HomeMy WebLinkAboutZON2017-00017 DCD permit formsMLA #
DEPARTMENT OF COMMUNITY DEZIMENTO
621 Sheridan Strcct, Port Townsend, WA 98368
Tcl: 360.379.4450 1 lax: 360.379.4451
_ Web: _ iEFF RSON COUNTY DCX)
1: -mail: c3cdlczcr>.j�tTcrsr>n.tva.u,
STORMWATER CALCULA ION WORKSHEET
PROJECT/APPLICANT NAME: J 6—rr ,S (y " I 1061/ ( 4/0/q
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 1.E, SITE
Size of parcel 15.22 acres An acre contains 43,560 square feet. Multiply the acreage by this figure.
Size of parcel in square feet 662,983.2 - 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 CUTIFILL
Calculate the total area to be cleared, graded, filled,
excavated, and/or compacted for proposed development
project. Include in this calculation the area to be cleared for:
Construction site for structures 1, 000
Drainfield, septic tank, etc.
Well, utilities, etc.
Driveway, parking, roads, etc.
Lawn, landscaping, etc.
Other compacted surface, etc.
Total Land Disturbance
600
400
551
0
0
2,551
sq/ft
sq/ft
sq/ft
sq%ft
sq/ft
sq/ft
sq/ft
Answer the following two questions related to
conversion of native vegetation:
Does the project convert '/< acres or more of
native vegetation to lawn or landscaped areas?
Circle: Yes No
Does the project convert 2 '/2 acres or more of
native vegetation to pasture?
Circle: Yes No
Indicate Total Volumes of Proposed:
Cut 15.3 Fill 15.3 (culyd)
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.
stormwatercalcworksheet — REV 10/20/2014
'rr�;
�:::::.:
NEW
Structures (all roof area)
Sidewalks
STORMWATER CALULATIONS – IMPERVIOUS SURFACE
1,666 sq;ft
6 - "If,
Patios 6 sq/ft
Solid Decks 6 sq/ft
(without infiltration below)
Driveway, parking, roads, etc 969 sq/ft
Other sq/ft
Total New 1,969 sglft
TOTAL NEW + TOTAL EXISTING" 14,767
EXISTING
Structures (all roof area) 74 sq/ft
Sidewalks 6 sa/ft
Patios
Solid Decks
(without infiltration below)
0
I
Driveway, parking, roads, etc 12,664
sq/ft
Other sq/ft
Total Existing 12,738 sq/ft
*This amount will be used to check total lot coverage
The following questions will help determine whether the proposed project is considered development or redevelopment.
DEVELOPMENT v. REDEVELOPMENT
Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: 1.9 %
Does the site have 35% or more of existing impervious surface? Circle: Yes 1-1 No F7
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 apph anon is being made with the full knowledge and consent of all owners of the affected
property, F-) (tel`' %J brr- �L 0
be , /r � Z� Z P V P, /Z -/Il�l1 [i-' QN-t API -1 f L
LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
FOR OFFICE USE ONLY
SMALL_ MEDIUM LARGE REDEVELOPMENT Stormwater Site Is. Yes Nts
slormwater calc worksheet — REV 10/20/2014 2
'I
DEPARTMENT OF COMMUNITY}F� 1 • ,j �=,�
621 Sheridan Street 1 ort 1 ownscnd, WA 98368
Tel: 360.379.4450 1 Fax: 360.379.4451
Web: �v4tii • .�Ftc rnon.� ae. r./rornn3i. i I Is.•.L+ nn :iit � 'x ` ,"'a t j � r , i,
..:
I�,-mail: dcclfi�c4o.is•lf4•i:�uli.wa.us
PERMIT APPLICATION
,.IF_ 9 ER,'30N G()U `9 B A DCP_
Steps in the Permit Process:
-Review application checklist to ensure all information is completed prior to submitting application.
-Make sure septic has been applied for and water availability has been proven.
-Make an appointment to meet with the Permit Technician by calling 360-379-4450.
-This is not a standalone application; it must be accompanied by a project specific supplemental application.
-Fees will be collected at intake. Additional fees may apply after review and payment is required before permit is issued.
For Department Use Only Building Permit #
Related Application #s: MLA #
Site Information
Assessor Tax Parcel Number: 702231010
Site Address and/or Directions to Property: 295312 Highway 101 Quilcene WA 98376
Access (name of street(s)) from which access will be gained:
US Highway 101
Present use of property: Jefferson County use as a Solid Waste Drop Box Site, Gravel pit to the north of the solid waste site.
