is required in conjunction with a stand-alone stormwater management permit application, building permit application, or other land use approval application that involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan,if required. PARCEL SIZE(LE..SITE Size of parcel i al acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet // %OC') sot / r / /P(//-tt 9 g pee°/�. Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover(both vegetative and non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to Gearing, grading, filling, excavation,and compaction associated with stabilization of structures and road construction. Native vegetation 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 salal;herbaceous plants such as sword fern,foam flower,and fireweed. LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION.AND VOLUME OF CUT/FILL Calculate the total area to be cleared,graded,filled, Answer the following two questions related to excavated,and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: /'� Does the project convert%acres or more of Construction site for structures sglft native vegetation to lawn or landscaped areas? Drainfield,septic tank,etc. sq/ft Circle: Yes Well, utilities,etc. sq/ft Does the project convert 2'h acres or more of native vegetation to pasture? Driveway,parking,roads,etc. sq/ft Circle: Yes N Lawn, landscaping,etc. sq/ft Other compacted surface,etc. � sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance /" J ) sq/ft Cut Fill (cued) [over] iiiimahLiitowatix talc workstarel-REV,2/20/2008 1 W . . • • I. • • Impervious surface is a hard surface that either prevents or retards the entry of water into theladll man%%as-war-natural 11------= c�tions prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof tops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving, g':Vel tads, pagked earthen materials, and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater. STORMWATER CALULATIONS–IMPERVIOUS SURFACE ) ' ' NEW OEM.OF COMMUNITY DIE 2 EXISTING Structures(all roof area) 15:3q sq/ft Structures(all roof area) 5 e7 Sidewalks sq/ft Sidewalks NM NM Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks (without infiltration below) sq/ft (without infiltration below) Driveway,parking,roads,etc sq/ft Driveway,y parking, roads,etc sglR Other sgiff Other sq/ft Total New sq/t Total Existing sofft TOTAL NEW+TOTAL EXISTING" %q� "' ! sq/ft This amount will be used to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v.REDEVELOPMENT Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: (,)'��!e/, Does the site have 35%or more of raistkig impervious surface? Circle: Yes FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be used to determine the applicable Minimum Requirements. If the answer is no, the proposal is considered new development and the attached Figure 1 should be used. At this juncture, the applicant should refer to the applicable Flow Chart to determine the Minimum Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements. For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices(BMPs) Packet. Proponents of"medium" projects--those that must meet only Minimum Requirements #1 through #5—and for "large" projects—those that must meet all 10 Minimum Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan, principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Sto,mwa/er 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. 1, �� d7;,• -- - r (LANDOWNER OR _ IATJVE�GNLr 7��//f/� D R' -ES NAz. SIGNATURE) 4'7 r (DATE) n , slomwaler cote worEsheel—REV..2/202008 2 , Ir ft i • y isLJ7 141-D02`f`� SEE SITE PLAN DETAIL SHEETS , EDGES OF EXISTING �� r �/ PAVEMENT I Va4'tf�/l�Q�,�. Ago� ' CULVERT O � / ;\ \ 5 1,d1� DX%/ � i 2 \\\ EXISTING / j&'2'• ` �'\ ` STORMWATER DITCH i / `� s , ;\ LOT 19 I I S ,,...„, 'x Vz• r 11 1 u N p• ` EXIS NL `I li / v' N ' • CULL 64 Z° \ 1 i ry, 1 yo a1 1 1 O N� 1 L /J TOE OF FILL \ --- ESP(n V L� i I �NL \ r - 'U001 r_0 C LI 1 '; / _,..------\-- \ 35''x0, ,4 , N /00 / / m N ,�-� TOP OF FILL JI �{� °- �� C� O N < JEFFERSON COUNTY nn � 4” PVC (BACKFILLEO PRIOR TO INSPECTI'N II 60� \ "r2'_7.t COPAM1-1"-"F.J1, _I - LOCATION PER INSTALLS` �`� Cl `' \ ,1 x \ 1 r , 7 .tQ w60 MAPLE DRIVE 0.. y r�� , /' 1-p.�Ql� O , O N� del\ a- . r . . �' I t�`0.Si `` �C� I��'ta�� N 68A0'� E�PER7Y LINES Jo LOT 18 APPROVED Izieil SITE PLAN SCALE IN FEET APPROXIMA' LCCAPOW CF EXISTING ABANDONED PAC TANK.! SEE ATTAC CERTIFICATE OF SEPT'C T4NK I SEVJ_iFI�jOW NDMARK EXCAVATING. fill->, 9 X2°4 June J0, 2014 10:57:49 a.m. Drawing: KAY SEPTIC DESIGN (STAKING) RCD DWG.DWG.OWG JEFFERSON COUNTY F�Rr © CREATIVE DESIGN SOLUTIONS 2009 DEPT.d!CO M1 Y , ,� REVISION DATE PRELIMINARY j" — - - TEM, ' PAF DRAWN BY: MICHAEL S. 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Tue. Wed. Thur. Fri. Date: V.3---2-2-- a BLD: 11-2y9 Contact Name: Owner: Contact Number: 360 (pgf 0??? Address: &rye WtA , Jr 206 Notes. ry Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block &Tile Ceiling ,` i JEFFERSON COUNTY 2 KDEPARTMENT OF COMMUNITY DEVELOPMENT S/f(V C5-e I Date: /h.-LS—Time Received: S _ a MP �� an�rr, Mon. Tie Wed. BLD: 1 Ci- rte, 'd, L/] Done: r v T7 Contact Name: Owner: / , Contact Number: 360 p 8/ Q7 77 Address: © ke 4 DA- 6.9^- (wCd 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Underground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Setbacks Final Inspection Floor Foundation Wall Block & Tile Address Posted Ceiling sON oo, JEFFERSON COUNTY �,e $•• DEPARTMENT OF COMMUNITY DEVELOPMENT 9S1,r G1' f `, Date: ill I - Time Received: am pn Mon. Tue. Wed. hur. Fri. Date: II/ 13 BLD: I LI 2 49 _ Contact Name: Owner: DA V ry Contact Number: 360 6 el -o71 r Address: /oO MTh° �K wag 206 Notes: MT Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation \, Final Inspection �C Setbacks Floor Foundation Wall Address Posted ❑I.,,l. R. Tilo Ceiling '�-' JEFFERSON COUNTY i F J-L DEPARTMENT OF COMMUNITY DEVELOPMENT Ss/t �GZ` i-e9-6--- Date: /0 /Clime Received: 74/ 3' �1 arn/p/ Mon. Tue. Wed. Cr, -nDate: 1 0 „(b BLD: Pi_A(aCi Contact Name: Owner: bA015 Contact Number: 360 qZJ gs-Cl Address: Coo i ,* KD 206 Notes: Dr--114.7e.11 Foundation Plumbing ", /Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block& Tile Ceiling • 1 • "5°N eoe, JEFFERSON COUNTY ,A DEPARTMENT OF COMMUNITY DEVELOPMENT G / 621 Sheridan Street' Port Townsend•WashtngtOn.98368 $� 360)37g�450• 360/379-4451 Fax htlp://Www.co.jefferson.waus/cOmmdevelopment/ . . Stormwater Calculation Worksheet IALA# _ PROJECT/APPUCANTNALtE: ,, .-f,./4;/ cj'' /,c,eSr'.% /J7 cJ c DETERMINING STORMWATER MANAGEMENT REQUIREMENTS:This stormwater calculation worksheet should be completed first to classify the proposal as'srnali"medium,'or'large.' The size determines whether a Stwmweler Site Plan is required in conjunction with a stand-done stom+water management permit app&cat ion, building permit application,or other land use approval application that involves stornwater review. The basic information will also be helpful for completing a Stormwater Site Plan,it required. EARCEL SIZE D.E..SITE Size of parcel _: :t c acres An acre contains 43.560 square feet. Multiply the acreage by this figure. Size of parcel in square feet_ /"r i‘L vg/ft --6-', rt l!"4.- l ys ,-/tile`( 1' Land-disturbing activity is any activity that results in movement of earth,or a change in the existing soil cover(both vegetative and non-vegetative)anther the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading,fit ng, excavation,and compaction associated with stabilization of structures and road construction. Native vepefadon is vegetation comprised on plant species.ether than noxious weeds,that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturaiy ocar 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,elderbeny,salrrwnbeny, and said:herbaceous paints such as sword fern,foam flower,and fireweed. LAND DISTURBING ACTIVITY," _CONVERSION OF NATIVE VEGETATION.AND VOLUME OF CUT/FILL Calculate the total area to be cleared,graded,filled, Answer the following two questions related to excavated,ardlor compacted for proposed development conversion of native vegetation: project Include in this calculation the area to be cleared for. Does the project convert 5:acres or more of Construction site for structures ''`i . sglft native vegetation to lawn or landscaped areas? Drainfield,septic tank,etc. sglft Cede: Yes ..t4Si • • Wes,utilities,etc. &gift Dose the project convert 2'h acres or more of native vegetation to pasture? • Driveway,parting,roads,etc. se/ft Circle: Yes :;"7O Lawn,landscaping,etc. NM Other compacted surface,etc. J WI Indicate Total Volumes of Proposed: Total Land Disturbance r��/. `7 stilt Cut Ff1 (etYyd) • • (over) 1 rE 0 E IN E J �° -RE=D-� AUG 1, 9 2014 1 alaxtmlatlar J 1 JEFFERSON COUNTY /(. DEPT.4 DEPT.OF COMMUNITY DEVELOPMENT Re U 15e.--�` Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A hard surface area whirls causes water to run off the surface In greater quantities or at an increased rate of flow from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not Limited to roof tops,walkways, patios,driveways,parking lots or storage areas,concrete or asphalt paving.gravel roads.packed earthen materials. and oiled,macadam ur other surfaces Mild.,similarly impede the natural infittration of stormwater. STORMWATER CALULAT1O$$-IMPERVIOUS SURFACE f DUSTING s Qµ' Structures(all roof area) . 'gift Structures(all roof area) 69...7- eq� Sidewalks sq/ft Sidewalks s ,y � g/ft Patios sq/ft Patios / C,--) sgft X l Solid Decks aq/R Solid Decks eq/ft (without infiltration below) (without ir&lbation below) Driveway,parking,roads,etc ''. )7"5 swft Driveway,parking,roads.etc sq/fl Other &l/ft Other sq/ft . Total New 87 / sg/t Total Existing i:5 7 7 sg/ft 111 y TOTAL NEW+TOTAL E](iST1NG ( 4(/ sq/ft `his'mount sill be used to check total tot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT y,REDEVELOPMENT 7 Divine the total existing impervious surface above by the sue of the parcal and co:wart to a percen4 •4r/� % Does the site have 35%or more of existing impervious surface? Circle: Yes ' Nom-.) FURTHER INSTRUCTIONS: if the answer is yes,the proposal is considered redevelopment and the attached Figure 2 stated 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 app&ant should refer to the applicable Flow Chart to determine the Minimum Requirements for adormwater management DOD staff will help verify the classification of the project and to application requirements. For proponents of 'lunar projects who must comply only with Minimum Requirement #2-Construction Stormwater Pollution Prevention--an additional submittal is not required. The proponent is responssbb for employing the 12 Elements to control erosion arid prevent sediment and other pollutants from leaving the site during the construction phase of the project- Pick up the Conetruction Stormwater Pollution Prevention(SWPP)Bast Management Practices(BMPs Packet. Proponents of'medium"projects-those that must meet only Minimum Requirements #1 through 405--and for large' projects-those that must meet all 10 Minimum Requirements-are required to submit a Stormwater Site Plan. OCD has prepared a submittal template of a Storrttxater Site Plan, principally for rural residential projects. Complete the template in the Storavwbr Site Plan Instructions and Submittal Template or prepare a Stcxmwater Site Plan using the step-by-step guidance in the StomrweterManagement Manual. APPLICANT SIGNATURE By signing the Stonmeater Calculation Worksheet I as the applicanVowner attest that the information provided herein is true and cored to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of al owners of the affected property. �' /7 —- •(tA14CO ra:a oR`"rte:-- o REME- eTnVE mawk*uaq (etc) -WV AUG 1 9 2014 J 1 I 1 L. ur JEFFERSON COUNTY DEPT.OF COMMUNITY DEVELOPMENT IP .... I 'AI Ai --iii—P,i-xt ID cninsp-.0 HA:1-136 '41/ 'A / Catr,h Basin -AI „: (. _ril Drain) 0 ,,,--.K, ---.------=••=—'. ---7-17P---, . __ 1_ DCINV011 ------,.. 0 Dfrf VirEli- 48 Int Dia ireter Hole Filled willi PLAN VIEW shri NTS Drain Roote t--,N)iiitteikic.,,,Terve j.:._ cifiHpoieve ["...1/—Ft cof Dolinap,i , Hous,g ,,,---Ctierflow / or Citrer rilvtrii3 1 \,.., —Si-A.5:h Block , i Topscii---\s, 1 Fiwilwith Sutep , 1., . ________ prArate/P.■ r°1 I :It r ••,,..- ,,,,...,,- ,-.-....1.,.2, i nn, ___;_l___ llii fpw 0,---.;4,,,,,oirFro., 1 .,-, tiv, h a, - — %i—tiilit1 4'ciai -.4%' *.-,4(4"4,"0:44..41t.tvw Ilkei-C - if^,75;e1 'A :.gt/P'" bIL, -41 , Fit: —, . tetn 1 Catch Bimin Put Pip., -3-411,1 1 -t i CArci Drain) ,,-.1 ., •l' 4i3 irch Dia ro--:ter side;of Hole-- ....„,- Hole Filleiiviiih IT Lineriwah Fite.Fatiri f.: a Drain Rock ; IP L________ 1.5"-miq. `... e. fr•rge _401 t Mb . 1'Sa-p.,s?. •`,DzI..:7esc).4s I DRY VItEll H igh Gmimdwalw Mbl.a ----1— SE alON MIS Figure 3.1.4-Typical Downspout Infiltration Drywell Source: King County Volume III-Hydrologic Analysis and Flow Control BMPs-August 2012 3-9 • • Setbacks Local governments may require specific setbacks in sites with slopes over 40%,land slide areas, open water features, springs, wells, and septic tank drain fields.Adequate room for maintenance access and equipment should also be considered. Examples of setbacks commonly used include the following: 1_ All infiltration systems should be at least 10 feet from any structure, property line, or sensitive area(except slopes over 40%). 2. All infiltration systems must be at least 50 feet from the top of any slope over 40%.This setback may be reduced to 15 feet based on a geotechnical evaluation,but in no instances may it be Iess than the buffer width. 