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HomeMy WebLinkAboutBLD2007-00583 '-� rr DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street,Port Townsend,WA 98368 • Tel:360.379.4450 Fax:360.379.4451 Itort Web:www.co.jefferson.wa.us/communitydevelopment `9sfr j NCti'SO E-mail:dcd(aiico.jefferson.wa.us CERTIFICATE OF OCCUPANCY PERMIT #: BLD07-00583 APPLICANT: BLAINE P SHAFFER PHONE: 360-437-9140 RAMONA D SHAFFER 425 SHINE RD PORT LUDLOW WA 98365-9277 SITE ADDRESS: 804 WALKER WAY Issue Date: 02/12/2008 PORT LUDLOW, 98365 Final Date: 9/6/2016 SUBDIVISION: Block: Lot: PARCEL NUMBER: 821084001 Section: 8 Township: 28 N Range: 1E PROJECT DESCRIPTION: 9/10/2013 Applicant cancelled permit, picked up plans. -meb NSFR WI ATT GARAGE & A/G 120 GAL PROP TANK THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2006 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/6/2016 Acting Building Official, Patty Charnas \\tidemark\data\forms\F_BLD_Occupancy.rpt 9/7/2016 Jefferson County Building Division Permit Numb'. BLD07-00583 E Applicant. SHAFFER HAFF_R ' 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 Erosion Control Foundation Footing 7 /,i d I, rek 1037ALL_ED 7//410s Footing Drains 1/Z?/ L Foundation Stem Wall l �� /Z� �erza, .`1l/U ,ktn UG:uf;*. Nn i N ;�LA4� Under Floor Framing Straps(hold downs) Ext. Shear Wall Nailing g jeg , / Rough-in Plumbing .LIZS/a' Framing Blocking r‘)/A, Airseal lOb i6g Insulation:Walls /®-9 oq Insulation:Floors 9i. C Insulation:Ceiling (�J—� CY OAVL-I Int. Shear Wall Nailing Vijiti 11 C iQ�I S/lGsJ9Q 44u. �/C 2/2-0'$k Wallboard Nailing 12_ _Oct Gas Line: Interior C2-11:7-09 Gas Line: Exterior t-VA Propane Tank ?/'/ �LI Heat/Chimney Clearance / /i , `� 64/ D 1Jt�G'i' V t.I'T' Drywell/Alt Drainage Address Posted FINAL INSPECTION (//i.///, f FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR ItUILDING PERMIT APPLICADN MLLA0700623 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00583 Received Date: 11/16/2007 SITE ADDRESS: 804 WALKER WAY PORT LUDLOW, 98365 OWNER: BLAINE P SHAFFER PHONE: 360-437-9140 RAMONA D SHAFFER 425 SHINE RD PORT LUDLOW WA 983659277 SUBDIVISION: Block: Lot: + PARCEL NUMBER: 821084001 Section: 8 Township: 28 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: STEVEN CROSS PHONE: (206) 786-5526 46 VILLAGE WAY PMB 124 PROJECT DESCRIPTIOr NSFR W/ATT GARAGE & A/G 120 GAL PROP TANK TYPE OF WORK RES SQUARE FOOTAGE: + ' , TYPE OF IMP NEW VALUATION - 5 OO.00-21510a MAIN: 2• ,557 CODE EDITION: 2006 ADD'L: 534 HEAT TYPE: EEE OCCUPANCY: R-3 HEAT BASE: HEAT TYPE: HTP OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE: 720 SETBACK: DECK: 191 BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 2 Prop: 3 Total: 2 Total: 3 Routing Date: - C Type Amount Paid By: Date: Receipt: APPROVED Permit $2,393.75 LYK 11/16/07 93500 Plan Check $1,555.94 LYK 11/16/07 93500 FEB (a 2008 State Building Code $4.50 LYK 11/16/07 93500 �l Potable Water Application $58.00 LYK 11/16/07 93500 Jefferson County Planning Total: $4,012.19 &Building Department • • CONDITIONS for Building Permit# :BLD07-00583 1.) PRIOR TO OCCUPANCY& BUILDING FINAL- FINAL APPROVAL OF SEPTIC SEP07-182 IS REQUIRED. 2.) 10' SEPARATION REQUIRED BETWEEN A WATER LINE AND ALL PORTIONS OF THE ONSITE SEWAGE SYSTEM; EFFLUENT TRANSPORT LINE, TANKS, TREATMENT AND DISPOSAL COMPONENTS. 3.) The identified Fish and Wildlife Habitat Area (Type 5 Stream), 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 structures. 4.) An additional setback of five (5) feet is required from the edge of the buffer area to the proposed structures. 5.) A permanent physical separation along the boundary of the 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. 6.) 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." 7.) 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.) A Stormwater Plan has been submitted and approved by the Department of Community Development. Once the subject permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. 9.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 10.) 