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Home My WebLink AboutBLD2014-00361 UILDING PERMIT APPLICAN BLD14-00361 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD14-00361 Received Date: 10/7/2014 SITE ADDRESS: 293937 HWY 101 QUILCENE, 98376 OWNER: CONNIE RAE PHONE: 360-301-4428 PO BOX 652 QUILCENE WA 98376-0652 SUBDIVISION: Block: Lot: PARCEL NUMBER: 702132016 Section: 13 Township: 27 N Range: 2V CONTRACTOR: TBD PHONE: 253-584-6606 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NSFR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION 235,000.00 MAIN: 1 926 CODE EDITION: 2012 ADD'L: HEAT TYPE: EEE OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: 803 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 1 PWELL BEDROOMS: BATHROOMS: Exist: Exist: 0 Prop: 3 Prop: 2 Total: 3 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,979.00 SRE 10/06/14 151616 APPROVED Plan Check $1,286.35 SRE 10/06/14 151616 State Building Code $4.50 SRE 10/06/14 151616 DEC 17 2014 Potable Water Application $67.00 SRE 10/06/14 151616 Total: $3,336.85 Jefferson County DCD 1 11tidemarkldata\forms\F_BLD_App_Bld.rpt 10/7/2014 rsoNc,,ei DEPARTMENT OF COMMUNITY DEVELOPMENT .4 621 Sheridan Street,Port Townsend,WA 98368 "< Tel:360.379.4450 Fax:360.379.4451 } Web:www.co.Jefferson.wa.us/communitydevelopment 9SHI NG�O~ E-mail:dcd@,co.jefferson.wa.us CERTIFICATE OF OCCUPANCY PERMIT#: BLD14-00361 APPLICANT: CONNIE RAE PHONE: 360-301-4428 PO BOX 652 QUILCENE WA 98376-0652 SITE ADDRESS: 293937 HWY 101 Issue Date: 12/17/2014 QUILCENE, 98376 Final Date: 10/22/2015 SUBDIVISION: Block: Lot: PARCEL NUMBER: 702132016 Section: 13 Township: 27 N Range: 2W PROJECT DESCRIPTION; NSFR THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes no� THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 10/22/2015 Building Official, 11tidemarkldata\forms\F_BLD_Occupa ncy.rpt 10/22/2015 Sally Ellis From: Linda Atkins Sent: Wednesday, October 21, 2015 4:45 PM To: Sally Ellis Subject: BLD14-361 -septic final is signed off Linda Atkins R.S. Environmental Health Specialist, JCPH Environmental Health Division 360-385-9444 ACways working for a safer and healt1iierjefferson County CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review use, disclosure, or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. All e-mail sent to this address has been received by the Jefferson County e-mail system and istherefore subject to the Public Records Act, a state law found at RCW 4256 Under the Public Records law the County most 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 disclosure under state law, including Kr 4256 1 Sally Ellis From: Linda Atkins Sent: Wednesday, October 21, 2015 4:45 PM To: Sally Ellis Subject: BLD14-361 - septic final is signed off Linda Atkins R.S. Environmental Health Specialist, JCPH Environmental Health Division 360-385-9444 Arways workingfor a safer anti IzealTtfiier Jefferson County CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. 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 RCN 4256. 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 disclosure under state law, including RCN 42 56. 1 11/20/2014 lL CCELA? •onditions Associated With . 11:40:13AM Case #: BLD14-00361 Condition Status Updated Code Title Hold Status Changed By Tag Date By 2001 APPROVAL FOR ONLY None NOT MET 11/20/2014 TSW This approval is for a New Single Family Residence 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. 2001 SITE PLAN CHANGES None NOT MET 11/20/2014 TSW The site plan as submitted with the Building Permit application on November 4,2014 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 November 20,2014 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 2001 CRITICAL AREAS -FINDING None NOT MET 11/20/2014 TSW This proposed new single family residence will be constructed on property abutting the Little Quilcene River,a Type 1 Aquatic and shoreline of the state designated Conservancy.Additionally,the property is mapped as having Critical Aquifer Recharge Areas, Seismic Hazard Areas,Channel Meander Zone,and Flood Zone A. The proposed development activities will all take place outside the 200 foot shoreline designation, High Risk Channel Meander Zone,and the Flood Zone A. Subsection 18.22.160(d)JCC provides that development within a Moderate Risk Channel Migration Zone is not suject to the Landslide Hazard Area protectin standards. 2001 TSW None NOT MET 11/20/2014 TSW TSW 2216 Aquifer Recharge Conditions(SFR) None NOT MET 11/20/2014 TSW Critical Aquifer Recharge Areas may require special protection measures to mitigate water quality degradation. The submitted proposal does not require additional aquifer protection measures. However, during construction the project shall follow the Best Management Practices(BMPs)and facility design standards as identified and defined in the Stormwater Management Manual for the Puget Sound Basin. 2401 BMPs None NOT MET 10/16/2014 TSW The project shall adhere to the Best Management Practices(BMPs)to control stormwater,erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 2402 Stormwater Plan None NOT MET 11/20/2014 TSW A Stormwater Site Plan has been submitted and approved by the Department of Community Development. Once the building permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. 1`1 (jk Page 1 of 1 CaseConditions_rpt Jc�ln Le_ 4 aveS1-1 1 n S fe-c47 oma? o n e l I et r 1cfcíhen VePn�-i DOI Goic k - 001 •3 ) heA04-D errra ba-ore ktu•N ccm -FIfak �,�� CaLI ,6i :ifyd wSalic. Is -Gig/ ( 5°oN cbLT JEFFERSON COUNTY 4, DEPARTMENT OF COMMUNITY DEVELOPMENT f/(4 9'SHINGS Date: ib / Time Received: 8: 40 /ma / m Mon. Tue. Wed. Thur. OFri. Date: /0 - -15 0036,/ Contact Name: BLD: /� O Owner: 360 60 Contact Number: 3 Address: - 9 '3 IlvY L) 206x, ---�II�{�L eGad 1+, 1.441:7 ei �-j. , 31104-4144T,�`4'� •�a SAM .*iv Notes: -7/4-e,-(aFoundation Plumbing Framing Propane Tank Mechanical Framing Under ground Furance Setbacks Under-ground Rough In Air Seal Above ground Gas Footing Stemwall Hydronic Exterior shear Exterior lines Oil Interior shear Interior lines Ducts Straps Hot Water Htr 1 1 Appliance — � ' Post Hole Ventilation v- V Underfloor \(1 :s Appliance Insulation Man-Homes FinalInspectio1* Floor ✓✓✓"""��` Setbacks Wall Address Posted Foundation CPiline `o-50N t ,�`` c� JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT ,,s,,,,,,,6,0 — Date: / /Z8- Time Received: 02,7 C 0� (1/pm Mon. 4 Wed. Thur. Fri. Date: 411,—.2-9 BLD: /4/— _gC/ Contact Name: Owner: Contact Number: 360 7/4, qy7 Z Address: 293 03 7 /7✓/ 70/ 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block &Tile Ceiling X. ,SO c 4;w any JEFFERSON COUNTY 4. KDEPARTMENT OF COMMUNITY DEVELOPMENT -,SHINGZ°2 Date: (p L 5fime Received: 124 am, it Mon. Wed. Thur. Fri. Date: &-1-3 BLD: / Cf" 3 / Contact Name: Owner: Contact Number: 360 Address: 2 q-3 i 2-? /7111)1 / 6/ 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block &Tile Ceiling w JEFFERSON COUNTY . o DEPARTMENT OF COMMUNITY DEVELOPMENT ,ti Hf l G- Date: ' /5- Time Received: Litt? arrtc72 Mon. Tue. Wed Thur. Fri. 3 ( Date: P/". r BLD: 7 Contact Name: Owner: Contact Number 360 7/(, 5el-7 2.. Address: 2‘ ' q3 7 ALL-</.0 /0 206 Notes: Foundation Plumbing Framing Propane Tank p Mechanical Setbacks Under-ground Framing Under r ound FuranceFooting 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 Man-Homes Underfloor Gas/Wood stove Insulation Setbacks Final Inspection Floor Foundation Wall ` Block&Tile Address Posted Ceiling�- ,�esO^ %N JEFFERSON COUNTY )-1 DEPARTMENT OF COMMUNITY DEVELOPMENT /� 'R.SFfINc� �5 444 Date: Time Received: f Y ame i�� Tue. Wed. Thur. Fri. Date: 4'—W > Contact Name: BLD: Contact Number: 360 -31(0, 9q77 Owner:ddref� 206 Address: � Notes: _ off) FoundationPlumbing Framing Propane Tank Mechanical Framing Under ground Furance Setbacks Under-ground � Rough In Air Seal Above ground Gas Footing — Stemwall Hydropic Exterior shear Exterior lines Oil Interior shear Interior lines Ducts Straps Hot Water Htr Appliance Post Hole Ventilation Underfloor Gas/Wood stove Insulation Man Homes Final Inspection Floor Setbacks Wall Address Posted Foundation Ceiling4 ..• 1 n T:1_ 4 4.1 5 o. % JEFFERSON COUNTY ` DEPARTMENT OF COMMUNITY DEVELOPMENT ry(V GSI Date: s-' l L Time Received: l ' .._ pm Mon. Tue. , ed Thur. Fri. BLD: i�_ 3CP i Date: 5' ' /3 Owner: Contact Name: Address: Contact Number: 360 31(0 /y72_X93 137 14v1Y 10 I 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Footing Under ground Furance Rough In Air Seal Above ground Stemwall Hydronic Gas Y Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Post Hole Interior lines Ducts Ventilation Appliance Underfloor Man-Homes Gas/Wood stove • Insulation Final Inspection Setbacks Floor Foundation Wall Block&Tile Address Posted Ceiling 4SON p - c'e. JEFFERSON COUNTY 9yDEPARTMENT OF COMMUNITY DEVELOPMENTg Hf NOtO Date:3/17/2)/5 Time Received: -27J am/ Mon. Tue. Wed. Thur. Fri. Date: . f ;Qi BLD: 14-_ 3 < Contact Name: , n Owner: emi , G q Rc� Contact Number: 360 316 _ 94r1 Address: i j 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 linesDucts Post Hole Ventilation Appliance Underfloo Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block &Tile Ceiling ,,,o- 2 JEFFERSON COUNTY 1, DEPARTMENT OF COMMUNITY DEVELOPMENT 9mosFf:ri,So$ )ate: Time Received: 3:,31/ am/pm Mon. Tue. Wed. Thur. A(/C Date: tl I 3LD: 14- d034) Contact Name: Contact Number: 360 3/4 . J/77.- Nwner: 206 Address: 213 43-7 I Ol irs Notes: ��.0 PUQ Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing X Under ground Furance Footing Rough In_L Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Ventilation Appliance Post Hole Underfloor Gas/Wood stove Insulation Man-Homes Final Inspection Setbacks Floor Wall Address Posted Foundation Block&Tile Ceiling ,�,�'"' `%t JEFFERSON COUNTY l DEPARTMENT OF COMMUNITY DEVELOPMENT 'rSyI NG-C`- ,�s�, Date: '3 c Time Received: ama Mon. 6D Wed. Thur. Fri. Date: BLD: SCI' 361 Contact Name: Owner: Contact Number: 360 -3 (to of`-(7 Z Address: ,Act 3q�j'i f{W7 ip ( 206 Notes: c TG ira vt 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 (4.10 Foundation Wall ,.7,0 Address Posted Block &Tile Ceiling s,:^: ,-O % JEFFERSON COUNTY -'sero$ DEPARTMENT OF COMMUNITY DEVELOPMENT Date: g ,Time Received: ( .2_,.7) am�' Mon. Tue. Wed. Thur. 0 r T-7BLD: ,- , 7 W \ Contact Name: Owner: IL �3�� Contact Number: 360 / �.`'49 -2) Address: 206 Q � vi• tp Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance FootingRough 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 �`O¢5ON CQ C? JEFFERSON COUNTY 6,61)5 'SH!I+GZO DEPARTMENT OF COMMUNITY DEVELOPMENT Date: Time Received: 0 ,‘01 am/pm Mon. Tue. Wed. Thur. Fri. l Date: 'tact BLD: > Contact Name: k. Owner: I > Contact Number: 360 2 tic —qZ-F7 a Address: 2.-l1 >--1 101 206 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 Final Inspection Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling house IIf Roof downspout "• serves up to 700 sf. Of roof �"" .............. ............... ........fill.. ..........:.... .............. ............. I, nmv....... 50' min. { .............. Vegetated flow path ,,,,,, 111111 IT Splash f. 'I1 block iY - Downspout extension NTS 20— Splash 1 block r Figure 3.1.7-Typical Downspout Splashblock Dispersion • Vc dme III—Hydrologic Analysis and Flow Control BMPs–August 2012 3-16 Design Criteria for Splashblocks A typical downspout splashblock is shown in Figure 3.1.7_ In general, if the ground is sloped away from the foundation and there is adequate vegetation and area for effective dispersion,splashblocks will adequately disperse stool'runoff. If the ground is fairly level, if the structure includes a basement, or if foundation drains are proposed, splashblocks with downspout extensions may be a better choice because the discharge point is moved..away from the foundation. Downspout extensions can include piping to a splashblock/discharge point a considerable distance from the downspout, as long as the runoff can travel through a well-vegetated area as described below. • The following apply to the use of splashblocks: 1. Maintain a vegetated flowpath of at least 50 feet between the discharge point and any property line, structure, slope steeper than 15%,stream, wetland,lake, or other impervious surface. Sensitive area buffers may count toward flowpath lengths. 2. A maximum of 700 square feet of roof area may drain to each splashblock. 3. For purposes of maintaining adequate separation of flows discharged from adjacent dispersion devices,the vegetated flowpath segment for the splashblock must not overlap with other flowpath segments, except those associated with sheet flow from a non-native pervious surface. 4. Place a splashblock or a pad of crushed rock(2 feet wide by 3 feet long by 6 inches deep) at each downspout discharge point. 5. No erosion or flooding of downstream properties may result. 6. Have a geotechnical engineer or a licensed geologist, hydrogeologist, or engineering geologist evaluate runoff discharged towards landslide hazard areas. Do not place Splashblocks on or above slopes greater than 15% or above erosion hazard areas without evaluation by a professional engineer with geotechnical expertise or a licensed geologist,hydrogeologist, or engineering geologist, and approval by the Local Plan Approval Authority. 7. For sites with septic systems,the discharge point must be downslope of the primary and reserve drainfield areas. This requirement may be waived if site topography clearly prohibits flows from intersecting the drainfield or where site conditions (soil permeability, distance between systems;etc) indicate that this is unnecessary. Volume III—Hydrologic Analysis and Flow Control BMPs—August 2012 3-15 0 0 '-ii --R-- C-Ot Dmp:31J Hiii5e "Av / Catr.h in OW Drain) 7-7---- 1..,.___, \—nOrt -,..-"--,.....,,,,,„._ , • DOitrpOti ----5- 0 DRY WELL 48 irth rk Fretpr Hole Filled with PLAN VIEW , lila-3*Wasried Drain R me., urs /----Ft o.st Downsp,:d. , ark Center of I-tole I WI I'Car.:ped RI Houoio / ttlow \., Srlash Block Topsdi— f or 4."...ter treari3 Fiwtriwith Strface '' i. inieffeacm i ,I: • . A 1 . '... .1 .4IC ) 1:, .4.'1" ,r4":•:f....:14-1 ,;. ,7".:*441! I i-rm_ \---7----___ *6—"'griEliitrite-goitz.- iik. itTN .ifv,,-..4,*„.vnIAITIQZ .a, I .9r-ie Mesh t:--ilween--- . Catch Basin PvC P-4:e , ok -11-.14. 7.0. 41,0..01Tifir.4.,1-, ti i (Yee d Drain) i,... z, 4a Irch Drcp, .I! '41 Thin. sid,,.,..of Hole..__; .4 Hole Filled with ; 1 Linedwith t.7.i 1412-,I'Mshed - Fitter Fabric: 61. Drain Rod< ,., 40y U4t . 2 15 Nit rgii . .......... kl fa. 1'-,45,-ppe 2,i,e-spfia I DRY WELL H 0-8r-surrdl,.,otc;'11.4.-,I, SE CTION NTS Figure 3.1.4 -Typical Downspout Infiltration Drywell Source: King County Volume III-Hydrologic Analysis and Flow Control BMPs-August 2012 3-9 • S 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 BMLIPs—August 2012 3-10 for Infiltration These s ms are designed as specified below. 1110 Drywells Gener 1. Drywell bottoms must be a minimum of 1 foot above seasonal high ground water level or impeiuieable 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 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$MPs—August 2012 3-6 S ' • 7/31/03 DEPARTMENT OF COMMUNITY DEVELOPMENT ADMINISTRATIVE WATER CONSERVATION MEASURES LIST To Promote Aquifer Recharge and Prevent Seawater Intrusion 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from storm water and roof catchments may be used for watering lawns and gardens. Unless catchments water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Ground water withdrawn from each property should not exceed a rate of three (3) gallons per minute. 