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BLD2010-00009
` -S"N re.) DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street,Port Townsend,WA 98368 Tel:360.379.4450 Fax:360.379.4451 Web:www.co.jefferson.wa.us/communitydevelopment *-9S,f,f NO..cO E-mail:dcd(a,co.jefferson.wa.us CERTIFICATE OF OCCUPANCY PERMIT#: BLD1 0-00009 APPLICANT: LYNN M STEWART PHONE: 360-424-1270 4040 LINDSAY HILL RD QUILCENE WA 98376 SITE ADDRESS: 4040 LINDSAY HILL RD Issue Date: 06/3/2010 QUILCENE, 98376 Final Date: 8/9/2016 SUBDIVISION: Block: Lot: PARCEL NUMBER: 701321012 Section: 32 Township: 27 N Range: 1W PROJECT DESCRIPTION: NSFR REPLACEMENT ON EXISTING FOUNDATION and shoreline exemption permit (SDP10-00002) THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2006 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM AO THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 8/9/2016 Interim Building Official, David Goldsmith \\tidemark\data\forms\F_BLD_Occupancy.rpt 8/22/2016 Jefferson County Building Division Permit Num/ BLD10-00009 Applicant: STEWART BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks Setbacks 7/29/2010 ;� Minimum setbacks from property lines shall be 5 feet. Minimum setback from OWHM shall be 30 feet to the house foundation. Erosion Control 7/29/2010 SEE CONDITION 2 FOR SILT FENCE Erosion Control Foundation Footing 7/29/2010 )f-' *ell 0 Foundation Footing Footing Drains Foundation Stem Wall Underground Plumbing Under Floor Framing Ls/Z 11" y T C Straps(hold downs) Ext. Shear Wall Nailing - "k 6,� .6 1 v - (f--IS—16 / ©F nA tS Ar06.-i& Rough-in Plumbing f% ... Framing197 Eigesirt 9-5/No l�C L 11 Airseal 3 ri i3 514, S U 17c Insulation:Walls , k� Insulation: Floors Insulation: Ceiling „Q. Int.Shear Wall Nailing 1 Wallboard Nailing ,Il3`i1 Gas Line: Interior Gas Line: Exterior g_13 (?!.. X 2. Propane Tank Heat/Chimney Clearance Drywell/Alt Drainage / SEE CONDITION l FOR SPLASHBLOCKS Address Posted pp 1, 3 WA FINAL INSPECTIONMx177704, qIek k - FINAL I SP CTION MUST BE APPROVED PR OR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD10-00009 1.) DESIGN CRITERIA FOR SPLASHBLOCKS: A VEGETATED FLOWPATH OF AT LEAST 50 FEET SHOULD BE MAINTAINED BETWEEN THE DISCHARGE POINT AND ANY PROPERTY LINE, STRUCTURE, STEEP SLOPE, STREAM, WETLAND, LAKE, OR OTHER IMPERVIOUS SURFACE. SENSITIVE AREA BUFFERS MAY COUNT TOWARD FLOWPATH LENGTHS. A MAXIMUM OF 700 SQUARE FEET OF ROOF AREA MAY DRAIN TO EACH SPLASH BLOCK. A SPLASHBLOCK OR A PAD OF CRUSHED ROCK (2 FEET WIDE BY 3 FEET LONG BY 6 INCHES DEEP) SHOULD BE PLACED AT EACH DOWNSPOUT DISCHARGE POINT. NO EROSION OR FLOODING OF DOWNSTREAM PROPERTIES MAY RESULT. FOR SITES WITH SEPTIC SYSTEMS, THE DISCHARGE POINT MUST BE DOWNSLOPE OF THE PRIMARY AND RESERVE DRAINFILED AREAS. 2.) A SILT FENCE SHALL BE INSTALLED JUST OUTSIDE THE CONSTRUCTION ZONE AND LANDWARD OF THE SHORELINE OHWM PRIOR TO ANY LAND DISTURBING ACTIVITY. APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO MAKE SURE THAT SILT DOES NOT ENTER THE STREAM. IF NECESSARY THE MINIMUM HEIGHT OF THE TOP OF SILT FENCE SHALL BE 2 FEET AND THE MAXIMUM HEIGHT SHALL BE 2 1/2 FEET ABOVE THE ORIGINAL GROUND SURFACE. THE SILT FENCE SHALL BE BURIED IN A TRENCH TO A MINIMUM DEPTH OF 5 INCHES BELOW THE GROUND SURFACE. THE TRENCH SHALL BE BACKFILLED AND THE SOIL TAMPED IN PLACE OVER THE BURIED PORTION OF THE SILT FENCE, SUCH THAT NO FLOW CAN PASS BENEATH THE FENCE AND SCOURING CAN NOT OCCUR. ANY DAMAGE TO THE SILT FENCE SHALL BE REPAIRED IMMEDIATELY. SEDIMENT DEPOSITS SHALL EITHER BE REMOVED WHEN THE DEPOSIT REACHES APPROXIMATELY ONE-THIRD THE HEIGHT OF THE SILT FENCE, OR A SECOND SILT FENCE SHALL BE INSTALLED. 3.) CONSTRUCTION ENTRANCES SHALL BE STABILIZED WHEREVER TRAFFIC WILL BE LEAVING A CONSTRUCTION SITE AND TRAVELING ON PAVED ROADS OR OTHER PAVED AREAS WITHIN 1,000 FEET OF THE SITE. THE ENTRANCE SHALL BE CONSTRUCTED ON A FIRM COMPACTED SUBGRADE. QUARRY SPALLS (OR HOG FUEL) SHALL BE ADDED IF THE PAD IS NO LONGER IN ACCORDANCE WITH THE SPECIFICATIONS. (BMP C105, 2005 DOE STORMWATER MANUAL). ANY SEDIMENT THAT IS TRACKED ONTO PAVEMENT SHALL BE REMOVED BY SHOVELING OR STREET SWEEPING. THE SEDIMENT COLLECTED BY SWEEPING SHALL BE REMOVED OR STABILIZED ON STIE. ANY QUARRY SPALLS THAT ARE LOOSENED FROM THE PAD, WHICH END UP ON THE ROADWAY SHALL BE REMOVED IMMEDIATELY. UPON PROJECT COMPLETION AND SITE STABILIZATION, ALL CONSTRUCTION ACCESSES INTENDED AS PERMANENT ACCESS FOR MAINTENANCE SHALL BE PERMANENTLY STABILIZED. • • O lc_4.) The complete demolition of the existing residence BLD10-49 and final approval of ` �t SEP07-279 is required prior to final sign off or occupancy of this new home. --a-� l 5.