HomeMy WebLinkAboutBLD2018-00295 - 05 STORMWATERt ot
DEPARTMENT OF COMMLINITY DEVELO
621 Sherid,rn Strect, Port'Iirwnscnd, WA 98368
Tcl: 3(10.379.-{450 | Ilax: .160.379.4"+51
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STORM$TATER CALCUI-ATION $7O RKSHEET
MLA #PROj ECT/APPTICANT NAME:t
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.
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.
Notive 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.
lmpervious surfdce 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
increasedrateofflowfromtheflowpresentundernatural conditionspriortodevelopment. Commonimpervioussurfacesinclude,
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 othersurfaces which similarly impedethe natural infiltration of stormwater.
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PARCEL SIZE (I.E.. SITE}
An acre contains 43,560 square feet. Multiply the acreage by this figure.
Size of parcel in squ arefeet 3.l.Bs1a sqift
Size of parcel 1.2(P acres
LAND DISTURBING ACTIVITY. CONVERSION OF NATIVE VEGETATION. AND VOLUME OF CUT/FILL
Answer the following two questions related to
conversion of native vegetation:
Does the project convert 7, acres or more of
native vegetation to lawn or landscaped areas?
Circle: Yes @
Does the project convert 2lz acres or more of
native vegetation to pasture?
Circle: Yes @
!ndicate Total
€\a),
Volumes of Proposed:
\p>
FiilCuto\
sq/ft
sq/ft
sq/ft
sq/ft
sq/ft
sq/ft
F,t' holLsSit*- p c?
Well, utilities, etc.
Drainfield, septic tank, etc.
Lawn, landscaping, etc.
Other compacted surface, etc.
(cu/yd)
Driveway, parking, roads, etc. 252t4 sqrt
Calculate the total area to be cleared, graded, filled,
excavated, and/or compacted for proposed development
project. lnclude in this calculation the area to be cleared for:
Construction site for structures I bg()
TotatLandDisturbance L\2J)3
stomwater €lc worksheet - REV. 1O2ODO14
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Structures (all roof area)
Sidewalks
Patios
Solid Decks
(without infiltration below)
Driveway, parking, roads,
Other
Tota! New
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NEW
sq/ft
sq/ft
STORMWATER CALULATIO NS - IMPERVIOUS SURFACE
etc 2oaS
s
sq/ft sq/ft
TotalExisting 4(Q? (D sqftt
q/ft *This amount will be used to check total lot coverage
-sq/ft
37AZ ,qnt
rorAL NEw + rorAL ExrsrNG* 9ZZZ
Driveway, parking, roads, etc
Other
EXISTING
Structures (all roof area)
Sidewalks
Patios
Solid Decks
(without infi ltration below)
&bLb sqr
sq/ft
Divide the total q.!g!!4g impervious surface above by the size of the parcel and convert to a percentag ", )S W
Does the site have 35o/o or more of existinq impervious surface?
DEVELOPMENT v. REDEVELOPMENT
Circle:Yes No m
FURTHER INSTRUCTIONS: lf the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be used
to determine the applicable Minimum Requirements. lf 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 lnstructions and Submittal
Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwoter Monogement Manuol.
APPLICANT SIGNATURE
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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 application is being made with the full knowledge and consent of all owners of the affected
property.
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stomMter Glc worksheet - REV. lODODO14
The following questions will help determine whether the proposed project is considered development or redevelopment.
USE ONLY
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thold Ecavatlng Inc.
Fold
PO Box 179
Poft Hadlock, WA 98339
360-385-0480
r,,rairro' JERRY LEE
PROPERTY INFORMATION
Location:125 CUB RD
Tax lD:001321094
Use:PO BOX 449
PORT
983390449 GENERAL SYSTEM TYPE: Gravity
ON lD: SOM90-00535
This report does not assure approvals by Jefferson County Public Health for ANY future building permits or development.