4. Install water-conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 5. Landscaping should include xeriscaping and native vegetation with minimal amounts of irrigation. 6. Use drip irrigation, soaker hose systems and root irrigation. 7. Use water basin techniques to water plants, shrubs and trees. 8. Routinely water deeply and less frequently. 9. Weed control is an important part of water conservation. 10. For your landscaping select drought tolerant plants, shrubs and trees stay away from heavy water consumers. 11. Limit the amount of irrigated lawn. 12. Mulch your garden as well as isolated plants,trees and shrubs. 13. Use shade and windbreaks to assist in water conservation. 14. Use low flow water closets, showerheads and water conserving dish and clothes washers. 15. Use rainwater catchment systems that corral rainwater from manmade surfaces and into storage. 16. Install water-conserving devices such as low-volume toilets and plumbing fixtures. 17. Only 400 gallons per day or less should be pumped from all exempt wells in Seawater Intrusion Protection Zones (SIPZ). 18.Water softeners that contribute salt to groundwater through infiltration should not be used in SIPZ. 19. Hose bibs (outdoor spigots)for outdoor water use should not be used in SIPZ. [end] PLEASE NOTE:THIS LIST ISA WORK IN PROGRESSAND MAY HAVE ADDITIONS DELETIONS MADE AT ANY TIME. USE CURRENT LIST. • i Standard Conditions for Residen'evelopment 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 pies. Portions of Jefferson County, ing 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 2 • BUILDING PERMIT APPLICAA•_AN BLD14-00361 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD14-00361 Received Date: 10/7/2014 SITE ADDRESS: 293937 HWY 101 QUILCENE, 98376 OWNER: CONNIE RAE PHONE: 360-301-4428 PO BOX 652 QUILCENE WA 98376-0652 SUBDIVISION: Block: Lot: PARCEL NUMBER: 702132016 Section: 13 Township: 27 N Range: 2V+ CONTRACTOR: TBD PHONE: 253-584-6606 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NSFR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION 235,000.00 MAIN: 1,926 CODE EDITION: 2012 ADD'L: HEAT TYPE: EEE OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: 803 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 1PWELL / t BEDROOMS: BATHROOMS: ` > Q v tJ tS 1 (yla Exist: Exist: 0 Prop: 3 Prop: 2 dilartr/ je1C" line 4.Total: 3 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,979.00 SRE 10/06/14 151616 Plan Check $1,286.35 SRE 10/06/14 151616 State Building Code $4.50 SRE 10/06/14 151616 Potable Water Application $67.00 SRE 10/06/14 151616 Total: $3,336.85 • 11 ,Ct 327o430 ^ .N....,3....,:gl..0"5:,.... . �� .'*�.�.-ice:r�..�._•. / ♦•' •1' "' CDi. • litl,,..1 :‘,6 1,..t_;:e0,,,,,.' na5r,c, 03 ,L., 41 • • r/ 4 • . pN ,� r k I71► ` rN i iAO.,rr4t. ). > WIN 4. r' • r' (D i'/ a y__._---- -... [fit, ,P-3 es CJ) II41 4 I � II I +1.F. Ca I♦♦+ ♦� � I W I t. IAu u� ♦pJ+ � ~ ,�+ , 44 50 s g a*-:;7 St4 0 4 " 'n � . �4`W'. +�� vii• Iy �.� �rtt � �� r I W ' I,M11f„, ``VN�\,VA /Cl I'F N �1 . W" I • • + ;•Q4. v/ iA r1l 107 .1 ,,, .r '`) LI0 / ♦..,,or� ✓ .�� i� • r r. . 1fA . • • ;eu. - •No ,__ .7.7777------.------1\(..,(c.--;.c.1‘,-:.) /. �.. l..4 a. , s. / p -- C 4l C`3 ` � d • 2 i t\ g' 17 ® m . r° '^ e) .. I • cb 0.!/ .r�1 rn0bkk rnFilOcD k a cl) �'� L. •8- t b b C'; cn J R b• O 'T..: 21 • 'gyp .sA u Q p� Q o r� • cn Q �, b r n -p CO o (II m 7.g 10 v �. 1..5 1 � n p ro �� t Ill Ij a . F r — Y_ rt, 1121 r 2,,..., lilt VVULi -4— i Tl n J P 'r N '7' o co Tv I f} � al o 2 so m cno' a �. ] (,f N S fO a F o a 9 l. g O o, a h'. —' FI co Dw• g2pipo�CQN o yenw = • II �O' I * cpm F m1J' a ° F. 9'e v O m v 3 1 ��/� / t G il.-.- ` I vim i l• JF , 3 +�)�� INTEGRITY HOMES & REMODELING Page 1 of 2 • • 0 Washington State Department of Labor & industries INTEGRITY HOMES & REMODELING Owner or tradesperson 124 SWANSON AVE CHARLTON, DONALD E PORT TOWNSEND, WA 98368 360-316-9472 Principals JEFFERSON County CHARLTON, DONALD E, OWNER Doing business as INTEGRITY HOMES & REMODELING WA UBI No. Business type 602 541 544 Individual License 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. INTEGHR953PD Effective—expiration 10/04/2005-10/04/2015 Bond CBIC $12,000.00 Bond account no. SG3504 Received by L&I Effective date 10/04/2005 09/29/2005 Expiration date Until Canceled Insurance CBIC $300,000.00 Policy no. C11SG3504 Received by L&I Effective date 07/25/2014 09/29/2010 Expiration date 09/29/2015 Insurance history Savings No savings accounts during the previous 6 year period. https://secure.lni.wa.gov/verify/Detail.aspx?UBI-602541544&LIC—INTEGHR953PD&SAW= 12/17/2014 INTEGRITY HOMES & REMODELING Page 2 of 2 Lawsuits against the bond or savir. S 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. Workers' 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. 149,464-00 Doing business as INTEGRITY HOMES & REMODELING Estimated workers reported Quarter 3 of Year 2014"1 to 3 Workers" L&l account representative T2/LINDA ALGUIRE (360)902-4678 - Email: POTH235@lni.wa.gov Workplace safety and health No inspections during the previous 6 year period. n Washington State Dept.of Labor&Industries. Use of this site is subject to the laws of the state of Washington. .Acc€mss Washington' 1044,x�An https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602541544&LIC=INTEGHR953PD&SAW= 12/17/2014 Ilf)L-1)ILI -3U ( _ , cot, JEFFERSO UNTY DEVELOPMENT ,.. .v . -B, /r' DEPARTMENT OF COMMUNITY "W7 04 621 Sheridan Street• Port Townsend •Washington 9836$) .. 360/379-4450 • 360/379-4451 Fax 11 OCT - 6 2014 „qs�N ,to www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA:JEFFERSON COUNTY — pFRT. u Project Description(include separate sheets as necessary): / N1L1ti1 .5INS (Q 4-A-- 1...4 R I 1QS I(LPNcuP Tax Parcel Number: "O a 13 2_0 14Property Size: -4- 1 a 30c1 (acr /square feet Site Address and/or Directions to Property: ag393 7 14w Got ^ Qut (crava- vitt g837C ,, Property Owner(s)of Record: l-r- R V 4 C OiYV,Q MI E. Telephone: om ,,- 0 - 2 Fax: email: 6Ce) frT'fllrwk.dlt Mailing Address: O SOX -5- 2-, Qr,i 1 QDN¢ ,Q4 Q 13-76' Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies 0 Lot or Road Segregation Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) 'k1 Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C)** ❑ Manufactured Home .0 Modular - 0 Discretionary"D"or Unnamed Use Classification I 0 Commercial* 0 Special Use(Essential Public Facilities)** 0 Change of Use 0 Boundary Line Adjustment ❑ Address 0 Road Approach_ ❑Short Plat** 0 Home Business 0 Cottage Industry 0 Binding Site Plan** 0 Propane ❑Long Plat** . ❑ 3iyn 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes" Use Consistency Analysis 0 Plat Vacation/Alteration** ❑ Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment *May require a Pre-Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Pleas identify any other local,state or federal permits required for this proposal, if known: c. f_? 13 1 3 ' DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: 1 By signing this application fon,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 assumed unless the applicant informs the County in writing at the time of the applicat•- hat he or she yr s prior notice. 0 v / _ / L' Signature: .. $ Date: The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your 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-transfer le onsibility for adpedyg to and complying with the ESA. The Applicant has read this disclaimer and signs anddates it below. Signature: /CA.. ..A1 r s-- — / Date: /0 ' - 1 — 1 ""1 G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc i BUILDER STATEMENT The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERA TOFj„OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: 41 Sa As p„.ts �r,_[ Nr , .04 PHONE ( ) FAX:( ) MAILING ADDRESS: Ca (or S n 6 s, 57 ft-- ( EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: C New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: _ Height: 0 Individual System ❑ Repair ❑ Masonry _ SEP Permit# L —'ZO L D Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: 0 Public Total: Name of System: If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed • IBC Occupancy: IBC Type of construction: Will you have Food.SerMice? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: I Underground Tank I Above ground Tank Size of Propane Tank: I Heat Stove I Cook Stove 1 Woodstove 1 Fireplace Insert I Hot Water Tank I Pellet Stove I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated (°102U ni aly.l O EH Bid App Review: 2 Floor Heated Consistency Review: �� , u v Other Heated Base fee: C? [i Mezzanine Additional Section: i.q . v v Heated Basement Plan Check fee: t) 3S • Unheated Basement State Surcharge fee: v Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL 3-lo Decks 9\51, 911/Rd Approach fee: Other TOTAL: $ 3-7pD-85 a_... 11.4),6�oUci Receipt Number: I GJ` 49 1 Cash/Check Number: ESTIMATED COST(REQUIRED) Date: (Q//// ' (`-i •Fair market value of all labor and materials foundation to finish 10 f I Initials: ( 4 G:\FermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application S-29-O8.doc Morger Cohstruction lhc. P.O.Box 475 /293114 Hwy 101 10/5/2014 Quilcehe, WA. 98376 360-765-3205/ Fax 360-765-3914 Proposal Connie & Gary Rae i E o r' 0 v E �\ P.O. Box 652 Quilcene, WA. 98376 OCT - 6 2014 JEFFERSON COUNTY DEPT.OF COMMUNITY DEVELOPMENT Description Cost Total If NO Asbestos is found estimated cost is 5,000.00 5,000.00T that includes Demo Permit, Asbestos inspection, demolition & removal of existing house. If Asbestos is found additional cost will apply, time and materials only. Dig and backfill new Foundation 3,000.00 3,000.00T Rock for driveway 2,000.00 2,000.00T Thank you for considering us ! Subtotal $10,000.00 Sales Tax C9.0%) $900.00 Tota 1 $10,900.00 -2,.,,S._-----__ I.- c-)0 o o IT rn —1 CD r-� 4 cof❑f/g(llll m o C. -13 C 47.-4" r. 10.-0" 23'-7" 14'-7" I 6'-0" 1 i 2Xfi EX(ERIOR STUDS 16. 0.0.(UON) AL0. A.® 4. D i W 4x i0 �II P 1 1 43 ra V iv � � O — / pQ o � •--, V--.1 p N"+J con 1 , I gIIo 1 m I sll- U777 \ �_ . ® LI ✓� P p Op a s, • N I O• •_I " - /,u 1z1Xbm I :uCI o._ .i ' l\ a !O �O ^ - Ai �Jc —It :4 01 (' Y' . I 5.m �. T ' iol —N>r, • �-y" I 40"¢I 6'_1• &OO ' m I ---28�G 1v� 1 I r\ u—� 10 1.......",„.....,.. `�- I 1\ r1' / ` ^v mACCsu a i 8 L4 J 012 518 x IQ14. s I n i' k " -./I 416 - Nw I ® rg I — v ---rzl— 4 n c C �jx / Ti x o f u / ��I m d• eN G , mw f 1J � c2 g' is / I_ l4'-81/4^ 1 III11 I. rnJ t R _ 4 Ili a 'I °'- 1 (- k. + D o o y 0 1'-4 3/4"-h.! 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Sb N 9I N 'O (O Za- aCi J y N y O O I} 8° `G c0 n Cr 2 n 0 N no ry 4 O 3 m rt W--. 0cn to no -0 a s 3 mo F o .� N cn N W 6 m a al N a o c a o o o rN ni n N a 2 23 0 '^ m o � �lj W a 3, _n o N zp 0 ° m °1 0m A T O o 0 y m y NN Q 3 N a) N • —1�}1} EIIVC 1LI/ t_I u IF— ON a JEFFERSON COUNTY , I NOVn,; ' - 4 2014 , t DEPARTMENT OF COMMUNITY DEVELOIi' Ef T j JEFFERSON COUNTY y �G 1 621 Sheridan Street• Port Townsend-Washington 983E COMMUNITY DEVELOPMENT 3601379-4450 • 360/379-4451 Fax <13-1-No HOhtlp-l/www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE 10,,,z1 4 7C? i32o( L„ Owl r C.o„,,,e. fAt. Rzsrd'g., I MLA# PROJECT/APPLICANT NAME: nei Id J Q V r, j q T /,'`” l i 4 .f P..z.'‘+vck ej,-. l ,J Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a separate stormwater site plan map. Project Overview 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site m rr ( t (1:24 s / mss- c ...i 13019._,r-s"�r- d�c.Gs C[,[,r�-rK� /lYRn1 a,n�2. 7PMl.� /r..tJw".c.1x11C'� I''� �- �r� l� �(K S/!�- � `/'{ -0lA1r37 .y •r-oir. i'33 51. 1.:er7t'1i _ )C C_.,- ..14--:-..15, d-jae_ c.,j. st„ rocut „�, :Jr71. S.:n.,a- iYLa-i, d N ,Of r a t-Lc,n gl c�res n� eX Z11467.15; c ik-ar e-r, c' r -c1, Existing Conditions Summary 2. Describe the existing topography. Indicate contours onthesite map. ,J, L ;s 4vl s,4 4 () rn,r i, -✓ ,..., 4_47(„4„,-,1 riv:cx--t1re.( r-11/4_4-- bC2P o•'[ Ea st eao.r-FP..r nM Prn rr4r 1'�. , Sr,."-1. ,;......--,-.4-- 44.r-r.9 c5�'near RF 1, 11 e_S 7 J / rr 'L' '811 r hChH Ino 2r'Q,J0. Rr PW‘c.� /O s'S t•L Cu3-�-Gr,o r+-t; PC'6�n�P' f Q�P!!a�[a•, �.Fi f-S GG.�s! t,s, v ` i • c,.nc,,.v.tS�- G-,rn Qr. Y1¢m r'(�-rUr psr��u 1.-......E.- r.,.--z, ' f rJ!-t'n •^.Ct ea .'_fl t.. { , t n 3. Describe the existing ve etati{on. Indicate native vegetation areas on the site nip L, ?s Mor-Py Jerrs'-ee-% I.71-71 c q'—'—r rr J 7 t t- JJo lar l( /�I�.CJ . fl�r}W Q�.'�SS.Q..S._FG?'T.0'.ttQ l' r- u1 /ail- Q4 i'l=',"A J4� ra KGs 2't ..�".Ap Y! c......1,-1.1-4-3,o JW , i 1 5l ( $^srn ..C'C'.�z U�r.Y rnyft._ ns..j Sa;at ['7tv.s4- T-1,;--'U` r.,1 7m �Aa x Sc 14�rfG.d D i"C 11 Q.G +� f p �.. G v. (( 1 .[ SM•.11 . 4o..>i S1 IST -'5r Sr qtr- W:4-‘, 1thry(_2-S'rt rM t 4Te-e-S 0T 5AlaI t • 4. Describe the®existing soils. Indicate soil type on the site map. Sg 61+S are_ pAa31 S I-I- )_oGM , e, 0 I areal €,-4L - -4-i,0, !'„tc btt , 5. Describe the existing site hydrology(i.e., drainage; behavior of water on the site—above, below, and on the ground). Indicate existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if applicable,and indicate acreage of each. )! (( / I St it d_r„r.,T 1.211 0;44. �Il Rv1 Gish cam-. r)T pQ'+ir)t r`v16y or SG ra4-ect_ C?ren. si ri.r r:n :,.e,C-r 10 Se7., . Iii (-vs.,_ . ffc.r•• . 4 v - ?ETAS J 6. Describe any excess levels of noise generated by the proposed use or activity: t ,,�1r.s'-rwIal-,.o ..",o 3 - ` 1 (jp rC&lr'ctnnn`q )a I I 1.3‘,14 �r�ceCS. 5 stormwater site plan leplate.tloc-rev.4/782014 0 III 7. • Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams, steep slopes,etc.)on the site. Indicate location on the site map. L t j..s , stop.es -c, i.1!- r ��1r?n'" tial-. _wa-f-te- lz0z1 pt or A¢. hi 1-411/2__(104l(cq-.r+ .4�_ r. r r-/tire„"- c, .l-- ey..u' ��'t ra r`�A�rr-.. ' c,5< i`C.\,n'1 fi-...c�.3 M /�dr' a U.^-�,+, c^s� 5� v'\ rT-Q7 rti/�.�r'J-u s v rr 1 U 8. Describe the general vicinity of the site,inducting adjacent land uses and structures,utilities,roads,and sensitive/critical areas (streams,wetlands, lakes,steep slopes,etc.). t .5- I, ci 4 kr-td 6, }I-,--,)-„,.,k„,..; 101 r+eh---of Viet`-.. 0 v .j n,,.;l'L, r1�11CSTFvt crnr -' s7 onl 1 :7.0.1:1:-• .-r , � j-T•T, Wt d W�� l-.MN Of tcCN 2-r W):3 r I k . 1-1.. 10- G tt L_- i"-',...v RA- rV .S rlir OVC `.\ C9lS 3llnCt ry ,-.,,,,,s'),-,.r.--2-,144:J-1-. to Q F16+(' f^! ' rte C. T £ tt AS^ ,,4 s. i p 1^ 1-, -r.c2•'• -- or. tr-!--'3.•r . rtiir 3.4141 c .,` r-;:,,r"-^':S a r'•f tvr 3( t�.re Q�.E.te-t A.�L� !✓! liar..o+.J r„!14 f S orv.� s.v,9(F_ ' p.r. t-I i'c;let£n CA-. Permanent Stormwater Control Plan This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs and facilities to remain in place after construction of the project is completed. "Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control facilities are not exceeded. 9_ Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed(i.e., per BMP T5.30 in the Manual)or,if not, what types of stormwater flow control will be utilized for the site or specific threshold discharge areas within the site. Locate these facilities on the site plan and differentiatera proposed facilities from existing facilities. p �eri Cira.�S ror1 os.,.-4 -1- - te ?er.. e- .rc �u4 a (ass, 1/e t anub r,t Fer t�a < f Q el.,'S�ttr-S 9_f4-� Vii-1-1,:a .1,;v,�,n.,rv,. 