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 6.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC)Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 7.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 8.) All construction activities shall not encroach upon the landslide hazard area buffer. This includes the storage or preparation of materials. 9.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 10.) 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. 11.) The identified Fish and Wildlife Habitat Area (Type 5 Stream per recorded plat), shall maintain a vegetative buffer setback of 50 feet. The setback shall be measured horizontally from the Ordinary High Water Mark(OHWM)to the proposed development. 12.) An additional setback of five (5) feet is required from the edge of the stream buffer area to the proposed development. 13.) A permanent physical separation along the boundary of the stream buffer area shall be installed and permanently maintained. Such separation can include installing logs, trees, a hedgerow, or any other prominent physical marking approved by the UDC Administrator. 14.) Stream buffer perimeters shall be marked with temporary signs at an interval of one per parcel or every one hundred (100) feet, whichever is less. Signs shall be in place prior to and during construction activities. The signs shall contain the following statement: "Buffer - Do Not Remove or Alter Existing Vegetation." 15.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP) Elements#1 through#12 of the Department of Ecology's Stormwater Management Manual for Western Washington to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 16.) A Stormwater Site Plan has been submitted and approved by the Department of Community Development. Once the subject permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. • • 17.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 18.) Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the requirements of JCC 18.20.100, Automobile wrecking yards and junk(or salvage) yards. In no case, shall any such junk motor vehicles be stored in a critical area. 19.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 20.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 21.) The building height is not to exceed 35 feet. 22.) 9/22/10 Revision: Minimum sdie yard setbacks shall be 5 feet. No portion of the proposed new SFR, decks, etc. shall be located no further waterward than the outer most edge of the existing seawall. 23.) 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. 24.) 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. 25.) Residential developers and individual builders shall be required to preserve shoreline vegetation and reduce the associated risk of erosion during construction and any future activity which may impact the stability of the shoreline. ¢goN • ,,��i 06, JEFFERSON COUNTY i44iiDEPARTMENT OF COMMUNITY DEVELOPMENT ` '� 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax • .�gS, 0�0' www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: MLA a 0 07 ect Description (include separate sheets necess • t):f.0 C7 cWA-tic P ` rfm t L AGIS'J 9;Irv_A �i vvC `3—tyuc e 0q . Tax Parcel Numikr: -101 '-2( Cj 1 Z Property Size: 1 t 38 ,QG[2,ES (acres/square feet) -- aI Fat. 17p, Site Address and/or Directions to Property:4640 LINosEy 13c PccH a (/�' I.IND 1 1-4.1LU 28 J aul 4_,,G \1E WA, Property Owner(s)of Record: i''f lat ¶— -f2.r I La n�� Telephone: 366- 4'24- 121 C) Fax: email: r] Mailing Address: )41- 1t..7 IP11 ON iz,N) 12.c( l'{ -'l r.\f t-Az iJONL'1 9 6 3-7 C, Applicant/Agent(if different from owner): j rC.- 1}I`-1 CA It- Telephone: ?jam- 2..-71 18 Fax: email: m(lU It jr$(G N e.GTJ Cs-►,Gobi Mailing Address: Won Pa E )o 312_, c_L. / t, )A , `3235 What kind of Permit?