3. For sites with septic systems,infiltration systems must be downgradient of the drainfield unless the site topography clearly prohibits subsurface flows from intersecting the drainfield. • Volume 111—Hydrologic Analysis and Flow Control BMPs—August 2012 3-10 for Infiltration These s -ms are uesigueu as JpcLuicu uciu w. • Drywells General. 1. Drywell bottoms must be a minimum of 1 foot above seasonal high ground water level or impermeable soil layers. 2. 'When located in course sands and cobbles, drywells must contain a volume of gravel equal to or greater than 60 cubic feet per 1000 square feet of impervious surface served.When Iocated in medium sands, drywells must contain at least 90 cubic feet of gravel per 1,000 square feet of impervious surface served. 3. Dry-wells must be at least 48 inches in diameter(minimum)and deep enough to contain the gravel amounts specified above for the soil type and impervious surface served. 4. Filter fabric(geotextile)must be placed on top of the drain rock and on trench or drywell sides prior to backfilling. 5. Spacing between drywells must be a minimum of 10 feet. 6. Downspout infiltration drywells must not be built on slopes greater than 25% (4:1).Drywells may not be placed on or above a landslide hazard area or on slopes greater than 15%without evaluation by a professional engineer with geotechnical expertise or a licensed geologist,hydrogeologist, or engineering geologist, and with • jurisdiction approval. • Volume III—Hydrologic Analysis and Flow Control BMPs—August 2012 3-6 • Standard Conditions for ResidentiOevelopment in Jefferson County 1. LIGHTING: 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. 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. 2. BUILDING HEIGHT: The building height is not to exceed 35 feet. 3. OUTDOOR STORAGE: Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 4. UNLICENSED VEHICLES: 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. 5. PARKING: A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 6. This permit has been reviewed consistent with JCC 18.40.130 & 140. Notice: this permit does not excuse the applicant from complying with other local, state and federal ordinances, regulations or statues, applicable to the proposed development, but consistent with RCW 90.58. Future development beyond that specified in this permit shall require further review. 7. BMPs: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. 8. NOTICE: This permit does not excuse the proponent from complying with other local, state, and federal ordinances, regulations, or statutes applicable to the proposed development, but consistent with RCW 90.58. Development pursuant to this permit shall be undertaken subject to the applicable policies and performance standards of the Jefferson County Shoreline Management Master Program and the Jefferson County Unified Development Code. If during excavation or development of the site an area of potential archaeological significance is uncovered, all activity in the immediate area shall be halted, and the Administrator shall be notified at once. The Federal Endangered Species Act rules to protect threatened Chinook and Summer-run Chum salmon became effective on January 8, 2001. Bull trout have been listed as threatened since early 2000. Under the ESA, any person may bring lawsuit against any individual or agency that"takes" listed species (defined as causing harm, harassing, or damaging habitat for the listed species). In addition, the National Marine 2013-03-07 SFR_StdConditions 3/7/2013 1 Fisheries Service can levy pellikes. Portions of Jefferson County, inclikg marine waters, are included as "critical habitat"for a listed species. Development of property along any marine shoreline, freshwater shoreline, or floodplains could harm habitat if protective measures are not taken. To minimize the potential to damage habitat, all property owners developing adjacent to marine shoreline, freshwater shoreline, or floodplains are advised to do the following: All development activities should avoid unstable slopes, wetlands, and forested areas near surface waters Remove minimal vegetation for site development, especially large trees Allow trees that have fallen into surface waters to remain there Infiltrate stormwater from buildings and driveways onsite through drywells rather than discharging directly into surface waters or roadside ditches The Federal Bald and Golden Eagle Protection Act requires landowners within 660 feet (1/8th of a mile) of an eagle nest to consult with the US Fish and Wildlife Service. This Eagle Act prohibits anyone from "taking" bald eagles. This federal law defines the term "take" and describes the possible legal consequences when a "take" occurs. Among other actions, "take" includes a disturbance of bald eagles or their habitat. Under federal law a permit may still be required for activities that impact bald eagles or their habitat. Contact the US Fish and Wildlife Service (http://www.fws.gov/pacific/eagle/) to learn more about how this law affects your project. Any individual, group, or agency can bring suit for a listed species "taking", even if you are in compliance with Jefferson County development codes. The risk of a lawsuit against you can be reduced by consulting with a professional fisheries habitat biologist, and following the recommendations for site development provided by the biologist. For more information, contact the National Marine Fisheries Service in Seattle, or the U.S. Fish and Wildlife Service. 2013-09-06_SFR_StdConditions 9/6/2013 all • ,`: cuc, JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 4, 1100 0 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.iefferson.wa.us/communitvdevelopment "r9er NO'C Tel:360.379.4450 I Fax:360.379.4451 I Email:dcdAco.iefferson.wa.us Building Permits&Inspections I Development Consistency Review I Long Range Planning I Watershed Stewardship Resource Center Master Permit Application MLA: Project pDescriptionn(include ara e shee as necessary): !Y-/,/ Math) C'r/ 1f1 '//-1-i c 1 7 Tax Parcel Number: 7 Ot� ©��'/`/9 \ Property Size: .11 /4709 5' ' (aacres/square feet) Site Address and/or Directions to P 47,_ n.NC ie U/"f6/t/• kiwi 20 7'6 5 AreB4'4r"/ Kt°& i�f2 Li" . ' -' • s'e S'. b�sc��v on 6�rt, '/514'.. .x, 7 M/!ee /e4-..44 c e4/2e teoi�c- '.0�/il' �9 �(d .✓G r 77r/c �y�-2 �Af7� /1/ ' ✓ r/tipj � / Property Owner(s)of RecofS = l/ I Telephone: 1 • 7 • '% _ Fa email: �'' Mailing Address: #6'D / ' /✓z /i T e,15 Applicant/Agent(if different from owner): ,.. . , ' .. ..e.f "`r ` /- /l /G/4 / Telephone: ;�ir'p40• 472'7• 6777 Fax: email: 4/41ithii /Pia 0-C Mailing Address: Z 5"954 3 A4 / /Q/ .4'eZ 0114/ k/4 9t3 2 _ What kind of Permit?(Check each box that applies ❑Lot or Road Segregation ❑Building ❑Critical Areas Stewardship Plan Cl Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) Cl Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),!C .r�o_!I / � Manufactured Home ❑ Modular ❑Discretionary"D"or Urlrigc I ❑ Commercial* ❑Special Use(Essential F? io'eeilitics) ❑ Change of Use LI Boundary Line Adjustment) 1 ❑ Address ❑Road Approach ❑Short Plat"' 1 1-1'• ❑Home Business ❑Cottage Industry El Binding Site Plan** ' 1. JUL 1 7 2014 1 ❑Propane ❑Long Plat" I III I i ❑Sign CI Planned Rural Reside illil Development(PRRD)Amend ' ❑Allowed°Yes"Use Consistency Analysis ❑Plat Vacation/Aiteraticc i"• JEFFERSON.CI UNTY. ❑Stomiwater Management ❑Shoreline Master P ram f{tfreinpli"t(R,, i"�NT ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management'SOtss k . a-. ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre-Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION 0 AGENT I hereby designate mize/,N/ 5d//I to act a-' y ag-• atters relating to this application for permit(s).- /OWNER SIGNATURE A, `-'" c" /4.-4 tLU-''r"°' A Date: /r0 Z04 s By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result In this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attomey's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staff's access and right of entry will be .. umed unless the applicant informs the County in writing at the time of the application.th t he or she wants prior notice. • / I Signature: a. C— G'�4C. ' t /J,C/✓ / i Date: AVIte/Z&/C/ 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 tents are defined in the federal law known as the "Endangered Species Ad"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- .nsferabta1yspgsibility for adhp ing to and complyi • with ijak The Applicant has read this disclaim r and gns and dates it below, Signature: ��cU'U<• ./ /l*'�C -?-�..r w.a... Date: 77/6(70/` / 07/24/2013 III • 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«5esponsibility of the General Contractor for the proposed project. / Signature: T) t .-f ',L_ / a.. Date: '7// tP//70/// Ai w. 1 GENERAL CONTRACTOR OR MANUFACTURED i-1 f NSTA L ': PHONE: FAx: o/-7e/T� f7,,tlr'f ( 2) / 0777 (.10c) f,!1�/, 077-0 MAILING ADDRESS: Z5�r</43 ID/ EMAIL:kiAtrcoc9U/l i ,. - ter CONTRACTOR'S LICENSE „ _,6,„`Q `�[Az_ /7171- WAINS W ` M.eie/eX ga.�.'30, NUMBER: (�C. V?I/C I l7 T C.C)7 NUMBER Y F ARCHITECT/ENGINEER: UL/ /o D13•,329' PHONE (9)bgg/,()7'7'I FAX:( ) MAILING ADDRESS:r y 5 /Ty /0/ "sea,,6� EMAIL (V r� , Project Type: 77 Frame Hype: Bathrooms: Shoreline: Type of Sewage Disposal: New Wood Existing: ❑ Sewer n Addition X! Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: Individual Syste U Repair _i Masonry S P Permit#,V�p7N7-- ❑ Demolition 7 Other: Bedrooms: Water Supply: Existing: a- Se tit: ❑ Private well ❑ Two Party Type of He Proposed: Public puir) Total: 'Name of System:LLt.fie C/' If this is a Commercial Proect you must answer the following: f/V� Number of Parking Spaces: Current: e12.-- Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed .2-- Occupancy: IBC Type of construction: Will you have Food Service? Ye /401 If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: Nitt Underground Tank Above ground tank Size of Propane Tank: Heat Stove Cook Stove Woodstove Fireplace.nsert rehtO 1 evotS telleP 1 knaT retaW toH I Is this appliance being installed in a anufacture Mobile Home? t I No When applying for a permit to install a nk 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 /43C EH Bid App Review: 2"0 Floor Heated Consistency Review: 7 2 g Other Heated Base fee: s 2 Mezzanine Additional Section: I.i9k Heated Basement _ Plan Check fee: Unheated Basement ! i J i-- C I—', {I V ��S�Surcharge fee: ' J , \}/ 1 16 . Other Unheated L t zter Review fee: I Garage/Carport 1 i JUL 1 7 2014 I SUBTOTAL u Decks J 11/R t Approach fee: JEFFERSON COUNTY Other DEPT.OF Env elJNIIY DEVELOPMENT ll( 5" TOTAL: $ `(�l Receipt Number: /S I 1 lG L� . Cash/Check Number: 3 �`�s - ESTIMATED COST(REQUIRED) Date: Fair market value of all labor and materials foundation to finish 1-11:":1•54C-1 VJ i_ 7 a Initials: • • CA4) ° JEFFERSON COUNTY _DEPARTMENT OF COMMUNITY DEVELOPMENT '9 �� _621 Sheridan Street • Port Townsend • Washin ton 98368-° 360/379-4450 • 360/379-4451 Fax ,• ��INC' http://www.co.jefferson.wa.us/commdevelopment/ )FFFER"SON COUNTY DEVEFOPN � Stormwater Calculation Worksheet MLA# PROJECT/APPLICANT NAME: /_ kV ,e/5/1.4- D 4-'( DETERMINING STORMWATER MANAGEMENT REQUIREMENTS: This stormwater calculation worksheet should be completed first to classify the proposal as"small,""medium,"or"large." The size determines whether a Stormwater Site Plan is required in conjunction with a stand-alone stormwater management permit application, building permit application, or other land use approval application that involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan,if required. PARCEL SIZE(I.E.,SITE) C° Size of parcel :.A acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet /7; Me; sq/ft r /a1 '/4 9'/c'?e O/8 Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover (both vegetative and non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling, excavation, and compaction associated with stabilization of structures and road construction. Native vegetation 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 salal; herbaceous plants such as sword fern,foam flower,and fireweed. LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Calculate the total area to be cleared,graded,filled, Answer the following two questions related to excavated,and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: /2 Does the project Convert' acres or more of Construction site for structures IBS sq/ft native vegetation to lawn or landscaped areas? Drainfield,septic tank,etc. sq/ft Circle: Yes Well, utilities,etc. sq/ft Does the project convert 2'A acres or more of native vegetation to pasture? Driveway,parking, roads,etc. sq/ft Circle: Yes (No Lawn,landscaping,etc. sq/ft Other compacted surface,etc. sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance ///3- sglft Cut Fill (co(yd) [over] slormwater cal°worksheet—REV.2!20/2008 .." uw 1 I Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof tops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving, gravel roads, packed earthen materials, and oiled, macadam or other surfaces which similarly impede the natural infiltration of stormwater., STORMWATER CALULATIONS–IMPERVIOUS SURFACE\; NEW EXISTING Structures (all roof area) /63q sq/ft Structures(all roof area) ) sq/ft Sidewalks sq/ft Sidewalks sq/ft Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads, etc sq/ft Driveway, parking,roads,etc sq/ft Other sq/ft Other sq/ft Total New ��j sq/ft Total Existing sq/ft TOTAL NEW+TOTAL EXISTING' ,46'9 sq/ft `This amount wig be used to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v. REDEVELOPMENT )^ Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: (2'1 W' Does the site have 35%or more of existing impervious surface? Circle: Yes No FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be used to determine the applicable Minimum Requirements. If the answer is no, the proposal is considered new development and the attached Figure 1 should be used. At this juncture, the applicant should refer to the applicable Flow Chart to determine the Minimum Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements. For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwater Pollution Prevention ISWPP) Best Management Practices (BMPs) Packet. Proponents of"medium" projects—those that must meet only Minimum Requirements #1 through #5—and for "large" projects—those that must meet all 10 Minimum Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan, principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater 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.. .2 / (LANDOWNER OR THOR 0 REORES NTATIVE SIGNATURE) (DATE) r_ ,a stormwater ak wukehool-REV.2/20/2008 2 JACK %VESTERMAN II. .cffcrrou C•ty Courthouse ASSESSOR PO 1tex 1220, Port Tow,.alend. W.1. 