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BLD2015-00096 - 01 PERMIT APPLICATION
BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD15-00096 Received Date: 3/26/2015 SITE ADDRESS: 684 SEAL ROCK RD Issue Date 4/14/2015 BRINNON, 98320 Expiration Date 4/14/2016 OWNER: KENNETH S BROCKWAY PHONE: 360-636-0383 KAREN F BROCKWAY 684 SEAL ROCK RD BRINNON WA 98320 9928 SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 992800004 Section: 26 Township: 26 N Range: 241 CONTRACTOR: TOWN &COUNTRY POST& FRAME PHONE: 425-743-1555 16521 HWY 99 SUITE C LYNNWOOD WA 98037-3161 Contractor's License TOWNCPF099LT Expires 6/30/2015 PROJECT DESCRIPTION: NEW PROPOSED 24' X 30' DETACHED POST FRAME STORAGE BUILDING UNHEATED NO PLUMBING SEP07-00017 TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 14.00 ADD'L: HEAT TYPE: UH CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: OTHER: SHORELINE: RA CONST TYPE: GAGE: 720 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $289.00 SRE 03/30/15 154249 Exist: Exist: Plan Check $187.85 SRE 03/30/15 154249 Prop: Prop: State Building Code $4.50 SRE 03/30/15 154249 Total: Total: Total: $481.35 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 3pm the day before 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 • Jefferson County Building Division Permit Number: BLD15-00096 Applicant: BROCKWAY BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2012 International Building Codes To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next days 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 S• etbacks :v (17 l t t'F Erosion Control P• ost Holes i t Z1� l I ^� (11J -k la`s `(-u Lsr(4.)k- 4�-4 AL Straps(hold downs) F• raming Int.Shear Wall Nailing Wallboard Nailing Septic System Finaled sep07-00017 A final inspection will not be scheduled until the following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed off • Public Works Permit Final(where applicable) FINAL INSPECTION -7/z4Jts-- FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD15-00096 1.) 50 foot building setback from Highway 101 reduced to 2 feet per Road Setback Variance JCC 18.30.050. 2.) This is for universal DRD conditions - not for custom case type specific conditions. 3.) The project shall adhere to the Best Management Practices (BMPs)to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 4.) The site plan as submitted with the Building Permit application on March 26, 2015 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated March 30, 2015 shall be resubmitted for review and approval by Jefferson County Department of Community Development. \\tidemark\data\forms\F_BLD_Permit_Bldg.rpt 4/14/2015 0 4D, ,,,-----)- <=-A, if % JEFFERSON FFERSON COUNTY I-) � „Q 1. DEPARTMENT OF COMMUNITY DE VELOPMENT 9 G� `� O� 621 Sheridan Street Port Townsend Washington 98368 ��c.0 6' SmN6S- 360/379-4450 • 360/379-4451 Fax �o 02 t Administrative Right-of-Way Setback Variance Request o� Note 6, Table 6-1, JCC 18.30.050 states in part, "The administrator may reduce the u' mum road setbacks if the strict application of such setback would render a legal lot of record unbuildable under the provisions of this code." Right-of-way setback variance requests not meeting the above may require a major variance. Date: 3-/9 - /s ,��}} Name of Property Owner: , 2t Reoc,,eui/dy/� Mailing Address: �oF�/, rkgL 4I-A. £� �2i/twei, Ifh 9kr3Zc i Phone#: 366 - 7s/-/33 Z- � Property Owner's Representative's Name: _ ` � �. r 1/4 Y j Mailing Address: /0S2i 44v7 99/ gr_ C LyaNrvopdr AV-4 9:P437 Phone #: 0__S -7413-15-63- Assessor's Tax Parcel Number: 99z r1'06 /2O Site Address: 6�y,�Fgz£ele ieb A,,,„v,A,, /Z 9,93 z O 1) What is the name of the road from which you are requesting a setback variance? //toy /D / 2) What is the distance you are requesting from the edge of the road right-of-way to the proposed structure? 2 3) Has the parcel been surveyed? If so, what is the Auditor's File Number Volume# Page # 4) Please stake your property line along the road right-of-way and stake the footprint of the proposed structure. Date this was/will be done. 3 7Fr-/S . • 5) Attach a site plan that has been drawn to scale showing: all property boundaries, all existing structures, buffers from critical areas (streams, wetlands, geologically hazardous areas, etc.) utilities (water lines, electrical lines, etc.), easements, driveways and septic system components. Label distances from the proposed structure to all of the above. 6) Please explain in detail why your proposal is unable to meet the required road setback. In your explanation describe all restrictions on your property which prohibit meeting the required setback (examples: streams, wetlands, landslide hazard, steep slopes, shoreline, etc.) Please attach any special reports or photos you have to support your request. In order to provide a complete explanation please attach additional sheets if necessary. // 4 ,4,ot b,y IV 1, 07 Fir/NS>Dl ",14Z 715 5 elhAtt'1e5 5) Attach a site plan that has been drawn to scale showing: all property boundaries, all existing structures, buffers from critical areas (streams, wetlands, geologically hazardous areas, etc_ ) utilities (water lines, electrical lines, etc.), easements, driveways and septic system components. Libel distances from the proposed structure to all of the above. 