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 autormobile 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 requriements 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. 11.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 12.) Setback from Walker Way right-of-way is no less than 20 ft., side and rear setbacks are no less than 5 ft. Special setback to the East of 35 feet from commercial ministorage. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 13.) Exterior lighting for residential usehall not exceed twenty feet (20') in height s the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 14.) The building height is not to exceed 35 feet. 15.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 16.) Use BMP C220 to stabilize drain inlet(culvert)downslope of construction. Use BMP C202 or C209 to stabilize chanel inlet downslope of construction. Use BMP C151 and C152 to control polutants from concrete handling and sawcutting. Copies of these BMP's are attached to the approved site plan. 4,.�SON c.06� JEFFER.�1 COUNTY ti DEPARTMENT OF COMMUNITY DEVELOPMENT 0 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax &:4 www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: �-((- 3 Project Description(include separate sheets as necessary): ►I f� ra- ; 1(1 r -- 5'�,9mac-2 c.v` .3 G9.ic, -c ! -G . L � �� !!c, Tax Parcel Number: 0 Property `a`(o i Size: 1 v 3`'5O O F (acres/square feet) Site Address and/or Directions to Property: (SCE c{ €A) 1/4.1 k V- t ),4C / P61T £.v D 43w Property Owner(s)of Record: a tr4�/A-P. r¢- le-p,,,�,�,A�,q -5ti A cv- Telephone: (,p -30 k (t t0 Fax: email: Mailing Address: 4ZS ..6A r,, . (-D Rs T too k c-),.« '- 3 G, Applicant/Agent(if different from owner): -S7`elt.efn I't'. Telephone: b 6-?'' -5-5 --z . Fax: email: Mailing Address: `-f7 (J.•/Ay-e Gc)thr /Otvri5 (zy 'ov;T C c,/J4.,),„) Gc',¢ '5315— What kind of Permit?(Check each box that applies) tt Building 0 Variance(Minor,Major or Reasonable Economic Use) 0 Demolition Permit 0 Conditional Use[C(a), C(d),or C]** BF Single Family - ❑ Discretionary"D"or Unnamed Use Classification t Garage Attached/ tD d 0 Special Use(Essential Public Facilities)** ❑ Manufactured Home 0 Boundary Line Adjustment 0 Modular ❑ Short Plat** ❑ Commercial* 0 Binding Site Plan** 0 Change of Use ❑ Long Plat** ❑Address ❑ Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments'"' ❑ Propane ❑ Plat Vacation/Alteration** 0 Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** 0 Stormwater Management 0 Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance ❑ Temporary Use 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment 0 Forest Practices Act/Release of Six-Year Moratorium *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: i DESIGNATION OF AGENT I hereby designate ` 1,C cI<4. Y' <— to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE f'� �I ,. Date: )) 14( 1, ' Ey signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application review and any required later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business hours. Signature: b Date: - v I dee 7 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 resp ibility for adhering't`o and complying with the ESA. The Applicant has read this disclaimer and s s nd dates it below. Signature: j /' ": L Date:' /t Ile 7 G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc 0 BUILDER STATEMENT 1 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 ass uing the responsibility of the General Contractor for the proposed project. 1_ r Signature: ;v 4Z•G --t-f� Date: v e 13,/u;4 00 7 r`� GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ig New $ Wood Existing: 0 Sewer O Addition ❑ Steel Proposed: '2..S` Bank Height: ❑ Community System O Alteration/Remodel 0 Concrete Total: 2. S X Individual System ❑ Repair 0 Masonry SEP Permit# OO iii L. ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: Private well 0 Two Party Type of Heat: Proposed: 1_ ❑ Public EL,ec t-r,.