COMMENTS & GENERAL INSPECTION IVOTES
No Deficiencies Aroted
GENERAL S'TE & SYSTEM CONDITIONS
lf deficiencies were identified on last inspection were they corrected before or during this inspection?YES
describe in NA = no deficiencies on last
Components, structures and appurtenances located per as-builUrecord drawing (reference Septic YES
Permit # in notes). lf NO, describe in notes and if no as-built exists or changes made, state NO and
record to Health
made to the OSS (valves adjusted, timer settings modifled, ports installed, etc.) (lf YES,
ln
ls case in comments)YES
O/VS'IE SEWAGE SYSIEM INSPECTION DETAIL
Fold
HereHere
NO
JUL e 2018
tr tr IVtr
Inspected:04/16/2018 - lnspection Type: ROUTINE - Correction Stafus.'Aro corrections needed
Company: Ceftification - Level 2 Work Performed By:
Shold Excavating lnc. Martin Fugere
Submifted 04/20/201 I by:
Timothy Johnson
ON€ITE WASTEWATER TREATTENT SYSTEM I NSPECTIOI{ REPORT
The General Site and System Conditions were:Fully lnspected
All Components accessible for mainlenance, secure and in good condition:YES
Surfacing effluent from any component (including mound seepage):NO
Components appear to be watertight - no visual leaks:YES
lmproper encroachment (roads, buildings, etc.) onto component(s):NO
Component settling problems observed:NO
Abnormal ponding present for one or more of the disposal components:NO
YES
NO
Subsurface components adequately covered
Owner compliance issues noted
NO
The house/structure was vacant or used infrequently, assessment of the drainfield was not possible.NO
This component was:Fully lnspected
Component appears to be functioning as intended:YES
Emuent level within operational limits (if NO explain in comments):YES
All required baflles in place (N/A = No baflles required):YES
Effluent Filter Cleaned (N/A = Not Present):N/A
Effluent filter/screen needed cleaning on arrival N/A
Compartment I Scum accumulation (lnches, if other specify):1
Compartment 1 Sludge accumulation (lnches, if other specify):4
Compartment 2 Scum accumulation (lnches, if other specify):0
Compartment 2 SIudge accumulation (lnches, if other specily):2
Pumping needed NO
Approximate Gallons to be pumped (if needed) by Certified Pumper:0
TANK: Septic Tank - 2 Compartment
ReportlD:671253 View inspection reporls online at www.onlinerme.com Page 1 of 2
This component was:Fully lnspected
Component appears to be functioning as intended:YES
Ponding present? lf YES explain in comments:NO
Drainfield was vacuumed, flushed or hydro-jetted? (lf YES, explain in comments)NO
Drai nti el d (d i sposal ) :
This repdl indicates cetlain characteislics ot the orsile sewage system al lhe time ot visit. ln no way is this repod a guaanlee ol opealion or lutu@ perlormance.
ReportlD: 671253 View inspection reports online at www.onlinerme.com Page 2 ot 2
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pRolecr/npprtCANT NAME:ttitt-c #
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DEPARTMENT OF COMMUNITY DEVELOP
621 Sheridan Street, Port Townsend, WA 98368
Tel: 360.379.4450 | Fax: 360.379.4451"
Web: www.co. iefferson.wa. us/communitydevelopment
[-mail: dcd@co.iefferson.wa.us
SUPPLEMENTAL APPLI CAT I ON
STORMWATER MANAGEMENT PERMIT
Applications for grading projects or land-disturbing activities which require a stormwater management permit shall include the following
information. This information may also be provided on other diagrams, plans, studies, or attachments submitted with the project
application. lf so, please indicate such on this permit application. The Administrator may waive specific submittal requirements
determined to be unnecessary for review of the application.
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1. Source of fill material and deposition of excess material.
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2. Physical characteristics of fill material:
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3. Proposed methods of placement and compaction consistent with the applicable standards in the lnternational Building Code
4. Proposed surfacing material.
5. Proposed method(s) of drainage and erosion control.
6. Methods for restoration of the site.
7. Demonstrate that instream flowof waterwill remain unobstructed. NIl(l-
8. Demonstrate that erosion and sedimentation from outflow channels will be minimized by vegetation or other means, and
demonstrate that pond runoff will be controlled to protect adjacent property damage irln
By signing the application form, the applicanUowner 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
1. 2./ y
(LANDOWNER OR REPRESENTATIVE SIGNATURE)(DATE)
property
G:\PemitCenterWFORMSrf#\DRD\Stomwate^stormwater mgmt permit-FlNAL.doc REV. '1ODO|2O14 Page 3
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PROJECT/APPLICANT NAME:MLA #a
oo
DEPARTMENT OF COMMUNITY DEVE
62'1 Sheridan Street, Port Townsend, WA 98368
Tel: 360.379.4450 | Fax: 360.379.4451
Web : www. co. iefferso n.wa. us/commu n itydevelooment
E-mail : dcd@co jefferson.wa.us
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STORMSTATER SITE PI-AN SUBMITTAL TEMPI-ATE
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
Describe the proposed developed conditions of the site. lndicate position and relative size of proposed improvements on the
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Existing Conditions Summary
Describe the existing topography. lndicate contours on the site map.2.