6). Please explain in detail why your proposal is unable to meet the required road setback. In your expla nation describe all restrictions on your property which prohibit meeting the required setback (examples: strams, wetlands, landslide hazard, steep slopes, shoreline, etc.) Please attach any special reports or photos you have to support your request. In order to provide a complete explanation please attach additional sheets if necessary. • __ ___ ___._ , 1 e r SIC-4 no i--e-- . Permits ?um From: Sally Ellis <SEllis @co jefferson.wa.us> Sent: Wednesday, March 04, 2015 3:22 PM To: Permits Subject: RE: Building Questions Attachments: Checklist- Building Application Submittal Checklist.pdf; Checklist- Site Plan Checklist.pdf; Permit Application2.pdf; Building Permit Application- supplemental BLDG.pdf; stormwater talc worksheet-writable.pdf; site plan from Septic sep07-00017.pdf Dear Steve As we discussed on the phone attached are the building permit forms that are required for all new Building Permits. 720sq.ft. Pole building- Unheated- No water Building base fee$289.00 Plan Check fee $187.85 Consistency review fee$234.00 Environmental Health fee$80.00 Scanning fee$ 19.50 State surcharge$4.50 Total est.cost of permit would be$814.85 cis, .�'Ct(U&Na $ 2 t 2-C c) fi Also I have attached the last site plan that we have on le for this parcel-in hopes that it will help you-with your site plan for the new permit! If you have any questions and or need more information please feel free to contact me! d �,�"! o �' �' AI I ' Thank you Sincerely Sally Ellis g.A.--a--.0-- ''r // rC,.=* pc:44,r/7-36096,041-4-A/ - ' Sally L Ellis Jefferson County Community Development Permit Technician 621 Sheridan St., Port Townsend,WA 98368 Mon-Thurs 9am - 4:30pm,closed from 12-1 TDLD1 C __ci Ph: 360-379-4452 Fax: 360-379-4451 � sellis@co.jefferson.wa.us http://www.co.jefferson.wa.us 1 1 • Permits From: Sporseen, Art <SporseA @wsdot.wa.gov> Sent: Wednesday, March 11, 2015 11:20 AM To: k2brockway @gmail.com Cc: Severson, Dale Subject: US101 vic mp305 left setback varience request To whom it may concern, WSDOT has no setback requirements from our Right of way (property) line.The only restrictions in this regard are, No portion of any building(roof overhang,gutters, porch slabs or the like) may encroach over said R/W line. No drainage or surface waters may be directed toward WSDOT right off way. No driveway or access to US101 from this parcel will be permitted. No parking or other use of WSDOT right of way will be allowed. If you have any questions,feel free to call me @ 360-357-2706 Art Sporseen WSDOT Development Review Engineer WSDOT Olympic Region 360-357-2706 D EoF [tv_g_fr .„ MAR 1 6 2015 it JEFFERSON COUNTY DEPT.or COMMUNITY DEVELOPMENT 1 •Up Front Parcel Reviews -5(G-09,62 Parcel 992800004 Printed: March 30, 2015 KENNETH S BROCKWAY Site Address(es): KAREN F BROCKWAY 684 SEAL ROCK RD BRINNON, WA 98320 684 SEAL ROCK RD BRINNON, WA 98320 Parcel Number: 992800004 S-T-R: 26-26N-2W Total Acreage 0 Legal Description SEAL ROCK LOTS 4& 5 SUBJ/REST COVT#519318 Land Use: 1100 CON @OWNER'S REQ 3/12 Flood District: Fire District: 4 Planning Area: 11 Flood Map(FIRM)Panel No: School District 46 Zoning: COMP PLAN DESIGNATION: CQ MIMUNITY PLAN: UGA: UGA Trans [ if] Plot plan states "property line" [ if AssessoI's Map (Property linesygsubmitted plot plan must match the property lines as identified on the Assessor's 1/4 map) [ 1..6 Legal Access to Property NO [ Parcel Tags or Scanned Documents ES NC) t u ESA's: Special Reports Nearby YES [ tY'/Designated Ag YES NO [ lX Shoreline Designation: YES NO _ [Li Shoreline Slope Stability: YES CP Stream Type:YES NO FWHCA: YES NO Wetlands: YES NO 9‘ 1 Rare Plants:YES NO Seismic: YES NO Landslide: YES NO Flood: YES NO Erosion: YES NO Aquifer Recharge Area:YES NO ■N., SIPZ: none At Risk High Risk Coastal CMZ: none High Risk Moderate RiskDisconnected CMZ Stormwater site plan sub is itted: YesNo [yr- Forest Lands: YES NO Adjoining Forest Lands: Commercial/ Rural/ Inholding [4r Mineral Lands: YES 0 [ Agricultural Lands: YES 0 [ kr Archaeology: YES N1�� [ 44"-- ' No Shooting Zone: YES CI [ t4"Stormwater: New Im.-+ '. s Surface `"ci 1 Land Disturbing Activity (Cl 9C( ESA's Stormwater Req'.:Min Reg#2 Min Req#1 thru#5 Min Req#1 thru#10 Engineering [ t/]' otice Provisions/Disc osure:Airport YES NO MRL YES NO Forest Lands YES NO [ v}�Landscaping Required: Yes 4 [t1 Parking Spaces Re a uire• NO 2 Other f v Building Height: ® I 'C Standard [ th Impervious Surface cover percentage: Resource Lands& Public: Iow Rural Residential dio\ Rural Indillikl: Per UDC Sec 6.7 Rural Commercial: 60% Area of Building . -rage:60%in Rural Industrial Lands only [ Total Building (s) Size: RVC: 20,000 SF CC: 5,000 SF NC: 7,500 SF GC: 1,0.00 SF All others:subject to se ti &water constraints/Non specified [ 1.eir- Setbacks: Front:7__Left Side: 5 Right Side: L, Rear: ', Shoreline Setback: �f -?..