3r(1 '�:F en-4 r+c\;:--, 't'O 7(1 tn]x\ VII- MPn Gt c9h. ^ f'�?Sr x 1 ti! 10. If the project requires the use of stormwater treatment facilities, describe the types of stormwater treatment facilities proposed for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is normally for"large'projects or projects that involve the potential for dispersion of contaminants.] 11. Describe the performance goals and standards applicable to the project 11 1n^� -1---, be. rn ..srv,o. bxr --- p r `�P du.3-)_,o.<' Q 11,\ !! ,-,1-1,-(›-!' ;I / L rQa 'S S�7�tc r� w j, , j 1 i 'i2 Ire.v'nr«-�;,LE, - r•..+ r?arv,.o- 2; rkmd r-n.cc C(utnP�P� ,-,r2,3i Tr ., lfd-W�'t� t,n At Sfw r'r0.iwe'L a 3.;t c(r-e c�S. t"II, c: t,r IN n rn a c .k, 'e_ re et aie4A fl. .�{31-"� r*ft,1 ., - s�--1-+'1n 6,F" v..rr\„r.+1-c:' s i S r r,.t,b S or Vie- 12. Describe` the flow control system. C r I�Od\ C+rcitnS 'o 4[t]t,j nor sp(ai i,J\c,L3 rr-Fn yea 2 -14ril sor Mrn�z.ii -Po, ) -✓ J,r . [�� 2012 T-'� � 1 hin � C{�G,� � Wil' - GT?n,1�1 li ow <,o.. rn Cf —r1U a a,�(� r'/ 2�. Gcc ri 11 �hCt '�'Q / r� .,74-,,,,....., -'---r .N,r.r e++, ;,ngv,:3..c 1 ( Or. cslc,trn C,\i 4,-,.11 us., / A- Ur dtarh JZ J" +7h c. . < ci, !{ OP.rf S•)-4 'Ml1,,nro. ..,•.. (M„n rM0.1J f .,,,6. L`.`.�r0v^. Cir-..s.r>, ten ir;- 'j Q1f?.Q..Cii it)tel. tnJf 1 I Jr n la c-C- �U 2 -,-n 2}ill ..%9 Ort.ck 4S ek.1 CJ' C S"G �-1 f..r f.CJ' ' \��r i l `I! �•y'1 , . I Ll! I1 i - stormwater sae plan template.cloc-rev.428/2014 4 '7 '� - 6 J 'I: ..if UPCY"11INHYUEVfl.OPMENT III • 13. DescribelIthe water quality system. .5-i t'e- t.T oui i--4 it 2 . . „t IX-. .,r• Y.: to!Z . S r'. ., -f . , , , a A 1, r�t t 1 41'4..e.--7444 Ar..-1;`,e.E'.,�-- 9- ..,,,„,r0..,,, ,t.-.R. .tii_noTcariu2g nn,n 4-o 040 e-„ -L-o S elr- ! t $.o 5,4.-;„„ick,,,,‘ c.rw. , fir s).-�-e-. n,,,,,_t ,,.,I1{ .bc n--. - ..z. a- ,,:9-t., e. PP (o.1....‘- r s r1e )) r P 'T' --i .� T- nom- Seer Mu ' /. -.c rr, t'J'a il:r 5 .� r S-44-44.r '^Lc, Ot>AU( tf4q c! 0"1 . -, ITnce7 e J _• j rF 3/c,rL'� f- 9- r,n. .Pt.^rz C.,. (telt,-t r,.0„,-, of PP, r: aA 44l-i_J 't.1�'ic=•,.. "r4-^.e 3 . ysystem anal s and design. / a 14. Describe the conveyance analyses �� (r,' )/ / } ( i � y/-�� 00tNnSnUN ^,10 be/ rM, qc.. -i3 ^P (G.S'^ b 1 OCK3 l.J 5D IM,i11M.Kf^'1 AU IF c qp e r e.�r-L. c�. --- ,,ifi crs,rn es el pn_ar2- -Hnan _cJ ZI u,f�'. „f rc1 ort.t. Lown_.? _` I ` Ceca th +.a71� -4Rrr�,,^G 1:.",-Lo erar ,.!4` AS Pkr, .a,x , rr r'.'e rf - I� n4 [l r'a cl+?_ b �e.,h,Ce::." —!cnn cfl.4 Crum v,`-- M / ....en ,,I( e.),,,,n,.t-fl- A..”,./..-(et .Ld Gar v°-ria& ,c,,_ Of A?d-1 uaL ✓T'i'A-dM fel t..-.r(-.c-Li-P-1.+ .r'r"c.:.. 'a.....c.. .. 15. Describe the source of fill material,physical characteristics of fill material, and deposition of excess material. ,o -gilt N .k, tgI 1......)114 "i?tz Ti-o i,..nac. orn QzCa,vrr roll � � e.... p(. +.. piLft)c,t/ ! alpkr'ie.(le ,f [ It f „rill- -Feu", ,{u--1 .-1 ,, 40 T n.ezi l,-i-o -P-- r r d.n (AZ 9n.P'- ?A r.t . r>,.' t e.&t'—rs-t 9S-1,? ,P-p;(1. 'r a 1. .1..‹, z-s Er . 2r',nu 4_,n, +res.% r,,"..4 -t-n (-en..9..- , 1' IS21ea,. Ur r✓z;�n re.-i - r,�£1s s'� e rr ( ✓ ..1_,..1_, TPe ft/)-`e. n.````''(('' Rf jr,,,..,...,-,� C ¢.. 'fn. re., �r.ctr,,n rr - 16. Proposed methods of placdhent and compaon consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. r 4 � F F.C5 w v,S..0 .^o.n t-0 0,r,P3j--S Q be- 1 cE..cf r..n L.•1 tf —,w c----L R..Ci' .t. ,1 , i e_ Lar 04 re),f ' " J1 • It 17. Describe the proposed surfacing material. p 1: 18. Describe methods for restoration of the site. / r A1) Areal 1- fj G V, /t4LJ Go.., �,c-''•-,v, . dr;wr.-z..tacj car- (�a 114.�siZ r t7!� ta&., ,ten r O v£r-ec% Y r e ; -5-0,-..-•...:_ .0-.tec T c1 i l c.T e% "�-. .:',.-11•‘• .F Z'.et -/P4dfset i., 0L. '4i 1 Qv.,..,..i. 0,- F nr,aw 4 !NI l-'' Ur M . Mt Ert E'ti ts.s-. _ iB_P- t'l..t— jam. q.. .4 _ 19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for "large"projects only and only those for which facilities are required to control flow or treat runoff.] If included, list the Manuals here. ,^i � e L 20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan, 21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditions or restrictions here. F( ( J [� ( - F PfeiC :s trt ('i' r' ,.�1{ca QtvX f>4(MI Y- u (1 ,P{.j.,v,,nS •,,? ' .t F 'P /� IT-N‘\1 Sit7- near ,q-e r�`i e,n 4 y�.,.> 11 tete,; ;>M 1. Pk,-M•-� -'-- -S F P'3,---c".1_31(=`' �� [--, I ! c)9 r,-.01141..5 141 t..-44 rod . CTr r:_%,..i s-,.,.C. lit.,r..'. ,..,e 7 stornrvrater site plan tempate-doc-rev.4/28t2014 1 , tY G. d!Iv!Ty[s vFLOPGiENT • • CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP) The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the template that follows must be installed on the ground during all construction phases of the project The proponent is responsible for preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential development SECTION I-CONSTRUCTION SWPPP NARRATIVE 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable to the proposal,justify in writing_ Descriptions of the 12 Elements are found at Volume II Section 3.2.3 of the Manual(beginning on page 3-7). 12 Required Elements-Construction SWPPP 1_ Mark Clearing Limits_ r _t-Q.c SPS Le.1+rn pfes°-,J:a�.•,:'.t^, t.IF.'.f'C'_c\ . lila AcYc�-1•<',z?ne. ? -rn� „.-is,,;Is-l'.r•-,,ah4.. -. 2. Establish Construction Access. `gpxlrr,. -, ,,� -._e yc (,,,J;(I 6/._ Ln-1-4 I r_2 ,r,5 eX,iI-..:,j ldr:,,& JcA i flnb� r II ✓ ---4.1i./.. dr'1vC_, ac i.n .h) -Qr ,1 ro dr✓l cc 14 -1-2 "N,al..” �� r.,7•. R tl-a el c._1-.2 ct r+..',�e ,. N, Vr o id -1-, .. l _-.f_ • 1 :S .✓i•. 'V r • /.. i 3. Control Flow Rates. / l e; -✓,s-Idl t 5114- 1'Q ca, a Y, 10 P 1�M Q..' er- U4 (}t��_/,4�/p 4�-k- t.cr.r�"---, O r j/ilQ prat n`la r r 5 4 1 1r a- c u' -FLs r -I& G+tf4 C r C. riFc,f 6, 2a'Cliu YQ tV �'ar +', K7Q��i..UR2✓i /ter r. f [^ RCS' S'QP y/�',,' J r r r! �, en�;} sr f, rd..t g,dzac. r.yLyp `4-4vl n,2 c S ,- n /K 4.y --ft,4 l f�f a.'-�_ Cer..k 06C. Hq.yr be,i'rsu � 6¢ �,(a ._i ne.-e�- 4e.. -:, d f istfor.rS _ f 4. Install Sediment Controls. (( ( / 1°1Ack 1f"c-tiL.J of l[rr'1C f"1ktc., 1 t,,.- aHc( r?!�-r� C'is—tutr4ect Fszr n . 5. Stabilize Soils. I I Much _,ri-.1j- n a rix.. -c.., c.--•,, . 6. Protect Slopes. n g 1 _ ' ! -1 NI,7, r'rhal s of LS �l a=2rr��'c-a et"( Crr.Lci-,( c,�c� Fa.c:@.4. G41 PO-4r c-:i;1 vi Ir7Q . IPti cac -an vl ;e, , 7. Protect Drain Inlets. /VIM -- ._ -----ii, , . 1 .. k stormwater site plan template tloc-rev.4282014 8 • • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. 9. Control Pollutants I , �. ) r .s- W ...4 rt` !to L'?-�,1,"-`,,,..''�r .,✓.4-01 G.V4.X Vl :!.£ r'2C�'L. J`2.o:/ 6- ? ci r i �71m r}P.c.- :�' �'s4_s': ..- </.;'r}r1 :.e, 'r' rdLf i) (a p fJ.„ S:/-u -�-, C�Gc: .. G�l.,-i 1 1 r r 41 4f `^-dc;Ea c.,ru L•1- t^.�.' ! :B I o' .2 f";"-:, "7.L.-. C';_ avoE tier -142.,....-... 10. 10. Control De-Watering(the act ofpumpinggroundwater or stormwater away from an active construction/site). -Ti y,�EGi�G( e(ec,... f'i'cJrM t.--•ot-1e. coy, )JO rr- . -'r. .e-r(1 r.,;-;-4- E 4- t r tivs.r-t- �. r I L , �d�'.� tam .m far G>-tcj Gt `.�a�J a 1' r �c�F aJ—+ i 21'\ "..s..,,, ..' Yt.-,•�r J.....' .,..,) _ �n r'1 ,'.ri.i�i 1C€`•ti riG.3,? c•G'1--1 -n- .7r,:� s� se. c_, eise.e •.- ,� •.. . -- - . ...-N ,. -'7-1 t ., S_0.4 S. 11. Maintain Best Management Practices(BMPs). f ('' .5...... em...-1-1-0-71iNrs. �, t Jr RO_GrV•e-t e5•P 11'11' S_ ell e---fr� Qh d ell VI Le 4iru-C—.'Lt 13 to Q- qts .. `..,- `et_c fr^,r— oS -)a "2,r--- I. Su-4_ ."-vrc*-ee.e: r r>^cl. i S.;-4-4.._ accP 'SS. a'04 tr,' C-:s el S"-` 'r'-- t ,$11 ,R. ^,I =e=r . 12. Manage the Project C--tr,1Crir ;1 tr>^r7 of t r" flit L Q- Oh S'st f ,_s. .1 (n..--1/ cA.l-/tLr c oma nrvc_QrSt-S at+ .Jj:[ r11a.,n4a.tn 3f1 P vtP.c 1 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). iticj r a,...c...1 J.- � 'Zs_ Lk ! c...,.-1- 6Q wftr 4.1 K P4-9 r � Ell� t Q(q ry,r t Crud+,/ niti4r' P11 Eu.44 Stcke atrarolJ�--f4 1n,-1J .ns-b b4 G_tt'er' • ASU rr054r__ I rt,4„. n 7(T(" ,v, ci,.es:t.,r,. of 4-",CrF G.M. c,.,e i :v a r.":. f-r F• .- R f;' h tet S'r'Ctr[.,.1 lit d e,S a r rd-/- k_" �.e b. Description of the downstream drainage path leading from the site is the receiving body of water(minimum distance of 400 yards). rr - I/ t f //�'' r yviar.7 clowrT4r .i drRr-Icp.A -rea.Y, r, :14, ,,.rJI 42,E. -, La/ar LA4t.INA lot �r•..r, I r/ t�C d: -tk - Co�4r-d! f/,9 t.JS• Qre..rnc� W ( to 2-. 5a_rn.C2 i r ..,-,±::._-s;-4,.%3� ,irnP �, 3. Environmentally Sensitive Areas. a Description of environmentally sensitive areas that are on or adjacent to the site. C C• E Y '..'.7 1 t I/ ? �'_.i. � L�.•: �2w� Ar v". <'��,.. @-!. pS 41nc--- '`�' :v-` /'e,•c...;t s.lcor, r- _ n �)'�+ � t 1 l r_ , .,•f Imo-- �) r q , I stor,nwater slie plan template.doc-rev 42812014 plT 9 • 11111/ b. Description of 1special requirements� for working in or near environmentally sensitive areas. /Y1 et .M QU W h S'rr�.t '1 r e+�l rt.G" iJE�12-1 V u'i CT G- o frsLi a...S :/),_1)6, P ( s .... `-r1,- `z-ort.e y S flMac L S5 r �/!ta.` ri+I_ - •:-Ec° :F.. .P • -1• . -',r of e. r� f; - co", c'-.a t°�! t.0./1rC/r1 t Orr- .F. r 1 A w #4.rv.. ..t dor> r�r6l°L elm - Al�w J:* n al.:f r.r 4cd) co It 2£^fSCR •,••n GQt+ t— •.` Are 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodibility,settleability, permeability,depth,texture,soil structure). N(IN 1 - 5. Construction Phasing. a. Construction sequence / n r="prix d_r•.an-�—of Wri�.e-eta. a r n.�s�:a.t,V tar moo...t.lrr..Er41'4vt . trX . j,`'.�� e;i]' L - /+^.tLG: ...•.<G G' /1%1%,Z.r tt !a w. Scc iacr.r b. .nstruction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. rovide a proposed construction schedule. t=x c.o..- 4-C G.T" ..,--:::?2�-...-i-F. :�� _al..E-slJ d-LfI Jv\ of QA-rr 9 s :rl'r7-,c, ft_ . 7Ornw iu7i%n f,na - 1:t>. 20t5 M. •.c ,"GIr , ,�� <,/ (Y141-C, z Cr,o r c -/• 2c�tS, �r*..r-..�vrn.1 II. Wet Season Construction Activities. IP',^ /31µy a.((Proposed wet season construction/activities. Cr"(, fJ r"�' �"�4_c�•��-.. c n 1 ti er,+c./`c3,s- ^;11.1.1_3. b. Proposed wet season construction activities for environmentally sensitive areas. 7. FinanciallOwnership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. G Pet— C.--b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. (� 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. - b. Diversions. c. Waterways. I d. RunofflStormwater Detention Calculations -- 4 `;r:71-•1 stormwater site plan templatesio[-rev.41282014 10 • • SECTION II—EROSION AND SEDIMENT CONTROL PLAN Sediment and erosion control measures may be depicted on the master land use application plot plan, a stormwater site plan,and/or a separate Construction SWPPP site plan. This is a checklist to ensure that the following are depicted on a site plan: 1. General. a Vicinity Map b. Jefferson County Approval Block c. Erosion and Sediment Control Notes 2. Site Plan. a. Legal description of subject property. b. North arrow. c. Indicate boundaries of existing vegetation(e.g.,tree lines,pasture areas, etc.). d. Identify and label areas of potential erosion problems. e. Identify FEMA base flood boundaries and Shoreline Management boundaries(if applicable). f. Show existing and proposed contours. g. Indicate drainage basins and direction of flow for individual drainage areas. h. Label final grade contours and identify developed condition drainage basins. i. Delineate areas that are to be cleared and graded. j. Show all cut and fill slopes indicating top and bottom of slope catch lines. 3. Conveyance Systems. a. Designate locations for swales,interceptor trenches,or ditches. b. Show all temporary and permanent drainage pipes,ditches,or cut-off trenches required for erosion&sediment control. c. Provide minimum slope and cover for all temporary pipes or call out pipe inverts. d. Shows grades,dimensions, and direction of flow in all ditches,swales,culverts and pipes. e. Provide details for bypassing off-site runoff around disturbed areas. f. Indicate locations and outlets of any dewatering systems. 4. Location of Detention Best Management Practices(BMPs). Identify location of detention BMPs. 5. Erosion and Sediment Control Facilities. a. Show the locations of sediment trap(s),pond(s),pipes and structures. b. Dimension pond berm widths and inside and outside pond slopes. cdepth,Indicate the trap/pond storage required and the d thgth,and width dimensions . , len c %7 r, - F r d. Provide typical section views through pond and outlet structure. e. Provide typical details of gravel cone and standpipe,and/or other filtering devices. f. Detail stabilization techniques for outlet/inlet g. Detail controUrestrictor device location and details. I i I ! h- Specify mulch and/or recommended cover of berms and slopes. - - i. Provide rock specifications and detail for rock check dam(s),if applicable. j. Specify spacing for rock check dams as required. " `a k Provide front and side sections of typical rock check dams. I. Indicate the locations and provide details and specifications for silt fabric. m. Locate the construction entrance and provide a detail. 6. Detailed Drawings. Any structural practices used that are not referenced in the Ecology Manual should be explained and illustrated with detailed drawings. 7. Other Pollutant BMPs. Indicate on the site plan the locations of BMPs to be used for the control of pollutants other than sediment(e.g., concrete wash water). 8. Monitoring Locations. Indicate on the site plan the water quality sampling locations to be used for monitoring water quality on the construction site. Sampling stations should be located upstream and downstream of the project site. stormwater site pan tempate.eoc—rev.428/1014 11 ! • Stormwater Site Plan Changes If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised drawings showing any structural changes, and any other supporting information that explains and supports the reason for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems, treatment facilities,flow control facilities, or structural source control BMPs (not standard on-site stormwater management BMPs),the applicant shall submit a final corrected plan ('as-builts")when the project is completed. These should be engineering drawings (stamped by a licensed civil engneer) that accurately represent the project as constructed. APPLICANT SIGNATURE By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. /9 IIP ,r/z//,( (LANDOWNER OR AUTHORIZED REP" SENTATNE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: E� r � _ II r VTY _1' 11r11'V'l1 D IC) ' ET storrnwater site plan template.tlos-rev.4/2812014 12 • 1 • .c",.1 ON cIIECEOVE 0G JEFFERSON COUNTY ,;.. DEPARTMENT OF COMMUNITY DEVELOPMENT ti .:, ) OCT - 6 2014 4 ,. . 621 Sheridan Street • Port Townsend • Washington 98368 - _ O 360/379-4450 • 360/379-4451 Fax JEFFERSON COUNTY 16,,4ING� http://www.co.jefferson.wa.us/commdevelopment/ DEPT.OF COMMUNITY DEVELOPMENT Stormwater Calculation Worksheet MEA# PROJECT/APPLICANT NAME: C,"-A-.n l A---e---- 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. 2 PARCEL SIZE (I.E., SITE) Size of parcel3 •) • acrelIs/ An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet t 6,a 3 O l sq/ft 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: Construction site for structures a/ a ( q Does the project convert%acres or more of sq/ft native vegetation to lawn or landscaped areas? Drainfield, septic tank, etc. sq/ft Circle: Yes No Well, utilities,etc. sq/ft Does the project convert 2 'Y2 acres or more of native vegetation to pasture? Driveway, parking,roads, etc. sq/ft/�/ Circle: Yes No Lawn, landscaping, etc. ,.