` / gam{JL,M/0 Total: 2 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: ❑ Underground Tank 7i1, Above ground Tank Size of Propane Tank: /2_O 'I'�� ❑ Heat Stove Cook Stove ❑ Woodstove Fireplace Insert 0 Hot Water Tank 0 Pellet Stove ❑ Other/iced-aloe 'tt Is this appliance being installed in a Manufactu'ted/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 fi -. i ' -E ','-( ' `` }Current ProPosed .r€ 4ii ',, _ .--- , —;. L : _ ' Main Floor Heated ''' rr EH BId App Review: ,is -T--) 2"1 Floor Heated l - , ce`i onsistency Review: Other Heated `� ..�- Base fee: Mezzanine V t . Additional Section: Heated Basement `fi.5 � Plan Check fee: ! I )J,q`�1 a :t Unheated Basement �" State Surcharge fee: SO •Sy• S, N Other Unheated A , , Pot Water Review fee: O� Garage/Carport ' . SUBTOTAL q Sit'` a b9 , f 1 Decks wi ,' 911/Rd Approach fee: X tL a , , . : COQ Crecy( ( Other TOTAL: $ t — • -A.�,ci - Receipt Number: Cr. --Z)U Cash/Check Number: :,- .2. i ( ESTIM• e • • P I • D) Date: . .' market value of all labor and -tertafs7ba►idafieA t fish '41- I(0 -05) Initials: G:\Pe • .�.v►•J:�• 6'.: 0 1tMS\Master Permit Application 12- S.doc ��_� • • � � JEFFERSON COUNTY -- 1 DEPARTMENT OF COMMUNITY DEVELOPMENT ! ys. JAN 2 9 2008 • , 4. 621 Sheridan Street • Port Townsend•Washington 98368 360/379-4450 . 360/379-4451 Fax err �r rr�.��ry http://www.co.jefferson.wa.us/commdevelopment/ I F or -rrT STORMWATER SITE PLAN SUBMITTAL TEMPLATE MLA# O'l' 2 3 PROJECT/APPLICANT NAME: G l RJ SV a4�G✓ 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. e.,®v..TjjPue_ r t4- ix)-G e-J S 4 in eO "9 -E, i 4) s (fiJc sc7s P • Existing Conditions Summary 2. Describe the existing topography. Indicate contours on the site map. ' I 3. Describe the existing vegetation. Indicate native vegetation areas on the site map. c-41n ,J, t i A-e- l��r J`�StY��rh� F Oft? lJ n.L 4. Describe the existing soils. Indicate soil type on the site map. 13 r&Jrn iqv9t410 ^Pv9-tot. 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. 'r- v'2 4- ►'L t • ,2-,cr`�fi-)lr‘ct :3 ft .—(4,K__4) ,{etr Fc.c .' I ,4-0,e 5 041. . 41 } t' . i h A ( -± a) 6. Desc be any excess levels of noise g erated bxtl» yet v� : �-- �'I1 t1I"��V� y� "ER PLAN (161 FEB 1 1 atte `� t ERSa co pca stormwater site plan template-rev.10/1/2003 JEFFERSON I�Ot. 6 5 DEPT.OF CO UN TY 4.Ti ,'NT SIGNATURE: \��, i1i ! • ., 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. % t4le:e_. t ,s 14- .( -rye el ) -t rr vt vit.1. j/ 6 i/-tL, Soeir-r- -Lo14 P, 60()(Ar/tiy 13 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.). --�� rs sct-d ,e-- ( 1) 7 fib 1—be.- eas-7 Va e-I4 -' /X4A.10 .q S4)01 tic .>(. rc Op_o c_e Via:--ti. c144D L- In&L! 44ABC e)of r t pry � )IALS' s� L104(/< f tic ff...( Scsv 4•1,\ 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. h4 fX v fd.2e'a'ste-e J©ti -f-vektr A l3 �� ✓- r'd F v`aanp&l- 4-bs 'sc r 'f-e 7' D)sS.te,y-Jcg,t "i-f'v1cG, -# 6 .?�sic✓S� to of-f- ��d �1-I Do-for/e.t.a", 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.] i/L)// ..) 11. Describe the performance goals and standards applicable to the project. 12. Describe the flow control system. 14. 0>S -ert-,) .. 4-1-D64,1w fi „/.jam Rif. soh-, �,y., � Ca� /` 1 �i7 i� r 1r v- �� //J!` �, IT-v- A l "fw_) or444,44.49 64/c LOS stormwater site plan template—rev.10/1/2003 Y1 v,u0.')lr 0e)13 tit 6 111,3tt4(i I4'" v t 4.30 3h•i iP•.+! ?t?. i • 13. Describe the water quality system. Aji4 14. Describe the conveyance system analysis and design. f/j// 1 15. De cribs the source of fill material,physical characteristics/of fill material,/and deposition of excess/material. / 09-- v9e4C.<00 s T Vp re__, L( ��xJcr 1 f" ► --er,4 t1 � I� '�'" • Iggsig -- ,� v" 1D4-. F3.e_ r a9 6. 4_ A) C( 16. Proposed methods of placement and compaction consistent with the applicable standards on Appendix Chapter 33 of the Uniform Building Code. 1 A 17. Describe� the proposed surfacing material. -/ /ne_ 6J r'i c c.2_L +34s-7 -1 G,c 4 ./IL 4)0...0 t i<i L cur` 18. Describe methods for restoration of the site. 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 andinclude any special reports or studies conducted to prepare the Stormwater Site Plan. /ld , 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. L p t --teupy-F-D jErrR. N Ctit 1\ - L. stormwater site plan template—rev.10/1/2003 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 section 2.5.2 of the Manual(beginning on page 2-15). 