— d _r , l•ktilitit (.6 L h foot— fft:. Z ci- LSHA Setback: [1/1 Road Classification: Road Approach: h : REQ'D RAP [L]/ SEPA Required: YES x /i A [ Flood Certificate: rr fiT [ LK. Existing Case(s) & Condition(s): Violations: Yes No [ 1,4"-- Recorded Date of Subdivision: ✓ AFN Over 5yrs=UDC Plat Conditions: <5yrs=Plat C itions on plat or Old Ordinance [t'1 Lots/Require Declaration of Restrictiv ovenant €010, submitted: YES ) NO _ t 8 [ 1.4- UGA No Protest Agreement YE 'submitted: YES NO [L Site Visit conducted YES O [ Require Final Zoning Approval YES NO ' r �.r [] ADMIN: Setbacks entered in Permit Plan cas ES (•-`,tA1 l© [ 21 "C. New Parcel Tags entered in rmit Plan /A YES Special Reports Scanne N/A YES Title Notes Updated Parcel tags found for parcel 992800004 1.) Eagle Management SEP07-00017 See Laserfiche or DCD Special Report Files 10/05/2007 Plan for full report. Parcel tags found for parcel 992800004 2.) WSRC Coaching - 2012-02-17, CZ 08/29/2013 Other Cases Associated with APN 992800004 Review Cases Name Type Status Planner BLD09-00081 BROCKWAY F Application Received: 3/17/2009 Permit Issued/Case closed: 4/13/2009 Case Finaled: 3/23/2011 CONVERT EXISTING CABIN TO UNHTD STORAGE/SHOP-REMOVE KITCHEN & BATHROOM BLD15-00096 BROCKWAY P David Wayne Johnson Application Received: 3/26/2015 Permit Issued/Case closed: Case Finaled: NEW PROPOSED 24' X 30' UE IACHED POST FRAME STORAGE BUILDING UNHEATED NO PLUMBING SEP07-00017 BLD99-00386 BROCKWAY F Application Received: 6/21/1999 Permit Issued/Case closed: 7/14/1999 Case Finaled: 7/11/2000 cabin remodel/repair porch CAM15-00113 TRIPLETT NA M Colleen Zmolek Application Received: 3/4/2015 Permit Issued/Case closed: 3/4/2015 Case Finaled: Seal Rock Rd. and Hwy 101 setbacks MLA09-00054 BLD09-00052 MLA09-00054 BROCKWAY I F Michelle Farfan Application Received: 2/24/2009 Permit Issued/Case closed: 4/1/2009 Case Finaled: 3/29/2011 NSFR W/ATT GARAGE SEP07-00017 BROCKWAY F Application Received: 1/22/2007 Permit Issued/Case closed: 10/17/2007 Case Finaled: 7/24/2008 SOM07-00017 BROCKWAY F Application Received: 1/22/2007 Permit Issued/Case closed: Case Finaled: \\tidemark\data\forms\R_Parcel_CRMtA.rpt 3/30/2015 Page 2 of 2 s v-> - • cgs°NCO JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT (-Is, 621 Sheridan Street • Port Townsend • Washington 98368n'% `%-iNo(- 360/379-4450 • 360/379-4451 Fax Administrative Right-of-Way Setback Variance Request . Note 6, Table 6-1, JCC 18.30.050 states in part, The administrator may reduce the mi -4*-}ir0ad-4 setbacks if the strict application of such setback would render a legal lot of record unbuildab '' ,r the provisions of this code." Right-of-way setback variance requests not meeting the above may requ : a major variance. Date: .3--/1 - /S Name of Property Owner: gieve,,e-ovAiy Mailing Address: (p�y._r�/{i �� ,E'j� �iNNDAi i it/4 9A'jzc Phone #: 360 -- 1;7-/33 Z Property Owner's Representative's Name: � � Zed.° - i T- / ca ti r tou/v 7-17 ss7 D`al')s Mailing Address: %(957/ 44/7 4/9/ Sir_ C 441/v 41-4"C'.6) i A 9'&437 Phone #: 7�s -75/3-/-5-65- Assessor's Tax Parcel Number: 9.9Z PDa &)y Site Address: i‘eysFAL ley el! 'Eb ,gie/N,vo.v J /444- 9<.9 3 zo 1) What is the name of the road from which you are requesting a setback variance? /iv, /a 1 2) What is the distance you are requesting from the edge of the road right-of-way to the proposed / structure? Z 3) Has the parcel been surveyed? If so, what is the Auditor's File Number Volume # Page # 4) Please stake your property line along the road right-of-way and stake the footprint of the proposed structure. Date this was/will be done. 3 - ZP-/S G:!Per mit Cent er\###FORMS###1DRD FORMSIROVV doc Page 1 of 2 • • 5) Attach a site plan that has been drawn to scale showing: all property boundaries, all existing structures, buffers from critical areas (streams, wetlands, geologically hazardous areas, etc.) utilities (water lines, electrical lines, etc.), easements, driveways and septic system components. Label distances from the proposed structure to all of the above. 6) Please explain in detail why your proposal is unable to meet the required road setback. In your explanation describe all restrictions on your property which prohibit meeting the required setback (examples: streams, wetlands, landslide hazard, steep slopes, shoreline, etc.) Please attach any special reports or photos you have to support your request. In order to provide a complete explanation please attach additional sheets if necessary. i�1 4 7 W e_Ain4.4e W e/ fArinu S OF- .3 Laenl T • G:\PerrnitCenter't##FORMS###\DR0 FORMS\ROW.doc Page 2of 2 • _._ • i 519 r1 8 it iilliiig 6�� IR 1E!r iliii I I�I Cl/CS/2007 1 or 3 39P Jefferson County Department of Community Development Development Review Division 621 Sheridan Avenue Port Townsend,WA 98368 �//DECLARATION OF RESTRICTIVE COVENANT Grantors: /1P44e-t S. i a , a /. L /I /-- .. a • Grantee: Jefferson County Department of Community Developmen Jefferson County Health&Human Services •0 �TT/HIS DECLARATION is made ndd entered this day of _r t _t..