(Check each box that applies 66Building El Critical Areas Stewardship Plan Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) Single Family ❑Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment 0 Address 0 Road Approach 0 Short Plat** ❑Home Business 0 Cottage Industry 0 Binding Site Plan** ❑Propane 0 Long Plat** 0 Sign ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance 0 Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium El Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference 0 Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: •, 4�_ " DESIGNATION OF AGENT I hereby designate ,_._ c///4?),,. �:. / to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE --- !-///r; - 4-1 x Date: /1 -7 2 Z1.29 By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attomey's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application th\at he or she wants..$ru(r notice. 4. Signature: rr > ' Date: ' 7 27 t-'1 The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable responsibility for adfiering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: . ,! _ Date: /2_4 -e'i"' 4; is t i L' G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-OB.doc • • 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: ri,/j � p c.,,. Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: Fax: ( 5'NL'- Ps O U..-`A)E.I2-1 ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: At, y j(j C Pc1W..t I T -T) PHONE (30)7(j2,_-7-1 0 FAX:( ) MAILING ADDRESS: Po eiqX 3t 2i el.E-A2L.Rfa EMAIL 11-yr ofL S(C/IJC___cl.) . COw\ Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ( New 71 Wood Existing: - C1 Sewer y Addition l 1 Steel Proposed: '1_. Bank ❑ Community System ). Alteration/Remodel LI Concrete Total: 2 Height: Individual System I! Repair ❑ Masonry C) SEP Permit# 01-00 2-19 i Demolition ❑ Other: Bedrooms: Water Supply: Existing: — Setback: I Private well El Two Party Type of Heat: Proposed: S . �� ❑ Public , L, Total: 3 Je�3 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 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- f $, SO,nit:.' ,„,,,; ,',, ,:Ai i't ." _sari,. ;,7. Main Floor Heated r , _. : _ EH Bld App Review: (�� 1 S3 1(32q,\',<�r 5 2"°Floor Heated ,, Consistency Review: Other Heated Base fee: Mezzanine -Additional � s.kQn-o° Heated Basement ` Plan Check fee: :,.= 1 ao _` b Unheated Basement �tg� ` ;, - z, State Surcharge fee: .� Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks v 911/Rd Approach fee: '1 Other TOTAL: $30I1 q 1 i,, Receipt Number: //3 53 - ' Cash/Check Number: ESTIMATED COST(REQUIRED) Date: I�,� J l O .Fair market value of all labor and materials foundation to finish r 4z1-21 � 1[5 Li',, 's /Initials: g �� It Lvi G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc • 110 , ONc. 44r 4q, JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 qs �O� 360/379-4450 . 360/379-4451 Fax biING http://www.co.jefferson.wa.us/commdevelopment/ STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# I b ^ r7 PROJECT/APPLICANT NAME: L..y Iv Iv ST Ir Zf Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a separate stormwater site plan map. Project Overview 1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the site map. 12-elr UU t=. `EtSTi WI Rie t. 3cf_. I f A\)I1vci UNpi ,J0 J- PDDI 52A- f AND F1uw'. R tOF.. -sc..E 4- 21Zu t w 1 1C,1 I to ci€ _ £�(S T`I N c-N '1;c) u 0 Pc - J Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. 1 lS The- PcrZ A Tv f3E- DC SMaerui3 Lb f oc' i t i-St. [ S .....•. 0 EU/ IR-Prr APPROVED 3. Describe the existing vegetation. Indicate native vegetation areas on the site msp. STORMWATER PLAN 6,12AsS • - 6) ra-o EA J PciLi - JUN 3 2010 4. Describe the existing soils. Indicate soil type on the site map. GIet t.� I f1'l (Z- -1P hp &OlU JEFFERSO C U TY `� KI DEPT.OF CO. • OPM. T') 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. - t P Pc 1't S W EA.I. L D va/ . S ) D ST1As c)I 1 1-A.) Pc i {L, • — 6. Describe any excess levels of noise generated by the proposed use or activity: 6 \. L-y •ST D zAD l -rt P t cac cc T 2 uc . t\) pO ism Stormwat B _ Required JAN - 7 2010 stormwater site plan template-rev.10/21/2008 5 • • 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. ST2.&p 11.)p +-30 ' 1-)4. r itAj 5l ' (51-4,15 Q t 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.). p<DJ e 'T Lerf 0 1A I S 9_0;ID ffl PcC. 6 t ucfr_ NC_ S-PST- Permanent Stormwater Control Plan This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs and facilities to remain in place after construction of the project is completed. "Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control facilities are not exceeded. g. