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Application & Site Plan
per� Iq - W _r:�) DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street, Port Townsend, WA 98368 Tel: 360.379.4450 1 Iiax: 360.379.4451 Web: tutvw.eu.icfferson.wa_url�anss»weit�el v nI)IIJent E-mail: r ' • n . &J � 193-74Z PRE -APPLICATION CONFERENCE r ' 40 The Jefferson County Code (JCC) 18.25,640 & 18.40.090 requires that before an application is made for all Type II and Type III project applications and Type I applications proposing impervious surfaces of ten thousand (10,000) square and/or non -single family structures of five thousand (5,000) feet or more, or all projects involving in -water work or work below OHWM, a pre -application consultation must be held. The consultation includes preliminary review and administrative assistance. This service does not include extensive field inspection or correspondence. Pre -application consultation does not limit subsequent administrative review. At the conference, Department of Community Development personnel shall provide the applicant with: (1) A list of the requirements for a completed application; (2) A general summary of the procedures to be used to process the application; (3) The references to relevant code provisions or development standards that may apply to the approval of the application; and (4) A list of any applicable hourly review fees that may be charged by one or more County agencies upon the filing of a project permit application with the County. Discussions at the conference or the information provided by the staff shall not bind or prohibit the County's future application or enforcement of all applicable laws and regulations. No statements or assurances made by County representatives shall in any way relieve the applicant of his or her duty to submit an application consistent with all relevant requirements of County, state and federal codes, laws, regulations and land use plans. NAME: P � alAd I d /-Ii &see o MAILINGADDRESS: 21 014 &W P, r,6 045 l�_JWl 83 TELEPHONE: (HOME) 20(v - % -/ -q5-:27 EMAIL i��rrre ro @ 6fM at' REPRESENTATIVE: MAILING ADDRESS: TELEPHONE: (HOME) EMAIL DIRECTIONS 1. Please answer all questions on this form completely. 2. Attach one sketch of the Conceptual Design for the proposed use or activity, showing the following information: a. Vicinity sketch; tF. Ob. North arrow and scale; c. Property boundaries and identification of land uses on adjacent properties; U d. Means of ingress and egress; e. Property/lot drainage; APR - 9 2019 f. Possible locations of sewage disposal and water supply systems; g. Location of utility easements; and h. Proposed location of buildings, including setbacks to property boundaries. 3. Attach payment of the applicable fee, as set forth in the Jefferson County Fee Ordinance -�(- C4 a,0ki( WR(Y�e April ZZ or Af fc✓ Aa 11-rh.t 2,619 we-R- 000LE? Property Description General Location: Legal Description (from Property Tax Statement): Cyr - 6�4-aY,�c Cols-iX, .01[/. 