•,by �JP/7,7,7`�i 3O G/t/py �latC/J ��lp c /1/dd�,herein' -' yy�'". to as"Owner(s)," the legal and equitable coiner(s)of the real property desefibe• erein. A.RECITALS O 1. Legal Description: This Restrictive Cove.. s•• affec d restrict the real property("the property")legally described as follows: Parcel Number 9Y2 Poo 00y -- e,O 0J.5-- Section ownship Range a W Subdivision Se fn, n Block Lot(s) i • Stott verification 2. Building Permit Application.The Ir. av applied or will apply for a building permit through the Jefferson County Departm= r• • •nity Development("the County")and/or an «. s. Health Human Services "Health on site sewage permit through a effe Hal & Department")to make certain iii . • •e the above-described property. 3. Purpose. For purposes of c. •• the County's building and land use codes and ordinances,as well as the He. 0 is • t : minimum land area for issuance of an on-site sewage permit per WAC 246-As the O '.- •esire to treat all of the above-described property as one building.tract,and in . • , , .-iy, do so for the purpose of constructing a 61INSAa, fam:i ' I I • t cf/ , utilizt g an indi • 1 •-site .•w,ge disposal system,as required by county code and/or state health regulatio C:\Docwnents and: mgs . h al Servings\Temporary Internet Files\OLK31\Declaration of Rest Ictive Covenant.doc f3 4/S11111C11111! IP • - 519318 VIII 1111111101111 111111 IIIIIII 0109fz00; 01.39P 1..,.rrn, rmmly O,M rr,WCru WinrWUOV rnu la M 4. Assurance to County. The Owner(s)desire to assure the County that the property described above shall be and remain as one building tract for purposes of improvements to be constructed upon the property; NOW,THEREFORE,in consideration of the benefits derived by this Restrictive Covenant,the Owner(s)declare,covenant and agree as follows: B. COVENANT /\ 1. Specific Restriction and Covenant. The property described above,shall constitute a single building site,and no lot or lots or any part thereof shall be transferred or/conveyed iil\any manner unless and until the building(s),structure(s)or on-site sewage disposal v smits-arenade to conform to the then-existing zoning provisions on a reduced site istri ve cod ant shall not be removed unless such an action is approved by the County the Health Depainnent. 2. Covenant Running with the Land. This restrictive covenant affx tc and} stricts the lm described property and shall be construed as a covenant rnifi • aid to ng and concerning the land and inuring to the benefit of the Owner(), a puplie generally,and the County. �' /� \ 3. Binding upon Successors and Assigns.This .estnctive gb)enant shall bind and restrict the land,the Owner(s),their heirs,grantees,successd7 and assigns. 4. Recording. Upon its execution,this Declarationshall_b_e-r6corded with the Jefferson County Auditor. All contracts and deeds or other/instruments of conveyance relating to the property or any part thereof shall contain reference tuenant. \ \ 5. Enforcement. In addition to any otherflarrytinving a legal right to enforce this covenant,the County shall have the right to enforce d eQrppe1'sgmpliance with this covenant,including all remedies available at law and eq}li_ty. p c�hlt) all have the right in any such proceeding to recover its attorney fees and co 6. Compliance with Code Requiremebt4. illis Declaration does not amend or modify,nor is it intended to amend or modify artyirequi<reTeAts of the County's ordinances or any other law or regulation dealing with or affdctiipg the use of land or construction of improvements upon lands. 7. Estoppel.The OWi ers� hectarraation specifically estop themselves and all of their successors and assignshahicl aft-persops presently or hereafter having any interest in the property from asserting ortorftenditiOn aitymanner that this restrictive covenant is not a full and adequate covenant miyvitlrthe land and binding upon the property. '') J C:\Documents and/Se tiii iiiiCh\LovaaI Settings\Temporary Internet Files\OLK3 l\Declaration of Restrictive Cavenanidoc cs,,,,._41!) III • ifillE11111111111111111111111111111011111117213238 9 , 3 39P I.(I, r...in.,, 1•.. vou6Tu oonrvL v rMl 9n MM 8. Severance.Invalidation of this covenant by judgment or court order shall not affect any of the other covenants which shall remain in full force and effect. 9. Warranty of Authority. The Owner(s)signing below warrant that they are the sole Owners in fee of the real property described above and are authorized to make this Declaration and so bind the property. 10. Governing Law. This RESTRICTIVE COVENANT shall be governe5l'b.'the laws of the State of Washington. \ \ \ 11. Disclaimer. Since no survey was submitted as part of your Restri� Covena t,,the County accepts no liability for what facts a survey might have revealed. A s ighit tie evealed that a structure or improvement believed to be on the grantor's property-is,in fact,1pcted wholly or partially upon someone else's property or upon property that is the subject of this application. But,in the absence of a survey,the GRANTOR be le ies c risibility if such a problem arises. ---- '--'' `, Dated this VA day of tiiilY1/Gq}Q)/ ,Rteir Owner ��( Owner II STATE OF WASHINGTON ) ss COUNTY OF 3E1� ') �. On this day personally appeared before . J).f to me known to be the individual described in and w ex ed tie within and foregoing instrumen and acknowledged that he signed the same as hisffrr r an yoluhtary act and deed,for the uses and purposes therein mentioned. 