983648 (3601 385.9105 MOBILE HOME INFORMATION FORM OWNER'S NAME/MAILING ADDRESS; NAME: _ .t / 44_, �i V.._./ ADDRESS: / lV / ry G(/ r-, //` PHONE NO /r • v, The purpose of this questionnaire is to obtain information regarding either the current location of a mobile home or the previous ownership and location of a mobile home. This will help our office determine whether the mobile home is already on the tax rolls in Jefferson County or if it has been moved to this county from another area. l}MOBILE HOME DATA: (A) MAKE ��Ste//v # r7 � =�9"`;' (B) MODEL � /l�aa-(C) YEAR O�QI (D) LENGTH (E) WIDTH;27, ,2__. (F)SERIAL# c228.523 IG) YOUR PURCHASE PRICE (Do not include sales tax) 6; - PURCHASE DATE 7//Y 2) PREVIOUS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE TO QUESTION 3) (A) FROM WHOM DID YOU PURCHASE MOBILE,/ -7//I eMec ADDRESS 2 `;4(d-3 berAl /0 ( Se4(/l W7 (t/,41 f3FZ (B)WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? Yes If Yes, Previous address of mobile_ _ If No, What Comity was Mobile assessed in last year_ aMM,U,M.., 3)WHERE MOBILE HOME IS TO BE LOCATED: 4)1 1 I ' l, UL "014 IJ (A)WILL THE MOBILE HOME BE IN MOBILE HOME PARK? iI III Y (B)IF LOCATED IN MOBILE HOME PARK: i l NA ME ADDRESS OF PARK JEFFERSON COUNTY 6RT AF COI a (C) IF NOT LOCATED IN MOBILE HOME PARK: NAME OF LAND OWNER: //"� LOCATION ADDRESS -t (r/(J AiL 'A6'G/(/e 7f/> IQHmSPiAl f REAL PROPERTY PARCEL #/DESCRIpTION 9 / g ,' -'7L(1. / -"/� i .� .�ri// THANK YOU FOR YOUR HELP! Signs urr of app an / ARO.. O?D 5S-Q Q X GO 6 JO I COSSELL, Property Technician • • Jefferson County Department of Community Development 621 Sheridan St, Port Townsend WA 98368, (360) 379-4450 APPLICATION FOR DETERMINATION OF ADEQUATE POTABLE WATER SUPPLY Resolution#99-90 requires building permit applicants to provide evidence of an adequate potable water supply. if initial information submitted is not adequate for approval and additional information or work is needed,an hourly rate will be charged accordingly. . Name ,/c P/r'2/ 01 //14,,� 4..- I ,GO Phone , .0 C/ • 741 • z. Mailing / /� �- / Address t20 /i'.4--,,,eL ,C14 444-1. . /2/�y''-22-! - Zip Code Parcel . ,O , , r> ID# c�� a-ti C'6) 3 Subdiv. Block Lot(s) Site Address G /"``�,�,rqq'� t "Le-'i'I-i Zip Code Type of Structure /plCr,2c1'/it t1/24',U71 Che k all that a.ii Note: Special conditions may apply within Seawater Intrusion Protection Zones. (SIPZ) UAlternative system (provide justification and design per Jefferson County Environmental Health policy 97-01) El Valid Water Right Permit(generally applies to springs, attach copy) PI Approved Public Water(Submit the attached Water Availability Not catio a g eyor stating the system is capable of and will supply water.) 1� � iw l ry CIndividual Well—attach copy of: 1) Well logs (If no well log report is on file, a 1 hr stabilization test may be Sutistitut ) , ,�1.1. 1i 2) Lab analysis for water quality parameters tested within 3 years of application: J t.t- ' - U -Total coliform i i I I -Nitrate-N I U U - -Chloride II"' CN CCt y�no*AEA_ Two-party Well—items above AND recorded Operation&Maintenance agreerhent-and-recorded Easement. 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 attorneys 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 purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested an -shall occur during regular business hours. �/ / Signature - �—� .fir '•`, Date �,, FOR OFFICE USE ONLY 7 el 1) Water Right Permit# . - 2) Public Water Supply WS ID# "^ In Compliance Yes Nd ' 3) Individual Well Driller Name Date Drilled Depth Production Meets Water Quality Standards Yes No WRIA 17 SIPZ Yes Circle:Coastal Moderate High No Subbasin Based upon information provided by the applicant, it appears that the potable water supply: meets conditionally meets does not meet the conditions of RCW 19.27 97 and the Guidelines for Determining Water Availability for New Buildings. Application Reviewed b Date Date ee Receipt# Check# Case#BLD • S Jefferson Count Permit Center 621 Sheridan St. Port Townsend WA 98368 WATER AVAIL WATER SYSTE AT10N M PU TO: Jefferson County Environmental Health Department FROM: Cape George Colony Public Water System System Operator: Greg Rae State ID Number: 11050C .640 �/�—�._ approved: ECEQ V EI - Total connection for which system is app Number of service connections existing(in Use): 516 Number of service connections committed: 0 I is J UNTY Date and results of most recent water bacteriological an ys s JEFFERSON CO DEPT OF COMMUNITY DEVELOPMENT 06-13-14_satisfactory -— -- The Cape George Colony water system is capable of and will supply potable water to the following location: Assessor's Parcel 1D#940800018 Legal Description Ca e Geor e Villa Division 4 1ot 18 Site address 60 Ma le Drive Operator Signature Date EXPIRATION 90 DAYS FROM ABOVE DATE BUY RITE HOMES Page 1 of 2 • • Washington State Department of Labor & industries I BUY RITE HOMES Owner or tradesperson 259403 Hwy 101 CAVANAUGH,JON RICHARD SEQUIM, WA 98382 360-479-0795 Principals CLALLAM County CAVANAUGH, JON RICHARD, PRESIDENT Doing business as BUY RITE HOMES WA UBI No. Business type 601 013 329 Corporation Parent company QUANTUM ENT& HOMES INC ILicense Verify the contractor's active registration/license/certification (depending on trade) and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. BUYRIH*0840B Effective—expiration 09/02/1992—05/20/2016 Bond .__............ OLD REPUBLIC SURETY CO $12,000.00 Bond account no, YLI222426 Received by L&I Effective date 03/15/2002 05/10/2002 Expiration date Until Canceled Insurance HANOVER INS CO $500,000.00 Policy no. ZHS905743800 Received by L&I Effective date 05/06/2014 05/10/2011 Expiration date 05/10/2015 Insurance history https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601013329&LIC=BUYRIH*0840B&SAW= 7/18/2014 BUY RITE HOMES Page 2 of 2 Savings • • No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period, but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. IWorkers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID Account is current. 547,322-00 Doing business as BUY-RITE HOMES Estimated workers reported Quarter 1 of Year 2014"1 to 3 Workers" L&I account representative T5/CARLOS GONZALES (360)902-4827-Email: GONG235 @lni.wa.gov Workplace safety and health No inspections during the previous 6 year period. ©Washington State Dept. of Labor&Industries. Use of this site is subject to the laws of the state of Washington. Access ANILWasilington jNC14�tSSEi Y .n4d(ik`KS.hGtff. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601013329&LIC=BUYRIH*0840B&SAW= 7/18/2014 Parcel Details Page 1 of 2 • • 11r` Jefferson County ., :�-r-- --e °7°---, *. ^ice' ' f£- xnr.: _- 075.-n*..=vs �'rLG�]ranl�.,_ i to - me res ate-^- . .:ter im. .c..........�.. Home County Info Departments Search Parcel Number: 1940800018 i SEARCH 1 Parcel Number: 940800018 Printer Friendly Owner Mailing Address: LARRY DAVIS 500 SAN MATEO CIRCLE HEMET CA92543-6806 Site Address: 60 MAPLE DR PORT TOWNSEND 98368 Section: 13 School Dom: Port Townsend (50) Qtr Section: SE1/4 Fire Dist: Chimacum (1) Township: 30N Tax Status: Taxable Range: 2W Tax Code: 0111 Planning area: Quimper (2) Sub Division: 9408 - CAPE GEORGE VILLAGE #4 Assessor's Land Use Code: 1900 - Cabins, Park Models, RV Utilities Property Description: CAPE GEORGE VILLAGE DIV 4 LOT 18 Tax,AN, Sales, Photos, and Permit Data Bldg Data Map Parcel fats &Surveys I I Septic Monitoring Info :f -'_ Jefferson County HOME I COUNTY INFO I DEPARTMENTS I SEARCH dr Best viewed with Microsoft Internet Explorer 6.0 or later 0 Windows- Mac http://www.co.jefferson.wa.us/assessors/parcel/parceldetail.asp?Parcel NO=940800018 7/18/2014 II Front Parcel Review RL`JIL+ - 002c( Parcel 940800018 Printed: July 21, 2014 LARRY DAVIS Site Address(es): 500 SAN MATEO CIRCLE 60 MAPLE DR PORT TOWNSEND, WA 98368 HEMET, CA 92543-6806 Parcel Number: 940800018 S-T-R: 13-30N-2W Total Acreage 0 Legal Description CAPE GEORGE VILLAGE DIV 4 LOT 18 Land Use: 1900 Flood District: Fire District: 1 Planning Area: 2 Flood Map(FIRM)Panel No: School District 50 Zoning: A2• / COMP PLAN DESIGNATION: COMMUNITY PLAN: UGA: UGA Trans [ ] Plot plan states "property line" [ ] Assessor's Map(Property lines on submitted plot plan must match the property lines as identified on the Assessor's 1/4 map) [ ] Legal Access to Property Y FS NO [ ] Parcel Tags or Scanned Documents YES NO [ ] ESA's: Special Reports Nearby YES NO [ ] Designated Ag YES N2/ J�) [ ] Shoreline Designation: YES N9/ [ ] Shoreline Slope Stability:0 NO 1 1 G.Qo 26.Jcue Stream Type:YES N,9- FWHCA: YES N9/ Wetlands: YES N,Y Rare Plants:YES ®q Seismic: YES N7 Landslide: YES N7 Flood: YES Nc Erosion: YES N9' Aquifer Recharge Area:YES N Y SIPZ: n At Risk High Risk Coastal CMZ: n High Risk Moderate Risk Disconnected CMZ Stormwater site plan submitted: YesNo [ ] Forest Lands: YES Adjoining Forest Lands: Commercial/ Rural/ Inholding [ ] Mineral Lands: YES IVD-- [ ] Agricultural Lands: YES NO [ ] Archaeology: YES [ ] No Shooting Zone: YES N_f [ ] Stormwater: New Impervious Surface Land Disturbing Activity ESA's Stormwater Req's:Min Req#2 Min Req#1 thru#5 Min Req#1 thru#l0 Engineering [ ] Notice Provisions/Disclosure:Airport YES MRL YES 1 Forest Lands YES rah [ ] Landscaping Required: Yes Ns!, [ ] Parking Spaces Required NO - Other f 1 Building Height: 35' UBC Standard moo,-�s �� � °�- - p(ate ° kald 7"he Demo f DeT1A 6 [ ] Impervious Surface coverage percentage: Resource Lands&Public: 10% •Rural Residential: 25% Rural Industria UDC Sec 6.7 Rural Commercial: 60% Area of Building Coverage:60%in Rural Industria ds only [ ] Total Building(s) Size: RVC:20,000 SF CC:5,000 SF NC:7,500 SF GC: 10,000 SF All others:subject to septic&water constraints/None specified [ ] Setbacks: Front: Left Side: Right Side: Rear: 5 Shoreline Setback: Al/A LSHA Setback: t.1/1, [ ] Road Classification: (hr,Q„c_ (P 2.' Road Approach: EXISTING NOT REQ'D RAP [ ] SEPA Required: YES EXEMPT [ ] Flood Certificate: /.l/A [ ] Existing Case(s) &Condition(s): Violations: Yes . Q [ ] Recorded Date of Subdivision: f3-26 G 5 AFN /84/84S Over 5yrs=UDC Plat Conditions: <5yrs=Plat Conditions on plat or Old Ordinance [ ] Lots/Require Declaration of Restrictive Covenant Y S NO, submitted: NO A f 5:2021‘ [ ] UGA No Protest Agreement YES 1 submitted: YES ND- [ ] Site Visit conducted YES 1 .— [ ] Require Final Zoning Approval YES NO [ ] ADM1N: Setbacks entered in Permit Plan case N/A YES New Parcel Tags entered in Permit Plan N/A YES Special Reports Scanned N/A YES No parcel tags found for parcel Cases Associated with APN 940800018 Cases Name Review Type Status Planner BLD08-00474 STOLTZ F Application Received: 11/6/2008 Permit Issued/Case closed: 11/12/2008 Case Finaled: 10/29/2009 DEMO EXIST M/H BLD14-00249 DAVIS P Application Received: 7/18/2014 Permit Issued/Case closed: Case Finaled: New Manufacture Home CAM14-00352 BY-RITE HOMES NA M Application Received: 6/9/2014 Permit Issued/Case closed: 6/9/2014 Case Finaled: Application process for COU and new SFR CAM14-00385 BUY RITE HOMES NA M Application Received: 7/2/2014 Permit Issued/Case closed: 7/2/2014 Case Finaled: Setback from building-715I OTH07-00003 KAY TRUSTEE F A GARDNER Application Received: 1/2/2007 Permit Issued/Case closed: Case Finaled: 4/24/2007 This case is filed with ShP0/-00031 WET SEASON EVALUATION SEP07-00037 KAY TRUSTEE I F Application Received: 2/8/2007 Permit Issued/Case closed: 5/1/2007 Case Finaled: 6/16/2009 SEP80-00027 is filed with this case. SOM07-00037 STOLTZ RCR Application Received: 2/8/2007 Permit Issued/Case closed: 6/4/2014 Case Finaled: SEP80-00027 KAY C Application Received: 1/1/1980 Permit Issued/Case closed: 1/1/1980 Case Finaled: 1/1/1980 This case is filed with SEF'0/-00037. 1l tidemarkldatalforms\R_Parcel_CRMLA.rpt 7/21/2014 Page 2 of 2 **e()OS- (.06 )(1- 0 '1-4Lb )41-z)oz41 , SEE SITE PLAN DETAIL SHEETS \ ,! EDGES OF EXISTING Az--• Ai,/,‘.9 �7` / PAVEMENT /e1,,, y e/ // kJ _, _ r° EXISTING r 7D � ,', CULVERT /get T-1"8°- / O01N A24,zr .# 9 / / ? - O. ,,d,7� / \\ ............../0130.4 0 \ ' I /, , !, . ,, EXISTING / i 2 • \ STORMWATER I i n \ ';, , DITCH i i LOT 19 I / ,1 p., < 411111,,) 1 x N'\ \ EX/S / 1 / o -T- `. \ ,, CULI NL \I r , N ® I, 1 4.,.- s . '1/ 4111111141 ..,,'"' o f 1 I 1 " o N 1 L__ 1 TOE OF FlLL — - Z I .1g� fi / ro N 6/oo �\N„.., : 1.'k5e.: (1=_ I, , / TOP OF FILL 15,0 • ,: jtfFERS0dCOU T1'rnp�fniT 4” PVC (BACKFRL£D PRIOR TO INSPECT•+N n7fi.OfCOMIh_�` ' -- - LOCATION PER INSTALL£' `_ i \ ` .v° CS� k b , .Z 60 MAPLE DRIVE r�� 6 - I `/rAGy I S N� ! ,rff \\ Ca�iA \°1. N 035 o p E�P£RTY LINES LOT 18 D 0 30 APPROVE SITE PLAN 1 SCALE IN FLIT APPROXf1AA LOCATION OF EXISTING ABANDONED PTiC TANK.! SEE ATTA CERTIFICAT OF S P71C TANKIfEN_T FROM NDMARK CAVATING.ZU June 30, 2014 10:57:49 a.m. JEFFERSON COUNTY Drawing: KAY S£P7IC DESIGN (STAKING) RCO OWG.OWG.DWG D LOP*.