-CJ sq/ft Other compacted surface, etc. Q sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance a-)a 1 sq/ft Cut Fill .-C3'.---(cu/yd) [over] slormwater calc worksheet Rev 9-9-2010—REV 9/9/2010 1 • • 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 i C �( EXISTING Structures(all roof area) sq/ft Structures(all roof area) L1 C'0r�sq/ft Sidewalks sq/ft Sidewalks -e9-"sq/ft Patios sq/ft Patios .-rJ sq/ft Solid Decks gd3 sq/ft Solid Decks ..- sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads,etc sq/ft Driveway, parking, roads, etc 3 000 sq/ft Other s /ft Other sq/ft L Total New - Q? sgft Total Existing 3 �00 sq/ft TOTAL NEW+TOTAL EXISTING* J _ .l sq/ft *This amount will be used BY STAFF to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v. REDEVELOPMENT op Divide the total existing impervious surface above by the size of the parcel and convert to a percentagt._ _ Does the site have 35%or more of existing 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 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. (LANDO ER OR AUTHORIZED EPRESENTATIVE SIGNATURE) (DATE) FOR OFFICE USE ONLY SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No stormwater calc worksheet Rev 9-9-2010—REV.9/9/2010 •p Front Parcel Review . 3t_D /41--&r-S--‘/ Parcel 702132016 Printed: October 15, 2014 CONNIE RAE Site Address(es): PO BOX 652 293937 HWY 101 QUILCENE, WA 98376 QUILCENE, WA 98376-0652 Parcel Number: 702132016 S-T-R: 13-27N-2W Total Acreage 4 Legal Description S 13 T27 R2W TX 115 116 117 & 118 CONSOLIDATED FOR Land Use: 1100 TAX PURPOSES Flood District: Fire District: 2 Planning Area: 10 Flood Map (FIRM) Panel No: School District 48 Zoning: /R S 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 YES NO [..1" Parcel Tags or Scanned Documents YES [_JV ESA's: Special Reports . by YES NO J [..-1-- Designated Ag YES [c.4 Shoreline Designatio ES - _ _. J \ ,,akS ae�,.. a vs c.."--7 , —. . ..--. ,v;, [.---1" Shoreline Slope Stability: YS Stream Typ O Little (,7i�,le,Kr Rlvc�r i e., l (V') FWHCA: S N• L.,6,44 ou:1cry, - k'c r_A) Wetlands: YES l• Rare Plants:YES tl) Seismic: • Landslide: YES 0 Flood: 4'1'0 N• - Jr ...1..., 1 _ , _ Erosion: YES 0 Aquifer Rech reaE�S NO use SIPZ: one t ' ' . ' . ' ' . Coastal CMZ: e I is Riir ' oderate '1 Disconnected CMZ Stormwater site plan sus 1 ed: 'es to [ Forest Lands: YES 0 Adjoining Forest Lands: Commercial/ Rural/ Inholding [--1. Mineral Lands: YES [ %] Agricultural Lands: Y .4• [_�----Archaeology: YES [..--r- No Shooting Zone: YES41:10 [ ] Stormwater: New Impervious Surface 2 Land Disturbing Activity 272? ESA's j2e / 57-rc..-e Stormwater Req's:Min Req#2 Min Req#1 t #5 Min Req#1 thrk#I0 Engineering [- Notice Provisions/Disclosure:: ''sort YES 6 MRL YES No Forest Lands YES 6 [ .--r----Landscaping Required: Yes II► W [/]- Parking Spaces Required I 2 Other [ Building Height: 35' UBC Standard--- [-'] Impervious Surface coverage�rcentage: , 6377 Resource Lands&Public: 10% Rural Residential: 25% Rural Induster UDC Sec 6.7 Rural Commercial: 60% Area of Building Coverage:60%in Rural Indus Lands only [i] Total Building (s) Size: if ',Z6 yeKt ,/Bos sFAd� 272T 312.7 sF - 4L 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: 50 Left Side: c Right Side: 5Rear: c Shoreline Setback: /SD ( ") LSHA Setback: [ 'f Road Classification: Road Approach: EXISTIISG Nt.T REQ'D RAP it L.5 [�] SEPA Required: YESEtv[ [ ] Flood Certificate: [ ] Existing Case(s)&Condition(s): Violations: Yes No [ ] Recorded Date of Subdivision: AFN Over 5yrs=UDC Plat Conditions: <5yrs=Plat Conditions on plat or Old Ordinance [ ] Lots/Require Declaration of Restrictive Covenant YES NO, submitted: YES NO [ ] UGA No Protest Agreement YES NO, submitted: YES NO [ ] Site Visit conducted YES NO [ ] Require Final Zoning Approval YES NO [ ] ADMIN: 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 702132016 Review Cases Name Type Status Planner BLD14-00361 RAE I P Tim Woolett Application Received: 10/7/2014 Permit Issued/Case closed: Case Finaled: NSFR SEPI 3-00131 CAM14-00293 RAE NA M David Wayne Johnson Application Received: 5/13/2014 Permit Issued/Case closed: 6/5/2014 Case Finaled: New Single Family Resident on Little Quil River SEPI3-00131 RAE A Joel Peterson Application Received: 11/21/2013 Permit Issued/Case closed: 4/5/2014 Case Finaled: info from SEP77-112 filed to this case SEP77-00112 RICHISON F Application Received: 8/24/1977 Permit Issued/Case closed: 8/25/1977 Case Finaled: 2/23/2000 filed to SEP13-131 SOM77-00112 FRANK F Application Received: 2/23/2000 Permit Issued/Case closed: Case Finaled: 1\tidemark\datalforms\R_Parcel_CRMLA.rpt 10/15/2014 Page 2 of 2 ',:-7)(..--' ..„, / - . .. . .. ....., , I . g ti 1.1 E p 0 = . 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I I II ' . 7t 1 '702132002' r. it "- Inr17r k A , i., Legend „' ' • . ,. 702132020 ti ge Selected Features JC• _Rads .N Parcels• I ' ql s 2013 Aerial Photos •� elk 702132016. • AL*. 41702132.}::' P ;. ... . } x 702932032,; lik702132009 '' ty fyy rAir - _ @ , x N. l ?' w t 702132010 ` g. s 9327000017021320, .702132033 . g702133026-. ,e 02132008 '�i `7.,.1 ,' . y; • t 702132024 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 correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Thu Oct 16 11:07:47 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion=4.0&Form=Tru... 10/16/2014 Map Output III/ 4111/ Page 1 of 2 ArcIMS HTML Viewer Map •-•-________„, 1 1;A He La rider Ln 323CCC9f.Y 1 \ 1 lk dinicZeTt/ ; : , /021 9 ' 9321Ce.:08/3 : ' 932./C0:324 9321. 2 . . . . . . „,ra /02'32,D32 = :3. 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Liget Industrial NPR•Recreaton Waste Mgn„CPF LBM LPC Crosareads-GC ■ Crossroads-CC ■ Cr ssroads•NC ■ AL 1:20 UGA-Urban Commercial UGA-Urban Light Industrial UGC MDR UGA-II DR UGA•Pubhc UGA•LDR UGA•Visitor Oriented Commercial MPR•DRN Dnnnon C F•86'M RLO Commercial Forest Mineral Resource Overlay 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. Thu Oct 16 11:08:12 2014 http://gisserver/serylet/com.esri.esrimap.Esrimap?Se rvi ceN ame=ovmap&C lientV er sion=4.0&Form=Tru... 10/16/2014 Map Output 40 di Page 1 of 1 ArcIMS HTML Viewer Map r 1 J f z;e ti �I 4 • i j - , ,.2.! \ R `y. • • ' 1 \-..._ \ . 1RI P . . yM* I. V 4 if Legend �•< Selected Features ,A \._.,_ _. JC_Roads Parcels-H Contours 10 Foot Contour % rf 50 Foot Contour [7 4 c rr Im I 6- !S . . .. 'J r!. -v:aY_J 1:-di:-w'r�oj- •Ce'c's x: cc:�;> C. 25211 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. Thu Oct 16 11:09:28 2014 http://gi sserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.0&Form=Tru... 10/16/2014 Map Output • Page 1 of 1 ArcIMS HTML Viewer Ma I. ' I , k r 93370001$ iMO ,, ;:::1111.' It, - 702132002 'rc ( 43zrawla MA r . f Legend 't z(1Y1�,•.1•y�, Selected Features ,• 1111• .�, ,. JC_Roads ', Parcels-H ` FEMA FIRMS 70213201 .. f'., • . 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Thu Oct 16 14:05:51 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.0&Form=Tru... 10/16/2014 Map Output • Page 1 of 1 ArcIMS HTML Viewer Ma a4 { 1 4jj.:.. ; i I j - 1 ti f ,r, -py_. 4, ,_". r ,i f ' i 1D6 ' i 11 ' S , 1_____61 � 'a 51 Le nd w `r-- �, I 1i 4 Selected Features 1 � I 1 I , ti, } JC Roads 1 } '' II }1 (\� +" ri It ', �, 'i I ,4 '1,4 1� Parcels-H ti >. r< '4' k � I u+ Contours , am x f7 I I . '. I �'I 10 Taal Canlaur Ike 'y , , . rt A \'�I 1145 •1� i I ��`. .,.../ 50 Foot Conlour I -A/4r- +IsoM'i+� .- %, ''• '' iI,4 Tom r 2013 Aerial Photos y y •�1 �, ' _ fi w �' + e .,dei .—__ ' . 1� V.�,�., III702132010 .l _ ,5 I,.o. ,_ ••�'^', C�, -�5 .,, II �.. . A �,� - _x . ?32704002?, ... 1 702132012 '•132033 'O 702132008 / 102'3302b +w. 7021 oro i 1•i �t i 4411hor t. Mas pereded by JebrmrCorr,Cmta Sa .= __-T: f`.__ 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. Thu Oct 16 15:20:00 '014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion=4.0&Form=Tru... 10/16/2014 Map Output i • Page I of 1 ArcIMS HTML Viewer Map 932 AY.018 II 444{{{ Helander Ln t 702132002 .2.c100088 11 702132002, _ .. 9327obaa9 I I 932700016 ��"" 93zroo46a ly� ( -- .',. ' __.932700004. •'`•, 702132023 \ -_- Legend Iy ti1 702132020 - Selected Features 902700002JC_Roads t, l '1 I Parcels-H \\ .11 \.1 DNR FP Stream 702132016 Classification /s/ F FKh Ilabdal 932700010 ` ',,`t /,,e' N�Namirsh Ilabdal ,i 702132001 r..' Np NamTrsPom h Ilab�alnnul ,.,__ 702132014 lNa Non Ilabnal$oasonal 702132021 I if 3 Inventorod Sno ahnc lI. t—_ I 9327=063 702132032•' '\ •', 702132009 r r� , 702132010 932700001 °1 I `',� f "` �, tis'`r. 11 It 702132012 702132033 g 702133026 I' y 702132008. 702132022, _ \ 6d4 X702132024 `q r, N:u:aondsd b7 dfbsm Caely Calm/Saiass131S — -1 .__4 •. 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. Thu Oct 16 11:11:59 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion=4.0&Form=Tru... 10/16/2014 Map Output III Page 1 of 1 ArcIMS HTML Viewer Ma. 1 9327000 J --- -1- 1 '.. . J• Helander In -I \ M2132002 93.21(0/88 1 g 32f00089 ,,, ..0.. 1111MMINIA' 93.27COCW) ' ----1 9.32700110.1 ..__.2,, ,.'. Legend - 0 Selected Features \ \ 9327:0002 ,, ,,, iv` JC Roads Parcels-H , \ \ SNIP Shoreline 7021320i.: Environmental Designations g32700010 InJEKW4i:M ' nAg u al lc , M Conservancy ..., N - , 702171 . I I h Intonedy re piNatural I702,32021 ., U ___. -.., L ] NA Pokorny Ae uet.n '2'21..V.Y.X0.:. S.• , liiiilii . M Shoreline Resident.al or:1 rA,.. 2 - r t I ,..7ilrf,. U1 12 ... 932100(X)1 ii 702132012 1:02132%2132008 0, mil 324 ' _2€. 7.. .....7: . 1 i i . P_..z . 1 ; ; 1 I 702132024 Mans truaded ny_c-Kr:Art Co..4 Cerrear So.cro.GIS 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. Thu Oct 16 11:12:38 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName—ovmap&ClientVersion=4.0&Form=Tru... 10/16/2014 Map Output • Page 1 of 1 ArcIMS HTML Viewer Map 1�932700015 ( , He'anderin (II t _ I I Cay 932700088 . - 932700089 701'..,2_L1 902700016 932700084 11 111 .. ---- Zr; :e i ._.. 932700004 i 1I 702".32'.23 1__ i Legend Selected Features 932700002 ti' \ JC_Roads Parcels-H Seismic Hazard 1� 1 702132016 9:12703010 - .-... 742132414 I1 Ii l 702132001 702132021 '1 it �- 'i 932740045 1 702132032 +� ..+. y m 1n 1021320102 l 33270004? 0 I I ._ /42132012 742132033 7421, f702132024-,+ , flys am:ded;ry..1irsai Cox*Coca aar(ms GIS NEMMIC:=-211 ,._�.._..___ -....__.___ 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. Thu Oct 16 11:16:05 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.0&Form=Tru... 10/16/2014 , I Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map 1 . , 932700018 I rs' I \\ He la nder Ln '- ll 1 9.327110988 702132002 I I 932700000- It 032700016 70213.200 I I 932709tX10 II II \ \ I \ , ......_932700094 - 1 702132023 \.\ '11, II, li \ ' Legend -........ \ \ 702132020 . Selected Features 932700002 ", % , \ \'‘ JC_R9ti as \ \s, \ 702132016 Parcels-11 \ Landslide Hazard 1\ SiKtes \ 932700010 i., \\\\ 7kin oa'q herate 02132031 .,, Slq111 I1.. \ \\ 702132021 702132014 \ I \ , I -,, i 1 93270X05 b-, ' \ i, RI 702132032 N, \ , \\ 702132009 'i i \ ,,;„ ---- II \ \ 702132010 \ _.... co i.1022\132%,20 84 '• 92700001 17(12132°12132°33 . 9. '70213302i6 , i1 02132, 02,2 ‘ , 702132024 \ M 4'..P.,.7cratkid by steiterscri Carly Cbtfral Sera0:13 GISt 21' 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. Thu Oct 16 11:16:39 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceNaine=ovmap&ClientVersion=4.0&Form=Tru... 10/16/2014 Map Output * • Page 1 of 1 ArcIMS HTML Viewer Map 93270Y 'I \318 II\ Me ander Ln__II \\ 1 YI 932700080 I' 'fe�i}}y} 932700099 1 932700016 [ '' 3 1 932700080 1 r " J 932700000t� 'I 11 7021 \� Legend \ ��` 7021"%ir. Selected Features 932760002 1'1 tI JC_ Roads t - Parcels-H els-H \i I FEMA FIRMS 70213201.', �` • A ANI 932700010 a X500 lip 01 tier pN\ 702132001 702132021 �� 702132014 ly�ll 1 E \� N, — 'lI 932700005 fo 702132032", ``2 ' -a702132009 \ x N m 1 _ \Ir .,t, 70213201. e ill __cit-'-- 4 ! 702132012 7021 702132008 3 7021 r ? Y021 .r Z !02132024_ Maps:rrn+`kd br-e Mrsal Corry Coea&moss GISa 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. Thu Oct 16 11:17:05 PP 014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion=4.0&Form=Tru... 10/16/2014 Map Output . • Page 1 of 1 ArcIMS HTML Viewer Map I 932708 yl 001IIt I, _ Iislander Ln_ �.'‘, I I 11111111 932700088 II I� I : ,,_. ° 70Q132002, 032700089 li 932700016 1 932700080 I 932700004 li i� 70213202.3 �,\., 1 1, IS `_ Legend '1 ' 702132020 `iy Selected Features 932700002 \ JC_Roads \ 5 Parcels-H \ \ ■ Erosion Hazard \ \ 702132016 11 1 ill 032700010 ! ' ` 702132014 702132021 ,M1 It 1 ' i 932700006 �. �.-- . o2132o32 c 70213.2109 J3 1 — SIal 702132010 k 8 1 932700001 702132012 702132033 f7, 702133026 70Qt32008 7021320 : — -i _ I 2132024 5 Maps vuwdnd M.k:6ym Cava Cow*Smiwes GIS 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. Thu Oct 16 11:17:44 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion=4.0&Form=Tru... 10/16/2014 Map Output • 11) Page 1 or 1 ArcIMS HTML Viewer Map r \ 932700018 I ill \ It t — I P. Helander Ln 702132602 1 *32790388 ...1 . 932700089 I 932700016 11 702132002 '., \ .. j 932700080 I 932700004 C 1 II 702132023 1 \ \ I - -. Legend \ \ 702132020 Selected Features 932/06:102 l \ \ \ t , JC_Roads 1 ' \ 'I Parcels-H \ \ Ii Critical Aquifer Recharge l .. 702132016 Areas \ k U SLISC.LINK 0.12/00°10 , IIISARPA -MSC SUSC 702132014 70202021 ' SARPA•URN \ \ 1 932700003 ' . \ Y. '-r-- a /02132032 \ . . ., \ = -'‘.,.... 702132009 \\ N. 702132010 --\\ ID 0 1 [:_\. 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Ix,. b�� •BUILDING PERMIT APPLICBLD14 00361ON Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD14-00361 Received Date: 10/7/2014 SITE ADDRESS: 293937 HWY 101 QUILCENE, 98376 OWNER: CONNIE RAE PHONE: 360-301-4428 PO BOX 652 QUILCENE WA 98376-0652 SUBDIVISION: Block: Lot: PARCEL NUMBER: 702132016 Section: 13 Township: 27 N Range: 21/1 CONTRACTOR: TBD PHONE: 253-584-6606 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NSFR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,926 VALUATION 235,000.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: OTHER: SHORELINE: GARAGE: CONST TYPE: DECK: 803 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 1 PWELL BEDROOMS: BATHROOMS: Exist: Exist: 0 Prop: 3 Prop: 2 Total: 3 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,979.00 SRE 10/06/14 151616 Plan Check $1,286.35 SRE 10/06/14 151616 State Building Code $4.50 SRE 10/06/14 151616 Potable Water Application $67.00 SRE 10/06/14 151616 Total: $3,336.85 \\tidemark\data\forms\F_BLD_App_Bld.rpt 10/7/2014 si l5� _ 3� ( .7.45,94°N o,, JEFFERS d GOUNIY Il �n IE [I DEPARTMENT OF COMMUNITY DEVELOPMENT I! V '' `4 621 Sheridan Street • Port Townsend •Washington 9836 [1.....» i 360/379-4450 • 360/379-4451 Fax �y $ www.co.jefferson.wa.us/commdevelopment r� I Q� - r 'r' ? Master Permit Application mEA;)t i[Qs( ,you ilY nro? nr CO' Project�lDescription(include separate sheets as necessary): e OAP. Ite510 .3'<Fmi 1� ��$ IAPN< .p Tax Parcel Number. -70. 