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3. Describe the existinq vegetation. lndicate native vegetation areas on the site map.
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4. Describe the existing soils. lndicate soil type on the site map.
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Describe the existing site hydrology (i.e., drainage; behavior of water on the site-above, below, and on the ground). lndicate
existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if
aoolicable. and indicate acreaqe of each.
5.
6. Describe any excess levels of noise qenerated by the proposed use or activity:
SkcrnAa,/c). \arn^tAinr^ l.roisL $:r C/ -nbt?r,rc.,kion durv:a'*ta,:l
Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams
steep slopes, etc.) on the site. lndicate location on the site map. Asnt,
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stomwater site plan templale - rcv. 12nDO15
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Describe the general vicinity of the site, including adjacent land uses and structures, utilities, roads, and sensitive/critical areas
(streams. wetlands. lakes. steeo slooes. etc.).
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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, pollutiongenerating impervious
surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control
facilities are not exceeded.
9. Describe the developed site hydrology, as proposed lndicate 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.
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Permanent Stormwater Control Plan
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10. lf the project requires the use of stormwatertreatment facilities, describe the types of stormwatertreatment 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.l
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11. Describe the performance goals and standards applicable to the project.
12. Describe the flow control system
13. Describe the water quality system
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14. Describe the conveyance system analysis and design
15. Describe the source of fill material, physical characteristics of fill material, and deposition of excess material.
16. Proposed methods of placement and compaction cpnsistent with the applicable standards on Appendix Chapter 33 of the
Uniform Building Code.
17. Describe the proposed surfacing material.
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.l lf 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. lf those permits or approvals include
conditions that affect the drainage plan or contain more restrictive drainage-related requirements, describe those conditions or
restrictions here.
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CoNSTRUCTION STORMWATER POLLUTTON PREVENTTON 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 - CONSTRUCT]ON SWPPP NARRATIVE
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Construction Stormwater Pollution Plan Elements. Describe how each of the Construction SWPPP elements has been or
will be addressed. ldentify the type and location of BMPs used to satisfy the required element. lf an element is not applicable to
the proposal, justify in writing. Detailed descriptions of the 13 Elements are found at Volume ll Section 3.3.3 of the Manual
(beginning on page 3-1 1).
13 Required Elements - Construction SWPPP
1. Mark Clearing
2. Establish Construction Access./-lol y<r-rrir.e A - €*ttlrtnq 0-rr-o-csUJ
3. Control Flow Rates.
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4. lnstall Sediment Controls.1'r\\ -Cenae te- ret r'1*A or vter qScrrcl
5. Stabilize Soils.
6. Protect Slopes.
7. Protect Drain lnlets.Yn) dra,-r^. i-nr\-r,r-s
stomwater site plan template - rcv. 12fif2O15 8
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13 Required Elements - Construction SWPPP (continued)
8. Stabilize Channels and Outlets.
9. Control Pollutants.
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10. Control De-Watering (the act of pumping groundwater or stormwater away from an active construction site).
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11. Maintain Best Management Practices (BMPs).
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12. Manage the Project.+
13. Protect Low lmpact Development BMP'sn
2 Adjacent Arcas.
a. Description of the adjacent areas that may be affected by site disturbance (e.9., streams, lakes, wetlands, residential
areas, roads).
b. Description of the downstream drainage path leading from the site to the receiving body of water (minimum distance of 400
yards).
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3 Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
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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.9., erodibility, settleability, permeability, depth, texture, soil structure).