1 .+� °„E K rrq S 8 tom' hand and Val \ day of ;-2996,.—'UlD7 �! vw y� W»oN' .ec�Y, \ I oo�NOLq,9 rb, ; ... • _ I _ l` . II w `"'� y; ; 7 \ `r) .•1 • t In and for the State of Washington li 7•s ',1•18L IC ,r : A) residing at r , _ O?f9-ag .. psi Y My commission e :ires: Z• APP���itsH\NG II I. 4 \� / C Administrat• .� � Date C:\Documents and j3enings\r tah\.o.10411 Settings\Temporary Internet Files 1OLK3I\Declaration of Restrictive Covenant.doc r � \ \ • • 'Permits From: Sporseen, Art <SporseA @wsdot.wa.gov> Sent: Wednesday, March 11, 2015 11:20 AM To: k2brockway @gmail.com Cc: Severson, Dale Subject: US101 vic mp305 left setback varience request To whom it may concern, WSDOT has no setback requirements from our Right of way (property) line.The only restrictions in this regard are, No portion of any building (roof overhang, gutters, porch slabs or the like) may encroach over said R/W line. No drainage or surface waters may be directed toward WSDOT right off way. No driveway or access to US101 from this parcel will be permitted. No parking or other use of WSDOT right of way will be allowed. If you have any questions,feel free to call me @ 360-357-2706 Art Sporseen WSDOT Development Review Engineer WSDOT Olympic Region 360-357-2706 i 7-- -- -- , , pi MAR 1 6 2015 k , ;,, , JTY ""T.0 COW MINITY f, !raffloMT t 1 BUILDING PERMIT APPLIC ON BLD15-00096 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00096 Received Date: 3/26/2015 SITE ADDRESS: 684 SEAL ROCK RD BRINNON, 98320 OWNER: KENNETH S BROCKWAY PHONE: 360-636-0383 KAREN F BROCKWAY 684 SEAL ROCK RD BRINNON WA 98320 9928 SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 992800004 Section: 26 Township: 26 N Range: 2V1 CONTRACTOR: TOWN &COUNTRY POST & FRAME PHONE: 425-743-1555 16521 HWY 99 SUITE C LYNNWOOD WA 98037-3161 Contractor's License TOWNCPF099LT Expires 6/30/2015 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIO1 NEW PROPOSED 24' X 30' DETACHED POST FRAME STORAGE BUILDING UNHEATED NO PLUMBING SEP07-00017 TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 14.00 ADD'L: HEAT TYPE: UH CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: DECRKAGE. 720 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date APPROVED Total: APR 1 u 2015 Jefferson Court [X [ 1ltidemark\data\forms\F_BLD_App_Bld.rpt 3/26/2015 • • 1 1 1 I EC , AVEr SO go oG DEPARTMENT OF COMMUNITY DEVELO NT' ( Ne 6 21 Sheridan Street,Port Townsend,WA 98368 n'I I I Tel:360.379.4450 I Fax:360.379.4451 11 i i MAR 2 • 2015 \\'eb:www.eo.icfferson.wa.us/eommunindevelopment LII E mad.dcd@.co.jefferson.wa,us J pJErFERSOIyyOfjjVJY s„f N EPT.Of COMMl1A4 DnJCin�elemr �'^!;iT STORMWATER CALCULATION WORKSHEET MLA k PROJECT/APPLICANT NAME: ,L j !(,'OyL e 91 Sly/244e/JlG7�—707,iv Jac`UNY.Q� DETERMINING STORM WATER 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(I.E.,SITE) Size of parcel ,'72 acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet 10,5.O 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 CUT/FILL Calculate the total area to be Geared,graded,filled, Answer the following two questions related to excavated,and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: Does the project convert'A acres or more of Construction site for structures APi/ sq/ft native vegetation to lawn or landscaped areas? Drainfield,septic tank,etc. sq/ft Circle: Yes (' Well, utilities,etc. sq/ft Does the project convert 21%acres or more of native vegetation to pasture? Driveway,parking,roads, etc. sq/ft Circle: Yes Ga Lawn, landscaping,etc. sq/ft Other compacted surface,etc. sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance sq/ft Cut 'Zs Fill 23 (cu/yd) 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. Stormwater calc worksheet—REV.10r20rz014 1 • STORMWATER CALULATIONS—IMPERVIOUS SURFACE NEW EXISTING Structures(all roof area) J9/ sq/ft Structures(all roof area) ZcCq sq/ft Sidewalks sq/ft Sidewalks sq/ft Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks sq/ft (without infiltration below) (without infiltration below) Driveway,parking, roads, etc 37 5 sq/ft Driveway, parking,roads,etc / d-5-C sq/ft Other sq/ft Other sq/ft Total New sq/ft Total Existing `1/> `t sq/ft TOTAL NEW+ TOTAL EXISTING* /Z 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: P % Does the site have 35%or more of existing impervious surface? Circle: Yes No V 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 Stor ater Calculation Worksheet,I as the applicant/owner attest that the information provided herein is true and correct to the best of my kn ledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. ( DOWNER OR AUTHORIZED P SENTATIVE SIGNATURE) (DATE) W FOR OFFICE USE ONLY SMALL MEDIUM LARGE REDEVELOPMENT Stormwater Site Plan: Yes No stormwater calc worksheet—REV.10/20/2014 BUILDIN E PLIC!ION BR view T pe : Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD15-00096 Received Date: 3/26/2015 SITE ADDRESS: 684 SEAL ROCK RD BRINNON, 98320 OWNER: KENNETH S BROCKWAY PHONE: 360-636-0383 KAREN F BROCKWAY 684 SEAL ROCK RD BRINNON WA 98320 9928 SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 992800004 Section: 26 Township: 26 N Range: 2■1 CONTRACTOR: TOWN & COUNTRY POST & FRAME PHONE: 425-743-1555 16521 HWY 99 SUITE C LYNNWOOD WA 98037-3161 Contractor's License TOWNCPF099LT Expires 6/30/2015 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NEW PROPOSED 24' X 30' DETACHED POST FRAME STORAGE BUILDING UNHEATED NO PLUMBING SEP07-00017 TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 14.00 ADD'L: HEAT TYPE: UH CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: DECRKAGE. 