12 Required Elements-Construction SWPPP 1. Mark Clearing Limits.r �,�` ,4e-T-�' k- +44v- .>(( Q-z wt v�-�(� 4-113 ►- yam 2. Establish Construction Access. � Q rL)c-1 r. p¢c.C.e.S5 c-� l( 6 . re�J 1 jl L e?oe.2�c+, 5,-� Lv 4,0 C , , c� —-, �\ � —� tt-.r4— 3. Control Flow Rates. /1}l1- 4. Install Sediment Controls. e ,/A- pgy�R✓; { i P c C0 5-1-en �iL4 GU't-10 Ack. `"hD J 4Pv r'Ajit y i Q 5 J g t✓so v F- eo,vA$-tVLt *)o(,1 5. Stabilize Soils. 'F i s Uu'r fig - c r) i0/91--J Okk S .5'e&L )) (( v O Lerl) dx.f r p , - C 11.3 ct.s v 4 e p 6. Protect Slopes. "Le z.)c � Jc /9v1 4 7. Protect Drain Inlets. 4, � �� 1ti kd "^ 14,'? 71t _ 11.iTble .t Y, r � vc1c! 8 q s r 5 bra?- in S stormwater site plan template—rev.10/1/2003 8 • • L_ 2 I t�2Gb6 12 Required Elements-Construction SWPPP(continued) GCS 'ate(l C 2,02 C 8. Stabilize Channels and Outlets. 4-0 54111 .G21 akettial I bl K � 0-4 Got[ Yfr 0-0 ficL_ 9. Control Pollutants. U h-t- L t i-1P is- r',I 5-2 10. Control De-Watering(the act of pumping . •• a eo r av y from an active construction site). 11. Maintain Best Management Practices(BMPs). (./f/te % C-4) J CI 1 6il/1Gf)vl_i'LCc- --�-� 12. Manage the Project. >� L( 4-V Qe,: ) /7 / o^e-) u ,5►-qui9 n (3/4.1 P 2. Adjacent Areas. a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential areas, roads). jl > { 04-P� t p4-v`e rAS b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400 yards). t4 Souk.. I-1 CT,do„� , ,1J (3PYd) 3. Environmentally Sensitive Areas. a. Description of environmentally sensitive areas that are on or adjacent to the site. r1 I_ i I. i ) �(C./ �' -�^tK.�4l �✓ -i FIl,!i2 of — .` ads f ►� rair MIEN I BISON CM] storrmvater site plan template—rev.10/1/2003 9 • • b.- Description of special requirements for working in or near environmentally sensitive areas. /Oa/LA— rJ.)v 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). (1.)0 WUw e." P br?as 5. Construction Phasing. a. Construction sequence sip t-s� Selo—re-4- -f-a i G( ��� r o f �Pe.,- r b. Construction phasing(if proposed) 6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual). I. Provide a proposed construction schedule. �0�5�"lwCrti^off a t22e JG. r-e_ a II. Wet Season Construction Activities. a. Proposed wet season construction activities. at"5-r-v,ci CrJ c^ a f- •Irte,os c /,9 6nt-se.-04G - b. Proposed wet season construction activities for environmentally sensitive areas. V)r, evA 57-12/0-2 eSnvt e J' 1 7. Financial/Ownership Responsibilities. a. Identify the property owner responsible for the initiation of bonds and/or other financial securities. ✓to e1 to 6 re4c,1ve0 b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation impacts. i/L)3 5 r`e-ai l 8. Engineering Calculations. Provide Design Calculations on a separate sheet for the following,if applicable. a. Sediment Ponds/Traps. b. Diversions. /� c. Waterways. /l/ d. Runoff/Stormwater Detention Calculations stormwater site plan template—rev.10/1/2003 10 1111 Stormwater Site Plan Changes If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan,the proposed revisions shall be submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised drawings showing any structural changes,and any other supporting information that explains and supports the reason for the change. Final Corrected Plan Submittal If the project included construction of conveyance systems,treatment facilities,flow control facilities,or structural source control BMPs (not standard on-site stormwater management BMPs),the applicant shall submit a final corrected plan ("as-builts")when the project is completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as constructed. APPLICANT SIGNATURE By signing the Construction SWPPP worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected I . , i perry. a Aso (LANDOWNER OR AUTHOR! -: REPRESENTATIVE SIGNATURE) (DATE) THIS SPACE MAY BE USED FOR ADDITIONAL NOTES,1F NEEDED: stormwater site plan template—rev.10/1/2003 12 e._. 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