•!T"`TT © CREATIVE DESIGN SOLUTIONS 2009 1 DEPT.OFCOM i_35fY ,� PRELIMINARY- -' �- - - EM, ' PA/ REVISION DATE SITE PLAN DRAWN BY: MICHAEL S. DEENEY SHEET I OF 2 DATE: 5/26/09 FOR. D t2 (D • !UILDING PERMIT APPLICATION B Review 0249 Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD14-00249 Received Date: 7/18/2014 SITE ADDRESS: 60 MAPLE DR PORT TOWNSEND, 98368 OWNER: LARRY DAVIS PHONE: 209-743-3923 60 MAPLE DR PORT TOWNSEND WA 98368 9408 SUBDIVISION: Block: Lot: 18 PARCEL NUMBER: 940800018 Section: 13 Township: 30 N Range: 2V1 CONTRACTOR: BUY RITE HOMES PHONE: (360)681-0777 259403 HWY 101 SEQUIM WA 98382 Contractor's License BUYRIH*08408 Expires 5/10/2015 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP New Manufacture Home TYPE OF WORK MOB SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 62,995.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: 11050 BEDROOMS: BATHROOMS: Exist: Exist: 0 Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $532.00 SRE 07/17/14 151260 State Building Code $4.50 SRE 07/17/14 151260 Potable Water Application $67.00 SRE 07/17/14 151260 Total: $603.50 \\tidemark\data\forms\F_BLD_App_Bld.rpt 7/18/2014 • • ^<w¢SON CO6. JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT ,':•�� . 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.Jefferson.wa.us/communitvdevelopment Is. .co Novo Tel:360.379.4450 I Fax:360.379.4451 I Email:dcd(rDco.iefferson.wa.us Building Permits&Inspections I Development Consistency Review I Long Range Planning j Watershed Stewardship Resource Center Master Permit Application MLA: Project Description(include ara a sheet as necessary): Tax Parcel Number: 7 O 0� ! Property Size: r2`� / sex-(acres/square feet) 9_ Size: Sao Ifn Site Address and/or Directions to Prope : Gt2. ap4? 00/4. lWI/20 ji S U1€01/ ��/ fed°6w/mu2 ee6-240• qry . 5. Pesci c / ,L . em (. 6 ; '' .x, 7 /N/(4o 2i,AP' m, ( 640c; 0/4 Property Owner(s)of Reco:: M rir Telephone: 1 • 7 ', _ Fa - email: ' Mailing Address: :{#/© / /✓Z f/ -il Thais 79" _ Applicant/Agent(if different from owner): . . ° iA" ' ` -/- /i iii i Telephone: ;?i/4:2• 70S(/- 6777 Fax: email:1*4Wpvfill pp 0.699A___. Mailing Address: 2.19503 1lwy/ /D/ ,c426twn4, L✓o( 98-. 2.__ What kind of Permit?(Check each box that applies ❑Lot or Road Segregation ❑Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) ❑Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),' .1 Fi Manufactured Home ❑ Modular ❑Discretionary"D"or thiriartf •js I liw l mV E ❑ Commercial* ❑Special Use(Essential Plbi:• :alb-sj-- ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach ❑Short Plat" J ❑Home Business ❑Cottage Industry ❑Binding Site Plan" ' I J U L i U 2014 ❑Propane ❑Long Plat** I ! I ❑Sign ❑Planned Rural Residet1tial i $velopment(PRRD)/Amend ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteratic i" JEFFERSON CIuNIY. ❑Stormwater Management ❑Shoreline Master Program i xeippPip l' b?r. ' 7 ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management : 1: ii .- .• - NT ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive Pian/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre-Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: / DESIGNATION O AGENT I hereby designate 5e ril to act a y ag -natters relating to this application for permit(s). OWNER SIGNATURE K. Z--^ c�`LL2-C.,..(_: 0a_tJ,...<2., .... Date: 7/10/70/5/ By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be - sumed unless the applicant informs the County in writing at the time of the,applicationt he or she wants prior notice. - / Signature: a, C_ a "t ,-.// 4' 4/ i r Date: 74 6,40/6/ 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-'- sferabte-r sP�sibility,for adh nng to and cpmpiyin' with t The Applicant has read this disclaim r and gns and dates it below. Signature: '7'CU'2/r.c% kia--C 1<-?,�, �irWi4f y Date: 7/,6(70/`/ 07/24/2013 , is • 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 assumin• esponsibility of the General C ontractor for the proposed project. Signature: . a �_ ,„ 1 . / Date: 7// Q�/ZQ// GENERAL CONTRACTOR OR MANUFACTURED H•• T,w A� NS�L- PHONE: FAX: Z //P(T'fief ( )6e/ 0777 (302 ,9,- 67S-0 1 MAILING ADDRESS: 05-94/4 /D/ EMAIL:A/�• seaaau �``�"'_ ""' . CONTRACTORS LICENSE ,t,(.Y x(74/ WAINS C'-^' �� � NUMBER: /Q�r/ I� (,p ( NUMBER W /1/48/660 4f,/6 ,423/15...423/ ARCHITECT/ENGINEER: U/1/ /))/• )/3,3 '9 PHONE (V ) FAX; MAILING ADDRESS:+� qO3 i )y ,1&l 5e1Q0`^A EMAIL ��/•v 7� ( ) Project Type: / Frame Type: Bathrooms: r f Shoreline: Type of Sewage Disposal: New 0 Wood Existing: ❑ Addition X Steel Proposed: Bank C Sewer ❑ Alteration/Remodel Concrete Total: ❑ Community stemm Height: Individual Syste ❑ Repair Masonry SEP Permit#,vi'j7 1 ❑ Demolition C Other: Bedrooms: Existing: Set ck; water Supply: Type of He� Proposed: ❑ Private well ❑ Two Party Pe Total: Public Name of Syst ,421 661 6 If this is a Commercial Project you must answer the following: I (j(J V Number of Parking Spaces: Current: Proposed: Number of occupants(includes owners,tenants,employees,etc) Current Number of ADA Parking Spaces: IBC Occupancy: IBC Type Proposed ype of construction: Will you have Food Service? Yes /t Vo If this Is a Propane Tank and/or Appliance Installation permit.mark all Items below that apply: nJ/4- Underground Tank Above ground tank Size of Propane Tank: Heat Stove Cook Stove Woodstove Fire•iace.nsert rehtO I evotS telleP I th s a••li,nce bein. in= :lied in . knaTretaWtoH I When applying for a permit to Install aa-a k you must also submit a site plan showing all of the buildings,all properly tank location and size,distances from the propane tank to all ' p new properly g including the reserve area. A pertY lines,buildings and septic system components, Square Footage I Current Proposed For Office Use Only Amount Revision Main Floor Heated Bid 7,Sj App Review: 2"°Floor Heated Consistency Review: Other Heated Base fee: `� Mezzanine ? :�2 Additional Section: Heated Basement jjj-- \-\ Plan Check fee: Unheated Basement � V ;rr„ , S rcharge fee: (,/ Other Unheated 1` '■ ; er Review fee; a t Garage/Carport JUL 1 7 2014 SUBTOTAL G ` Decks ) 1---___ JEFFERSON COUNTY i /R. Approach fee: Other h DEPT.OF CO:,t,JNIiY UL/ELOPM,'PTT TOTAL: $ 0(6 q S-0 . Receipt Number: / Ti) C-0 Cash/Check Number: •ESTIMATED COST(REQUIRED) c S 2y -V' 'Fair market value of�all labor and materials foundation to finish Date: 4111 7�/. G( Initials: JACK WESTERMAN III. Jefferson Co Courthouse ASSESSOR 1'O flu 1220, Port Townsend, WA 98368 (360) 385-9105 MOBILE HOME INFORMATION FORM OWNER'S NAME/MAILING ADDRESS; NAME: ( 4- ii V-_," • all _ ADDRESS: iiITRAIMFAff/� ,o �o w S^'= /1i PHONE NO a. #v • . The purpose of this questionnaire is to obtain information regarding either the current location of a mobile home or the previous ownership and location of a mobile home. This will help our office determine whether the mobile home is already on the tax rolls in Jefferson County or if it has been moved to this county from another area. l)MOBILE HOME DATA:` '- (A) MAKE '/7. 'v `S�//v (B) MODEL_# J i/Z P/' 4-(C) YEAR Q/ (D) LENGTH 51'2- (E)WIDTH;2-7. (F)SERIAL # (.528523 (G)YOUR PURCIIIASE PRICE (Do not include sales tax) .)02-� 7 PURCHASE DATE 7//,2D// 2) PREVIOUS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE TO QUESTION 3) (A) FROM WHOM DID YOU PURCHASE MOBILE,' M/Tc //e24/te ' ADDRESS 2 5 G7'(cJ 3 -G(1 /d r 5eq(/i WI Gr/4 .6F-0'- (B)WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? Yes If Yes, Previous address of mobile. _ If No, What County was Mobile assessed in last year. .TialMSY/1011n1 3)WHERE MOBILE HOME IS TO BE LOCATED: UL 42, 014 (A)WILL THE MOBILE HOME BE IN MOBILE ROME PAR 1 Ye (B)IF LOCATED IN MOBILE HOME PARK: JEFFERSON COUNTY NAME die ADDRESS OF PARK1,,,, , ll'r• .° (C) IF NOT LOCATED IN MOBILE HOME PARK: NAME OF LAND OWNER: y LOCATION ADDRESS il (DO a // 'o/. -d// /Dkv4 S?ih/ 44 ' BEAL PROPERTY PARCEL #/DESCRIPTION ' !4OOeoOI8'f 1? _ ����' Signatur• of applies': / THANK YOU FOR YOUR HELP! C -Q OM Q�_ JOD( 9D COSSELL. Property Technician • • a s C al m E z D "" to _ e m � z m 0 < zm ro • 5 m D• h. ::-:sit 4 Ad Is APA�at a ,. rc'n' i i I (,11,ii 111 t1'I!l!I!IA 1. ii „1 itt 1 I 0�.f. , 1111 t,. 1 , 111 ii i li i 1111111 A. �lffU��F.0 ® A Y -s— ,-q r ?t�I i01o0Y i -.,§f6 i'n�,�.'e, 111, i-� l 1,ii i g_ , + ,1 111 i1 1: I1tif'i10 li L.DP '' E1111111111111" I �� l )� � OS + is ", P.11111111111111,11411111111111111111� N m ;� +,11I11 S 1 in '1 41,I1!ll,tl,ll,!1 111111;114111111 '..a._n -- - —� o Iltll'llllllllill 111lIIt111litlllli] n f3 1I 11111111h ,1I1111111111I , g € p--- li�litlill�;Ii,11�11f1IIIi�l ilIIIi{11 A 'z �' ' lit il i II II I R II 1i1, I , N W Ii I4 o h r:x°im i r� o i ,, it 11 lfl F, g aqt ti _u ,- Ps`F ,,..�._..v...� �Ii—II—III �__ 0 �aA4#..- kilat'U —,F 1 'n�fp�Jnl i! J W , O or c _ r uTn�" ' QPIP21- s /7//b4,,,,/ • • SEE SITE PLAN DETAIL SHEETS EDGES OF EXISTING ere PAVEMENT —91//5 1.ac $` lee<c/a, ,a` e / •`" _ Ar EXISTING (!' /["', vG}!'�V✓'�if �Gf /�N//1�' , -- , CULVERT � N� Pa rte.( 9yok000/6:-ft/9 N'd 0,..P' N \ K n✓7 7 JIPG( #D772G_ / •••• I O A • O * /�t Stt plug, 6y.'A',,-.Ihe: para> ">/ -- � 36.0 Z,k/-0777 5 71,01' "i/ / EXISTING / STORMWATER / 2 / n\ D?CH LOT 19 i // K3 // /// `x) `Z / / r.. <, / / I 6 1 / / ` // W A EXISTING I / v/ o� N CULVERT er C 4 \ I I\ z I � 4 r -r-- --41„. �L I1 \i #446,,,..„-, o �. , 1 11 f TOE OF FILL ` \ ~ ---- D 4Pr NL � 1 R --., TOO Ire , • 01140-_,----- � z 1 N /p0 / a. TOP OF FILL , I O I.3. \ 1 NV ' P f 4" PVC (BACKFlLLED PRIOR To/INSPECT O 1NSPfCT?N — LOCATION PER INSTALLE 9 4 .-- 4 Z 60 MAPLE DRIVE ~' Z. o� .4‘ o . ..- '.-- r N $d35'� � - . . ` N B�DOD hr E I V IF I LOT 18 �. / , IU 0 30 JUL 1 7 2014 SCALE IN MT L APPROXIMATE LOCATION OF = ■ .T Le ABANDONED SEPTIC TANK. A ACHED CERTIFICATE OF SEPTIC TANK •eNMENT FROM 0u.a. ' •VATIN . JEFFERSON COUNTY DEPT.OF COMMUNITY DEVELOPMENT June 30, 2014 10:57:49 am. Drawing: KAY SEPTIC DESIGN (STAKING RCD DWG.OWG.DWG © CREATIVE DESIGN SOLUTIONS 2009 REVISION DATE PRELIMINARY SEPTIC SYSTEM, PARC DRAWN BY: MICHAEL S. DEENEY SITE PLAN SHEET 1 OF 2 I DATE: 5/26/09 FOR: • • 4 N-°°a JEFFERSON COUNTY • A DEPARTMENT OF COMMUNITY DEVELOPMENT S+, 621 Sheridan Street•Port Townsend•Washington 98368 c0 360/379-4450• 360/379-4451 Fax W h1tp:/iwww.co.Jefferson.wa.us/commdevelopment/ • • Stormwater Calculation Worksheet OALP.7{ PROJECTIAPPUCANT NAME- DETERMINING STORMWATER MANAGEMENT REQUIREMENTS:This stormwater calculation worksheet should be completed first to classify the proposal as'amat!"mecum'or large.' The size determines whether a Slonnwater Site Plan is required in conjunction with a stand-alone atormwater management permit applicat ion,buiding permit application,or other land use approval application that involves stomrnvater review. The basic information will also be helpful for completing a Stormwater Slte Plan,If required. ] L EARCEL SITE 11.E..SITE1 Size of parcel r �(.1 acres An acre contains 43,560 square feet Multiply the acreage by this figure. • Size of parcel in square feet l' 't' sgifi %C; 7 r;•t( ..Li c • z1>r3lE( 1.3' Land-disturbing activity is any activity that results in movement of earth,or a change in the existing soli cover(both vegetative and non-vegetative)and/or the existing soil topography Land dsIurbing activities include, but are not limited to clearing,grading.filling, excavat ion,and compaction associated with stablizadon of structures and road construction. Naga*vsyetadon 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,salm onberry. and sake✓,herbaceous plants such as sword fern,foam flower,and fireweed, LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Calculate the total area to be cleared,graded,filled, Answer the following two questions related to excavated,and/or compacted for proposed development conversion of native vegetation: project Include in this calculation the area to be cleared for: - Does the project convert'I..acres or more of Construction site for structures f,=. tight native vegetation to lawn or landscaped areas? Grainfield,septic tank,etc sq/ft Circle: Yes No) Wei,utilities,etc. sryf Does the project convert 2'f,acres or more of native vegetation to pasture? Driveway,parking,roads,etc. miff( Circle: Yes No Lawn,landscaping,etc. win Other compacted surface,etc. sgrtt indicate Total Volumes of Proposed: Total Land Disturbance r / agMt Cut Fitt (curyd) [over) E C E J � V sloonwtelar cat twM1.151*-REV 2,2=0›, AUG 1, 9 2014 JEFFERSON COUNTY //(/� DEPT.OF COMMUNITY DEVELOPMENT III • Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A hard surface area which causes water to tun off the surface in greater quantities or at an increased rate of flow from the pow present under natural condtons prior to development. Common impervious surfaces include, but are not limited to roof tops,walkways,patios,driveways.parking Iota or storage areas.concrete or asphalt paving,gravel roads.packed earthen materials. and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormweter. STORMWATERCAl.ULAT1ONS—IMPERVIOUS SURFACE Y EXISTING t/qy/ ' iii Qf f+ J .