720 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Total: \\tidemarkldatalforms\F_BLD_App_Bld.rpt 3/26/2015 rrom: n naermere mood Canal,innon 3607963122 030/2015 09:57 #031 P.002/003 Z�/7 fl [ D AV [ n05°N i DEPARTMENT OF COMMUNITY DY LOPMENT 621 Shendm Soon Port 1°wound WA 98368 i d 360 379 4450 1 1 ax 360 379 4451 I I) MAR 2 6 2015 Web)Yww cotefrrr.on via us/c0mmumtydevelopmcnl I J L maJ a i JEFFERSON COUNTY DEPT.OF COMMUNITY DEVELOPMENT PERMIT APPLICATION Steps in the Permit Process Review application checklist to ensure all information 1s 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 It Related Application Rs MLA ti Site Information Assessor Tax Parcel Number 992 800 004 Site Address and/or Directions to Property 684 Seal Rock Rd Access(name of street(s)) from which access will be gained Seal Rock Rd Present use of property Rural Residential Description of Work(include proposed uses) Proposed 24'x 30'detached post and frame storage building Wastewater-Sewage Disposal This property is served by Port Townsend of Port Ludlow sewer system? YES _ NO _f If not served by sewer identified above,identify type of septic system below • Type of Sewage System Serving Property 1 Septic septic permit It SEP07-00017 • • _ Community Septic Name of System Case it _ • • A • re other residences connected to the septic system? YES-Cabin Additions or repairs to sewage system Is it a complete or partial system installation Complete _1— Partial Has a reserve drainfield been designated? Yes I_ No Date of Last Operations&Maintenance check Attach last report to application Describe or attach any drainfield easements,covenants or notices on title,which may impact the property f • Pmw Appbcaoon Pace 1 or2 • • • • rrom:winaermere Hood Canal -Binnon 3607963122 03/110015 09'57 #031 P.003/003 The authorized agent/representative is the primary contact for all project related questions and correspondence The County will ( mad/c mall requests and information about the application to the authorized agent/representative and wilt copy(cc)the owner noted below The authorized agent/representative is responsible for communicating the information to all palsies involved with the application It is the responsibility of the authorized agent/representative and owner to ensure their mailbox accepts County eM2,1 e,County email is not blocked or sent to junk marl ) Applicant/Property Owner Information Property Owner Name Ken Brockway Address 684 Seal Rock Rd Bnnnon, WA 98320 Phone# 360-751-1332 E mail Address Please contact Autrt d Agent/ epresentative with project info (select only one) Property Owner Signature „.‘1/"--`� �f� Date t /f' C/✓r 1 'Note For projoots with muttipfe owners attach a separate sheet with each ,�ner(s)Information and ngnauues Applicant Authorized Agent/Representative(Pouter than owner) Name Town&Country Post Frame Buildings-Sieve Tnpletf Address 16521 Hwy 99,Ste C Lynnwood,WA 98037 Phone# 425-743-1555 E-mail Address permIts{a)permabilt corn Professional Is this art Authorized Agent/Represeptative for this project? NO ✓ YES Engineer Architect _ Surveyor Contractor Consultant Name Address Phone# E-mail Address Professional is the an Authonzed Agent/Representatrwe for this project? NO 1 YES Engineer Architect Surveyor Contractor Consultant Name Address Phone# E-mail Address Professional Is this an Authorized Agent/Representative for this project? NO ✓ YES Engineer — Architect _ Surveyor Contractor Consultant Name • Address Phone# E-mail Address Professional Is this an Anti oraed Agennt/Represeittatrre for this project? NO 1 YES Engineer 1 Architect Surveyor Contractor Consultant Name Terry Powell-TSE Engineering Address 12810 NE 178th St,Ste 218 Phone ft 425-481-6601 E-mail Address terry(�tse-alp con Attach additional pages rf necessary Builders Statement The signer of this stet•- •m certifies that they are the Owners of the parcel referenced herein,that they are not licensed contractors and th. >ley will • arming the respcns hilrty oft the General Contractor for the proposed project Signature ,� 1� �� Print Name elt8eITr eti S "'LETT-Date 3-3-15 • Pea=Amiaan Page 2<12 • • .