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed (i.e., per BMP T5.30 in the Manual) or, if not,what types of stormwater flow control will be utilized for the site or specific threshold discharge areas within the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. got,4,4 PkW,, 'D A 1t P+E. ' ! COLLk� 4N O F CMu.TT A? S 171*¢-i?S D Ti-DLouc t-{ Dow N ap u Tc TZ S pu c M POLO C r- 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.] 1\--\ ( 11. Describe the performance goals and standards applicable to the project. 12. Describe the flow control system. v spalAT l3LOa-S lc�C �z PaRi ( S cs) i T hJ stormwater site plan template—rev.10/21/2008 6 • • 12 Required Elements—Construction SWPPP(continued) 8. Stabilize Channels and Outlets. 9. Control Pollutants. 10. Control De-Watering (the act of pumping groundwater or stormwater away from an active construction site). 11. Maintain Best Management Practices(BMPs). 12. Manage the Project. 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas,Y roads). lv b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. Lu.k L,C,EASE- PyPsl stormwater site plan template—rev.10/21/2008 9 • • b. Description of special requirements for working in or near environmentally sensitive areas. 4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site soils(e.g.,erodibility,settleability, permeability,depth,texture, soil structure). 5. Construction Phasing. a. Construction sequence b. Construction phasing (if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). Provide a proposed construction schedule. s)ClJ Ns A Lcz;1—tt Tb PLEA,(vest M 13- 1 1 S fi (A , N. O. i> -tuiN C-U t)ST. _ CUNTPl. A I NA (L Ct-L &c c , l S t- U .IN), 0. II. Wet Season Construction Activities. a. Proposed wet season construction activities. b. Proposed wet season construction activities for environmentally sensitive areas. 1J 11A- 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. L'1 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. d. Runoff/Stormwater Detention Calculations stormwater site plan template—rev.10/21/2008 10 • • 13. Describe the water quality system. 14. Describe the conveyance system analysis and design. //Pt 15. Describe the source of fill material, physical characteristics of fill material,and deposition of excess material. ` 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. 17. Describe the proposed surfacing material. 1'Y�fc �— R 6�� ► 1\1(1 18. Describe methods for restoration of the site. p 6Tuv.iihf.O pi-afa6W J G 1'L c 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. 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. 1v � — 7 2010 stormwater site plan template—rev.10/21/2008 7 • CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN (SWPPP) The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential development. SECTION I—CONSTRUCTION SWPPP NARRATIVE 1. Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable to the proposal,justify in writing. Descriptions of the 12 Elements are found at Volume II Section 3.2.3 of the Manual (beginning on page 3-7). 12 Required Elements—Construction SWPPP 1. Mark Clearing Limits. '-`-f 15T1`n1 >�v- (\ 2. Establish Construction Access. f,1s-n Liu- - !L( o w► 3. Control Flow Rates. 4. Install Sediment Controls. • Cc>N L` '�-DI� w t� pE' 5. Stabilize Soils. �-�`►- p tth,c 1— 5 iTE- 6. Protect Slopes. N1� 7. Protect Drain Inlets. stormwater site plan template—rev.10/21/2008 8 • • . . Stormwater Site Plan Changes If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems,treatment facilities, flow control facilities, or structural source control BMPs (not standard on-site stormwater management BMPs), the applicant shall submit a final corrected plan ("as-builts")when the project is completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as constructed. APPLICANT SIGNATURE By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners o he affected property. // lb (LAND NER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED: stormwater site plan template—rev.10/21/2008 12 II • O \ 1 //J� IDN09V100 .9C of N N i \ \ t iF.„4 N N i7 t x \ co 1 M N J� O., w6 ,z ,I �I to cr) 1 :} .:0 - W X J x O .". -'. .... .'"I I 1(:14-I '15.- ,' CV OI `n �o CO Iin Q a! „...... 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