13 2_O 1 to Property Size: -h' 14p a 3� (acr !square feet Site Address and/or Directions to Property: x1393 7 Hviy tol -, Qui (e-ovJ2 INif ge376 Property Owner(s)of Record: (-r R V A- C©tvw,v / /gam m � Telephone: 366-"30( — -/'l Fax: _ email: 6�146�-JE+ty (rakawl Mailing Address: F V Box 2-, '�vy i apNfL tM4 4 1•376, Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies 0 Lot or Road Segregation Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use) TQ Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C)** ❑ Manufactured Home -0 Modular 0 Discretionary"D"or Unnamed Use Classification I 0 Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use El Boundary Line Adjustment ❑ Address 0 Road Approach_ ❑Short Plat** ❑ Home Business 0 Cottage Industry • ❑ Binding Site Plan** ❑ Propane 0 Long Plat** o Sign • El Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration** ❑Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use 0 Shoreline Management Variance 0 Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment 0 Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment *May require a Pre-Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Pleas identify any other local,state or federal permits required for this proposal, if known: EP13 - 131 DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: I 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. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applicatknethha�t he or she ,.s prior notice. Signature: L. r. . ' Date: I 0 `- r " / 44 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 lake"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-transfer le onsibility for adperii g to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: CA_A__Ai (----C,..._-7,_______ - l - - Date: /0 ' - / — / "1 • • , BUILDER STATEMENT The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERA': TOIj.,OR MANUFACTURED HOME INSTALLER: PHGNE: FAx: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: LI J¢ PHONE • ( ) FAX:( )f-50a�S r Al e 'i Q MAILING ADDRESS: /P /ar S / L .se_ � '9— EMAIL Project Type: Frame Type: Bathrooms: I Shoreline: Type of Sewage Disposal: f, New ❑ Wood Existing: { 0 Sewer U Addition ❑ Steel Proposed: Bank ❑ Community System C Alteration/Remodel 0 Concrete Total: _ Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# ' —1-C)i U Demolition ❑ Other: Bedrooms: Water Supply: Existing: _ Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: 0 Public Total: Name of System: • If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(indudes owners,tenants, employees,etc) Current Proposed .3C Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: i Underground Tank i Above ground Tank Size of Propane Tank: i Heat Stove i Cook Stove i Woodstove I Fireplace Insert I Hot Water Tank i Pellet Stove i Other . Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use.Only- . Amount Revision Main Floor Heated i q p EH Bld App Review: 2�Floor Heated fa� �,a/y)O UCS — Consistency Review: A,;s. C., a Other Heated Base fee: C� Itq --49 .w Mezzanine • Additional Section: 1 q , U v Heated Basement Plan Check fee: I Unheated Basement State Surcharge fee: 4 •S° Other Unheated .. V Pot Water Review fee: Garage/Carport • SUBTOTAL • Decks 911/Rd Approach fee: Other TOTAL: $ ' -a 5 `1 ) 3 r'U� Receipt Number: I GJ) i (p d I Cash/Check Number: ESTIMATED COST(REQUIRED) Date: / {{ .Fair market value of all labor and materials foundation to finish to) IQ/ 1 i 1 Initials: . ,-f j • • 5°N 1 w� �� JEFFERSON COUNTY 1 J DEPARTMENT OF COMMUNITY DEVELOPMENT h 7,(› -- -- P $ 621 Sheridan Street •• Port Townsend •• Washington 98368 � is O 360/379-4450 • 360/379-4451 Fax �sFIINC*� JEFFERSON COUNTYhttp://www.co.jefferson.wa.us/commdevelopment/ DEBT OFCOMMUNITY DEVELOPMFNT Stormwater Calculation Worksheet MLA# PROJECT/APPLICANT NAME: Gs -ra l RA—az-- 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. 2 PARCEL SIZE (I.E., SITE) Size of parcel .3.`T 3 acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet 16a. 3 O(I sq/ft 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: Construction site for structures a--/ Does the project convert Y4 acres or more of sq/ft native vegetation to lawn or landscaped areas? Drainfield, septic tank, etc. --PX' sq/ft Circle: Yes No Well, utilities, etc. saCJ sq/ft Does the project convert 2 Yz acres or more of native vegetation to pasture? Driveway, parking, roads,etc. .9-- sq/ft .l�� Circle: Yes 0 Lawn, landscaping, etc. SCJ sq/ft Other compacted surface,etc. --er-- sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance .a.---)aI sq/ft Cut � Fill _. cu/yd) [over] S • 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 t QQ�(F, EXISTING Structures (all roof area) la!lift" sq/ft Structures(all roof area) O O sq/ft Sidewalks sq/ft Sidewalks -"sq/ft Patios sq/ft Patios –Fsq/ft Solid Decks gb� sq/ft Solid Decks X/ sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads, etc sq/ft Driveway, parking, roads, etc 3 000 sq/ft Other s /ft Other sq/ft Total New jY " sq/ft Total Existing 3 L/00 sq/ft TOTAL NEW+TOTAL EXISTING* Gi - sq/ft *This amount will be used BY STAFF to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v. REDEVELOPMENT 00,038 Divide the total existing impervious surface above by the size of the parcel and convert to a percentagt._ _ _ Does the site have 35%or more of existing 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 StormwaterManagement 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. —yam • (LANDO ER OR AUTHORIZED SIGNATURE) (DATE) FOR OFFICE USE ONLY SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No 1 _ r 0 T 47-4" ID'-D' 23•-7" 14'-7" I 6'-0" ! 3'-2" 2X6 EXTERIOR STUDS 16" O.C.(UON) --O . 4,,,O - O• W ji I (IP q>tD VD I I F1 rn 15'-7• z'-s' 1 I'-2" 1 1 , € I O., CO I l� C u 0 II m R ' m t ^ /�1 N 0 XI XI O r- ° - O I ? _ OP- --rte O U 1. mI 2I I�yl•! N 1 v61' - rr �I P ' N. ) m 0 - L I 1/ \-- -P'3- IAg _I O / I �'l3 -' ,n 0 _I 2_5 I 4'-°- -0"�I 0 3.-Cl. -I — 6-8 I 24X8 , _ 6-1•I L i —_ ttJ t v I Zia II I I ,�y_ 22X3B�� Amc 1 ACCESS 1. _ 4. nl. _ ''—�— � A' bS1 • 4j ; o ; - / 11 tt x 9f _V Lw I / 4�I -- - _ _n_. r m I Nj6 ��Fm II`npp,1, f I I ,�� i "aI I. c �" N I!! ` �. �`�'g, I !/p . I 14'-81/4" i rill + ? D p I m u@d .. I : 1'-4 3I4'I""' A ,7 •'.f 4 \ , _, Is I 1at ' 0 al -I` v S' 0 N f*1 -tt ( cN Z\ e a ;m n r �O. 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TZ # -0 2i - Aga 6 y - F5n p :g'F z §; 41 a LI o - as '; 1 g p � IR ., p x x 6 x x x x x x = O 0.-5,.. \ „ '453. w c0 (l $ d m$ CI m m m n ,1,a „P A4 i-±- 1 Z 1 Ia '� � �� o m i ! 0 m m d a o N ma X x O D O 'IIO m (j 6" $ F r I c m r�i r� NI; co G p •� , N U V G 4 W 111 m _ P w1j1 NY 1 ro : i i i • m m - . m s 11/LV/LV 14 ' .CCEL1 ?- conditions Associated With 11:40:13AM Case#: BLD14-00361 Condition Status Updated Code Title Hold Status Changed By Tag Date By 2001 APPROVAL FOR ONLY None NOT MET 11/20/2014 TSW This approval is for a New Single Family Residence 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. 2001 SITE PLAN CHANGES None NOT MET 11/20/2014 TSW The site plan as submitted with the Building Permit application on November 4,2014 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 November 20,2014 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 2001 CRITICAL AREAS-FINDING None NOT MET 11/20/2014 TSW This proposed new single family residence will be constructed on property abutting the Little Quilcene River,a Type 1 Aquatic and shoreline of the state designated Conservancy.Additionally,the property is mapped as having Critical Aquifer Recharge Areas, Seismic Hazard Areas,Channel Meander Zone,and Flood Zone A.The proposed development activities will all take place outside the 200 foot shoreline designation,High Risk Channel Meander Zone,and the Flood Zone A. Subsection 18.22.160(d)JCC provides that development within a Moderate Risk Channel Migration Zone is not suject to the Landslide Hazard Area protectin standards. 2001 TSW None NOT MET 11/20/2014 TSW TSW 2216 Aquifer Recharge Conditions(SFR) None NOT MET 11/20/2014 TSW Critical Aquifer Recharge Areas may require special protection measures to mitigate water quality degradation. The submitted proposal does not require additional aquifer protection measures. However, during construction the project shall follow the Best Management Practices(BMPs)and facility design standards as identified and defined in the Stormwater Management Manual for the Puget Sound Basin. 2401 BMPs None NOT MET 10/16/2014 TSW The project shall adhere to the Best Management Practices(BMPs)to control stormwater,erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 2402 Stormwater Plan None NOT MET 11/20/2014 TSW A Stormwater Site Plan has been submitted and approved by the Department of Community Development. Once the building permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. Page 1 of 1 CaseConditions..rpt 10— hou E€ i w Roof f I . .. .......1 downspout IIl� :;:':' . .. ...::::..:... serves up to 700 sf. Of roof _ =� 50' min. Vegetatedr______ _ flow path MM I y Splash block I•••••••- r __ it _ �. .Iy-rim `'• Downspout extension NTS Splash block Figure 3.1.7-Typical Downspout Splashblock Dispersion Vc lime III—Hydrologic Analysis and Flow Control BMPs—August 2012 3-16 • • Design Criteria for Splashblocks A typical downspout splashblock is shown in Figure 3.1.7. In general,if the ground is sloped away from the foundation and there is adequate vegetation and area for effective dispersion, splashblocks will adequately disperse storm runoff. If the ground is fairly level, if the structure includes a basement, or if foundation drains are proposed, splashblocks with downspout extensions may be a better choice because the discharge point is maved..away from the foundation. Downspout extensions can include piping to a splashblock/discharge point a considerable distance from the downspout, as long as the runoff can travel through a well-vegetated area as described below. The following apply to the use of splashblocks: 1. Maintain a vegetated flowpath of at least 50 feet between the discharge point and any property line, structure, slope steeper than 15%,stream, wetland,lake, or other impervious surface. Sensitive area buffers may count toward flowpath lengths. 2. A maximum of 700 square feet of roof area may drain to each splashblock. 3_ For purposes of maintaining adequate separation of flows discharged from adjacent dispersion devices,the vegetated flowpath segment for the splashblock must not overlap with other flowpath segments,except those associated with sheet flow from a non-native pervious surface. 4. Place a splashblock or a pad of crushed rock(2 feet wide by 3 feet long by 6 inches deep) at each downspout discharge point. 5. No erosion or flooding of downstream properties may result_ 6. Have a geotechnical engineer or a licensed geologist,hydrogeologist, or engineering geologist evaluate runoff discharged towards landslide hazard areas_Do not place Splashblocks on or above slopes greater than 15% or above erosion hazard areas without evaluation by a professional engineer with geotechnical expertise or a licensed geologist,hydrogeologist, or engineering geologist, and approval by the Local Plan Approval Authority. 7. For sites with septic systems,the discharge point must be downslope of the primary and reserve drainfield areas. This requirement may be waived if site topography clearly prohibits flows from intersecting the drainfield or where site conditions (soil permeability, distance between systems,etc) indicate that this is unnecessary. Volume HI Hydrologic Analysis and Flow Control BMPs—August 2012 3-15 /It 'Al ..------R opt D ow n$PDa ',1 / HaTE:45 'Al' / C-3.-1.3h Basin ..?A /ACY.'erti Drain) ...---7-_, ,...____„: \----A ort -----t,:'---,- --,- 1 - ..... 0 DRYWELL 48 troth Dia rrEttRr '• . Hale E died w ilk) :. PLAN VIM . 1112-1'',,Ilashed NIS -/----Ft cd Dvinsp%i in vort7,1iihatoThicCrilot}1.0 }-1,01. 0 ,----Ctierflow 1 Fimhviith Surbev, V i Tr..1p8cii—\ , —Splash1310cli, i l 4 1 , , \ . tintur.rsed : " 'V III . ,, j‘ , . ,..'•I. _i ":t7:!--rt:,.-.1,",.t; ''•*"..'...x '-- 1-•"--5r7 - _17 r.,; #1,54mfraile i Fine tvle..4h 61:leen-- , t',:litil::'.':.0: .f,L,e -11.0it Pic Pke — i Catc.116'.4.in ,T. t tt114 - 1 ( r' Drairi) .., ,. 4:-.1frx,11 Dja.frelf-:•,r : • 4'-*I- I shiFs3 of Hob ' i, Hoe Riled wit '''.: Lheciwith I Fitter Fobric: Drain Rd* .: Ir.t .'11 ill. 1)'th',1. •r,..4ZI:='Ss)Cr..i I DRY VVEL I H 0-81-.Toctd-wair'Thi-34 ----1-- SECTION i , NTS Figure 3.1.4-Typical Downspout Infiltration Drywall 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 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 111—Hydrologic Analysis and Flow Control BMYMPs—August 2012 3-10 for Infiltration These s stems are designed as specitren below. . Drywells Gener 1. Drywell bottoms must be a minimum of 1 foot above seasonal high ground water level or impeuneable 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 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 • • 7131103 DEPARTMENT OF COMMUNITY DEVELOPMENT ADMINISTRATIVE WATER CONSERVATION MEASURES LIST To Promote Aquifer Recharge and Prevent Seawater Intrusion 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2_ Water collected from storm water and roof catchments may be used for watering lawns and gardens. Unless catchments water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Ground water withdrawn from each property should not exceed a rate of three (3) gallons per minute. 4. Install water-conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 5. Landscaping should include xeriscaping and native vegetation with minimal amounts of irrigation. 6. Use drip irrigation, soaker hose systems and root irrigation. 7. Use water basin techniques to water plants, shrubs and trees. 8. Routinely water deeply and less frequently. 9. Weed control is an important part of water conservation. 10. For your landscaping select drought tolerant plants, shrubs and trees stay away from heavy water consumers. 11. Limit the amount of irrigated lawn. 12.Mulch your garden as well as isolated plants,trees and shrubs. 13. Use shade and windbreaks to assist in water conservation. 14.Use low flow water closets, showerheads and water conserving dish and clothes washers. 15. Use rainwater catchment systems that corral rainwater from manmade surfaces and into storage. 16. Install water-conserving devices such as low-volume toilets and plumbing fixtures. 17.Only 400 gallons per day or less should be pumped from all exempt wells in Seawater Intrusion Protection Zones (SIPZ). 18.Water softeners that contribute salt to groundwater through infiltration should not be used in SIPZ. 19. Hose bibs (outdoor spigots)for outdoor water use should not be used in SIPZ-[end] PLEASE NOTE: WORK IN PROGRESSAND MAY AADDITIONS DELETIONS MADE AT ANY TIME. USE CURRENT LIST.E Standard Conditions for Resident.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 Fisheries Service can levy pe s. Portions of Jefferson County, inclu marine waters, are included as "critical habitat"for a listed s ecies. 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 2 /, �� tN3 `� _ 6:17:::::::::::::"116-;— _3 70s Cry,;. /• ...:.: �5 3-"E ,222.73' iti 0. i I r NI ' . . 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(�t',\,...) —ire' .�1 , • kil 1Y r �• b- r' it• iq,� O k • t tl! ✓ ,r l V^)� r ��CD CO Li b CD cD 0) Q IUF n-- t ?t OOk k• 4�`i CD e cn 414,41 co I; ');' 1 r"" *- CD m CCD `a c� U • • C7 fCD . n Q �cb QC• c� 0 C') n O • i S{ j j j c co n_. • t(cc c#0 0_ co — — J1 O • rh 51 I t tl l�11 •. _ K �i •m IV • T' 1 1 N i ,. r ��—� S O n -o p mo V !. �_, 4.��,` fi !S' a m.a c d C7 T �D m N O p o al Er z m -.I a ItIuu•72-:.