HomeMy WebLinkAboutMLA16-00035- FPA16-00001 Stormwater Management Application17 sFM;
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street, Port Townsend, WA 98368
Tel: 360.379.4450 1 Fax: 360.379.4451
Web: wwwco'effersonwaus/communitvdevelooment j I
E-mail: dcd(aco: efferson.we us J
SUPPLEMENTAL APPLICATION
STORMWATER MANAGEMENT PERMIT
MI # I(n—() JJ PROJECT/APPLICANT NAME: t+ro lr
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Applications for grading projects or land -disturbing activities which require a stormwater management permit shall include the following
information. This information may also be provided on other diagrams, plans, studies, or attachments submitted with the project
application. If so, please indicate such on this permit application. The Administrator may waive specific submittal requirements
determined to be unnecessary for review of the application.
1.
Source of fill material and deposition of excess material .c
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2.
Physical characteristics offill material: L-Jblf/ �" NB
3.
Proposetl methods of placement and compo n consistem with the applicable standards in the International Building Coda.
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4.
Proposed surfacing material.
5.
Pro osed methotl(s) of drainage and erosion control. r ric+
6.
Methods for restorafion of the site. 1A,
7.
Demonstrate that instream flow of water will remain unobstructed.
e.
Demonstrate that erosion and sedimentation from outflow channels will be minimized by vegetation or other means, and
demonstrate that pond runoff will be controlled to protect adjacent property damage.
By signing the application form, the applicant/owner attests that the information provided herein is hue and correct to the best of their
knowledge. I also cenify that this application is being made with the full knowledge and consent of all owners of the affected
property��i�,
(ANDDOWRIER OR AUI'IpRIZEO PRESENTATIVE SIGNATURE) (DATE)
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