Description of Work (include proposed uses): septic utility work, new attendant office, new household hazardous waste collection unit,
new site lighting and surveillance,
Wastewater - Sewage Disposal
This property is served by Port Townsend or Port Ludlow sewer system? YES NO
If not served by sewer identified above, identify type of septic system below:
Type
of Sewage System Serving Property:
V Septic Septic Permit #: Existing system = 13-121
Community Septic Name of System: Quilcene Solid Waste Drop Box Site Case #: SEP16-00198
Are other residences connected to the septic system? NO
Additions or repairs to sewage system: Addition to the existing septic system at the adjacent County Road Shop.
Is it a complete or partial system installation: Complete Partial Y(
Has a reserve drainfield been designated?
Yes %( No
Date of Last Operations & Maintenance check: August 11, 2016 Attach last report to application
Describe or attach any drainfield easements, covenants or notices on title, which may impact the property:
required for the septic permit. BoCC date is April 10, 2017
The authorized agent/representative is the primary contact for all project -related questions and correspondence. The County will mail
/ e-mail requests and information about the application to the authorized agent/representative and will copy (cc) the owner noted
below. The authorized agent/representative is responsible for communicating the information to all parties involved with the
application. It is the responsibility of the authorized agent/representative and owner to ensure their mailbox accepts County email (i.e.,
Countv email is not blocked or sent to "iunk mail").
Applicant/Property Owner Information
Property Owner:
Name: Jefferson County Public Works
Address: 623 Sheridan St. Port Townsend, WA 98368
Phone #: 360-385-9380 E-mail Address: gramstrom@co.jefferson.wa.us
Please contact Authorized,�gent/Representative with project info. (select only one)..
Property Owner Signature: I�I�%� "'4`-! Date: �� 7-1
Note: For projects with multiple owners, attach a separate sheet with each owner(s) information and signatures.
Applicant: Authorized Agent/ Representative (if other than owner)
Name:
Address:
Phone #: E-mail Address:
Professional: Is this an Authorized Agent/Representative for this project?
NO YES
Engineer Architect Surveyor Contractor
Consultant
Name: License #
Address:
Phone #: E-mail Address:
Professional: Is this an Authorized Agent/Representative for this project?
NO YES
Engineer Architect Surveyor Contractor
Consultant
Name: License #
Address:
Phone #: E-mail Address:
Professional: Is this an Authorized Agent/Representative for this project?
NO YES
Engineer Architect Surveyor _ Contractor
Consultant
Name: License #
Address:
Phone #: E-mail Address:
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 or her 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 making any issued permit null and void.
I further agree to that all activities I intend to undertake or complete associated with this permit will be performed in compliance with
all applicable federal, state and county laws and regulations and I 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. Applicant may
request notice o�# he C ty Jnten r enter upon the property for visits related to this application and subsequent permit issuance.
Signature: �'�: `ter I� i Print Narne: Gordon D. Ramstrom Date: April 7, 2017
Permit \pplicatiun Page 2 4 2
LEI
DEPARTMENT OF COMMUNITY DE
621 Sheridan Street, Port Townsend, WA 98368
Tel: 360.379.4450 1 Fax: 360.379.4451 r
Web: n.wa ommunitydevci n
E-mail: d� c o jei[Crsnn.tiv'd.us 6r c' . ,
''Fj�FER80N CORNY{ DCEI
SUPPLEMENTAL APPLICATION
CONDITIONAL USE
MLA# PROJECT/APPLICANT NAME: Quilcene Solid Waste Drop Box Site
The purpose of the conditional use permit process is to provide flexibility in the application of the use regulations contained in the
Jefferson County Code (JCC). No conditional use permit can be granted unless consistency with the performance standards of JCC
18.20, the development standards of JCC 18.30, the procedural requirements of JCC 18.40.280, and the approval criteria of JCC
18.40.530, and other applicable requirements of the UDC have been satisfied. Approval of the conditional use is effective for three (3)
years from the date of original approval. If a building permit has not been issued within the three (3) year period, the conditional use
approval will expire.
The following questions will assist in the evaluation of the conditional use request:
1-
Describe the requested conditional use.
The installation of a 275 S.F. Attendant Office. Also, upgrades to an existing shipping container to serve as a
Household Hazardous Waste collection station. Utility improvements such as a septic tank and a transport line to
the existing septic system location onsite on the adjacent county parcel to the east.