< , (all area) 6 G I _ rf'�'-r •Structures(all roof area) earn Structures all oe/area Sidewalks sq/t Sidewalks se* � Patios sgrft Patios / C) sglft Solid Decks sq/ft Solid Decks sq/ft (without infiltration below) (without infilbution below) Driveway,parking,roads,etc ti -y'7 f 5 sant Driveway,pelting.roads,etc sggl • Other ��//// NMI Other stiff . Total New cif/'7 l�'/sq/t Total Existing i 77 sq/t TOTAL NEW+TOTAL EXISTING f f0 (,/ sglft 'This amount will be used to dreg*total rot coverage_ The following questions wilt help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT y,REDEVELOPMENT Divtoe the total ex+eirig impervious surface above by the size of the parcel and convert to a percent :t1F 76 Does the site have 35%or more of glcistinp impervious surface? Circle: Yes FURTHER INSTRUCTIONS: tf 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 end the attached Figure 1 should be used. At this juncture,the applicant should refer to the applicable Flow Chart to determine the Minimum Requirements for slormwater management DCD staff w ll help verify the classification of the project and the application requirements. For proponents of "smair projects who must cornply only with Minimum Requirement #2-Construction Stormwater Pollution Prevention—en additional submittal is not required. The proponent is responstfie for employing the 12 Elements to corned erosion and prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwst+er Pollution Prevention(SWPP)Beet Management Practices(BMPS)Packet Proponents of"medium"proiects—use that must meet only Minimum Requirements #1 through #5—and for large' projects—those ose that must meet all 10 Minimum Requirements—are required to submit a Stormweter Site Plan, MD has prepared a submittal template of a Stormweter Site Plan, prsxdpaty for rural residential projects. Complete the template in the Storrawater Sits Plan Instructions and Submittal Template or prepare a Stormweter Site Ptan using the step-by-step guidance in the Storem ter Management Manual, APPLICANT SIGNATURE By signing the Storm rater 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 at owners of the effected property. — (LANDOWNER OR`fns r oRmps BONEstow.U.eE) (GATE), !.._�. .. '.•,l y. `. .fir.. .. ,vme..rr ak.ala'.n-pry.rye AUG 1 ^ f �s 2O 1 I JEFFERSON COUNTY , DEPT OF COMMUNITY DEVELOPMENT • • ` SL) 141-6)0 Z4 t SEE SITE PLAN DETAIL SHEETS 1 ECCES OF EXIST':G �• - PAVEMENT \ ��L L�'�1,./ T W-- ' EX15T/NC / CULVERT -i Aa T _ i ce - t-3-6°- \ l ' � O --1, ,\\\ 7id19 40"/ / \ \ \ ` �30 / / \ r / des 1, �, . EXISTING / 2 1 STOR,'dWATER ' r1? n�N. \ DITCH LOT 19 I i x� `z`\\\ / r , 40/ ,a \ . i1 I 1 I EXIS ®NL ,I N N, CUL \ h4 1 i*\ 1 1 1 I 1 1 1 • o > i \ I 1 1 Qom/ E* TOE OF FILL '-- / 1 lj NL \ \ , / f DP 001 .------ -V , i, ..........ri.:„0.0. .....z.--/-----'-''..-.. t•• ,,,, \ •E �3fib N /oo / a j / TOP OF FILL \ r I .() O N. • itif`cRSON COUNTY ` ba - *t`•G M':':11.1UP:f`Y Gr.!Ft�pMcf�,T_ 4" PVC (BACKALLED PRIOR TO INSPECTI'N -- - LOCATION PER INSTALLf' k b, I) \ '` z 60 MAPLE 0(71VF ��� - tlLrV :" - � ° ice,v. q `t x,� ��p `Y/'y11'yIN' O N� � �yy 1e■. k, Lv�' G� Ivy ,` 1�,�G� l N 6�3 e.....------- . /PERO APPROXIMATE• 30 LOT t 8 APPROVED SITE PLAN SCALE IN FEET y� �APPRDXIMA;£ LOCATION OF EXISTING ABANDONED PTIC TANK' SEE ATTA CERTIFICATE OF SEPTIC TANK/ I, fEN_T F M \'DMARK Er'CAVATING. June 30, 2014 10:57:49 a.m. (� ntTh� Drawing: MY SEPTIC DESIGN (STAKING) RCD DWG.DWG.DWG JEFFERSON COUNTY ©CREATIVE DESIGN SOLUTIONS 2009 DEPT OPCOMM�( YDL r�,Q__rte REVISION DATE PRELIMINARY' " - ^ _ STEM, PA/ DRAWN BY: MICHAEL S. DEENEY SITE PLAN SHEET 1 OF 2 DATE: 5/26/09 FOR. 0811212014 11:49 Cape George ny Club ff0360385308 P.0021002_ _ REY14.7 , --f ":_)( T -E: ` ___ — Wks J `ij ( J i(t V1 SEE SITE PLAN DETAIL SHEETS =gig ExISTrNo �_.a EXISTING CULVERT Qd / 5`2N. N / t °• \ ,/15" r _ _ tea. i ..'". 1 7 ExlsfINC , 2�, STnRMwATER ., DITCH LOT � x VY >` r .. < �' io , w EXISTINI I CULVER I I 1 1 &, \ 10110 Y \ I1y�d IT-^� �• \ I 1 IS jit'410101 o� ¢ I \ r L_ !• TOE or FTLL •\ - tit,_.:�.\P• ` ,bf , / .e11P� .AIL .+' �..� q _ `.t' ` D¢G\ �� ,.�— N x"� I •i FS TOP OF FILL � - N" 1 4" FM: (&gCKFTLLED PRIOR TO lNSPE�•'RON s• 1111110„44 - LOC APON PER INSTAL l\-) �' ` , z fiD NAP!£ DRVE ��y �` �' 3 '. q 4 b ‘' ' I�a�- .x;� vd 1 1 , 41 Ora ' .✓ Sl ' APPROXIMATE 1 R ` ..•,. :-� �O PROPERTY LINES o�p��O JO .0".{y CS Tar A°PROX(M4TE LOCATION OF EXISTING'MAROONED SEPTIC TANK SEE AITACNE CERTIFICATE Of SEPTIC TANK AAANDONTMENT FROM L4/DMARK EXCAVATING. J Jvn, 10, 2014 70:5J49 am. Orowinq: KAY SEFDC CES!GN (STARING) RCO OWO,DWG.OYYG CREATIVE DESIGN SOLUT(DNS 2003 PRELIMINARY SEPTIC SYSTEM, PART REVISION _ I DATE ' SITE PLAN DRAWN BY: MICHAEL S. DEENEY SHEET 1 OF 2 DATE: 5/26/09 FOR: SUSAN STO L 7 Z • L.P-vol0175 P9 114865 CAPE GEORGE VILLAGE DITV 4 SECT/ON 13 - T3ON - R.2 W- WM. 07777.00 SECT/0/94? r,.50..5/30,011i JEFFERSON COUNTY, WASH/N6TON .0=0.50%.7./7 u _- ®-- -566'/r'SL•f./' Mil l3 _. '4Fs� .a'7::),4c i:'fi.: `- 0i:';? ,'..1:;"‘".4,P44) eir N- DEN 11/0 _ 0 97.60-.56- BLVD 2 320.00 - f °•s 6r °n c _114:-.' 272% _ __ 3 / "';'''",=e7 /0 /3000 /30.30 6• T69p5 /w \� �8 2/ " I z a a q P L k, 22 a° 43 ti "' . m' d..- . ?$ 4. �/ $,i1! �4.7.9rX- v M 4.,512•04".''4. ��'� 44 65 d ^, •.4.,X47007:0-00 4'8 '.0 / '..116'00 /04.4 or 1%1,1 w� r•op0 _,. 35 x' E . og� \,Z ass, Port t 0-4r.0,01.,-,.•3 �Y �4.2rir:a- .., „XS" r3 % ".100.640 0 1. ro\ 0 k d k 23 42 45 o Z y 6 66 < a g 79 "` y.. 190 Q L N 1.0:'," . $ N�0� ' `` \�i Of 16.0 . 0 .:,pt s\ b 0 A' 5, 24 a s</ �\� m∎ $ 6.030 . /9 ,E \: v 2 67 N $ • \ c. 8 •. ,\-.'"" l\ �. je'E.�n� a ONUV�6br0 /-...J»/0 N 9 N; Caveri,4-JY ./14-rAliq'/8 a 4p 62 B 4S�N %.7 pU O W s / /ao' =° ' F\A�, 6B It 7B t., \$`Ncr 8 0;s1;;•44...44:,00' n y D=OOR x { a$,40143:18 4--ti T. o.�'�,yf r' � 0°,47'69 �µ �s' ��` r. 1. \\o ØØ, 27 3d to ,8 49 s' ' C 60 g 1, 8 .4.33' o y w a. ''.:,..\3 <- ,i, ° .04 - \ ffiP N6r..6 <, .. 0 . 'W` mm :" /5 a No 28 a 37 2 . 50 $ 59 N si p rotso • id ??�� „. �. E nee a' 0'0' ` a 0'fz SArER ,..e.rj410L7' `M\ '-aS �R' : ,. "• . iNIOr4 SA N�f0.00 g e:Ot65 • �, -of V.\. N7t N ..5.03'.010' M 7/ 0..045$5' /4 era"P „°.f'6 ° 36 `fit`', S6 N� 5..W" / 8 �• <, $ 4.0•0000 '-� 29 u,°,.0.0.5'.0" w�1, - ;± /� I., N 7 02.0•• sorer347`' N.. 01sT.. rq1 NN:TYOYR. x07.0 72 /3 t Y ' ° 0' 35 1.. c S2 0° S7 r ...,,,. a2 ry1 ¢ p ,Ns, .R :` 1' n9g��A�• ,'°,•,rv- 0. 0.4.$•43'/6' 6 C•I'/f:JM-w K6I•r0'011. N61'69---86y N�a30•E.R MAf•$0'0E2E N09'40:.E"E 42.5473' • N Ws or 0707 a Al11,0 Y7'0:R. 73 k le J' a e•svTa % - d•3•a.'CD-�!� , I/OW-9sr'N' t §6 o w 4•r/s�s• 6,.0.09•.0.0•. /2 w Jr , 53 S6 ••m N6 �. V' 4.10.0071- Y°75-x` �� t.:,41 /2 `.!47'500070 4'407' OW ti • 007's4017r 007•SE0971 ; ,,' ?4 $ 3' /9040 �% /3aoo /-•00 :�w 1 1 /'3000 /90.00 74 q,, . �,7�I�? ,. 4Y�* /9030 ' /0/43 2 g /1 8 �e 32 39 34 8 SS o Z'554-5:--4c1 ,-,14=-?.00 % : $ °�*�u 2 � 4ff /3000 , 1 /1000 /3000- /30.00 4602 40�86 `*.dam 499.12 -,0 /96.66 32.200 x43.32 'M1/r 5 ---kr- R/D6E .x.07•.54.09'010 ss'O/' .q DRIVE - - .. .. 9000 0 ;c 0. '� 0 3 in ng 8 dbrg o TRACTA ry at °@ /0 ' 9 ' 8 7 ' 6 ' S ' 4 ' 3 °,D 2 a / ti h q h Z � ____ 9000 x , ry " - 9000 ezes _ /9706 J01f N.al'JI'09'IK 161.3/ - 060.70 OESCR/PT/ON Thies P/or of CAPE GEO.PGE Y/LLAGE O/✓ 4 '- r6mTfd Me P/o1 of Cope 6'660.0947 Ni eee D/✓3 recorded/N Yo/. 4 in /he no-thwest quo.tar of Y.be .5070,/h•00-/Quo-707.and ofP/oer,..0%'os 59160 o///n Me...L.co.-dr of✓e/ s-.om Can/y, 0/.047 "00,0 0•00.0-7`quo-/e. of 7YOe soulh •osl gox7ifar of Sec. 7n9,1174.79 7'017 and in o//Me Oa-10021W'Qo0•7•/-of#0 Juu//kvs/ /3,700Yn4'440 30 A/o.,-.M, Range 2 Nast, /YM ono'Cron/o/ns 76601 foo-ter- /yi.7y Nest of County Rood Na 40/ass /ho/pO.t/on O.-en oessc.ibed oS !/'/ows; ,4//of Me no.te/vasl Focule. `997f /i/so/dP/o/ of Cope Geoiye Y/%/Dye Di✓. 2. of/110 Soulhaosl f4O7/07 /ass /ha p/7/ of Cope 69090 Yi%/o'a D/.1 2 re-o.-oE 'in Yo/4 of P/o/J,Aye f4 and/ess SHEET I OF 2 5 L.n-‘,o) PP176 w CAPE GEORGE VILLAGE DIV, 4 s SECT/ON 13 - T30N - R.2W- WM. JEFFERSON COUNTY, WASH/NG TON ACRNOWL EDGM£Nr STATE of WASH/NGTON l S.S 9 COUNTY of JEFFERSON On this I!!ooy of_ 1%5, before me, the undersigned,a Notary Rib/ic M and for Me Shah of Washngton, duty comniJr,oned and sworn,personally'.r$, appeared Ho,raid G Ridde/f and V Kedh Colman,to IOC known to be President p _ and Seereiwy-T .rune i respedivdy,of CAPE GEORGE MOB/LE VILLAGE,//C. ,v , and of CAPE GEORGE LAND CO,N C., the corporations that executed the foregoing mstrumenh,and aeknan/edged the said.nsfrumen/to be the frera d F i �v vo/un/ar act and deed of arch of sad corpwdforw,far the ores oral porpases'' q� .r C wx7r3nv xffJJ ' therein ymerth n.o and on oath slated NM they ware orMhonxed to eremite 4 Ammar, the Said au'trumerd and that the soots affixed are the respective corporate , a e ,qa.a/s of mid corporations. I••• , I�a ���� ^I WITNESS my above and oFfi'e:at rra//ramie affixed the bey and year in th_:. .;��, Qo 1® , certificate shore m:flea tusz sTA I3tttT$ �e . X/✓ , i Z ,i%IM N/[eSiDINC e rA7[A xw,wwsrav, RKILL/YL N'SSL ��� a° T NNR Wa. Me vreN- CXb _ w•r'ISJ"w /` m „d Md. ,rM 1fl//Y „at94Cl„e,. tCJSN 4„,,„,„,. rd ea,e/^^' EN$/MEERY CERT/F/CATE SUBOL VIS/ON of SECTION seem-. 1 hereby certify that the plat of"Cape George VA/sye Diva'ra based upon an actual survey and sabdivision of Section Li,Township 30 North,Range 2 West, WM., that the distant s and col/rsty are shoran hereon correcfy,end stn//have fair r COMA/ied wdh the p'ovisionr of the statutes.dp✓at/iny reguratien. rL aa.K LwN3.jaRYl/'Pf 7c TREASORERS CERT/F/CATE I DEDICATION AND RESTRICTIONS /, 7r&surer of Jefferson County, Woohmgton, hereby certify that WI taxes on KNOW ALL MEN h THESE PRESENTS l'n the ulp/at ofd owner r ter slop/. the above prgoertf, , ether with the poyaent of adrunre faxes revoked befbre of the /and der vn platted, Hereby eaewa es this plate, 'Cape George Vi//aye tiiing of the p/at,we fully paid up to and bxtuding the year/%5.4-/MAL OM 4", subject h the reshichens;covenants and reservations set forth in Not certain 'AGREEMENT FOR RESTRICT/ONS COVENANTS,AND RESERVATIONS AND PROP/DING FOR ANNEXATION 0F PLAT''dated the 9"day of July,/%3, __ and recorded M Whom/GI,pages 548 to 555 under Auditor$file No-/76650 TRlrV4aeR OF JeffORSO records of Jefferson County, Washington. al IN WITNESS WHEREOF the,,deraigned hove hereunto set their hendr this J_?_ day of1$r445t_,N65. CAPE GEORGE VILLA CE, INC. APPROVALS • Exomved and approved thiS_L4 day ofsivrev--__,1965 Ege.,.,/a.t ..G✓ tY Era Tined and approved by No Board earthly COMOMBaimrs tbiar_oaya t%5 DECLARATION OF ANNEXATION ,� A t- (/';�� / _ - - ANe _ —_ �.e�`AI/M!1 C01-COUNTY R FCOR'R CoMBy C �''L. . The u�rsigned doer hereby scknoer/edge that tAe tercgm/Ng p/at of`C"dpr Gewgo emARp LOrMTY crorr.W'/onERr Boca o/co<evlY cpayr.&AZaJ Vi//aye Div 4"is hereby annexed to "Cape George Colony and the plats thereof dnsofar/het the same privileges as to the am of the reserved properly and riyht, under"Cape George Cony acrd the plats thereof ere extended to each and a//pr/rehasers end owners of any lot, tact or parr./ within the//inns of'Cape George Village Diy4"as are granted to the purchases end owners RECORDING CERTIFICATE of any lot, trod or parcel of the plats of'Cope George Co/any;sebJrcf however to the some/imihfions end restrictions as are applicable to sack F d for rd el the nest of Howard G.Redd.//on Phis Z feBday of use is provided 4r/n M.plots of'Cape George Colony. ^^7 /965, et request of Howard past_f_07_d d./l Week, and resided in CAPE GEORGE LAND CO, INC V.A. _ _of PIe1, payee76Y4,/msrdso_f Jefferson Count., NashNgtan./) ...L CAET/Oe T ry ar°/TOR r''''---2 �C -- ---JeCRETARF-n!f CRU 0 everr aumnaR - SHEET Z OF.0 ' S • 6 111' gill I111111111111' IIIIIII III5202106 1.11.r...n r,nJV 11,,,1 4111 Tc Yov MI %I PO When recorded return to: Name: JefferSOn County DCD Address: 621 Sheridan St. City: Port Townsend State,Zip WA 98362 DECLARATION OF RESTRICTIVE COVENANT Grantor(s): Hillis Kay,Trustee Grantee(s): Jefferson County 11�� �^ A NOTICE IS HEREBY GIVEN TO mj'//!•7 G. A / ,his/her -_ d a Igns, and the general public. This restrictive covenant shall bind and restrict the Ian. I . e, Ier(s),th=ir h-irs, grantees,successors and assigns and shall'run'with the land into perpetuity. O DESCRIPTION OF REAL PROPERTY AFFECTED: Lots) 18&19 Block(s) Div. 4 of Cape George Village Section 13 ,Township 30 North,Range 2 West,W., . \ ASSESSOR'S TAX PARCEL NUMBER(S): 940800018& 1: ' NOTICE IS HEREBY GIVEN THAT the combination .f - .bove :ferenced description of real property(lots,parcels,etc)Is required to meet WA 12.6-272 im m Land Area for issuance of an onsite sewage system permit. Sale,transfer or.Nth: segrega io of only part of the property described in this Notice and in the onsite sewage pe it. 'I re •It' a violation of the terms and conditions of the onsite sewage permit. TYPE OF STRUCTURE: Single Family Residence ADDRESS OF STRUCTURE: 60 Maple Dr..Pdk.Townsend.WA 98368 THIS NOTICE may not be lifted or removed wit ut t consent and written approval of the Jefferson County Health and Human Services Recording. Upon its execution.this Declaraf• .=II be ,•rded with the Jefferson County Auditor. All contracts and deeds or other Instruments of c•n e :rlc rel. ing to the property or any part thereof shall contain reference to this covenant. Compliance with code requiremefga/ ‘'s Dec are to •oes not amend or modify,nor is it intended to amend or modify any requirements of t Cou 's• •noes or any other law or regulation dealing with or affecting the use of land or construction of i -•rov-••ents upon lands. Warranty of Authority. The owner sle ing ••o . arrant that they are the sole Owners in fee of the real property described above and are , t • ed • ma e this Declaration and so bind the property. • • GRANTOR(S) �- '64'_ • Acknowledgment: �1 tti r I SUBSC: :EDA ' OR • bete athis(day of rE..0 ,2807 e 'Diary pu• •` the Stateo iWashington. lllrllr_�1A1 er,, residing ��At Washington. 111 (4•...•..•..Wo9t` My c•. mission a Ores: t -O 6 111 01 g:'12,45tON F�..O. Zli aw•• v• t.N .. PUBLiO 12 r �c F� SN I11 F W 4IZIIIIp - —...... •.nirry 414111111111111P C:1Data'Wpe\County A State Form,Ueirersoe\Combine Lots(Min.Land Area)\Reynolds W.Lon,RESTRICTIVE COVENANT LAND AREA 070901(Fined Om).wpd O • JN • . 6 > . . 8 1 4 \ (, d W N.II re< w C .z C R " ro W W CD cv (n (n F- °o •.. LL (ML-NQ-B /l MS) „.■Or .zrcesL o m �.