HomeMy WebLinkAboutBLD2010-00269 Jefferson County Building Division Permit Num : BLD10-00269
Applicant: PARFREY
BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2009 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 4/14/2011 Minimum setback from W. Egg& I Road right-of-way shall be 20 feet.
--��- Minimum north and south property line setbacks shall be 5 feet.
Minimum setback from the wetland boundary shall be 140 feet.
Erosion Control SEE CONDITION 4
Post Holes 4/14/2011 JL
Footing Drains
Underground Plumbing
Under Floor Framing
Straps(hold downs)
Ext. Shear Wall Nailing
Rough-in Plumbing
Rough-in Plumbing 11 ,
Framing 6 ' I ( ( j
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Airseal
Insulation:Walls
Insulation: Floors
Insulation: Ceiling
Wallboard Nailing
Mechanical Systems
Syr yiy ie Ivo S 61/4. ��e_ till()Lied c-,tt Mivrr blocked oft
Duct Test Cert
Blower Airtight Test
Smoke&CO2 ti/g /"7 �`�
Drywell/Alt Drainage
Drywell/Alt Drainage SEE CONDITION 3 FOR DRY WELLS
Address Posted CI /1 g1 j 7 si
Water Meter Inspection NOT- ,L ` O
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(2_k Grnid •- 1 Pita_ to aD
FINAL INSPECTION
2,Yir F:fe . ?r- I c1 t 7 L et.f ,
FINAL I SPE TION MUST BE APPROVED PRIOR TO BUILDING BEING/OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• BUILDING PERMIT •
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD10-00269 Received Date: 7/28/2010
SITE ADDRESS: 925 W EGG & I RD Issue Date 12/22/2010
CHIMACUM, 98325 Expiration Date 12/22/2011
OWNER: JULIET PARFREY PHONE: 360-531-4883
CARRICKBANAGHER
COUNTY SLIGO
IRELAND
SUBDIVISION: Block: Lot: TX 6+
PARCEL NUMBER: 801041007 Section: 4 Township: 28 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: NSFR - REVISED 8/22/11 - SEE FILE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 864
VALUATION 107,462.00 ADD'L: 576 HEAT TYPE: EEE
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: R 3 UNHEATED: #OF STORIES:
OCCUPANCY:
CONST TYPE: 5N OTHER: 0 SHORELINE:
GARACONST TYPE: DECKLE 56 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: 2PARTYWELL Type Amount Paid By: Date: Receipt:
BEDROOMS: BATHROOMS: Permit $411.45 LYK 07/28/10 118050
Exist: 0 Exist: 0 Plan Check $267.44 LYK 07/28/10 118050
Prop: 2 Prop: 1 State Building Code $4.50 LYK 07/28/10 118050
Total: 2 Total: 1 Potable Water Application $98.00 LYK 07/28/10 118050
Total: $781.39
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 7 am the day 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
• •
CONDITIONS for Building Permit# :BLD10-00269
1.) REMOVAL OF THE CHICKEN COOP AND ANY OTHER BUILDINGS FROM
DRAINFIELD IS REQUIRED PRIOR TO FINAL APPROVAL.
2.)JCPrior to final occupancy/approval for use of this building, the easement as part of the
required 2-party well policy must be notorized and recorded to the satisfaction of JCPH.
3.) 2005 DOE STORMWATER MANUAL DRYWELL DESIGN CRITERIA
ALL INFILTRATION SYSTEMS SHOULD BE AT LEAST 10 FEET FROM ANY
STRUCTURE, PROPERTY LINE, OR SENSITIVE AREA.
FOR SITE WITH SEPTIC SYSTEMS, INFILTRATION SYSTEMS MUST BE
DOWNGRADIENT OF THE DRAINFIELD UNLESS THE SITE TOPOGRAPHY CLEARLY
PROHIBITS SUBSURFACE FLOWS FROM INTERSECTING THE DRAINFIELD.