- ipt co NSS O N Y S Front Parcel Review • ND /'/- v36/ Parcel 702132016 Printed: November 19, 2014 CONNIE RAE Site Address(es): PO BOX 652 293937 HWY 101 QUILCENE, WA 98376 QUILCENE, WA 98376-0652 Parcel Number: 702132016 S-T-R: 13-27N-2W Total Acreage 4 Legal Description S13 T27 R2W TX 115 116 117& 118 CONSOLIDATED FOR Land Use: 1100 TAX PURPOSES Flood District: Fire District: 2 Planning Area: 10 Flood Map(FIRM)Panel No: School District 48 Zoning: /R S` COMP PLAN DESIGNATION: COMMUNITY PLAN: UGA:_ UGA Trans [ ] Plot plan states "property line" [ I Assessor's Map(Property lines on submitted plot plan must match the property lines as identified on the Assessor's 1/4 map) [ 1, Legal Access to Property YES NO [ Parcel Tags or Scanned Documents YES t� [ ESA's: Special Reports earby YES „N [/J Designated Ag YES N [ Shoreline Designation: ? J �� ,,4II �/��e/y .-_rr ,s �0ts 1. �..,.,�(. [ ] Shoreline Slope Stability: YES Stream Typ 54 NO ., FWHCA: Sc..L. QutL -. a ,Pe cc)cv- Wetlands: YES Rare Plants: Seismic: ES NO Landslide: Y • Flood: O NO Erosion: YES Aquifer Recharge. NO SLA-SC SIPZ: no At R; .' :- Coastal CMZ: none s sigh Ris a oderate Rls 'l isconnected CMZ Stormwater site plan su..1 itted: 'e "o cAo userN [/r Forest Lands: YES I 0 Adjoining Forest Lands: Commercial/ Rural/ Inholding /60 [—] Mineral Lands: YES •, Cttr1 [4- Agricultural Lands: , NO [ 4' Archaeology: YES (NO _ [ „]` No Shooting Zone: YES NO [ -f Stormwater: New Impervious Surface '7,21 ,scLand Disturbing Activity �,'./ ei= .- ESA's Stormwater Req's:Min Re #2 Min Req#1 thru#5 Min Req#1 thru#10 Engineering [71 Notice Provisions/Disclosure:Airport YES &DD MRL YES Forest Lands YES [/f Landscaping Required: Yes dair [/] Parking Spaces Required o` 2 Other f /r Building Height: 35' iBC S lord [ ] Impervious Surface coverag rcentage: 1 Resource Lands&Public: lOW Rural Residential: 25% Rural IndustOPer UDC Sec 6.7 Rural Commercial: 60% Area of Building Coverage:60%in Rural Industrial Lands only [ 4 Total Building (s) Size: 2..V.4 ( + go-3 5 k� RVC:20,000 SF CC:5,000 SF Ne: 7,500 SF GC: 10,000 SF All others:subject to septic&water constraints/None specified [ /] Setbacks: Front: 50 Left Side:_ S Right Side: Rear: s Shoreline Setback: AO / (a.// e.,,d.c-&�;s o,.r Zao' e-V,.. , LSHA Setback: [ -] Road Classification: ,S,k /f;fL,.,,y /0/ Road Approach: EXISTING No�T EQ.'D 4AP [—1 SEPA Required: YES �I [ �]' Flood Certificate: cs uTTL ago ( z¢.,r A [ A- Existing Case(s) &Condition(s): Violations: Yes No [ -4 Recorded Date of Subdivision: AFN Over 5yrs=UDC Plat Conditions: - <5yrs=Plat Conditions on plat or Old Ordinance [✓f Lots/Require Declaration of Restrictive Covenant YES NO, Itted: YES NO [-] UGA No Protest Agreement YE, , submitted: YES [ /] Site Visit conducted YES NO [ -] Require Final Zoning Approval YES li\_,> [ -3 ADMIN: Setbacks entered in Permit Plan case __i3 YES New Parcel Tags entered in Permit Plan N%A YES Special Reports Scanned(TZD YES No parcel tags found for parcel Cases Associated with APN 702132016 Review Cases Name Type Status Planner BLD14-00361 RAE I P Tim Woolett Application Received: 10/7/2014 Permit Issued/Case closed: Case Finaled: NSFR CAM14-00293 RAE NA M David Wayne Johnson Application Received: 5/13/2014 Permit Issued/Case closed: 6/5/2014 Case Finaled: New Single Family Resident on Little Quil River SEPI3-00131 RAE A Joel Peterson Application Received: 11/21/2013 Permit Issued/Case closed: 4/5/2014 Case Finaled: info from SEP77-112 filed to this case SEP77-00112 RICHISON F Application Received: 8/24/1977 Permit Issued/Case closed: 8/25/1977 Case Finaled: 2/23/2000 filed to SEP13-131 SOM77-00112 FRANK F Application Received: 2/23/2000 Permit Issued/Case closed: Case Finaled: \\tidemark\data\forms\R_Parcel_CRMLA.rpt 11/19/2014 Page 2 of 2 �UILDING PERMIT APPLICA•N BLD14-00361 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD14-00361 Received Date: 10/7/2014 SITE ADDRESS: 293937 HWY 101 QUILCENE, 98376 OWNER: CONNIE RAE PHONE: 360-301-4428 PO BOX 652 QUILCENE WA 98376-0652 SUBDIVISION: Block: Lot: PARCEL NUMBER: 702132016 Section: 13 Township: 27 N Range: 2V\ CONTRACTOR: TBD PHONE: 253-584-6606 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION NSFR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,926 VALUATION 235,000.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: "G OCCUPANCY: OTHER: CONST TYPE: SHORELINE: CONST TYPE: pECKGE 803 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 1PWELL 4e1) YeCelved r( BEDROOMS: BATHROOMS: �..�.„,� l Exist: Exist: 0 fr Ti \IV Ve r-1 Irt Prop: 3 Prop: 2 (ah, . Total: 3 Total: 2 `v'-- � W�( QJ� .S( �G Routing Date: S c'P Type Amount Paid By: Date: vReceipt: Approved/Date Permit $1,979.00 SRE 10/06/14 151616 Plan Check $1,286.35 SRE 10/06/14 151616 State Building Code $4.50 SRE 10/06/14 151616 Potable Water Application $67.00 SRE 10/06/14 151616 Total: $3,336.85 \\tidemark\data\forms\F_BLD_App_Bld.rpt 10/7/2014 f • • IE Fr) 4,'�S°N U. JEFFERSON COUNTY TO �I \z, DEPARTMENT OF COMMUNITY DEVELOPMENT �� ...._, r: Ii L: 1 3► ,, 621 Sheridan Street • Port Townsend • Washington 98368 ! LI L. ALJ <qS, ,sO 360/379-4450 . 360/379-4451 Fax ( teffgp;y COUNTY NG http://www.co.jefferson.wa.us/commdevelopmentl rrr DF Co^,1'`<+!i';i7 DEVEI.OP^.ENT Stormwater Calculation Worksheet m LA# PROJECT/APPLICANT NAME: ( 2 Ir"-a---- 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) Size of parcel 3 i 3 acresAn acre contains 43,560 square feet. Multiply the acreage by this figure. 1.// Size of parcel in square feet ba 3 Oy sq/ft 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: n Does the project convert%acres or more of Construction site for structures `1 sq/ft native vegetation to lawn or landscaped areas? Drainfield, septic tank, etc. � sq/ft Circle: Yes CS Well, utilities,etc. sq/ft Does the project convert 2'/2 acres or more of native vegetation to pasture? Driveway, parking,roads, etc. sq/ft rj,/ Circle: Yes CO Lawn, landscaping, etc. °-�J sq/ft Other compacted surface, etc. sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance c2. a 5 sq/ft Cut Fill (cu/yd) [over] 110 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 piled. macadam or other surfaces which similarly impede the natural infiltration of stormwater. STORMWATER CALULATIONS–IMPERVIOUS SURFACE NEW Q EXISTING Structures(all roof area) ` - sq/ft Structures(all roof area) q 00 sq/ft Sidewalks sq/ft Sidewalks -'sq/ft Patios sq/ft Patios Solid Decks �G3 sq/ft Solid Decks Xr sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads,etc sq/ft Driveway, parking, roads,etc 3 O 00 sq/ft Other sq /ft Other sq/ft � 3 Total New �� sq ft Total Existing �Ce sq/ft TOTAL NEW+TOTAL EXISTING' J ` t sg/ft *This amount will be used BY STAFF to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v. REDEVELOPMENT I 01.033 Divide the total existing impervious surface above by the size of the parcel and convert to a percentagt._ . _ Does the site have 35%or more of existing 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 StormwaterManagement Manual. APPLICANT SIGNATURE By signing the Stormwater Calculation Worksheet, I as the applicantowner 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. (LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE) FOR OFFICE USE ONLY SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No oN c • (D�I LI -3 I �� o�," JEFFERSCJ7.,�UR�TY _ (� M a DEPARTMENT OF COMMUNITY DEVELOPMENT ` I I� '' ` 14 621 Sheridan Street • Port Townsend •Washington 98 :.,1' 360/379-4450 • 360/379-4451 Fax, ;fes;, i �<4, �0 www.co.jefferson.wa.us/commdevelopment � I - Master Permit Application MLA: Project Description+(include separate sheets as necessary): e, Ir .r2 k"-) J I N o ' Mi ' R S i a Q N< .P Tax Parcel Number: -70 o. 13 Z.0 I (a __— Property Size: ± 6 a 0/ (acr=./square feet Site Address� and/or Directions to Property: a. -t 3 9 3 7 ('H Wj to( '- 0 u i (c-ov42 vill ci r;76, Property Owner(s)of Record: (-r R k) 4- C O/YNf so .k/E- �,�`� "" Telephone: 340—30( —y rV 42 Fax: email: °t6e�-,�Tv7n ifivkA Mailing Address: P o Rev< S-2..., 0 t i e fa;y.g_ 0) Gq e 3-i Applicant/Agent(if different from owner): Telephone: Fax: _ email: _ Mailing Address: What kind of Permit? (Check each box that applies 0 Lot or Road Segregation Building ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use) ,4 Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C].. ❑ Manufactured Home .0 Mcdular • - ❑ Discretionary"D'•or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use 0 Boundary Line Adjustment ❑ Address___0 Road Approach— 0 Short Plat** ❑ Home Business 0 Cottage Industry 0 Binding Site Plan** ❑Propane ❑ Long Plat** ❑agn ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** ❑ Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Aovance Determination (SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use ❑ Shoreline Management Variance ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices A.ct/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Pleas identify any other local, state or federal permits required for this proposal, if known: EP 13 - 131 DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or as knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the applicationihat he or she ; . .s prior notice. • Signature: L" us&— Date: / & `^ / — / U( The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take°of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable onsibility for adhedig to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: 1 1, '.—'--------- Date: (In / "- /e-( IV-- S BUILDER STATEMENT The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL TOF�OR MANUFACTURED HOME INSTALLER: PHONE: FAX: Y/s ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTORS LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: LI 46 G4. ? PHONE MAILING ADDRESS: LP r ( ' C. f.. �s� i� /At EMAIL Project Type: Frame Type:� Bathrooms:lShoreline: Type of Sewage Disposal: `; New i7 Wood Existing: C Sewer Li Addition n Steel Proposed: Bank 0 Community System L Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System 0 Repair U. Masonry — SEP Permit# 4 j —2-4°L D Demolition 0 Other: Bedrooms: Water Supply: Existing: _ Setback: 0 Private well C Two Party Type of Heat: Proposed: 0 Public Total: Name of System: - If this is a Commercial Prosect you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed • IBC Occupancy: IGC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: I Underground Tank i Above ground Tank Size of Propane Tank: I Heat Stove I Cook Stove I Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove i Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use Only - Amount Revision Main Floor HeatedI O EH Bld App Review: 2nd Floor Heated Consistency Review:• c?,•-) . u o Other Heated Base fee: Mezzanine Additional Section: t q'1 . o v Heated Basement Plan Check fee: s , s Unheated Basement State Surcharge fee: LL LL's U Other Unheated .. Pot Water Review fee: [©7 Garage/Carport SUBTOTAL -7 .02450 Decks 911/Rd Approach fee: 5'03 }_M 3 Other TOTAL: $ `1 5 .1(' ci��( Receipt Number: GJ 1 te I l d t r Cash/Check Number: 1 -P-4z • ESTIMATED COST(REQUIRED) Date: r^' •Fair market value of all labor and materials foundation to finish ` / t/ ( LA Initials: - J-6G cCiel:,-7,\ JEFFERSON COUNTY ! NOV — 4 2014 ,.a ti ' DEPARTMENT OF COMMUNITY DEVELOPMENT � 621 Sheridan Street• Port Townsend•Washin on JEFFERSON COUNTY� .98OF COMMUNITY DEVELOPMENT � p 360/379-4450. 360/379-4451 Fax � ZINC httpJMrww.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE Pc1r # 701. 0?3 2 0? C� MLA# PRQIECT/APPIICAM NAME: cm� C//oh n e. 1 SAG. i e S!dp e.+',c_4"�� Jl Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a separate stormwater site plan map. Project Overview 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site mapp rr / / f / )CULLt�S�'rv1.�7_. ✓1 i >`r y Tq"�"t(� f.ZfI;':�u1C_� e (1.2 c Sly. ,�(-' !�a,1-v_ S/�F•:-1 cc`rt'C/ C�C f'�''dr• �•cc1`�s 'k AIr%L15t 7t rt')r, Yr--- (r .4.(1-!/r2-003 txrSh j d.-f ievicy c ci rot c,i.l� r ,:/'1 �J,7 s0' �,a Tlc r+1 4r.2-c nil �.x?S- ,:1y c1/4-li�Jr�C.l r,ramal, Existing Conditions Summary / / 2. Describe the existing toography. Indicate contours on the site map. .../.1(4.- iS 41 04 /4.4./& z„hiL rel./ Yet. �Ln1.� bC- ,- f �SS�Lrua.r- r of �ry„+x.Ir"� t, - ,�..4 l!r.-..4.5�✓ -fh.?cx r'r4�en-IF '¢� s/y S Nect,et.1C PJt✓a41�++ Gis hu e-IN qS /O�aS r.1 CC.r - ,.T r.-.k "i �rhp. r- u P�PL,q�Tew ,.„es G4ia.J•1 '1L ..2 i1.nT�nW 4.S�. c,orn4� /42Q��rtOj r t.-.r F.:.E_ ^p fG r�E` ' '�It-• 4A.1.11.4.;1410 ` . 3. Describe the existing vegetation. Indicates native vegetation areas on the site map. if Noma[ L v o - - r � J eS " !Yea e ,f r-1-,q of i,,t;1 ow . 4141/. rtCFc, Ow pmFSY,S. �Gy9- Qt.�ar r �1'I' ��-� :aa* w �..✓c_ r �,.'..e» ca Jf r s ic @.�T n,.l�,/� ev.U( S�c,�t':P-f.-�- wnP rn.an lrC.. a�n r� saYc� , .'`G.3� "}.kv,-C;. ryr". I 41as Scq-H u'ect (4,1i 540- d S CETtsr or Gec -- wl4- UttncS�{rc-)brc{ o{�- sr� �f o" sq�a�r 4. Describe the existing soils. Indicate soil type on the site map. J IIS are.- ge..I�c.JJ ,S,11__ 1--0Cf.M r 0 11. GfNu%r n-l2.o t- -{-�o - r"n.trt r&CC . 5. Describe the existing site hydrology(i.e., drainage; behavior of water on the site—above, below, and on the ground). Indicate existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if applicable,and indicate acreage of each. II j r aro t..l��'1 ,„1-L1 rn0 4V+U "\44„ r)� /)QylrF�inQ ©f SG-tt�n rF�£C-L. Ar-�J1r N�rr.'�eF ,�,r✓' A r - i > �f ✓ Sc'+n • A10 r«•- .,;'-;- Tr41�' 01 fitiaA+ AaPQ'e' IS. 6. Describe any excess levels of noise generated by the proposed use or activity: ' ir--_!I1+ .�oq.73 tarPealPCr.Afte\ latni.lirn9 (rocett stormwater site pan tempiaffi-tloo-my.428/2014 5 • • 7. Describe significant geographic features and critical areas (i.e_, environmentally sensitive areas such as wetlands, streams, steep slopes,etc.) ton the site. Indicate location on the site map. F-4-fr- Store �O i'� -Qr1-t•'1 �fr?r1-1 AtS:I-, Wr )*�.✓4.F Ior d,2. f21M r +�{-`t 1{ � J r � il�.i 7.r.4 �Gf•n6__ e ✓—' r ' 111 Fell'-I- ey„v' rSt rUy'.C.r^s>. • W -`r'n,^`'i ^.t,:.3 11'6M /Id C--g) -500 fie es-1 1;-72 1 1 4, 8. Describe the general vicinity of the site,including adjacent land uses and structures,utilities,roads, and sensitive/critical areas (streams,wetlands, lakes,steep slopes,etc.). Sl is 13d rritr2r(X a ►„��t� rUl r.gh of i& oat R:l. In IIS ffr/ e,� r ..{�,.e f .� C r'<1 sj' JKJ `S .1-/-er-S tc_ 4 n W,=i. YS'e �':e,z.-'" ,..-�Tp,^VA.:. GN ♦:S'L OT ��r e'c�t.e_, L",1:� Tk i-/ I2. CXµ tQ tn_C- r;'If yr1If C 1 .w3 1'11ret oz Yg% s + gvvGt IA'2:", i t/rtic",'` 37 = }yGS'r"' /f! cCi^ rtf f4�a1"�1RS . ir. n4.j.1r�,." 4C-fdr' l'�%.°CB o,re P'I,YtC.( tro arft.ci A vt.C''fV' Q of rot..? u.:! S'r r,01__ SE v.q 1f- f .,l i-KSrcs¢n Permanent Stormwater Control Plan This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs and facilities to remain in place after construction of the project is completed. "Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control facilities are not exceeded. 9. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed(i.e., per BMP T5.30 in the Manual)or,if not, what types of stormwater flow control will be utilized for the site or specific threshold discharge areas within the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. FF e- / /f r Rtl nL drz,.V; 47rC1^'•. 4141'i'�'{TS .- -- :,A.. "£r-...�'+.G-r-�-t+' O+n�^e CrJI. rL, j,fo cL f 4v..f� , � f (F eI.'7�`lzrTQ,-f4-. Wills ,v.;v,?,..,,M rit? �-_ c+,y .c\.,`.�.., tG, jnwf. c.r Mrr 10. If the project requires the use of stormwater treatment facilities, describe the types of stormwater treatment facilities proposed for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is normally for"large"projects or projects that involve the potential for dispersion of contaminants.] 