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5 Construction Phasing.
a. Construction sequence
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b. Construction phasing (if proposed)
o Construction Schedule. Wet season is October 1 through April 30 (page 2-20 of the Manual).
l. Provide a proposed construction schedule.
il.Wet Season Construction Activities.
a. Proposed wet season construction activities.
b. Proposed wet season construction activities for environmentally sensitive areas
7 Financial/Ownership Responsibilities.
a. ldentify the property owner responsible for the initiation of bonds and/or other financial securities
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. SedimentPonds/Traps
b. Diversions.
c. Waterways.
d. Runoff/Stormwater Detention Calculations
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stomwater site plan templale - rcv. 121712015 10
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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:
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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. lndicate boundaries of existing vegetation (e.g., tree lines, pasture areas, etc.).
d. ldentify and label areas of potential erosion problems.
e. ldentify FEMA base flood boundaries and Shoreline Management boundaries (if applicable).
f. Show existing and proposed contours.
g. lndicate drainage basins and direction of flow for individual drainage areas.
h. Label final grade contours and identi! 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 disturlced areas.
f. lndicate locations and outlets of any dewatering systems.
4. Location of Detention Best Management Practices (BMPs). ldentify location of detention BMPs.
5. Erosion
a.
b.
c.
d.
e.
f.
g.
h.
i.
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k.
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and Sediment Control Facilities.
Show the locations of sediment trap(s), pond(s), pipes and structures.
Dimension pond berm widths and inside and outside pond slopes.
lndicate the trap/pond storage required and the depth, length, and width dimensions.
Provide typical section views through pond and outlet structure.
Provide typical details of gravel cone and standpipe, and/or other filtering devices.
Detail stabilization techniques for outleVinlet.
Detail control/restrictor device location and details.
Specify mulch and/or recommended cover of berms and slopes.
Provide rock specifications and detail for rock check dam(s), if applicable.
Specify spacing for rock check dams as required.
Provide front and side sections of typical rock check dams.
lndicate the locations and provide details and specifications for silt fabric.
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. lndicate on the site plan the locations of BMPs to be used for the control of pollutants other than
sediment (e.9., concrete wash water).
Monitoring Locations. lndicate 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.
stomMter site plan templale - rev. 12n /2015 11
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Stormwater Site Plan Changes
lf 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
lf 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
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
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By signing the Construction SWPPP worksheet, I as the applicanUowner 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.
OR AUTHORIZED REPRESENTATIVE SIGNA
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stomwater site plan templale - rev. 1217D015 12
Case #:d lnfo date
Reviewer:Pa rce l:
I w{ Site-Plan shows all property lines and matches Assessor's map
f, U ." Legal Access to proPertY RAP
I u) Relevant ParcelTags
r1 Relevant Case History
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Zoning
Streams Wetlands
-
Landslide Flood _ SIPZ
Buffers Setbacks
f, d Shoreline Designation haeology-
Slope Stabil
trz
tq
No Shootin gTone oz
Stormwater lmpervious Surface %
--Proposed
New
Land Dlsturbi OZ Treatment method
Engineering
Parking spaces (2)
Building Height 35'
Setbacks
Plat conditions
Declaration of Restrictive Covenant
Additional lnformation Request
Tidemark fields, activities and conditions
UPFRONT REVIEW CHECKLIST
Go o?o ro ou."
?A/I lnvoice sent date:
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Last Revised :9/27 /20t7 C:\Users\davidj\Desktop\UPFRONT REVIEW CHECKLlST.docx
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DEPARTMENT OF COMMLTNITY DEVELO
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'l'el: 360.3i9.1450 | liar: .i6U.-119.4-{51
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STORMWATER CALCUI-ATION WORKS
MLA #PROJ ECI/APPTICANT NAME :,
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.
Land-disturbing dctivity 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.
Ndtive vegetofion 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, elCerberry,
salmonberry, and salal; herbaceous plants such as sword fern, foam flower, and fireweed.
lmpervious surldce is a hard surface that either prevents or retards the entry of water into the soil mantle as under naturai
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 ftow 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'
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PARCEL SIZE (I.E.. SITE)
An acre contains 43,560 square feet. Multiply the acreage by this figure.
Size of parcel in square feet 3{.8 sq/ftL6
Size of parcel l.2QP u.r."
LAND DISTURBING ACTIVITY. CONVERSION OF NATIVE VEGETATION. AND VOLUME OF CUT/FILL
Does the project convert 7, acres or more of
native vegetation to lawn or landscaped areas?
Circle: Yes @
Does the project convert 2/.acres or more of
native vegetation to pasture?