� 0 O F1 ' G� . \ • s 3 Cr) 41 NI VI& LA �ii y CO 2 la IX IA o m Q q ow; W 11\ O ON C.) rn R°P° a 0 W V NOV —1 °PpE R LW 0081 0 OOe. z DRIVE V 40 V O o 0 o00 w 0© ■ ©© ° te11©©© ° 411k, Q m�� ��a o 10 111 0 41 0 I i . , 0 go ym© olp DRIVE ow.. d LL, • 11001 A 2 2 110 m 0-cc- we 2 1111110,0w s,.\\g 2 E pa-NOS-SI VI MS) ACmsz :) w oo ° _ • ■ FMS m ss$ W>6'g a ''. wOw — 32A i5 xS n`A a "- _ ' 0 3€ 35 x' rc °w� y V_• j'a NgBi • Dom =,, .,,g i� 3 e� zs o p_ a W b NL^ §' �3i�6w 4 i °'6mg4 ,';;,,s�$g 8 $ kgcag�Ewg S road Page 1 of 1 • • ADDRESS INFORMATION FOR 60 MAPLE DR ROAD NUMBER:P92 ROAD NAME:MAPLE DR ADDRESS:60 APT: REAL MILE POST: APPLICANT: ADDRESS CREATION DATE:01/01/68 PARCEL: LEGAL: GRID:AA-5-I FIRE DIST:6 ZIP:98368 POSTAL DISTRICT:PORT TOWNSEND PLANNING AREA:2 VOTING DIST:104 CEMETERY DIST:- HOSPITAL DIST: SCHOOL DIST:50 WATER DIST: SITE LONGITUDE: SITE LATITUDE: SITE COORDINATE TYPE: ACCESS LONGITUDE: ACCESS LATITUDE: MODIFY DELETE ADDRESS NAME SEARCH REPORTS http://isserver/Address/RoadAddressDetail.asp?ROAD NUMBER=P92&ADDRESS=60 7/28/2014 Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map d Legend Selected Features JC_Roads Parcels-H ,.._, 94Gci:.•-. ,.-. County Zoning MPR-SF Tracts Rural Residential 1:5 R oral Raselental 1:10 94fi2107020 94C,OCCO21 Rural Reamer t a 1:20 94 ri�l: MPR-Seigle Fanrty ■ MPR-Nueaanay NPR Resort Compels Parks and Renaat.n 9408.00Ct'9 ■ MPR-Open Space &lfi&%}fi24 C 44CEc•=-I' Rural Forest Comnsmcusl Fares. ld >t Inbomg Forest heavy Induatrat 943E07_�6 4Y MPR-Vusg MPR-VEIL ga Center AP 1:20 Rural Village Center ■ Resource Oaxul lna Lpbt tiles.::-a '.. - -. . MPR Rent=tr. r Wale Ngst CPF L1M , Lit Crossroads GC Crossroads CC Crossroads NC AL 1:20 UGA-Urban Celrenerca ., ,..., UGA Urban Lido Mrdudra: 11 UGA-MOR UGA.FI GR UGA.Pa etc UGA.LDR Up UGA-Vlsnor Oranted Commer_..i MPR-ORN Busses CF-8OMRLOConsnorcal Forest Meters,Resource Oaeelw FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Mon Jul 21 14.47:20 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion=4.... 7/21/2014 Map Output • Pale 1 of 1 ArcIMS HTML Viewer Map `s10U''.Cf'23 9-1,-WY-X).12 9408CUC4"9 4 940..00024 r•u8 Legend 105009408000C 9e Selected Features JC_Roads Parcels-11 Shoreline Slope Stability 940890018 9.1tkY1-VZS I I Stang OIntarmat ela Z I� Unafabla Unst zeta Recant LanIsid: Cy ❑ llnslank Oki L3mas,de 94080XXY. 94C4I0)316 94060:k2T 5y1C?S0Ci0'B 9408(."._ 11a:r,vwtlntl n:-c'vsal Co l r, _a Sawa,Gtt 0 imemmumummalii FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Mon Jul 21 14:46:54 2014 http://gi sserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion=4.... 7/21/2014 Map Output • Page 1 of 1 III • ArcIMS HTML Viewer Map ■ 940e00013 940e0002 -- -.--- ' 1 919891:{}20 ` '+ 940800413 l�III .r 1 9446400t9 \1 94MOOe14 910e00024 � �. Legend 1 I� Selected Features �, JC Roads - Parcel3-H ' � SIPZ 990800018 Iy 910e0C+.: Pa li nk SWZ 1\ �\ ■ Decamrx StV2 r II 1 . �5 le ` KSg11W$IVZ � i 9a , caastai SOU 9m5o9o29 1� Q 940500017 9/0800018 1 ' 9408000b 1 Q 1 1 9945o9oaa' .- � 1, 990800018 '�,. , 990500017 't ` ,., 9408100027 940500027 \� +9,40500018 N- 0 81f1990e0\ FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Mon Jul 21 14:47:09) 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion=4.... 7/21/2014 Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map i1 ` 940500013 / ( 940000021 74_81Y.5J22 — /• 94080 4.17 l / r ; � 940000023 , • • \ ( ' I fr, � _--------— } \ --11------ \ /.> 111.04, . , 5 1 55 �1` 940500014 '� 940000019 } 040900024 94080 .,V 0041 Legend } / Selected Features r ti '. 551 JC Roads �\ ,1 ,1 rte' _ 5 i " Parcels-H //• \ 5 Contours 1 9105000/8' ./i•' 940900025 10 Foot Contour -/ 50 Fam Contour I a' 'l O ,5 f� • s ,� Q , Y105000t?Y 15 l 940800017 ,' rr+• 1 940500018 } l '1 \ 940800028 �y1 5 !� 940500028 t. y r'' y 1 ----.1,---` �� 940500017�I1 9408000 • , 'may ',, 1 .,I r 11I.dUFU71 % } 940600027 \ N yam- 040500018 r 040000015 \ �- ` S ! \ /1 y 940800098 Mee va,dal by�s>»Ca54y GYMS SennOns laS 0, 81fl L' 1 FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Mon Jul 21 14:44:29. 2014 1 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion=4.... 7/21/2014 Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map . Legend Selected Features 1C Roads Parcels-H oc FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Mon Jul 21 14:48:39 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.... 7/21/2014 Map Output • • Page 1 of 1 ArcIMS HTML Viewer Ma. a Legend VIFYr' Selected Features .s• } JC_Roads Parcels+I 2013 Aerial Photos it:t1(%1026 940500028 9105(:1 Maps Va.\da]by Agana.Carr. ... FOR INFORMATIONAL PURPOSES ONLY- efferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its orrectness or validity. Data contained in this map is limited by the method and accuracy of its collection. Mon Jul 21 14:48:30 "014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.... 7/21/2014 Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map it imeraerillims ,I • 9,1Ztit:gib.:■ 1 940200023 94 04:0i.iA2 El • % Ai ` 9405{x70.4 94080CC19 • 94,.. '+t1 Legend n Selected Features 908000'8 /V JC Roads I 111 [_ Parcels-H • 9408C0tY25 USGS Topes • INN Q oa 9409t1i(r'r' F 9406:Vr..r6 940800026 co ■ � 1 1 940800016 , :1 M. ' 9441500017 - • .1 =40800027 III 940500021 • - 18 940800015 •• ■'t�. 'f •Ater awK6d W.eg[vrm Canty Ca tral Serr m GS '' 0��76h ,� �1 FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Mon Jul 21 14:48:06 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion=4.... 7/21/2014 Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map I 1 I_ 940500013 940800021 ' l .. \: \ \ 940800020 \S ----)1‘ ......____ t \ \ 940800023 , 4 ------- -- 1. 1 \ _______. %, ‘.. 5 .w ■ \ 940800019 ., 9:405000 . \ 94088:0044 Legend ..,_,..„--A. Selected Features JC Roads Parcels-H CrAlcalAquOerRecharge 940800018 Areas I I SOSC-UNK ----11-----:\ ---- El SAM PA•SU SC \\\'2 \\\\ lr..„ ....-•-- t .--- 1 1 Stl SC ., 948008017 SARPA t 940500016 . I I &ARR.% 't \ _ ____,..--- ■ __--- .„--- 140S0t)228 \ ., , t2. ..\.6gitietia°24.- \9408000;08c5,00: _. .c-•-• , \ \ 940800016 ,, '). '\, 940800017 % • \ , ,t ,' ..-'•-2'l 940800027 --- l , .....- , 948600027 l. ' .----- 948600018 940800015 Maps waded a anceson Canty Cann Strata GIS \ 01■111■81tt FOR INFORMATIONAL PURPOSES ONLY- \04080w2sy.,;,,,,,i Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Mon Jul 21 14:46:32 2014 / http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.... 7/21/2014 Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map 940500013 i,k6_tz' qw,9,.•:_.:: I 990800043 v, rti 940600820 '�.., \ 940800023 \ -----\ \ 74 M ,t 5 \\\\ 1 \ \ l 910500014 940800019 • m 09 Legend '�Cc 9408024 94080004'.94080004'. Selected Features �'.� ��,� � 1 JC Roads 1 ti �+v �� Parcels H t, \\ � -, - SOils-H 1 t 940800018 , t \ �1 940800025 5 \ 10 r \. \ 1 dvti C_Y3 \ 940800011 t a. �'S -'" ,1 940500016 t 1 1, _1 l`_ ,t 940800026 �'y �' 94050::,:: \'14, '-" 940800010__,,,A 4 ' 910500017 5l� ' 990800027 firsue" �y 940500018 r ~� r 940880015 �' 940800928 Maps pradadq Jlsam Canty Cabal Simms GIS 0■ 8111 FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Mon Jul 21 14:45:53 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.... 7/21/2014 Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map 940800013 9401100021 'Y1C Xce ■ c' . 1.' n , \ .. . 940000020 \� , 9.0600423 '^ '1 /if jil r 1 940800Ca2 VIIIIIIkowm r- 990e000/9 940600014 1� %4080.}D24 94080004/ Legend j '� Selected Features _-- } Lots '` "- \ -- JC Roads L-` Parcali-H l 1 \ 940800028 1 \\ \\y es .y 94O5O 29 Q '� 940800317 a 940606076 ,s , y,7:O(%:r'% 9405X,028 - V- 940800018 '1 944500017 N , —'` ',9406004,, 944!Qfti27 9'1v0-- '.6 944800(:'S , . '940800018 Max:ra.ded w-eMs,Carr,Co ra•r-.ce,Cu ,.∎8'Ii FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Mon Jul 21 14:44:19 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.... 7/21/2014 • • JEFFERSON COUNTY ,�� '� DEPARTMENT OF COMMUNITY f'-i 1''I DEVELOPMENT 4 '4:" 621 Sheridan Street,Port Townsend,WA 98368 I Web:www.co.Jefferson.wa.us/communitydevelopment "'"'' Tel: 360.379.44501 Fax:360.379A451 I Email:dcd(a?co.lefferson.wa.us SquareONE Resource Center I Building Permits&Inspections I Development Review I Long Range Planning July 29, 2014 LARRY DAVIS 60 MAPLE DR PORT TOWNSEND WA 98368 RE: SITE ADDRESS: 60 MAPLE DR CASE#: BLD14-00249 Dear LARRY DAVIS: The Department of Community Development is in the process of reviewing your application. The following information is needed to continue review of your project. We have found that your parcel is mapped by Jefferson County as a geologically hazardous area. Therefore, your proposal will require a geotechnical report prepared by a state-licensed geologist or engineer that complies with Articles V (geologically hazardous areas) and VIII (special reports) of Chapter 18.22 JCC. The proposed downspouts, as shown on the submitted site plan, do not meet the stormwater requirements of the 2012 Ecology Stormwater Management Manual for Western Washington. Please revise the site plan to comply with this manual. Additionally, your stormwater calculation worksheet submitted July 17, 2014 needs to provide areas for new and existing patios, decks, and driveways in addition to the roof areas already provided. If you have any questions about stormwater requirements,you may want to consult with your geologist or engineer. Once you have completed the above requirements, you will need to submit a revised site plan so we can resume the review process for your application. If you have any questions, feel free to contact me by phone at 360-379-4484 or by email at twoolett@co.jefferson.wa.us. Please submit the above information to the Department of Community Development by October 27, 2014. Pursuant to Jefferson County Code, JCC 18.40.110(3) and (6), if the applicant does not submit the additional information or does not request additional time to submit the required information within the ninety(90)calendar day period, the application will be considered abandoned and therefore withdrawn and the applicant shall forfeit the application fee. The Department of Community Development shall not be responsible for notifying the applicant of an impending expiration. Sincerely, .5-kit Wae ett Department of Community Development Staff c: File KIMBERLY BARNETT 1ltidemark1datalforms\F_MLT Addlnfo_Requst.mt 7/29/2014 :1311146 259403 Hwy 101 •Sequim WA 98382 360-681-0777 800-640-8591 Fax:360-681-0780 TO 1G DATE 07* FROM c1-. /,i PAGES i f / 10b/1, PA/11d/A a e Est. &IVMill 2"/ / 4 427 19//721..ji Grp T / ., pAo ei.u/hrinm wai / kvit.4� . ear- '(-- 5 1-4ewe- bt 17-c. fiat - ..9.41cg r4 3,5 o -77&tj (//ajt: r lECEDVE-p)AUG 1 9 2014 JEFFERSON COUNTY DEPT.OF COMMUNITY DEVELOPMENT 08/1212014 11:49 Cape George Colony Club • TAX)3603853038 P.002/002 i„/ v E �tT E J ” 1`-( -2(f- c -.'1 6S ' i SEE SITE PLAN DETAIL SHEETS' EVES cF EXISTING PRVEMENT xr o EXISTING CULVERY I �a � o' N- ..,. I `, °• / / 1" !e 1 d 17 ' /S 7 }O 0 I / f �' r`2�'S &V I N ATER I '° LOT 1_ / av 1.. ` <r/ x7 `, --ti 1 ..+ EXISTINI I r r /` `" �; CULVFR �NL ,l II v �, 1 c. it J,` J4 rr–- a � I N l r I 6 \ 1 r r tO 1 _ l >b/ / r Tiff£ OF PILL „ / .cNP„vg. 1 , 11 s s i If v N ��!1°.:e° � I r .4 "is�' U 70. 'OP OF FILL 1-1 ° t-`100011# f 7 4” PVC (BACXALLED PRIOR TO INSPE,O ON ` – L0C4770N PER INSTAL��-) 1 � � `>, I ` z 60 APPLE vAm- 'y `4% .4, 400 . tA.. . AO' ''' '`.i4r4 . : t".1 r .#11 '•T8I,,..4(IT 1 r APPROX MATE Nt�� .- �� i+ PROPFRl1 L1N£5 ���,.�. 70 r I U `-CEATR1OOX 11 T6 SEPT ; Isa ANA FROM(WVDMiR An-Acm 1 JEFFERSON COUNTY ✓„r. Jo, 2014 lcs7 E, r,.m DEPT OF COMMUNITY OF VFLOPMENT Drawing. KAY. 5%F IC DESIGN (STAKING) RGO OWO.OWG.OSrGC © CREA71VE OESION SOLUTIONS 2009 REVISION DATE PRELIMINARY SEPTIC SYSTEM, PART DRAWN BY: h(IGRAEL S, DEENfY SITE PLAN SHEET I OF 2 DATE: 5/26/09 ,FO : SUSAN STOLTZ • • Tim Woolett From: Tim Woolett Sent: Thursday, August 14, 2014 12:18 PM To: 'kimsequim©yahoo.com' Subject: Larry Davis Hi Kim, We received the Geologic Hazard Study and Geotechnical Report for Larry Davis' property. Their drainage observations and recommendations provide that a simple drywell system is recommended to infiltrate stormwater from the home and that the southwest section of the site would be the ideal location for the "drywell" system. Will NTI also be providing the stormwater site plan showing the system and drywell location? If so, this site plan could also include the impervious surface calculations which would satisfy our request for a revised site plan meeting the requirements of the Stormwater Manual and the additional impervious surface calculations. I appreciate your efforts in this matter and look forward to hearing from you. Tim Tim Woolett Assistant Planner,Jefferson County Department of Community Development 621 Sheridan Street*Port Townsend,WA 98368 Phone 360-379-4484*Fax 360-379-4451 twoolett(a,co.jefferson.wa.0 s All e-mail sent to this address has,been received by the Jefferson County e-mail system and is therefore subject to the Public Records Act,a state law tbund at RCW 42.56.Under the Public Records law the County must release this e-mail and its contents to any person who asks to obtain a copy(or for inspection)of this e-mail unless it is also exempt from production to the requester according to state law,including RCW 42.56 and other state laws. 1 • • Tim Woolett From: Tim Woolett Sent: Thursday, August 14, 2014 4:54 PM To: 'kimsequim @yahoo.com' Subject: Larry Davis Kim, I forgot that you were still on vacation so I apologize for my earlier email. However, I need to clarify that the message was not meant to imply that you needed an engineer to submit a revised stormwater site plan. You can call me once you return from vacation and we can discuss the site plan. I believe we can address this with relative ease. Until