DRYWELL BOTTOMS MUST BE A MINIMUM OF 1 FOOT ABOVE SEASONAL HIGH
GROUNDWATER LEVEL OR IMPERMEABLE SOIL LAYERS.
EACH DRYWELL MAY SERVE UP TO 1000 SQUARE FEET OF IMPERVIOUS
SURFACE FOR EITHER MEDIUM SANDS OR COURSE SANDS.
TYPICALLY DRYWELLS ARE 48 INCHES IN DIAMETER (MINIMUM)AND HAVE A
DEPTH OF 5 FEET (4 FEET OF GRAVEL AND 1 FOOT OF SUITABLE COVER
MATERIAL).
FILTER FABRIC (GEOTEXTILE) MUST BE PLACED ON TOP OF THE DRAIN ROCK
AND ON TRENCH OR DRYWELL SIDES PRIOR TO BACKFILLING.
SPACING BETWEEN DRYWELLS MUST BE A MINIMUM OF 4 FEET.
4.) 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.
5.) The septic system is limmited to one residence 3 bedrooms or less. An ADU or second
residence is not allowed on the current septic system
6.) When plumbing fixtures are added a separate building permit is required
7.) 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.
• •
8.) A minimum setback of 280-feet, measured perpendicularly from the wetland edge, shall
be permanently maintained as a buffer. No filling, grading, clearing, or other alteration of
the wetland or its buffer is allowed.
9.) Wetland 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 contain the
following statement: "Wetland & Buffer- Do Not Remove or Alter Existing Vegetation."
10.) A permanent physical separation along the upland boundary of the wetland 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.
11.) 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.
12.) 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.
13.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
14.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
15.) 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.
16.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
17.) The building height is not to exceed 35 feet.
18.) Minimum setback from W. Egg & I Road right-of-way shall be 20 feet. Minimum north and
south property line setbacks shall be 5 feet. Minimum setback from the wetland boundary
shall be 140 feet.
19.) 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.
20.) 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.
• •
21.) The existing well for this development lies within the WRIA 17. Per Washington State
Department of Ecology consultation on_7/28/11_, documentation has been provided to
support a determination that the well is exempted and not subject to the in-stream flow
rule for domestic use, metering, and exempt well irrigation.
• •
No plumbing has been reviewed or approved for this project by Jefferson County Public
Health. WHEN BUILDING USE IS CHANGED AND PLUMBING FIXTURES ARE
TO BE INSTALLED, POTABLE WATER MUST BE PROVEN OUT.
FEES HAVE ALREADY BEEN PD BUT APPLICATION FOR POTABLE WATER
WILL STILL NEED TO BE APPLIED FOR.
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•
ii-i.soiv C'O JEFFERSON•UNTY
' V.' DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend •Washington 98368
�� 360/379-4450 • 360/379-4451 Fax
,� www.co.jefferson.wa.us/commdevelopment
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Master Permit Application MLA: t ( ; - :. 1 1
Project Description(include separate sheets as necessary):
f , - �0( 3 ' PoI t3L3 ; '')'i''g
Tax Parcel Number: U I(..) q 1007 Property Size:,,2/6 y //Z, 5C),i1
(�(acres/square feet)
Site Address and/or Directions to Property: I ` /�/� �/J�
y 5 w Pgr d -1 (2.i. C',11 , v✓I Gt e 4'"1 r 'v 4. / g 32
Property Owner(s)of Record: Tu I i e 1-- ?gr. r cy
Telephone: 3 5 3 7/ 9/1 -7 0$4• Fax: — LL email:
I Mailing Address: CcirrI`CK , grta 41 h-er / ruv"1 F►'n ' -cr 5 T 0w✓t S i cl r'e G
Applicant/Agent(if different from owner): .fie rr y :Mt rct 303 Ky : et r ' os k F on 5 r uc_ "o.,
Teiephone: 3,t'-' 7 b 5'- c 3 t"J Fax: 3“)-- 7 C 5-- b 3 t<,t/ email: J°k rqcy.,5 k 0 Itr e,1, Cc el--'1
Mailing Address: W9 7 S t-�w y /c'1 0 v : Ice.1-e_ , t,,--•-A 7a- 77 .b
What kind of Permit?(Check each box that applies 0 Lot or Road Segregation