2.
Explain how the conditional use is harmonious and appropriate in design, character and appearance with the existing or
intended character and quality of development in the vicinity and with the physical characteristics of the subject property.
This drop box site has been in service for several decades to serve the Quilcene area. This County parcel is 15.22
acres and includes a gravel pit. The adjacent County Parcel which serves as Road Shop and Fueling Station, is
9.65 acres in area and together form a contiguous County site. The site is buffered on all sides by wooded areas.
3
Describe the infrastructure including but not limited to roads, fire protection, water, wastewater disposal, and stormwater control
which will serve the requested conditional use.
These two County Parcels are served by an existing access drive from US Highway 101. The Solid Waste site
(#702231010) has a 2" water service supplied by the JC PUD #1 Quilcene water system. Connection to this water
source is subject to confirmation of potable water availability. A Restrictive Covenant shall be executed by the BoCC
to provide for the septic transport line to the adjacent County parcel to the east (#70224205).
4.
Describe the location, size, and height of buildings, structures, signa e, walls and fences, and screening vegetation for the use.
This site is fenced with a 6'-0" tall chain link fence and gate, which will remain in place. The proposed replacement
of the Attendant Office is a 275 S.F. modular office, and 11'-6" tall. The Environmental Center, for the collection of
household hazardous waste is 560 S.F. and is 9'-6" tall.
5.
Describe any noise, smoke, dust, fumes, vibrations, odors, outdoor lights or other impacts will be generated by the conditional
use.
This facility produces moderate impacts that are listed under item #5. The site is operated on a part time basis,
three afternoons a week, plus all day on Saturday. Setbacks and the wooded buffer effectively block any
disturbance generated from Solid Waste operations.
6.
Describe the pedestrian and vehicular traffic and parking area associated with the conditional use.
The site is operated the afternoons of Monday, Wednesday, and Friday, as well as all day on Saturday. Parking is
provided onsite. The customers drive to the respective part of the site to unload solid waste, recyclables and
household hazardous waste. Three new parking spaces are also provided
Page 3
ACKNOWLEDGEMENT
By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of
his/her knowledge. Any material falsehood or any omission of a material fact made by the applicant/ w r W�tj"� respect Is
application packet ma result i this permit bein null nd vayd. P r -r '4i� � 1/ (.1
n it f7La 1- - �'v°1"� i ,
GAR LICANT OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
Nf OTE: Representative authorization is required if application is not signed by the Owner.]
Page 4
T
Will the proposed conditional use result in the siting of an incompatible use adjacent of an airport or airfield?
No. There is no airport in the area,
8.
Are there any significant adverse impacts on the human and natural environments caused directly by the conditional use? If yes,
can these impacts be mitigated?
No. This is an attended site, and impacts are mitigated. All waste products are handled properly according to the
Solid Waste operations plans.
9.
Describe how granting the conditional use will not be materially detrimental to uses or property in the vicinity of the subject
arcel.
This is a continuation of an existing use. This site provides an essential public service.
10.
Describe how crantinc the conditional use will not be substantial!y detrimental to the public interest.
Granting conditional use will support the continuous operation of this service to the Quilcene area.
11.
Does the conditional use have merit and value for the community as a whole?
This site provides an essential public service to the southeast portion of Jefferson County.,
12.
Describe how the conditional use complies with all other applicable criteria and standards of the Jefferson County Code (JCC)
and any other applicable local, state or federal law; and more specifically, conforms to the standards contained in JCC 18.20
and JCC 18.30.
This is a County Waste Management Facility as referenced in JCC 18.20. Parking, vegatative buffer, lighting and
signage will be upgraded.
13.
Describe how the conditional use is consistent with all relevant goals and policies of the Jefferson County Comprehensive Plan.
This site has provided an essential public service for decades. This project will maintain and upgrade this use. The
household hazardous waste Environmental Center is an upgraded service for the proper disposal of moderate risk
household waste.
ACKNOWLEDGEMENT
By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of
his/her knowledge. Any material falsehood or any omission of a material fact made by the applicant/ w r W�tj"� respect Is
application packet ma result i this permit bein null nd vayd. P r -r '4i� � 1/ (.1
n it f7La 1- - �'v°1"� i ,
GAR LICANT OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
Nf OTE: Representative authorization is required if application is not signed by the Owner.]
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