then, enjoy your vacation. Tim Tim Woolett Assistant Planner,Jefferson County Department of Community Development 621 Sheridan Street*Port Townsend,WA 98368 Phone 360-379-4484*Fax 360-379-4451 twoolett(al co.jefferson.wa.us All e-mail sent to this address has been received by the Jefferson County e-mail system and is therefore subject to the Public Records Act,a state law found at RCW 42.56.Under the Public Records law the County must release this e-mail and its contents to any person who asks to obtain a copy(or for inspection)of this e-mail unless it is also exempt from production to the requester according to state law,including RCW 42.56 and other state laws. • 1 • • Tim Woolett From: Tim Woolett Sent: Thursday, August 21, 2014 10:36 AM To: 'Rick Cavanaugh' Attachments: Drywell Standards.pdf Hi Rick, I've discussed the matter with staff and looked at the stormwater manual. The design standards of the manual are adopted standards that we can approve at the administrative level. Anything beyond those designs could only be accepted if designed and stamped by a licensed engineer. I believe I sent you the standards for drywells in a previous email. All I can suggest is that you send me a site plan as requested in my previous email and show that it meets the standards outlined in the attachment I am again providing with this email and the recommendations in the geotechnical report that I previously sent to you. Just to recap, I am asking for a clean map (site plan) much like the map submitted with the building permit application,that is drawn to scale and shows the stormwater system as recommended in the geotechnical report(i.e., in the southwest corner of the property)and is consistent with the attached standards. Thank you. Tim Tim Woolett Assistant Planner,Jefferson County Department of Community Development 621 Sheridan Street*Port Townsend,WA 98368 Phone 360-379-4484*Fax 360-379-4451 twoolett(d co.jefferson.wa.us All e-mail sent to this address has been received by the Jefferson County e-mail system and is therefore subject to the Public Records Act,a state law found at RCW 42.56. Under the Public Records law the County must release this e-mail and its contents to any person who asks to obtain a copy(or for inspection)of this e-mail unless it is also exempt from production to the requester according to state law,including RCW 42.56 and other state laws. 1 • • /1 t 41 11 „----Payif Dilqinsroi. Hat.:ie A , ---Catch Basin 1,, d Drain) ./...",„///,..-4, -4,- i„ , ----\ flow Dompoil --7---i4 0 DRY WELL 4e Irch Dia n-e4f=r Hole Filled wilt) PLAN VIEW lila-""?\kiaeheA ' Dra-ki Rook MIS 7----R cot Doivnapplit r-Melt Center of Hote / 1 With r Carpal PO HoLexl. /-0,ettlow 1 or Clio!rreeris —St-hal Block Topscit--i / Fkitihwrth&Atm 2, 2 1 2' F.,....•-,-- -------774-1 : 2k•122.2., ,,,,_ ',2. 2. tj.t. I rim_ ':FE;Alit --* 'Ifiumrs■-e21.2, 0211,,ro,7t2.62.,”2., r •&—..- . .-Avls. APO 411./it*Li flow 2.ti3:10* oltrello Fine me,i,..,hsaea.-, RIC Pire „ ., , i ktrisfiiv, 4 CaJTih Basin lc:wroi. (;.arei Driiin) f* ... %* 48lrell Diarrekr 11 "ii min- sides of Hole— ii.i. Hole Flileilwit "- Lined'ikith el. 11-?gfli”n\lillacird Fi Rot.Fobri I:: 'egg.. i.5)Sri iii. ..,.. •1 M iii. DRY WELL High Grcd.irdwatgr Tablo. SECTION UrS Figure 3.1.4-Typical Downspout Infiltration Drywell Source: King County Volume III-Hydrologic Analysis and Flow Control BMPs-August 2 01 2 3-9 • Setbacks Local governments may require specific setbacks in sites with slopes over 40%, land slide areas, open water features, springs,wells, and septic tank drain fields_Adequate room for maintenance access and equipment should also be considered. Examples of setbacks commonly used include the following: 1. All infiltration systems should be at least 10 feet from any structure, property line, or sensitive area(except slopes over 40%)_ 2. All infiltration systems must be at least 50 feet from the top of any slope over 40%.This setback may be reduced to 15 feet based on a geotechnical evaluation,but in no instances may it be less than the buffer width. 3. For sites with septic systems, infiltration systems must be downgradient of the drainfield unless the site topography clearly prohibits subsurface flows from intersecting the drainfield. Volume III—Hydrologic Analysis and Flow Control BMPs—August 2012 3-10 for Infiltration These sy s are designed as specified below. • Drywells Genera 1. Drywell bottoms must be a minimum of 1 foot above seasonal high ground water level or impermeable soil layers. 2. When located in course sands and cobbles, drywells must contain a volume of gravel equal to or greater than 60 cubic feet per 1000 square feet of impervious surface served.When located in medium sands, drywells must contain at least 90 cubic feet of gravel per 1,000 square feet of impervious surface served. 3. Drywells must be at least 48 inches in diameter(minimum)and deep enough to contain the gravel amounts specified above for the soil type and impervious surface served. 4. Filter fabric(geotextile)must be placed on top of the drain rock and on trench or drywell sides prior to backfilling. 5. Spacing between drywells must be a minimum of 10 feet. 6. Downspout infiltration dryweIls must not be built on slopes greater than 25% (4:1). Drywells may not be placed on or above a landslide hazard area or on slopes greater than 15% without evaluation by a professional engineer with geotechnical expertise or a licensed geologist,hydrogeologist, or engineering geologist, and with • jurisdiction approval. Volume 111—Hydrologic Analysis and Flow Control BMPs—August 2012 3-6 • Standard Conditions for Resideni•Development in Jefferson County • 1. LIGHTING: 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. 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. 2. BUILDING HEIGHT: The building height is not to exceed 35 feet. 3. OUTDOOR STORAGE: Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 4. UNLICENSED VEHICLES: 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. 5. PARKING: A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 6. This permit has been reviewed consistent with JCC 18.40.130 & 140. Notice: this permit does not excuse the applicant from complying with other local, state and federal ordinances, regulations or statues, applicable to the proposed development, but consistent with RCW 90.58. Future development beyond that specified in this permit shall require further review. 7. BMPs: 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. 8. NOTICE: This permit does not excuse the proponent from complying with other local, state, and federal ordinances, regulations, or statutes applicable to the proposed development, but consistent with RCW 90.58. Development pursuant to this permit shall be undertaken subject to the applicable policies and performance standards of the Jefferson County Shoreline Management Master Program and the Jefferson County Unified Development Code. If during excavation or development of the site an area of potential archaeological significance is uncovered, all activity in the immediate area shall be halted, and the Administrator shall be notified at once. The Federal Endangered Species Act rules to protect threatened Chinook and Summer-run Chum salmon became effective on January 8, 2001. Bull trout have been listed as threatened since early 2000. Under the ESA, any person may bring lawsuit against any individual or agency that "takes" listed species (defined as causing harm, harassing, or damaging habitat for the listed species). In addition, the National Marine 2013-03-07-SFR_StdConditions 3/7/2013 1 • Tim Woolett From: Tim Woolett Sent: Wednesday, August 20, 2014 3:32 PM To: 'Rick Cavanaugh' Subject: RE: Davis Building Permit BLD14-00249 C Attachments: Davis Geotech excerpt.pdf Thank you for the updated drawing. However,we seemed to have gotten away from the recommendations of the geotechnical report,which I am attaching to this message as guidance.As per the drainage observations and recommendations, it is the southwest portion of the lot that was identified as suitable for a drywell system. I am unable to sign off any design outside the recommendations of the report. Please revise and submit a clean copy to scale that clearly illustrates the proposed drainage system including no less than two drywells at your earliest convenience. I appreciate your efforts in this matter. Tim Tim Woolett Assistant Planner-DCD Phone 360-379-4484 All e-mail sent to this address has been received by the Jefferson County e-mail system and is therefore subject to the Public Records Act,a state law found at RCW 42.56.Under the Public Records law the County must release this e-mail and its contents to any person who asks to obtain a copy(or for inspection)ot'this e-mail unless it is also exempt from production to the requester according to state law,including RCW 42:56 and other state laws. From: Rick Cavanaugh [mailto:rickc @buy-ritehomes.com] Sent: Tuesday, August 19, 2014 3:30 PM To: Tim Woolett Subject: Dry wells 1 • • Geologic Hazard Study and Geotechnical Report 1 2014 footing at a depth of 3 feet below the existing grade for a distance of 8 feet. • Footings should be built in accordance with the current building code's prescriptive dimensions and reinforcement for single story construction except the depth of the footing embedment and height of the stem walls should be as noted above. Note that these depths are measured from the original grade, not from the top of structure fill that may be added to level this site. • Steel reinforcing rebars extending from the stem wall may be bent into the plane of the foundation slab which should be cast directly over the stem wall after backfill and vigorous compaction. • Maintain and encourage the growth of dense ground cover and trees on the slope beyond the house on the north. A sketch of the conventional foundation system with deepend footings was provided during the site inspection. Alternative foundation construction methods that transfer loads deeper into the soil at the northwest corner and the north line of the proposed house may be discussed with the undersigned Engineer at the option of the Contractor. 5.0 DRAINAGE OBSERVATIONS AND RECOMMENDATIONS The southwest section of parcel 940800018 is nearly flat with a gentle slope to the west. This area is an ideal location for a stormwater system to serve the new house. A simple "drywell" system is recommended to infiltrate stormwater from the modest-sized home. The drywell should be filled with washed drain rock (1 %" to 3" in diameter). At least 6.7 cubic yards of drain rock should be used to fill the drywell. The top and sides of the drywell should be covered and wrapped with filter fabric to prevent fine soils from migrating into the voids of the drain rock. An underground non-perforated pipe can be used to convey runoff from downspouts to the drywell. 6.0 THE LIMITATIONS OF THIS STUDY AND REPORT The observations and conclusions of this report apply only to the subject property and they are not transferable to nearby or adjoining property. This report is the property of Mr. and Mrs. Davis and may be used by others only with their permission. The observations of this report were made during a limited reconnaissance study in which inferences were made from surface conditions. No borings, detailed measurements, soil testing or observations over time were made. Unknown subsurface conditions that were unseen could affect the outcomes of the study. Users who need a high level of reliance on the observations and conclusions of the study may wish to obtain further investigations. 5 • " !-- ' E l ( \11 ) ;-,�, IJL-i0 ! `-/ - ,? in SEE SITE PLAN DETAIL SHEETS Jrr .\r. v o = SNG — — woo- 4. . ...... „4.„.4 , ,,'\------ .... .-- ______._-----,-.; 'X84 / di7i / I 3040 EXISTING 2` STORMWATEP / 2^`•\ �1 DITCH 3 �, \` ., \ \ ' ` \1 LoT 19 _ / 1 <�N. r/ N \ \ ' I EX/STINc r r `� A• , �, CULVER r 1 .\ ANC 11 r 4 \ Iti o o.• N? I' \ I 1 L_ I -+ l/ � TOE OF FILL \ ---' • e bi / / /0,1 A \ � i \/. ;.` .0 A N' jp.00 I / \\/ 1 , TOP OF FILL \ ` 4' PVC (BACKF7LLED PRIOR TO INSPEk.ION \ - LOCATION PER INSTAL:.R) `, )44,...H\ \ x \ bt�rk \ z 60 MAPLE DRIVE , 'C'-- •" �w e-(C tzi �, 5.