,ftuilding 0 Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use)
Cj Single Family [Garage Attached]Detached ❑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 0 Boundary Line Adjustment
❑ Address 0 Road Approach 0 Short Plat**
❑ Home Business 0 Cottage Industry 0 Binding Site Plan**
❑ Propane 0 Long Plat**
❑Sign - 0 Planned Rural Residential Development(PRRD)/Amendments**
❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration**
0 Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions *
❑Site Plan Approval Advance Determination(SP D *n Shoreline Management Substantial Development**
❑Temporary Use V�� ' (-' �'�' ' CI 0 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 0 Tree Vegetation Request
**Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal, if known:
DESIGNATION OF AGENT
I hereby designate e c'r Vic=t r 4 ram'' 5 CC y to act as my agent in matters relating to this application for permit(s).
'6 WNER SIGNATURE '7/-C, - /0
By signing this application form,the owner/agent atte is 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 app cation that he or she nts prior notice.
/Signature: —.-v-vN- f '/ Date: / - 27 /0
The acti r actions Applicant i 1 undertaRe 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
nd non-transf able responsibili r adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: -.K.-.- A" ---s4------7 Date: 7 - 2.7 —/0
k n.._...e.—.--\ttttiiPnRMS###\DRI7 FORMS\Current DRD Fnrmc\Macter Permit AnnliraticT 5-99-11R liar
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 CONTRACTOR OR MANUFACTURED OME INSTALLER: PHONE: FAx:
�ctc-c,ac3�'5ky eon s ±rvc_ i-i'c>.-, IA(, (76,) 765--O763 (3Eh) 745 -036y
-MAILING ADDRESS: Z&(-9 7 5 NL`'y l o ( EMAIL: i cc,,cJ3,S(c O/ Qf rl , cc,ii‘-‘
CONTRACTOR'S LICENSE c WAINS
NUMBER: <,J c\r c < V.61 7IC 1< NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAx:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type; Bathrooms: 0 ' Shoreline: Type of Sewage Disposal:
New t . Wood Existing: 0
❑ Sewer
CI Addition Lk Steel Proposed: Y` Bank ❑ Community System
❑ Alteration/Remodel 0 Concrete Total: {jam Height: i1,Individual System
O Repair ❑ Masonry SEP Permit# 9 5—cm0 75
O Demolition ❑ Other. Bedrooms: Water Supply:
Existing: —
O _ Setback: X. Private well Two Party
Type of H at: Proposed: _ —
0 Public
Total: V' Name of System:
If this is a Commercial Project you must answer the following: r1 O .
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: n c
i Underground Tank i Above ground Tank Size of Propane Tank:
t Heat Stove i Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i Pellet Stove 1 Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / : • ,_
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 syste/n components,
including the reserve area.
Square Footage Current Pro s osed For Office 14 h + s `s, ,.ma5,Mtkint Revision
Main Floor Heated - Q(00 EH Bld App Review: 4-73.- 1 f -
2` Floor Heated - kc Consistency Review: -' ,-1 .r 11
—
Base fee: 1a56; 1.5 , 1077-
Other Heated
Mezzanine . .- Additional Section: _ -- __
Heated Basement Plan Check fee: 2
Unheated Basement State Surcharge fee: PO
Other Unheated r(f 3%, y Pot Water Review fee: i .5-1,r-5 Wl
Garage/Carport Ne4
SUBTOTAL
.. ci
ISecks , 911/Rd Approach fee: E)CI ST1 OA
bon Other TOTAL: -$ I 1 . 21 � 3 •7
Receipt Number: l 00_51t312 gQ5
- Cash/Check Number:
ESTIMATED COST(REQUIRED) Date: 4_`�-� — r
.Fair market value of all la or and�materials foundation to finish _ f� t
r � Initials:
G:\PennitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc
C�.�oN
6,444 , JEFFERSON COUNTY
�, DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend • Washington 98368
�•qS, NG.O'r 360/379-4450 . 360/379-4451 Fax
http://www.co.jefferson.wa.us/commdevelopment/
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# I v ( l PROJECT/APPLICANT NAME: -T) I 1' e P�r r t-el.