„,$()N r, DEPARTMENT OF COMMUNITY DEVELO �Q4 � � � E G 621 Sheridan Street,Port"Townsend,\WA 98368 ��} l�• Tel:360 379.4450 l Fax:360.3724457 I f r _- < Web:tti�tw.co.jefferso n.wa.us/eommunitydevelopmcnt J I mail:dcd(<L:co.jcfferson.wa.us { 1) I • 2 6 70 �Sff l N GAO SUPPLEMENTAL APPLICATION ` If FFERSOLGQl]NM.,,, RESIDENTIAL OR COMMERCIAL BLDG PERMIT r coMValNirY DwE[OPM - For Department Use Only Receipt#: Date: Related Application#s: Payment#: Site Information Owner Name: �?Assessor Tax Parcel#: C �/Z ,�nc; ocj y Type of Building New Replacement Relocated Addition Repair Demolition Select One: "A separate permit is required Single Family Residence Modular Other,--"" ��9/✓��d list Proposed Building/Project Number of floors #new bedrooms existing total bed #new bathrooms existing total bath Heat Source Select all that apply: Electric Heating Oil Wood Propane Enter the square footage(sq/ft)that applies in each field: Structure Existing Sq/Ft Proposed Sq/Ft Residential/Commercial Main Floor Residential/Commercial Second Floor ��� I Z�" Additional Floors-heated/unheated Basement-unfinished Basement-finished space or habitable Detached Garage-heated/unheated Attached Garage-heated/unheated Garage 2nd fl-unfinished storage Garage 2nd fl-finished space or habitable Carport-2 walls or less — Deck-uncovered — Covered porch Other(shed, barn, pole bldg,etc.) Estimated Cost of Project(Required): Supplemental SFR I From:Windermere Hood Canal .nnon 3607963122 03/402015 09:57 #031 P.0021003 ���Sax °oG DEPARTMENT OF COMMUNITY DEVELOPMENT fir{. 621 Sheridan Stied Port 1ownscnd WA 98368 .., Id 360 379 4450 I lax 360 379 4451 Web www c cffrnen Wa us/communnydsslopmcnl L mad I shl NO,co PERMIT APPLICATION 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,rt 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 Budding Permit# Related Application#s MIA# • Site Information Assessor Tax Parcel Number 992 800 004 Site Address and/or Directions to Property 684 Seal Rock Rd Access(name of street(s)) from which access will be gained Seal Rock Rd Present use of property Rural Residential Description of Work(include proposed uses) Proposed 24'x 30'detach .d post and frame.,storage bulk1ing Wastewater-Sewage Disposal This property is served by Port Townsend of 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 • _1 A Septic Septic Permit# SEP07-00097 _ Community Septic Name of System Case# Are other residences connected to the septic system? YES-Cabin Additions or repairs to sewage system i Is it a complete or partial system installation Complete _t/_ Partial _ i a Has a reserve drainfield been designated? Yes _1_ No _ _ ) Date of Last Operations&Maintenance check Attach last report to application i t Describe or attach anydrambeld easements,covenants or notices on title,which may impact the property r f I • • l • Pmnu AppLeumn Page i of 2 I M A� 2 6 2015 • F�<ZS�IV, p„,, OF COMMUNITY DEVELOP urT From:Windermere Hood Canal 110nnon 3607963122 03/02015 09:57 #031 P.003/003 t I I t The authorized agent/representauve is the primary contact fat all project related questions and correspondence The County will mail/c mail requests and information about the apphcanon to the authorized agent/representative and coil!copy(cc)the owner noted below The authorized agent/represartaove is responsible for commuotcaong the tnfozmation to allparttes involved with the apptration It is the responsibility of the authorized agent/representative and owner to ensure then mailbox accepts County email p e,County email as not blocked or sent to tank mart ) Applicant/ Owner Information Property Owner Name Ken Brockway I Address 684 Seal Rock Rd Bnnnon,WA 98320 I 1 Phone# 360-751-1332 E matt Address I` Qj/A,�t. _✓ Please contact Auth d Agent/ epresentattve with project info (select only one) !4_ Property Owner Signature Date Note For protects with tnultrpieowners attach a separatesheet with onnation and ngnatures /l Applicant Authorized Agent/Representative(umber than owned Name Town& Country Post Frame Buildings-Steve Tnpleft Address 16521 Hwy 99,Ste C Lynnwood,WA 98037 Phone# 425-743-1555 E-mail Address petmds(a)permabdt corn Professional Is this an Authorized Agent/Representative for this project? NO t/ YES — Engineer Architect ` Surveyor Contractor Consultant Name Address Phone# E-mail Address Professional Is this an Authorized Agent/Representatae for this project? NO I YES Engineer _ Architect Surveyor Contractor Consultant Name Address Phone# E-mail Address Professional Is this an Authorized A entflepresentatjye for this project? NO 1 YES _ Engineer Architect Surveyor Contractor Consultant Name • Address Phone# E-mail Address Professional Is this an Authorized Ageritillepresentatrve ter this project? NO t/ YES • Engineer t/_ Architect _ Surveyor Contractor Consultant Name Terry Powell-TSE Engineering Address 12810 NE 178th St,Ste 218 Phone# 425-481-6601 E-man Address terry(.tse-aep cam • { Attach additional pages if necessary i !- Statement The signer of this star m certifies that they are the Owners of the parcel referenced herein,that they are not licensed contractors and th hey will .5...-.