-SI �' :\ \� 35'18 C, '' APPROXIMATE - 6 ,may' ,' PROPERTY LINES - Bd � \LOT1 8 � pI 30 I[11I® SCwF IN FEET APPROXIMATE LOCATION OF EXISTING' ABANDONED SEPTIC TANK. SEE ATTACH CERTIFICATE OF SEPTIC TANK ABANDONMENT FROM LANDMARK EXCAVATING. June 30, 2014 10:57.49 am. Drawing: KAY SEPTIC DESIGN (STAKING) ROD OWG.OWG.DWG © CREATIVE DESIGN SOLUTIONS 2009 PRELIMINARY SEPTIC SYSTEM, PAR REVISION DATE SITE PLAN DRAWN BY: MICHAEL S. DEENEY SHEET 1 OF 2 1 DATE: 5/26/09 FOR: SUSAN STOLTZ • • 60 Maple Drive, Port Townsend, Washington TPN: 940800018 & 940800019 Geologic Hazard Study and Geotechnical Report Prepared For Mr. and Mrs. Davis August 2014 NORTHWESTERN TERRITORIES, INC. 1111114,_ 717 SOUTH PEABODY STREET. PORT ANGELES,WA 98 Engineers❑Land Surveyors ❑Geologists Construction❑ Inspection❑ Materials Testing(360)452-8491 IECEdVED Email:info(anti4u.com NTl AUG 1 4 2014 JEFFERSON COUNTY DEPT.OF COMMUNITY DEVELOPMENT \. • • 'R{`'L NORTHWESTERN TERRITORIES, INC. ■ i_ 717 SOUTH PEABODY STREET,PORT ANGELES,WA 98362 u I 914 WASHINGTON STREET SUITE 6,PORT TOWNSEND,WA 98368 Engineers Land Surveyors Geologists Construction Inspection Materials Testing Port Angeles(360)452-8491 NTI E-Mail: info{dnti4u.com August 13, 2014 Trisha and Larry Davis 500 San Mateo Circle Hemet, CA 92543 Subject: GEOLOGIC HAZARD STUDY AND GEOTECHNICAL REPORT FOR THE PROPERTY AT 60 MAPLE DRIVE IN PORT TOWNSEND, WA 98368.JEFFERSON COUNTY TPN: 940800018 AND 940800019. Dear Mr. and Mrs. Davis and Others Concerned, 1.0 BACKGROUND AND SCOPE OF WORK NTI Engineering and Land Surveying (NTI) was requested to complete a geologic hazard study and drainage review related to the potential development of the subject parcels. The property is located within the Southeast Quarter of Section 13, Township 30 N, Range 2 West, W.M., within Jefferson County, Washington. The parcel, which lies within Cape George Village, is currently the site of a small cabin whose address is 60 Maple Drive, Port Townsend, Washington. The two subject adjoining parcels are to be developed, with the northerly parcel, #940800019, supporting the proposed on-site wastewater treatment system. Most of the two-lot site dips gently towards Discovery Bay on the east at an approximately 12% slope. The site is about 1,500 feet from the east shoreline of Discovery Bay according to measurements made with Jefferson County's Geographic Information System. Several decades ago the site was re-graded to create a nearly-level site for a house trailer that has since then been moved off the site. The original work, completed prior to 1990, resulted in the creation of a gravelly sand fill with an informal rubble cladding on the north and west sides. The new house is to be constructed on the same site over the same fill material. The proposed site plan calls for the construction of a manufactured home with its long axis parallel to Maple Drive. Due to site geometry there is no other reasonable alternative for placing the new home on the parcel. The sandy fill is 11 to 12 feet in height at the northwest corner, its highest point. The possibility of shallow slope failures and slumping of the fill over time are the only issues of geotechnical concern at this site. The fill slope can be seen in Photograph 1 of this report. • • Geologic Hazard Study and Geotechnical Report 1 2014 60 Maple-Dr Port Townsend, WA.98368 USAF • d0'°GW91e to. - ..x. ' Coo Ic earth a1993 r , Imagery file_7:.2013 la[ 06 =lon-121 67703, eler /Bm eye all 205 m 0 Photograph 1—Aerial Photo of the Davis Parcels at 60 Maple Drive 2.0 SITE CONDITIONS AND LOCAL GEOLOGIC SETTING Vegetation The site is covered with grass, but there are few trees as may be seen in the photograph above. The westerly face of the slope described above has shrubs and brambles that form the darker green area just above and left of the red site marker in the Google Earth image above. The Surficial Soils The Soil Conservation Service maps the area as having Clallam Series Gravelly Sand Loam soil. This soil was deposited as a derivative of the glacial till that underlies the area. Hoypus Gravelly Sand Loam that was deposited as glacial outwash forms most of the soil profile. The presence of the gravelly sand soils was corroborated by on-site observations. The Geologic Setting A 1995 geologic map compiled by Jefferson County and the Coastal Zone Atlas of the Department of Ecology indicates that the site is underlain by Vashon glacial advance outwash. The sand and gravel spewing from the advancing glacial was later over-ridden by the ice leading to some consolidation. Geologic maps indicate that Vashon Stade lodgement till, a dense glacial hardpan, is widespread at the surface in the upslope areas. This till was identified as a restrictive layer at shallow depth in test pits excavated for the design of on-site wastewater 2 • • Geologic Hazard Study and Geotechnical Report 1 2014 treatment facilities. (See attached soil log courtesy of Creative Design Services, LLC.) �_ 1 ,3i, r Ax,., , „.. _ ,:„.,._: . , ,. . , . . , ir _ ,, s„, , , ,,,,,. • y . . . ,,,,a. p t- ; ‘,.,,,., ._, .. , , _ a.v . Photograph 2—View Looking West Showing North Line of the Proposed Davis House 3.0 GEOTECHNICAL OBSERVATIONS AND INDICATORS Due to gentle slopes and the occurrence of relatively strong glacial till at shall depth, the two subject parcels are,for the most part, solid, stable, and free from geologic hazards. Probes and shallow excavations of the fill on the site suggest that it is mostly gravelly sand. Extensive probing of the fill suggested that the fill has been consolidated during the several decades that it has been in place. The north line of the proposed new house is shown in the photograph above. Just to the right (north)the rim of the slope is visible in the photograph above. The northwest corner of the proposed house site will fall at the point marked by the red flag shown in the photograph above and the photograph below. This north line of the proposed house point is about six (6) feet from the rim of the descending slope. The proximity of the slope indicates that shallow foundation elements along this line could subside slightly after periods of heavy rain and over time. Although the fill and slope have been in place for some time, the slope will tend to adjust to a flatter condition over time. In this case, subtle and slow slumping of the slope may lead to slight subsidence along the proposed north line of the parcel. A simple remedy for this condition that involves deeper footings is recommended below. 3 • • Geologic Hazard Study and Geotechnical Report 1 2014 ei r •I : rr's my 'l a r '• . n, tiny. • :- 7 '‘,4* ) Si• x i,{.( i p -• a� ,` a. d f- ,. s- , 1 h . ' +y ,,,; i�.,s*A1'+ , � .••'4 , 4 \ • _ 5 r Y '"r P -� 41. / 5l� 1• t�`Y j}Ijy, t�,, / � A' �•YJ yY p" 4Si r i 6 . ''''''';;17q"'� t .,":„!...,.:,,--1_ ',"q�..j�, .-i r t a7-'. of +^ � I � ' / y r „j ' � k (A I d , , p .w ry ,i lYJ r tS rr r r �. r ■S;IAA b. 9\ e Ii ' .riS \p. r > >k. ,,,, ', —, + ' i f i (a S t ,i Sii , r : Ex 44, , ' '"a 42 -..0 Photograph 3—View Looking Southwest of the Fill Slope 4.0 GEOTECHNICAL CONCLUSIONS AND RECOMMENDATIONS The fill at this site is a suitable position for the proposed one-story manufactured house and future settlement of most of the footprint area is likely to be insignificant. The northerly foundation of the house may be constructed with deep footings to prevent or substantially reduce subsidence of the north extremity of the foundation. RECOMMENDED FOOTING DESIGN AT NORTHWEST CORNER It is strongly suggested that the foundation at the northwest corner be constructed as noted below: • Construct a conventional stem-wall foundation along all of the north side of the foundation area, a length of about 26 feet. Extend a conventional stem wall foundation from the northwest corner of the house a distance of 8 feet along the west line. • Install the footings at two depths. Along the north end of the foundation area from the northwest corner, install the footings at a depth of three (3) feet below the existing grade for 12 feet, that is about one-half the distance to the northeast corner. The balance of that footing may be installed at a depth of two (2) feet below the existing grade. From the northwest corner along the west line of the foundation, install the 4 • • Geologic Hazard Study and Geotechnical Report 1 2014 footing at a depth of 3 feet below the existing grade for a distance of 8 feet. • Footings should be built in accordance with the current building code's prescriptive dimensions and reinforcement for single story construction except the depth of the footing embedment and height of the stem walls should be as noted above. Note that these depths are measured from the original grade, not from the top of structure fill that may be added to level this site. • Steel reinforcing rebars extending from the stem wall may be bent into the plane of the foundation slab which should be cast directly over the stem wall after backfill and vigorous compaction. • Maintain and encourage the growth of dense ground cover and trees on the slope beyond the house on the north. A sketch of the conventional foundation system with deepend footings was provided during the site inspection. Alternative foundation construction methods that transfer loads deeper into the soil at the northwest corner and the north line of the proposed house may be discussed with the undersigned Engineer at the option of the Contractor. 5.0 DRAINAGE OBSERVATIONS AND RECOMMENDATIONS The southwest section of parcel 940800018 is nearly flat with a gentle slope to the west. This area is an ideal location for a stormwater system to serve the new house. A simple "drywell" system is recommended to infiltrate stormwater from the modest-sized home. The drywell should be filled with washed drain rock (1 %2" to 3" in diameter). At least 6.7 cubic yards of drain rock should be used to fill the drywell. The top and sides of the drywell should be covered and wrapped with filter fabric to prevent fine soils from migrating into the voids of the drain rock. An underground non-perforated pipe can be used to convey runoff from downspouts to the drywell. 6.0 THE LIMITATIONS OF THIS STUDY AND REPORT The observations and conclusions of this report apply only to the subject property and they are not transferable to nearby or adjoining property. This report is the property of Mr. and Mrs. Davis and may be used by others only with their permission. The observations of this report were made during a limited reconnaissance study in which inferences were made from surface conditions. No borings, detailed measurements, soil testing or observations over time were made. Unknown subsurface conditions that were unseen could affect the outcomes of the study. Users who need a high level of reliance on the observations and conclusions of the study may wish to obtain further investigations. 5 r . • • Geologic Hazard Study and Geotechnical Report 1 2014 Nil Engineering and Land Surveying warrant that this study and the related report were conscientiously prepared in accordance with the practice of professional engineering and according to the principals of geotechnical science. No other warranty, neither express, nor implied, is provided herewith. Please call on the undersigned Engineers if you have questions about the contents of or meaning of this report. Sincerely yours, NTI Engineering and Land Surveying fri, ov wask4, 10 OA 104 h .. "+s' 4,5/i3 iie art.41'. ..1, ,23767;/- . +bNAL _ da Steve S. Luxton MSc, PE Trent T.Adams BSCE, EIT Senior Geotechnical Engineer Geotechnical Project Manager 6 • • APPENDIX `( tt li 4th 1,41. w ii4 l • � TES 01 2007 SOIL HOLE LOGS i ` R� c EEEEk��U��U�N`YOCD, Page / of / Designer /S'J> t» /.90 Date / Z-ZD 3 7 Property OwnerBuyer fi`/Gil 5 ,iozy Parcel# 94O V 0)1$ i 01? Backhoe Operator JW/f21/1-' ill 7'754G142-r Job# /74"-i"am( Project k$.5/pai1p-,,.pre s"-P)—/C- ,€'l�O.rfl Sec(Twp-Rng) s'F'l /-?(34'9 4a) HOLE NO. w 0 TYPE O P u7_ co OF DEPTH 0 x -� x Z Z SYSTEM (Inches) h APPL. E- o j TEXTURE RATE s 0 (gPd(gft') a z::-.i ¢OBSERVED 0 U O P rt Z Q / /6 sL r/1L F64 t 2- )z4 2 ¢ 33 F'D /we sL o.4 27 $.01.1:'� 3q 6,OAY G q-/LG 1L 31" Z 3 ' 54. Fic4 NA t$ S 23 23 47 F-D vARr65 /45 to (s cS No LS GO-4t 56EPN 4-4-4444-' G f ?.2>P4v, G5L. F-2'.Z 3 a - ' s` `/G �./.4- 23 sL D.& 13 >Z3 2'3 s��P3B G-7 sG-pie- & SL M G5 0,(o-045- 42 &/l S" G � ,ew, ev 3o" ia S SL FILL NA (2 >1 lS sL- re Ls e9..& a4 F z3 srrP MC SL �O LS O.4S 7v? 3 t !oA?f" G (f4.7 t517A^‘ p ow poerers of r/1G /nst<-G Lip 0 /Ylal Ki- NL Jefferson County Building Division Permit Number: BLD14-00249 Applicant: DAVIS BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2012 International Building Codes To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next days inspections. 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 MH Foundation h 1'4 Blocking&Tie Down Jp�br Skirting&Ventilation 1 r (I L L(, Address Posted P e i'1 FINAL FINAL Building it D�1� Septic System Finaled sep07-37 A final inspection will not be scheduled until all of the following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed g off • Public Works Permit Final(where applicable) FINAL INSPECTION (1/M (L{ FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • S CONDITIONS for Building Permit# :BLD14-00249 1.) 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. 2.) The revised site plan as submitted for the Building Permit application for placement of a mobile home on August 25, 2014 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated August 29, 2014 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 3.) This approval is for a single family residential mobile home only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 4.) A Geotechnical Report was submitted in conjunction with this application. The report addressed the stability of the geologic hazard area. Although no LSHA setbacks are required, the Report provides for the location of drywells for stormwater control which shall be a requirement of this permit approval. 5.) TSW \\tidemark\data\forms\F_BLD_Permit_Bldg.rpt 9/8/2014 • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00249 Received Date: 7/18/2014 SITE ADDRESS: 60 MAPLE DR Issue Date 9/8/2014 PORT TOWNSEND, 98368 Expiration Date 9/8/2015 OWNER: LARRY DAVIS PHONE: 209-743-3923 60 MAPLE DR PORT TOWNSEND WA 98368 9408 SUBDIVISION: Block: Lot: 18 PARCEL NUMBER: 940800018 Section: 13 Township: 30 N Range: 2V1 CONTRACTOR: BUY RITE HOMES PHONE: (360) 681-0777 259403 HWY 101 SEQUIM WA 98382 Contractor's License BUYRIH`084OB Expires 5/10/2015 PROJECT DESCRIPTION: New Manufacture Home TYPE OF WORK MOB SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 62,995.00 ADM.: HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: 11050 Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $532.00 SRE 07/17/14 151260 Exist: Exist: 0 State Building Code $4.50 SRE 07/17/14 151260 Prop: 2 Prop: 2 Potable Water Application $67.00 SRE 07/17/14 151260 Total: 2 Total: 2 Total: $603.50 Directions to Site: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. Request must be received by 3pm the day before the inspection is needed. Office Hours 9:00 am -4:30 pm MONDAY- THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY- SEE ATTATCHED