Circle: Yes @
Driveway, parking, roads, etc. 252(4 sqltt
q?-t)z
Construction site for structures lbr(>
lndicate Total
€\a,,
Volumes of Proposed:
\o$
b ?(,tl hd-LS
sq/ft
sq/ft
sq/ft
FiII
Drainfield, septic tank, etc.
Well, utilities, etc.
(cu/yd)cd6
lit*-
sq/ft
sq/ft
sq/ft
Other compacted surface, etc.
Total Land Disturbance
Lawn, landscaping, etc.
Answer the following two questions related to
conversion of native vegetation:
Calculate the total area to be cleared, graded, filled,
excavated, and/or compacted for proposed development
project. lnclude in this calculation the area to be cleared for:
stomwater calc worksheel - REV 10DO|2O14
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STORMWATER CALULATIONS - IMPERVIOUS SURFACE
Sidewalks sq/ft
Patios sq/ft
Solid Decks sq/ft
(without infi ltration below)
Driveway, parking, r.os6s, s1s 2DaB sq/ft l1u>
Total New
LZTOTAL NEW + TOTAL EXISTING*
&blb "qnt
sq/ft
sq/ft
t ,-t sq/ft
s q/ft
tft
o.lllb1
TotarExisting 4(Q2@ sqtt
q/ft *This amount will be used to check total lot coverage.
Driveway, parking, roads, etc
Other Other _sq/ft
EXISTING
Structures (all roof area)
Sidewalks
Patios
Solid Decks
(without infi ltration below)
NEW
Structures (all roof area)
DEVELOPMENT V. REDEVELOPMENT
Divide the total existinq impervious surface above by the size of the parcel and convert to a percentage:
Does the site have 35%o or more of existino impervious surface?
*l*"8CircleYes
The following questions will help determine whether the proposed project is considered development or redevelopment
FURTHER INSTRUCTIONS: lf the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be used
to determine the applicable Minimum Requirements. lf 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 staffwill help verifythe 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 lnstructions and Submittal
Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Monogement Monuol.
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 application is being made with the full knowledge and consent of all owners of the affected
property.
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stormMter elc worksheet - REV. 1Ol2Ol2O14 2
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PROJECT/APPLICANT NAMEMLA #
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DEPARTMENT OF COMMUNITY DEVELO ENT
621 Sheridan Street, Port Townsend, WA 98368
Tel: 360.379.4450 | Fax: 360.379.4451
We b : www. co. ieff e rson.qrq.gs/com mu n itvd eve lop ment
E-mail: dcd@co.iefferson.wa.us
SUPPLEMENTAL APPLICATION
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STO Rh{WATE R I\,{ANAGEMENT PE
Applications for grading projects or land-disturbing activities which require a stormwater management permit shall include the following
information. This information may also be provided on other diagrams, plans, studies, or attachments submitted with the project
application lf so, please indicate such on this permit application. The Administrator may waive specific submittal requirements
determined to be unnecessary for review of the application.
1.t5 Source of fill material and deposition of excess material
I
3. Proposed methods of placement and compaction consistentwith the applicable standards in the lnternational Building Code
4. Proposed surfacing material.
5. Proposed method(s) of drainage and erosion control I,
6. Methods for restoration of the site. h rr r<S{ar<,\-Lan nt/.AL^
7. Demonstrate that instream flow of water will remain unobstructed. Nlr+
8. Demonstrate that erosion and sedimentation from outflow channels will be minimized by vegetation or other means, and
demonstrate that pond runoff will be controlled to protect adj acent property damage fulA
By signing the application form, the applicanVowner 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
(LANDOWNER OR REPRESENTATIVE SIGNATURE)(DATE)
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2. Physical characteristicsoffill material: ndi*.f. <^it -'Iaadte SCfe4-t r--r<,eAs (,.. Slfe
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PROJECT/APPLICANT NAMEMLA #a
o
DEPARTMENT OF COMMUNITY DEVE
621 Sheridan Street, Port Townsend, WA 98368
Tel: 360.379.4450 | Fax: 360.379.4451
Web : ran,rrw. co iefferson.wa. usicommu n itvdevelopment
E-mail : dcd@co.iefferson.wa. us
STORMWATER SITE PLAN SUBN{ITTAL TEMP
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
Describe the proposed developed conditions of the site. lndicate position and relative size of proposed improvements on the
site
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Existing Conditions Summary
Describe the existing topography. lndicate contours on the site map
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3. Describe the existinq veqetation. lndicate native vegetation areas on the site map.