-uming the responsibility of the General Contractor for the proposed project t Signature ., 1_ _ f Print Name v$r etc c /re,P(.ETT Date 3-3-15 's .._.T EVV Eu YJ IC, Pass,„,--„p„,d2 r^- / 1--„) MAR 2 6 i —I 2015 Li V I JEFFERSON COUNTY t DEPT OF COMMUNITY DEVELOPMENT • • _SON , DEPARTMENT OF COMMUNITY DEVELOP E' \V, 11, 4G 621 Sheridan Street,Port Townsend,WA 98368 I Tel:360.379.4450 I Fax:360.379.4451 MAR -C Web:www.co.jefferson.wa.us/communitydevelopment • 115 a L'-mail:sled�co.jefferson.wit us '4-1/I N C; () SUPPLEMENTAL APPLICATION _ Tic Di RESIDENTIAL OR COMMERCIAL BLDG PERMIT For Department Use Only Receipt it Date: Related Application#s: Payment#: Site Information Owner Name: r Assessor Tax Parcel#: � -/ Type of Building New Replacement k Relocated Addition Repair Demolition "A separate permit is required Select One: Single Family Residence Modular Other a,_4',/Ci ist Proposed Building/Project Number of floors #new bedrooms existing total bed #new bathrooms existing total bath Heat Source Select all that apply: Electric Heating Oil Wood Propane Enter the square footage(sq/ft)that applies in each field: Structure Existing Sq/Ft Proposed Sq/Ft Residential/Commercial Main Floor , ®Cl JZd Residential/Commercial Second Floor Additional Floors- heated/unheated Basement-unfinished Basement-finished space or habitable Detached Garage- heated/unheated Attached Garage-heated/unheated Garage 2nd fl-unfinished storage Garage 2nd fl-finished space or habitable Carport-2 walls or less Deck-uncovered Covered porch Other(shed, barn, pole bldg,etc.) V Estimated Cost of Project(Required): $ /7 700 J j Supplemental SFR 1 / /I I I MAR 2 6 it IJ�L_..__ 2015 'II JEEEERSU CuUi'■TY l.. "Or COMMUNITY DRVEMI:WEN" • • ! 1-1I I= !rte y vE -- SON ��� ,. - c(��� DEPARTMENT OF COMMUNITY DEVELOPMENT K L. 621 Sheridan Street,Port Townsend,WA 98368 ! } . TeL 360.379.4450 I+ax.360.379.4451 I I 1 ^O�� Li x Web www.Co.jcfEnsun wa us/communitydevelo meat 1 U �L E-mail:dcdf�co.jc0irson.wa'us )ci YE.L0l,COUNTY /�9S�IN��O� i_. __rrr1_OF COMMUNITY DEVELOPMENT STORMWATER CALCULATION WORKSHEET ML4 It PROJECT/APPUCANT NAME: 13'I((/'ici(/ vZ4 a/glG�q- evN1Co uu7,e� DETERMINING STORMWATER MANAGEMENT REQUIREMENTS:This stormwater calculation worksheet should llbe 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(I.E.,SITE) Size of parcel ,f/7Z- acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet 10106 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 CUT/FILL Calculate the total area to be cleared,graded,filled, Answer the following two questions related to excavated,and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: Does the project convert Y.acres or more of Construction site for structures 64/ sq/ft native vegetation to lawn or landscaped areas? Drainfield,septic tank,etc. sq/ft Circle: Yes CO Well,utilities,etc. sq/ft Does the project convert 2'h acres or more of native vegetation to pasture? Driveway,parking, roads,etc. sq/ft ��; Circle: Yes V Lawn, landscaping,etc. sq/ft Other compacted surface,etc. sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance sq/ft Cut 25 Fill � C , Impervious surface is a hard surface that either prevents or retards the entry of water into the s•i• antle as under nature-al jl conditions prior to development. A hard surface area which causes water to run off the surface in :r:ater citmitie2 g ax !; increased rate of flow from the flow present under natural conditions prior to development. Commo Y p rlvious surfaces Inc j, but are not limited to roof tops,walkways, patios,driveways, parking lots or storage areas,concrete o4- p r It paving,gravel roads, it packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of s f €XeEuUNTY 1 .. ..!.'T.OF COMMUNITY DFVELOPM_F_NT stormwater calc worksheet—REV.1020,2014 1 • • • nMn STORMWATER CALULATIONS—IMPERVIOUS SURFACE NEW EXISTING Structures(all roof area) J9/ sq/ft Structures(all roof area) 2C2-4/ sq/ft Sidewalks sq/ft Sidewalks sq/ft Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks sq/ft (without infiltration below) (without infiltration below) Driveway,parking, roads, etc 'i75 sq/ft Driveway, parking, roads,etc / ,5 O sq/ft Other sq/ft Other sq/ft Total New sq/ft Total Existing 4/3 I sq/ft TOTAL NEW+TOTAL EXISTING* /Z/i G 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: Jr: Does the site have 35%or more of existing impervious surface? Circle: Yes No }f 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 Stor.mwater 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. 7 ' (L N: DO WK R O>AUTHORIZED P SENTATIVE SIGNATURE) (DATE) p:Fgt.frp -.r, J 3 kar,3 ' " ,. Ti �{�TIIB .i.` , , h { ? , li.&-a,. • ae.�.mom d� stormwater calc worksheet—REV.10/20/2014 2 Parcel Print Page 1 of I S Parcel Number.992800004 03/26/2015 Owner Mailing Address: KENNETH S BROCKWAY KAREN F BROCKWAY 684 SEAL ROCK RD BRINNON WA 98320 Site Address: 684 SEAL ROCK RD BRINNON 98320 Section: 26 School District: Brinnon (46) Qtr Section: SE 1/4 Fire Dist: Brinnon (4) Township: 26N Tax Status: Taxable Range: 2W Tax Code: 0441 Planning area: 98320 Sewer: Drainage: Bank: View 1: View 2: Zoning 1: RR-5 - Rural Residential Zoning 2: Zoning 3: Sub Division: 9928 - SEAL ROCK Land Use Code: 1100 98320 Property Description: SEAL ROCK LOTS 4 & 5 SUBJ/REST COVT#519318 CON @OWNER'S REQ 3/12 17))f7:7 PVEr t ` MAR 2 6 2015 11i JEFFERSON COUNTY ')CPT.OF COMMUNITY DEVELOPMENT http://www.co.jefferson.wa.us/assessors/parcel/parcelprint.asp?PARCEL_N0°992800004 3/26/2015