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Jefferson County
Board of Commissioners
Agenda Request
To: Board of Commissioners
Mark McCauley, Interim County Administrator
From: Monte Reinders, Public Works Director/County Engineer
Agenda Date: October 11, 2021
Subject: Open Right-of-Way Request - Pittsburg Ave.
Statement of Issue:
Public Works has received an application to open a portion of platted Pittsburg Ave.
right-of-way for approximately 150 feet for access to the Applicant's parcel.
Analysis/Strategic Goals/Pro's &t Con's:
The proposed area of right-of-way to be opened is located within the Plat Irondale
No. 5. This road is not proposed to be a County Road, therefore the County will not
be responsible for maintenance should this request be approved.
Per RCW 36.80.030, the supervision of right of way, including the development of
road standards is under the review of the County Engineer, acting under the
supervision and authority of the Board of County Commissioners. The County Engineer
has prepared standards for opening County right-of-way at this location as outlined in
the attached report.
Fiscal Impact/Cost Benefit Analysis:
There will be no cost to the County for maintenance or construction should this right-
of-way be opened.
Recommendation:
Jefferson County Public Works recommends approval of this application to open a
portion of platted Pittsburg Ave. for approximately 150 feet, as outlined on the
attached Engineer's Report. The Board is asked to sign the Resolution and return to
Public Works.
Department Contact:
Terry Duff 360-385-9159
Reviewed By:
4/411
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Mark McCaully, Interim County Admtrator Date
STATE OF WASHINGTON
COUNTY OF JEFFERSON
In the Matter of a Resolution }
to Construct a Road and Utilities on a } Resolution No.
Portion of Public Right of Way )
Known as Pittsburg Ave. )
WHEREAS, an application to construct roads and utilities on public right-of-way has been
submitted by Leil-ei Mae Raiguel for the purpose of providing access to their property, and
WHEREAS, said development will require opening approximately 150 feet of platted Pittsburg
Ave., and
WHEREAS, the Revised Code of Washington (RCW) 36.75 and 36.80 places the supervision of
right of way, including the development of road standards, under purview of the County Engineer, acting
under the supervision and authority of the Board of County Commissioners, and
WHEREAS, the applicant has proposed to construct roads to a standard less than what would be
required for public roads, and
WHEREAS, the County Engineer has examined the right of way and the existing road system and
the potential for future development and recommends that this request be approved provided the
standards described in the County Engineer's report dated September 28, 2021 are followed, and
WHEREAS, the applicant will be responsible for the maintenance of this section of roadway and
it is understood that the County will not be responsible for maintenance of this section of roadway and
that it will not be added to the official County Road log until such time as the road is improved to public
road standards and added to the County Road Log through Board action, and
WHEREAS, in lieu of requiring the road to be constructed to full public road standards at this
time, the applicant will be required to sign a no protest agreement waiving rights, except as to the
method of assessment, to protest formation of a pro-rata cost sharing arrangement such as a Road
Improvement District (RID) should it become necessary in the future to upgrade this road, whether
proposed by petition or a resolution of the Board of County Commissioners,
NOW, THEREFORE BE IT RESOLVED, that applicant shall be granted permission to open the following
right of way:
A portion of platted Pittsburg Ave. starting approximately 350' south from its intersection with
W. Island View Ave. continuing southerly for approximately 150 feet.
BE IT FURTHER RESOLVED, that roads shall be constructed in general conformance with the standards
recommended in the County Engineer's report dated September 28, 2021.
BE IT FINALLY RESOLVED, that prior to performing construction the applicant shall receive any and all
necessary permits including a permit from the Department of Public Works specifying any conditions
that will be required by the County Engineer to ensure that said standards are met and that the
applicant shall pay any inspection costs incurred by the Public Works Department to ensure that these
standards are met.
ADOPTED this day of , 2021.
JEFFERSON COUNTY
BOARD OF COMMISSIONERS
Kate Dean, Chair
Heidi Eisenhour, Member
Greg Brotherton, Member
ATTEST:
Carolyn Galloway
Deputy Clerk of the Board
Jefferson County Public Works Department
County Engineer's Report
Open Right -of -Way Portion of Platted Pittsburg Ave., Irondale No. 5
This Report is in response to an Open Right -of -Way Permit application (Exhibit A) submitted by
LeiLei Mae Raiguel. The intent of the County Engineer's Report is to evaluate and provide
preliminary design parameters/criteria to facilitate the appropriate design of the project. After
agency approval of all documents required by this report the applicant shall be issued a permit
by the Public Works Department.
PROJECT DESCRIPTION
Plat name: Irondale No. 5
Road / Street Name: Platted Pittsburg Ave.