7, ;51/-- 1q1 1-d f11,10 9-Digit Parcel Number (from Property Tax Statement): 13 q r �° Total Acreage: 3 ACC rr Zone: — h S Applicant: >� Owner ❑ Contract Purchaser Project Description 601 `/3 9 % Lot Coverage: / S. % l ❑ Lessee ❑ Other _ A__u a , ?a ra q e -f A L-f is ,bo -f4 a La et d ward mot' Ga ex�a ycs. ' v a.vt ax i S ,?' A a" . Ad l cz. be-dr-oa-AA 44,LA su/1 a a-m a�e.e cam. Ga,lcea P e� .r`sga�, . Al! of fhe a.ol sC�! Spy ce is .i.ros� cur 11.4 11 7Y-e /Sd 5 A.P y�_, l •n, 6 t,�,r c+.0 dt r f %S c�z t �>✓fi✓ n sic4 1-4-0 Property Owner (name and mailing address): 9 �C6-td Gt fits log 211 Co l /Ka u- f>1. of 8 36 Standard Disclosure Information provided to a prospective applicant during the pre -application consultation is based on County regulations in effect at the time of the pre -application consultation. Revised or new CountV regulations could affect a future development application- A pre - application consultation does not vest a future development application. By signing the application form, the applicantlawner attests that the information provided herein is true and correct to the best of their knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property_ Any material falsehood or any omission of a material fact made by the applicant/owner 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. This right of entry shall expire when the County (through the Administrator or the Administrator's representatives) concludes the application has complied with all applicable laws and regulations. AcC&_s_s_a'pd right of entry to the applicant's property shall be requested and shall occur only during regular business hours. -"5-- / (SIGNATURE) (DATE) I hereby designate co�rence. \Z O CjAz,,_� (LANDOWNER SIGNATURE) (DATE) act as my agent in matters related to this pre -application APR -92019 G:\PerrnitCenler\###FORMS###\DRD\Pre-App\preappconference form doe REV 11/1/2013 11ane2 TOP OF BANK r r EDGE OF BRUSH - /EX15TINO CONCRETE , r rr 5TA I Viz" / TOP OF B INK —sllr rY 21 TOP OF ANK a� 0 j�— � r� r / / EDGE OF BRUSH r r r l002132002 1 r I 45' • 'P- ����� 50' 1 WOOD DECK CONCRETE RETAINING HALL EXISTING WOOD DECK PROPOSED SUNROOM PROPOSED BEDROOM EXTENSION zu EDGE OF LAUREL HEDGE EDGE OF BRUSH 45, Ng EDGE OF 5' SIDE YARD BRUSH SETBACK HEAT PUMP 5' RETAINING HALL �' a 5O EXISTING HOUSE � ss' LA a �' 5EPTI T K ID ' PRO . RAIN IE OC )ON EL. = 62.55'. + EL. i LAWN EL. 4H L. 62.2ci YI --� i 60, EXISTING - — :,ONCRETE TO BE REMOVED NORTH K HALL i WOOD 51I UKAGE SHED SITE PLAN SCALE: 1 II = 20' . �: 'A • � :: ° � `.'::. Y;�:rti fir' ij r 4 10 5' 51 DE YARD SETBACK w � o z• riX 0 k� o 4-3-19 PRELIMINARY REV DATE DESCRIPTION © TERRAPIN ARCHITECTURE, P.C. 2018 EX15TINO ROGK HALL TO BE REMOVED — PROPOSED DRIVEWAY PROPOSED G�1 RAGE 1 r ++� EDGE OF 65' PAVEMENT l POTENTIAL ' RESERVE r+ SEPTIC SYSTEM I EDGE OF PAVEMENT EX15TINO CONCRETE STEPS — EX15TINO CONCRETE DRIVEWAY POTENTIAL ADDITIONAL 5EP7IG RESERVE LOT 40 14,420 SQ. FT. .33 ACRES NOTE: THIS IS NOT A SURVEY RICH & JOSEPHINE FERRERO PROJECT DE50R I PT ION: RESIDENTIAL RENOVATIO TAX PARCEL # a3a60143a OWNER ADDRESS: 21 COLMAN PLACE PORT TOHN5END, HA 983 SITE ADDRE55: 21 COLMAN PLACE PORT 70HN5END, HA c155 CONTRACTOR: PHONE: TBO ZONING: RR-1:5 RURAL RESIDENTI LF-O AL DEaCRI PTION: GAPE OEOROE COLONY DIN/ 7, BLK 14, LOT 40 WIND SPEED: 110 MPH' 5EPTIG PERMIT SEP75-00 �6 EXPOSURE: C. LOT COVERAGE LOT SIZE = 14,420 5G2. FT. EX15TINO IMPERV IOU5 SURF C . FLOOR AREA SCQ. FT. cr EXI5T HOUSE (HEAT) NEW ADDITION (HEAT) 10 NEW 5UNROOM (NO HEAT) NEW GARAGE (NO HEAT) 0 EX15TINO SHED fE APR - 9 2019 D O BY: TH DATE: - SCALE: SEE DWGS a a� W 0 op �- v o 10 U M co Q W 3 W w N U o3 W JQ Q� Z O Z J � O W Z O me IL co 0 o w Q Q O O C O Cie Z� Lu +�WOZ LL a v0 O f SHEET: A1.1