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4. Describe the existing soils. lndicate soil type on the site map
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Describetheexistingsitehydrology(i.e.,drainage; behaviorofwateronthesite-above,below,andontheground). lndicate
existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if
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applicable, and indicate acreage of each
6. Describe any excess levels of noise generated by the proposed
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use or activity.
Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep slopes, etc.) on the site. lndicate location on the site map. f\ Olr4-
7
stomwater site plan template - rev. 12n12015
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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.).
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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.
"tVtedium" 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 lndicate 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.
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Permanent Stormwater Control Plan
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10. lf 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. [his is
normally for "large" projects or projects that involve the potential for dispersion of contaminants.l
f)onJ.-
11. Describe the performance goals and standards applicable to the project.
12. Describe the flow control system
'1 3. Describe the water quality system
stomwater site plan lemplale - rcv. 12nf2015 6
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14. Describe the conveyance system analysis and design
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
18. Describe methods for restoration of the site.
1 9. 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.l lf 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. lf those permits or approvals include
conditions that affect the drainage plan or contain more restrictive drainage-related requirements, describe those conditions or
restrictions here.
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stomwater site plan template - rev 12rl2015 7
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CoNSTRUCTTON 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. ldentify the type and location of BMPs used to satisfy the required element. lf an element is not applicable to
theproposal,justifyinwriting. Detaileddescriptionsofthel3ElementsarefoundatVolumell Section3.3.3oftheManual
(beginning on page 3-1 1)
13 Required Elements - Construction SWPPP
1. Mark Clearing mits.
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2. Establish Construction Access.f)ot r<-q-u.irrd - €*taA{nq 0.rs_S$v J
3. Control Flow Rates.
Q S"e.r. Contrru$ s Soits r.A tg Y@-4-SSatvt
4. lnstall Sediment Controls.
5. Stabilize Soils.
7. Protect Drain lnlets
stomwater site plan template - rev 12r/2015 8
6. Protect Slopes.
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13 Required Elements - Construction SWPPP (continued)
8. Stabilize Channels and Outlets.
9. Control Pollutants
Cou2vln a S€r-r-urr<- la=l-iorr si{<
10. Control De-Watering (the act of pumping grou ndwater or stormwater away from an active construction site).
1 1. Maintain Best Management Practices (BMPs)
12. Manage the Project.
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Protect Low lmpact Development BMP'sn
2 Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.9., streams, lakes, wetlands, residential
areas, roads).
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b. Description of the downstream drainage path leading from the site to the receiving body of water (minimum distance of 400
yards).ulA
J.Environmentally Sensitive Areas.
a. Description of environmentally sensitive areas that are on or adjacent to the site.
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stormwater site pl an template - rev. 1 27120 1 5 I
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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.9., erodibility, settleability, permeability, depth, texture, soil structure).
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5 Construction Phasing.
a. Constructionsequence
A
b. Construction phasing (if proposed)
o-Construction Schedule. Wet season is October 1 through April 30 (page 2-20 of the Manual).
l. Provide a proposed construction schedule.
il Wet Season Construction Activities.
a. Proposed wet season construction activities.
b. Proposed wet season construction activities for environmentally sensitive areas.
7 Financial/Ownership Responsibilities.
a. ldentify the property owner responsible for the initiation of bonds and/or other financial securities.
b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
B. Engineering Calculations. Provide Design Calculations on a separate sheetforthe following, if applicable.
a.
b.
c.
d.
Sediment Ponds/Traps.
Diversions.
Wateruuays.
Runoff/Stormwater Detention Calculations
stomwater site plan templale - rcv. 121712015 10
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Stormwater Site Plan Changes
lf the designer wishes to make changes or revisions to the originally approved Slormwater 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 forthe change.
Final Corrected Plan Submittal
lf the project included construction of conveyance systems, treatment facilities, flow control facilities, or structural source control BMPs
(not standard on-site stormwater management BlVlPs), 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
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
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.
t/.)Jr-,^-c- tt ZaY
OR AUTHORIZED REPRESENTATIVE SIGNATURE)(DArE)
stomwater site plan templale - rev. 12nP015 12