I
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. 13u, tt s c2�x ,3C PoI-c C3u,tea1'n/L_A-iC
Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
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3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
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4. Describe the existing soils. Indicate soil type on the site map.
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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.
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APPROVED t
6. Describe any excess levels of noise generated by the proposed use or actil ity: $TMWATER PLC
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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.
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.).
2- 5 rcfA
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.
ry/ 1.14
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.]
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11. Describe the performance goals nd standards applicable to the project.
S .10 �
12. Describe the flow control system.
r 7/14-
stormwater site plan template—rev.10/21/2008 6
• •
13. Describe the water quality system.
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14. Describe the conveyance system analysis and design.
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15. Describe the source of fill material, physic 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.
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17. Describe the proposed surfacing material.� /
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18. Describe methods for restoration of the site.
.4///9 _
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.
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20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
N I_ 2 8 L3I0
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.
71/./ .-
stormwater site plan template—rev.10/21/2008
7
10.
• •
CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP)
The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the
tern o,."^".vs must be installed on the ground during all construction phases of the project. The proponent is responsible for
preveniii ; ii gut 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
SECTION I—CONSTRUCTION SWPPP NARRATIVE
1. 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.
2. Establish Construction Access.
3. Control Flow Rates.
4. Install Sediment Controls.
5. Stabilize Soils.
6. Protect Slopes.
7. Protect Drain Inlets.
stonnwater site plan template—rev.10/21/2008 8
• •
12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
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9. Control Pollutants.
10. Control De-Watering(the act of pumping group ater 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, roads).
.7//4._
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards).
I 711P
3. Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
UL 28 ��IC
stormwater site plan template—rev.10/21/2008 9
• •
b. Description of special requirements for working in or near environmentally sensitive areas.
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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).
A//T.)"
5. Construction Phasing.
a. Construction sequence
/17/#
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.
II. Wet Season Construction Activities.
a. Proposed wet season construction activiti s.
b. Proposed wet season construction activiti for environmentally sensitive areas.
7. Financial/Ownership Responsibilities.
a. Identify the property owner responsible for a initiation of bonds and/or other financial securities.
b. Describe bonds and/or other evidence of fi ancial responsibility for liability associated with erosion and sedimentation
impacts.
8. Engineering Calculations. Provide Design, alculations on a separate sheet for the following, if applicable.
a. Sediment Ponds/Traps.
b. Diversions. �1
c. Waterways.
d. Runoff/Stormwater Detention alculations
stormwater site plan template—rev.10/21/2008 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.
c. Indicate the trap/pond storage required and the depth, length,and width dimensions.
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 control/restrictor device location and details.
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.
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 plan template—rev.10/21/2008 11
• •
Storrs"- " •r Site Plan Changes
If the ue igne, wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be
su. miffed Hor to construction. The submittal shall include substitute pages that include all proposed changes, revised
drawings shorvilig ly structural changes,and any other supporting information that explains and supports the reason for the change.
Ilan Submittal
It Li le piujei.. tt,,uued 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
cr;r�.SU u,ted.
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.
DOWNER OR AUTHO ZED REPRE NTATIVE SIGNATURE) (DATE)
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
stormwater site plan template-rev.10/21/2008 12
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