11. Describe the performance goals and standards applicable to the project J ! L -ZM:.u,,. ! .-r-, bQ_ r.+%.�r•no.i a CXr "a`lt's C..rQra , �p Gs a7-?--rnr Z j1Ci.S 712.. r t.rr\a !Irr£c F.^:i� r-=n.^, b1 4 rr-ety CJ UW 7r Pf �Y71 irrnc Pr (./n liA`°7 a,n ,A i SSG rrt*LVrlfJ oT� c{r-e•e • pi1 d ss1,, 5 tG s � fifth �, o H, 0 r r 2 �+�tr a Q, re �. s:.)Ft>a S c �:- r<F' n-,�.+r++r p,_d� S 1+1 n e a r O r 4-70--,P- 12. r-F -12. Describe the flow control system. f P06{ c ,s 4(' PO 1.,1Sp tax�4�'pG4Gr rN� 119 Z474e_ef -70 Mt+,i MEAnet "(��ltnl /�G�3.S . I fee {din..efa-{rnv. a�-c ... 4, aa . arulW v ( Gre, $irr�(.{ Gcrrrr ,:" - 'L012. y L r JI f a�'r1�r}•�,n�.J a^"r Po-,a1ev1`i'; r"�,Gw�a� '�O r� L./£11C.V'r! LAM 4-at_�nro. , �_ ' 1 fl1 U �t a ren Q..''CS�/Gla cif -C. (jcrr-r. i Orn, Til S•�C. �.7n of^•. M...k 'iron irXR .d.1 C'�'si•';',1%,,1 es 1. ;- r O��Q-r,''r Q✓1 WIII r 4 1 4-rt,t.c_ , nu_ rlr,. Q -F„ n9 ?ra I41 a,el zs4-G4,frseu 3�-at is) II I stermvmler sae pen tempale_doc-rev.4428+2014 iN O V - 4 2014 ' B ,c u err ')' i OF COS"AUNTY DE:/FLOPMFNT • • 13. Describe the water qualityl system. 1 Z / .- ...5" p Q Sj iS ouar'a(l 4.,t P72rmLnbtf.� . 3-1i`4.L,4- 1 (a ! tJ v {! p I ,/ T cSl ,�'r1�gf or- nrRvs S�/n In f1r'nsfkF'e pitrfo�r-,r+,� gUl e_k -4.. ,.ttlo,.F! /k. kid) AO�lertYll rbndl04 4717 ad1' .-ln-t--grcc,c nr' ,f J r�`(' t (� t Ir �r '�D ft-.rQA,M 1 lama . An t/xcf.-TS r•tn+t,,f wIV .bP ilt.i'I --..„-Cc. fN At, Qd?.Fa,S1`;^+,/ S0.ri Alio[ „I� L4Ca--t-en 'cTrt,r-I or var kLf /h.. 1rI �,n )lee- pla c4 t. el.-% di-S-'70,..44.-c,> @nr41' 1-,s oet„n FM re B.- aN r3 e, ff d.iriI M5, co Gl---Ov. t- r-t!-/�3- 1 14. Describe the conveyance system analysts and design. f 1 ` 'r Oaty IA free...(-kV -Iw be.-- -1-e-rn,.,ita}¢c..0 rn. S 0 foal. to 1ocLs E.41-1A--, 5a 'M,nire. &r-t let`NU ilers4L. ( F4‘A's- o�1.�� •,�0,...+tt-�i-w 1-q Sr...;.,f ..,r, n.,,ZhF�F - .0.n 5S sc f7_ n reset art.,*. "Fen.”QC#:4:4-1' 'N cire11W 4.4 ill !4esM,^G-+C I;t /ro CYi rw_7<1.1 IA QX-1G.A IA' r n I r2 dNk-k, ( r-0.cif— la i,w'A Ind-WI — C en rf.N t tO- - nr-r'�r0 t MwXt r]r) kJ All,Q_,...4- -tX,�f✓1 si4-C GO.t Sift/44,e V. -Tt f �,"- /� ( Of r94" U?T i ct.r", fo,n..rScc- o r ca.,--.,,,..;., It 4 - , 15. Describecthe (ti-0W of fill material,physical characteristics tof fill material,and deposition of excess material. 'Fitt Ma 4I WPIC 4311_ -Front "FAL...1,JclJiat.t erC-a.r, o,.n .pp•t„n rrr 0pr/,N F le f 04- cC4v,A• aa-iittlei 4ofrycJ0.L_ .1¢- rtrrfn.:t c r ry�erg(ctvt . 'koess / te71-1.(4 'l-o b e rtrtove4--8,--,4--8,--,4--8,--, r%Je Se-Ce " ill, Cr.rT,,. or ,vl r,r) r eci. s41.., 'elle -1-.- -Poo cti{s_I-rc-`I, rW.-�``''(('' xr circAr:+cq t 't'rilmm flat}Q.nc - 16. Proposed methods of placeihent and compaction consistent with the ad'plicable standards on Appendix Chapter 33 of the Uniform Building Code. { - r { 9,4 nikQ--E1,+n - .o-o4-i-Raf`f b2. p(G CC_;c r)�n 9s,tiC211 71:1—1 R..-fa,/ tr7?r`-',a 54:. v0iC p t 17. Describe the proposed surfacing material. Pit). - 18. Describe methods for restoration of the site. nn / r All a real nn'l- e o trf rate-013 f t (IQt.N) e.�n.-.'r'kC- 001.0N r d vis- j rir- rta e-lc."G Li lit btu ✓ J rs.,,n...„ r, t.:,-1--... "9 rSa.X . SOMP ..401-31 QrS ~iss r• - �^,+ 4'..3n.& rv,si S. rat. Mt. -vis..,,' a - r1I' elArl Lea /".11-4",_ r).rv.c t"t.t. - i Sin,,,— , 1, HP" A"fkir-el<V, t' 19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for "large"projects only and only those for which facilities are required to control flow or treat runoff.] If included, list the Manuals here. 4 20. List here and include l!include any special reports or studies conducted to prepare the Stormwater Site Plan. PI 7// 21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include conditions that affect the drainage plan or contain more restrictive drainage-related requirements, describe those conditions or restrictions here. [[• _ _ __[[[_ t r n r yy_�Ce__[_e Sa{S ,.rv'. r.` r n ,-�I1 t-_ 0.1,.,cJt ttrr,r I- Lx a t,.r e ,...c,((��}i "[.gei o„, L7;',. czA,J7 -cv,j 6,_,g ra..-et to 4r 1'eL.tr-tri a1 a7we1r1,^1 cif et -) rex Ct'�kr _Qp., .. - S Qu Lr Gr,v.+�t - tri . 4e, et el.) 4etw-leo. P.ect",'-{-- SFP! * .'-z t r1 \ / 0efv.0114;on eLr l t1 -iaf gyri{-,�y .7414C-4e._ r 1.1 1I I NOV - 4 2014 1111'111 LJ i stormwater see pantempate.dos-rev 4028/2014 .. .,. -.-:-:: S["dCU-- 1 °a-- i (r Com,iii.;wry DP/FLOPMENT • • CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP) The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the template that follows must be installed on the ground during all construction phases of the project The proponent is responsible for preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential development SECTION I-CONSTRUCTION SWPPP NARRATIVE 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable to the proposal,justify in writing. Descriptions of the 12 Elements are found at Volume II Section 3.2.3 of the Manual(beginning on page 3-7). 12 Required Elements-Construction SWPPP 1. Mark Clearing Limits. pr-ea +�.a S �-.2L+.tn f3i �'�'tJi 4+.n�:�J� C 1•C F"�..5_�`-'_Ci • NO 4441011,0.41+4 c/e 161 e'tq(.Y'/'riVA e-C, 2. Establish Construction Access. II v' a -: - wilt L. u�-t Ire . r14 (2).:4-7-1-,‘A3 a�nvCwuIsot) Qr' /7roxte-1.. ) nQw 1, �Ancl ..aic Z-,q,J& �Ft..a Sere,u�t . in to o lcL #r ,(MG r n'72e.+ci � til-`--@Y.c t"•-"l,-a C 2x, }�+t q G'r r r\ Wo.c! G cJr t f' 3. Control Flow Rates.ff� (( r /J J / rstal� sr(-� Temic on I erriM24Qr CT( K�laeclt P_ct r rtr- iseT3-1-tri/,, 11 P p!F�; Q.y errt,�a�¢c. F-A('r`�"u� C. 4_, ri- ausr rn.-.fl w r-/[z�•- a rL �Fpr'Y� r.-/�k:'�/v ri'.t dr..lc. T Cl�,�'1- r:�.F.e+ K ,c r� n MCy `TC�[if/ja fl.. �...� OFF. 17Cty F_ II / }� r 1 rJa e..S 4, nQ nicer c-tidy�T'✓+Ft.c`x'4 n- •4i ' '/ eitc ,r-P s r 4. Install Sediment`Controls. // )) ft r r.) of bark M kA(Cjl 6"7 am ( cre.r GICs*Krbec Ec rah . 5. Stabilize Soils. cif 6. Protect Slopes. t� l / nn,.r, ;M.aA� slar'S us r=� �cr� .rt c!rAcd41 al Cr r0,cka. Cc�nd-tn�tc.�JAvi r .Q • Ain of c- 7-a wt 4,.4-ck e.d , 7. Protect Drain Inlets. r// NOV — 4 2014 � � I T,0 C0'"iOE'FLOPMENT stormwater site plan 4mptate-Wc-rev.42812714 8 O 12 Required Elements-Construction SWPPP(continued) B. Stabilize Channels and Outlets. I l 9. Control� Pollutants. .S'l1 r a 1..f Gs[ !h{� s�(.•e.- a.t.1A—. G n 4 d.n• Gari h? r'e.lt'LO (+@.v1.•rd` per". JLr SS, "!i },e�4 ,A.Ill b o o� Sd 4 Cie e �Q. ,'td! ©f •11- 't u 8-i s/ft 'S,1-4PF f G.54 1.44114 r- W1-11 .•s. HV41 fICf 15 JZ-r. 10. Control De W nng(the act ofpumpinggroundwater or storms away from an active active construction site). s T-� ln�Eu Le c�ea•. ei'a?rrvl -'k-kr- C.aE!n )�R r.„,„R..c er+ Etri--Ire- W tft" ( Car+ 07 •a'RaQr a99' .. •+wla!' Riesz ad-?-iqA Aw<l% .' 4r cc./ raht aw r1Px`tn�rwl fst r' i,'l P.:lC i,'�4&^�'- -x.�a Sc./ 4r sS a.-(i c.c.. 4.+A.tj' Cti3/?.tr 3 f..,t! � -,� ^r^. r!a"t+r .t se. 11. Maintain Best Management Practices(BMPs). S•. c 9�+ ( 1! t/v�1 Q /+ f ;;;,-Fa 2cX cif )i3 p to S •' (n c_.t_- !? .rf jof O-t r'''Gr�i.t K1 n 4r' C r— 0 rib "A lea r- Ok.T Ctr),4. r.• c 4-[ _S n"r, Silt_ o •�S. 12. Manage the Project rco sc4-S antX wr'l 1+na•:;14d1.n c>J1 Q"./3 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,roads). / (idra[en� p, ,.cr- es-�es u•.1! "4- 6tz at't'ecI4 cera -/-f M1/34f1 lo. ( y rut uc �R [an.L 4a S s. f. O•%a fjt. 1 a � /It i,e nrva Y•41Yn 3 Cl tji4�-4 tricVa ( (aver- n,n Eas-F si- of/arno e a FFer4 . /3.1e5 r.asr'•le, . • 1".47rG,4,e1, 111 'a r« r rr '`` P • . . r. • Lf 4M e• b. Description of the downstream drainage path leading from the site '• the receivi g body of water(minimum distance of 400 yards). / T Ia�. { •-i 444).1 wrt. 4rr�lSqc -ECvrt•a (i LGo 414 uz) be -{= a /,45Lwail fr ( en., l, c 141 Cli � �4c. ce -b.- / ��t l S. Df2.e n c5 W.ZI toe S c,m.e A S 2 c✓.-irh>1 d&. , /-s, 3 Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. L1 ,t Lit "</I4o_ r •t.qe^- C11))4iS Eas'(- Qrns. Of hr.` f.&,<'', :n lvtl . __ lI - 4 2014 _OA stormwater site pan tempate.tloc-rev.4128/2014s, '�'i I1rVrinrA?rNT • • b. Description of special requirements for working in or/ near environmentally sensitive areas. 011 ,rf-I-a,; all CO•+.d Yi.�.c..i..r�a✓l tce."1l`✓ei'�2`a tiLAI4x OA PS r_i a t,ar �(c asMvt c t cis (Jos..;11 c.�`+ _ C�a'ti Ta R.14 t'��1" $C"+- Ja r!>• s t �-t,�e q-"ti,.., cop, ��( Its ♦17 C /�f o••;•4••Fl+ ('yi m9 t!f /A 4114 $r c.f cy,/g1A6tit elf 1 ".7M� hl, +\ d.k i r 9 C(Q SAO A!/f �f Fsth Ate RGe la 1"/" T! ctreQ}. 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodibility,settleability, permeability,depth,texture,soil structure). AlUNE 5. Construction Phasing. a. Construction sequence i Mnru,nC_h,an� (( f �ri�L�njjJwy A r r rt rt-(e_cf .Y oW SiYa,t[ i'DN )fix cav=v" c1,n'^c�"C 1.01C,r14 t 1Q Ch1-e-r-b 2 r ..o-,Vf: b. Construction phasing(if proposed) AL;!,' 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. /Provide a proposed construction schedule. A=oc c.0.a,� L•""fE ,i? ^a a-.cX de,/1,4rr1 of ex r-r-71-, C-'tr`..,c:i re . 7—pNw fi a :oti - �, ✓ .2.-015' �r'�r-, ., - r� e �j. 2-Ot_ .a F�S e r 1 'h-�1.-10 J -Rrr II. Wet Season Construction Activities. ��4.s fir• t ,�a'-1 May N„ a.( Proposed wet season[ construction activities. EkC LC- •r0>( W44 •-1 , 1(Ct M713 M Or.Ly Ara, , t9is/ e.A kimr,- lentlh�C. b. Proposed wet season construction activities for environmentally sensitive areas. 7. FlnanciallOwnership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. Ci•wr'y r Cd�nt . f?a. . b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. 1 ) P4rSa•.at rerr -,sFt�F 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if appiipbie. / \��/'///� --7 t-_ b. Diversions. -� 1 a. Sediment Ponds/Traps. v c. Waterways. 1. d. Runoff/Stormwater Detention Calculations 4 �_. stormweter site pan tempate-eoc—rev-6282014 10 • SECTION 11—EROSION AND SEDIMENT CONTROL PLAN Sediment and erosion control measures may be depicted on the master land use application plot plan, a stormwater site plan, and/or a separate Construction SWPPP site plan. This is a checklist to ensure that the following are depicted on a site plan: 1. General. a. Vicinity Map b. Jefferson County Approval Block c. Erosion and Sediment Control Notes 2. Site Plan. a. Legal description of subject property. b. North arrow. c. Indicate boundaries of existing vegetation(e.g.,tree lines,pasture areas, etc.). d. Identify and label areas of potential erosion problems. e. Identify FEMA base flood boundaries and Shoreline Management boundaries(if applicable). f. Show existing and proposed contours. g. Indicate drainage basins and direction of flow for individual drainage areas. h. Label final grade contours and identify developed condition drainage basins. i. Delineate areas that are to be cleared and graded. j. Show all cut and fill slopes indicating top and bottom of slope catch lines. 3. Conveyance Systems. a. Designate locations for swales,interceptor trenches,or ditches. b. Show all temporary and permanent drainage pipes,ditches, or cut-off trenches required for erosion&sediment control. c. Provide minimum slope and cover for all temporary pipes or call out pipe inverts. d. Shows grades, dimensions, and direction of flow in all ditches,swales, culverts and pipes. e. Provide details for bypassing off-site runoff around disturbed areas. 1. Indicate locations and outlets of any dewatering systems. 4. Location of Detention Best Management Practices(BMPs). Identify location of detention BMPs. 5. Erosion and Sediment Control Facilities_ a. Show the locations of sediment trap(s), pond(s),pipes and structures. b. Dimension pond berm widths and inside and outside pond slopes. c. Indicate the traplpond storage required and the depth, length,gth,and width dimensions I= d. Provide typical section views through pond and outlet structure. e. Provide typical details of gravel cone and standpipe, and/or other filtering devices. f. Detail stabilization techniques for outlet/inlet. NOV — g. Detail controllrestrictor device location and details_ 4 2014 �' h. Specify mulch and/or recommended cover of berms and slopes. i. Provide rock specifications and detail for rock check dam(s),if applicable. j. Specify spacing for rock check dams as re uired. D VTY k Provide front and side sections of typical rock check dams. W'IJ^U ITY T D IELOPMF V I. Indicate the locations and provide details and specifications for silt fabric. m. Locate the construction entrance and provide a detail. 6. Detailed Drawings. Any structural practices used that are not referenced in the Ecology Manual should be explained and illustrated with detailed drawings. 7. Other Pollutant BMPs. Indicate on the site plan the locations of BMPs to be used for the control of pollutants other than sediment(e.g., concrete wash water). 8. Monitoring Locations. Indicate on the site plan the water quality sampling locations to be used for monitoring water quality on the construction site. Sampling stations should be located upstream and downstream of the project site. Stormwater slte pantemplate.ticc-rev 4052014 it • • • Stormwater Site Plan Changes If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised drawings showing any structural changes, and any other supporting information that explains and supports the reason for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems, treatment facilities, flow control facilities, or structural source control BMPs (not standard on-site stormwater management BMPs), the applicant shall submit a final corrected plan ("as-builts")when the project is completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as constructed. APPLICANT SIGNATURE By signing the Construction SWPPP worksheet, I as the applicantlowner 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. �f • " 1(/4/R l (LANDOWNER OR AUTHORIZED REP SENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: • LIVE LI . NOV - 4 2014 ;•" ifRT..5ei1 COUNTY 7 '',i. CO. MUNITY DEVELOPMENT storrnwater site plan template.doc—rev.4!282014 12 Map Output Page 1 of 1 ArcIMS HTML Viewer Map # 14,3131:1-2r Ln 1 aiwO°' , I .C41, 1 .,- ... e.!,c,..:......,M ..V.' ( .., r , , i Q ,. ' ... 7 • i r rN.‘.......2..e ;,, \\-. '' Legend Selected Features '. e _ *, ‘ \\\\ fA JC Roads Pa rce Is-H Contours 10 Foot Contour / 50 Foot Contour '• ', C- 1 ___—_,,------ rA 1 2 c i 3 A 0 ( 242 +..:2'2.ee2'2 z .,z- ,...,412,:YR 01 -14211 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. Thu Nov 20 08 00 53 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.0&Form---Tru... 11/20/2014 Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map 93270008 if.. ... .., 93277\ 1. • 9:32700089— I • i . :• ) t I 93270001'6 ,..---" ..\,..). • . . . , . \l., '... , ,-, . i "..) ) ? '7. 11 \ \ I. 111c, \ \I \. I , Legend 111 \ \ 1 Selected Features 932700002 \ \ 11 \ \ \ 1% Louv ., JC Roads \.'..I. 1[,..\\ )1 \ i.%,0 \ r Parcels A .. \ . \ tr\) \ 702132018 )'\,...., R \ \I\\\\\\ \ \\ \\\N\ • '''- Contours 10 Fool Conlour ....,V 50 Foot Contour \l' I I „ 232700010 `,..„, , c., \ \ ---________---- \ ----1 „.., i„, \ \ \ , ,. , , , .7021820 702132021 702132014 \\ 9327a000s ., ...s.,.- ( '1 c......, ...:. I., ? 702132309 In -------\, 's`` • \ \ \'------- . .12 \ 702132010 .I I I 1-_ I \' VI l'''• e,._ c, 1 ii A \ 1 02700301 I . !02132012 702132033 i .. a>. ' ', 702132008 M2133°26 '' \ ( k ./ / ) 702132022 ,I /../ , r"---' ' \' 702132024, 1".... 1, \\4, --/ / L 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. Thu Nov 20 0801:23 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.0&Form=Tru... 11/20/2014 Map Output Page 1 of 1 • ArcIMS HTML Viewer Map • - 1\ 1 962700018 y y __. Hetander in l ' \•� -f , •,`.. 702112002 9327000881 1, �• 932700089I \ \ .. trf 932700090 \ \ "I J 932700004 \ li y\ . Legend \ h ..r;:�•,�,:�c JC Roads 932700002 \ y Parcels-H Channel Migration Zone Hazards t 5 \\ :' C'�,L' , \ nomen flouted crnz .y 7 Ilrgh Rrek 932700010 Moecratety IIrig n Risk \ ?02132001 El Moderate R,zk iL:�'l'z''',I- \\) 932700006 s.70Q,32032 •‘ iJ., - _ ....._ P 1. J q r rn A 932700001 702132012 702132031 \\,..,,,,_„:,:,!2,1:-,,;,,..... i 1 7oi . ."- �L � � k, 70213.2024 ''� MzepsvaricIsdtry.,Y�scriCattily Call Senora G75 � i _0 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. Wed Nov 19 16:02:05 2014 http://gisserver/servleticom.esri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion=4.0&Form=Tru... 11/19/2014 Map Output • • Page 1 of 1 Arc IMS HTML Viewer Map 932700018 11 111 , 1 Rolando L0 1 • c ' 'il 1 . . ' 702132002 9321(X109$ 1 932/ ,702132002 - . • 1 .1 00089 i ill 932700016 11 . , 932700080 1 11 .- frIgel I 1 , --- 932700001_ 4\ II 702132023 111 '1. \ . Legend l JC_Roads 932700002 \ \ \ Parcels-H Critica I Aquifer Rec ha re .,. . \ \ 1 Areas \ \- 702132016 n SUSC=U Nit . \ , .., 1.1 SAW%4 SUSC 932700010 , \. .., . 1-1 susc ' \'1, '702132001 SARPA .„, •1 ri SARPA 4 UNK , 702132014 I 702132021 .. , I 11 ., ... 932700606 ''''• ,. ! 1 /0213202 , ., , • ;- , •, \N, '‘. 702132/309 r __„ M ,\\ ... ' - • .:1.., 11 , \ •-• 702132010 • i , ' 01 .2,(0001 702132012702132011 1 ' 702132024 ••,, i . . Maas wooded by Johrsol Canty Caws Sernces GtS l ' ---—-- 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. Wed Nov 19 16:02:32 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.08cForm=Tru... 11/19/2014 Map Output . • Page 1 of 1 ArcIMS HTML Viewer Map I Helander 1_11 I L t 1 9327000M 932f0.2089 I 1702'32f:•_:: ,. 932700016 j +1700080 ), .P-rd) --932700004_� I 102'2.2p21' L 11' _.. 1 Legend '02'22`-'2`-' Selected Features 432700002 '� '� ._..,...,.._.. y 1t JC_Roads ` +l Parcels-H \ +, 702t3201fi Seismic Hazard 932700010 .'*ti m2.3p 702132021 \ i02'320+4 ' ' 7 702152032, �`\ ::,.... t 932 `. \` 702132000\I----------/- 70z'3�_ , A 432700001 702132012 702152033 o 702132008 ' 702133Q26116, i �,, 1 7021320 I 702132024. Al4P5 wooded by Jaeersan Cosly CaM1'M Services GO _ w211 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. Wed Nov 19 15:56:46 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.0&Form=Tru... 11/19/2014 Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map I \I932700413 1t Hander Ln� I l --` •„_, 932700065 1 . 932704089- II l i.13z9oz: •. \ .trari I I 932700016 �l 1 932700080 -... _. 932704004 t y 702132023 \ \ Legend 702132020 Selected Features 932700002 \ \ 1\ t .4 JC Roads 5 Parcels-H FEMA FIRMS +, 702132016- . A AN I '2700010 x503 1 III' Cl her Il 702132041 __—_ 702132021 702132014 II iI 11 932700005i 702132032\.. c 702132009 1---T--- ' 2 T- 5 01 7oz132o1 4. jj 432700001 a r= � .• r 702132012 702132033 Gy •.. _ 702132046..,..., 7021 rnr . S j ( 702132024 114r J'V:d]d T'-L^t"Nri Corr"Cant95rooms GtS - 0 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. Wed Nov 19 15:57:29 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.0&Form=Tru... 11/19/2014 Map Output Page 1 of 1 ArcIMS HTML Viewer Map 93274oma , ; -`"" wander Ln 'I I +. 932Tdt%W8l i '.:1 y . 992700089 l 702,32txiZ 932)O ,6 y- 932700080 I 9327000161 I -- -. - 932700004 111\ ty` f I 70213202.3 :' \ \ --=� Legend 702132020 .� ❑ Selected Features 932700002 \ \ 7^J JC_Roads \ • , Parcels+l \,` \\\ DNR Streams �\ 702132016 \ ./ Typo ,4. f` Typo 5 932700010 Type 4 Typo 3 l \ t` 702132001 ` + y ,A/ Typal _.. _._ 702132021 `\ 702132014 IIyl !_ e f Ty1 l; 1, Other ?32100='C'.9 s. '� ' .4 , .G2'it+3Z ' t \ ',.t 702132000 ;, Tp , to, I 'N,, 702132010 . n111i 93270004, 0 �'s.,,,,,, �r ,, yi ',,,t�., N ? 702+32012 702132433 ` g 702,33026 ti 702732009,... 702332022'-. +L22132024 Maps va+kdpd try.hNvsvi Carts Gerard S rces btu_ 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. Wed Nov 19 15:50:49 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName ovmap&ClientVersion=4.0&Form=Tru... 11/19/2014 Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map II 932700018 III1 He la oder Ln '._... I t 702132002 9.2 a<1_Sif.' \\ } 202.22_;j. i . . S, 932700016 1_ 1 3200080 } — y . IJ , \ \ _.. 932700004. 702132023 \t 51 /02132420 Legend Selected Features 932700002 \ �\ 1t, JC_Roads \ l 4 Parcels-k1\ I DMR FP Stream — \ '. 702132016 Classification 1\., F•Fist,Habitat 1 932700010 N.Non-{rsh Habitat �4 { N -Non irsh Habitat ul 702132001 I fl Ns-Non-ilsh Ilabnal.Soasonal _.. _.... 702132014 l 70213'!021 1 1 v S.Inwnloro!Shoreline I��`\ - III \, 932700005 # 7021320321•, R • -c 7421.32009 m .. 1 (11';'7,---- 7021.32010 N U' '- '� M ( 4 , A 932700001. 0 702132012 702'32033 �Oj �- 't\ 702132006 ro213342s 102132022. it 702132005 4 ±102132024. III .1'. Mum:Tu.-skd ar..c%-:r Carltr Cally Semen GtS 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. Wed Nov 19 15:51:06 2014 http://gisserver/servleticom.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.0&Form=Tru... 11/19/2014 Map Output Page 1 of 1 A IMS HTML V - 11 - M. • 1 932700018 11 I Helandet Ln_ \\932 ...i.., 1111. 932700004 A 4� r�"": • ,,%. t t Legend •,� y I -,-yY,;,;_ • Selected Features iliehlieF 932700002 � yl A JC_Roads \ 5 l— Parce Is-H 5 \ \ SMP_Shore line �t 70213201•:. Environmental \ — Designations Little Qulicene Rived 933700010 ( Aquatic MIConservancy +,� •..`4 702132"_" Iltgh Intensity 7021`Ya i:: Natural 702132021 ell 3I— -'. �'•�- D NA ty Mg r Prouty Anuatc 933700005 Y 702132032 Sho elate Ras,dontal t ` \ 71(21 Attei SD ''4 f %� 432700001 4702132012 702132033 Dy t:"1'Vi'li," 702132008 't I 'Q2132024. Maps prattled M.Mkram Corm Centra{9s>.+=GO 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 correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Thu Nov 20 08.09:17 2014 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.0&Form=Tru... 11/20/2014 A coG JEFFERSON COUNTY { DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street, Port Townsend,WA 98368 I Web: www.co.Jefferson.wa.us/communitydevelopment ssHiNG � Tel:360.379.4450 I Fax:360.379.4451 I Email:dcd@co.jefferson.wa.us SquareONE Resource Center I Building Permits & Inspections I Development Review I Long Range Planning October 17, 2014 Gary Rae P.O. Box 652 Quilcene, WA 98376-0652 Re: Building Permit No. BLD14-00361 —Assessor's Parcel No. 702 132 016 Dear Mr. Rae: As a follow up to our telephone conversation yesterday, in the review of your building permit application submitted for the above referenced property we have found that additional information pertaining to stormwater will be required. Due to the addition of more than 2,000 square feet of impervious surface, minimum requirements 1 through 5 of the Stormwater Management Manual for Western Washington will be required per JCC 18.30.070 (4)(b). This Jefferson County Code section provides in part that"all new development that includes: (i) the creation or addition of 2,000 square feet, or greater, of new, replaced, or new plus replaced impervious surface area... shall comply with Minimum Requirements Nos. 1 through 5 as contained in the [Stormwater Management Manual] SMM. The Stormwater Management Manual for Western Washington, stormwater minimum requirements 1 through 5 are as follows: 1. Preparation of Stormwater Plans. 2. Construction Stormwater Pollution Prevention Plan (containing 13 elements). 3. Source Control of Pollution. 4. Preservation of Natural Drainage Systems and Outfall. 5. On Site Stormwater Management. Minimum Requirement No. 1 is the requirement for a Stormwater Site Plan which can be accomplished by completing the packet enclosed with this letter. In completing the Stormwater Site Plan you may find that Minimum Requirement No. 2 of the five requirements applicable to your proposed project is likely the most technically challenging and may, in some cases, require the assistance of a professional engineer. This is the requirement for a Stormwater Pollution Prevention Plan, also referred to as a SWPPP, which has thirteen elements that need to be addressed in your plan. Your project is relatively small so I do not foresee the need for extensive plans. For additional information I have enclosed Jefferson County's application packet for Construction Stormwater Pollution Prevention and you may call me it you have any questions. If you require additional information regarding the stormwater management requirements, the Washington State Department of Ecology's website is a great resource for stormwater information and also contains guidance and templates. The link to their website is as follows: http://wwwecy.wadov/programs/wg/stormwatedindex.html. • We appreciate your time and efforts in this matter. I am available for any questions you may have and am willing to render any assistance in helping you through this process so please don't hesitate to contact me at (360) 379-4484. Sincerely, ----T Tim Woolett Assistant Planner End: Construction Stormwater Pollution Prevention Application Packet 2 III Ili 587773 PGS : 1 COV 12/02/2014 02:59 PM $72.00 GARY Jefferson County WA Auditor's Office - Donna Eldridge, Auditor 11III10r11L',ral,Isi 'ii.kiliN'Itffil41fuE'r+l rii lyh 11111 AFTER RECORDING MAIL TO: / Name: 0i\IN ( -Q Address: I 0 ° °X 65"2 .0FCo2Z City/State: Q UIC-0fVQ ) ,,,,AJ I 9 76 01,f DECLARATION OF RESTRICTIVE COVENANT CONCERNING DRINKING WATER SUPPLIES Grantor(s): Jefferson County Public Health Grantee(s): NOTICE IS HEREBY GIVEN TO Connie Rae his/her heirs and assigns, and the general public. DESCRIPTION OF REAL PROPERTY AFFECTED: Section 13 ,Township 27 N, Range 2W WM ASSESSOR'S TAX PARCEL NUMBER(S): 702132016 NOTICE IS HEREBY GIVEN THAT the potable water supply source for the above described property does not meet criteria of RCW 19.27.097,requiring that the applicant for a building permit shall provide proof of an adequate supply of potable water for the intended purposes of the building. Specifically,the system fails to meet the criteria for the following: [X] Adequate Supply-well is a shallow well vulnerable to quantity issues during dry seasons of the year. [X] Potability-The water supply is a shallow well without information regarding construction and is considered a source that is ground water under the influence of surface water. This type of water supply that is vulnerable to contamination. Approval of the building permit has been predicated on the following: [X] The applicant acknowledges that continuous treatment is may be necessary to comply with potability parameters listed in WAG 246-290,Drinking Water Regulations. [X] The applicant acknowledges that the water supply source is a shallow well and may not supply adequate volume for house hold needs throughout the year. (Ni) THIS NOTICE ma, not be lifted or removed without the consent and written approval of Jefferson County Public l Health. X tr DATED this , y of \- ( .- , s,\A fESignature of Applicant: _____„„C�e��. /4...) Acknowledgment: 1n SU SCRIBED AND SWORN to before me this day of ` V° °V Y t `r/ i ,zyt i iiiiiiiiiiii No public in an ff�o��r the State.o,,f IW,as' ngton, �/ residing in WO Gv MVI t Qllilit Washington. Notary Public n� j � State of Washington My commission expires: ' (I] lX VICTORIA MC ALLISTER My Appointment Expires Dec 6,701 S 'A • ell' Signatures are to be notarized,and completed form filed for record with the Jefferson County Auditor a Jefferson County Building Division Permit Number: BLD14-00361 Applicant: RAE 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 S• etbacks (k _iC- c02- E• rosion Control 2-1?-(€ t Foundation Footing F• ooting Drains 51 t \tc Foundation Stem Wall 2-0)-7- c/.. U• nderground Plumbing Under Floor Framing 3I' )' ' S• traps(hold downs) Ext.Shear Wall Nailing S'I Rough-in Plumbing I is )� F• raming f Blocking A• irsealJ)5 I .� Insulation:Walls !ll I IJ 15- Insulation: Floors ,21, )y- Insulation:Ceiling L�t ) � 2 Int.Shear Wall Nailing S— Wallboard Nailing . L12_3�i S' Gas nterior Gas . terior Pro ank �, Heat/Chimney Clearance /o/2/s i i'� ( C W• ood/Pellet Stove toNt r /r '3- Mechanical Systems (�t� l� r-t--(^ - D• uct Test Cert �I(/� �� `• t c- Blower Airtight Tei( U ,—rte 40* C S• moke&CO e /2c fir Drywell/ i ragr • r Address Posted V2-TAr �e Septic System Finaled C-10 . P Z `�``�` A final inspection will not be scheduled until the following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed off • Public Works Permit Final(where applicable) FINAL INSPECTION FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD14-00361 1.) This proposed new single family residence will be constructed on property abutting the Little Quilcene River, a Type 1 Aquatic and shoreline of the state designated Conservancy. Additionally, the property is mapped as having Critical Aquifer Recharge Areas, Seismic Hazard Areas, Channel Meander Zone, and Flood Zone A. The proposed development activities will all take place outside the 200 foot shoreline designation, High Risk Channel Meander Zone, and the Flood Zone A. Subsection 18.22.160(d)JCC provides that development within a Moderate Risk Channel Migration Zone is not suject to the Landslide Hazard Area protectin standards. 2.) 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. 3.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water quality degradation. The submitted proposal does not require additional aquifer protection measures. However, during construction the project shall follow the Best Management Practices (BMPs) and facility design standards as identified and defined in the Stormwater Management Manual for the Puget Sound Basin. 4.) A Stormwater Site Plan has been submitted and approved by the Department of Community Development. Once the building permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. 5.) This approval is for a New Single Family Residence 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. 6.) The site plan as submitted with the Building Permit application on November 4, 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 November 20, 2014 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 7.) TSW 8.) The potable water supply serving this parcel is a shallow well with no records of the construction standards. Notice to title was recorded under AFN 587773 \\tidemark\data\forms\F_BLD_Perm it_BIdg.rpt 12/17/2014 • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD14-00361 Received Date: 10/7/2014 SITE ADDRESS: 293937 HWY 101 Issue Date 12/17/2014 QUILCENE, 98376 Expiration Date 12/17/2015 OWNER: CONNIE RAE PHONE: 360-301-4428 PO BOX 652 QUILCENE WA 98376-0652 SUBDIVISION: Block: Lot: PARCEL NUMBER: 702132016 Section: 13 Township: 27 N Range: 2V' CONTRACTOR: INTEGRITY HOMES & REMODELING PHONE: (360) 316-9472 124 SWANSON AVE PORT TOWNSEND WA 98368 Contractor's License INTEGHR953PD Expires 10/4/2015 PROJECT DESCRIPTION: NSFR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,926 VALUATION 235,000.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N SHORELINE: CONST TYPE: DECKLE 803 SETBACK: 150 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 1PWELL Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $1,979.00 SRE 10/06/14 151616 Exist: Exist: 0 Plan Check $1,286.35 SRE 10/06/14 151616 Prop: 3 Prop: 2 State Building Code $4.50 SRE 10/06/14 151616 Total: 3 Total: 2 Potable Water Application $67.00 SRE 10/06/14 151616 Total: $3,336.85 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