Adjacent to: Assessor Parcel #962112310
Distance: Approximately 150 feet
Sections 34, Township 30 North, Range 1 W
The road is not proposed to be a County Road (Exhibit B = Site Plan).
EXISTING CONDITONS
This Permit would officially open a segment of platted Pittsburg Ave. right-of-way (subject
ROW) to provide access to the Applicant's parcel #962112310.
The access to this segment of Pittsburg Ave. is a continuation of N. Pittsburg which starts at W.
Island View Ave. and runs southerly toward Prospect Ave. for approximately 350 feet. This
segment averages a minimum 14 foot wide roadway with four foot shoulders on each side.
There is potential for this right-of-way to become a through road connecting to Prospect Ave.
which is approximately 90 feet from the termination of the new segment of Pittsburg Ave. to be
opened.
DESIGN STANDARDS
Roads shall be constructed to the County's adopted County Road design standards:
American Association of State Highway and Transportation Officials (AASHTO) Policy on
Geometric Design of Highways and Streets (most current version),
Washington Department of Transportation (WSDOT) Design Manual and Standard
Specifications for Road, Bridge and Municipal Construction,
Jefferson County Unified Development Code JCC 18.30.060 Grading, JCC 18.30.070
Stormwater, and JCC 18.30.080 Roads.
Based on proposed use and the potential for this right-of-way to connect to Prospect Ave., the
minimum typical section required will be for a "Local Access Road" with a minimum 18 foot
wide traveled way and 22 foot unobstructed width. The request to open this proposed
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segment of road is not for a county maintained roadway, therefore, it is not required to be
paved and the applicant will be responsible for the maintenance of this section of roadway.
RIGHT-OF-WAY
Platted right-of-way width: Sixty feet is the AASHTO recommended ROW width in rural county
areas. The current ROW width as platted is 50 feet. This width appears adequate in this case.
Right-of-way centerline location
Roadways shall be constructed on the right-of-way centerline unless this is not feasible due to
topography, environmental conditions (e.g., wetlands, water bodies, unstable slopes), or
transitions to existing roads.
Prior to construction, the right-of-way centerline shall be staked by a licensed professional land
surveyor or located in the field based on existing monuments or property corners set by a
licensed professional land surveyor.
DESIGN SPEED
Speed limit may be less than 25
This is a privately maintained dead-end road on public right-of-way, and no posted speed limit
is required.
DESIGN TRAFFIC VOLUME
The projected Average Daily Traffic (ADT) per residence is less than 10 trips per day for this new
road segment to serve two parcels.
SIGHT DISTANCE
Adequate sight distance must be met based on the criteria within the WSDOT design manual,
Chapter 1340 and/or the AASHTO design manual.
ROADWAY CONSTRUCTION PLANS
The proponent shall construct the roadway to the minimum standards depicted on the Typical
Section shown in Exhibit C.
The proponent shall submit road construction plans prepared by a licensed civil engineer to the
Public Works Department for review prior to commencing construction.
Road Construction Plan general requirements
Road plans shall meet the following general requirements:
• Be prepared by a licensed Washington state civil engineer;
• Include a plan view and a profile view;
• A scale of 1 inch = 50 feet or less;
• Depict the typical section;
• Depict project limits;
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• Depict right-of-way centerline;
• The design shall accommodate both existing and future lot access and utility service.
Plan View
The plan view shall at a minimum depict:
• Horizontal alignment of the proposed centerline at 50 feet stations;
• Horizontal curve data;
• Cut and/or fill slopes;
• Drainage facilities: Existing and proposed, including culvert size, length, and material;
centerline station and elevation; slope, and skew angle;
• Stormwater management facilities;
■ Utilities: Existing and proposed, both above and below ground; and
• Any existing or proposed features that would be affected by the proposed road
construction, whether in or outside of the right-of-way.
Profile View
The profile view shall at a minimum depict:
• Existing elevations and proposed finished grades at 50 feet stations;
• Vertical curve data; and
• Drainage facilities.
MINIMUM STRUCTURAL SECTION
Privately -maintained roads: The typical minimum cross-section consists of 9 inches compacted
gravel base over compacted subgrade and 3 inches compacted crushed surfacing top course. An
asphalt surface will not be required. A thicker structural section may be required by Public Works
based on roadway function or site soils. An alternative structural section may be proposed based
on analysis by a licensed civil engineer.
All materials used in the construction of the structural section shall meet the requirements of
the WSDOT Standard Specifications for Road, Bridge and Municipal Construction.
SURFACING
Privately -maintained roads: An improved roadway surface (asphalt or bituminous surface
treatment) is not required.
MATERIALS TESTING
Privately -maintained roads: The applicant shall be responsible for ensuring that materials and
construction methods conform to WSDOT Standard Specifications. At its discretion, the Public
Works Department may direct replacement of materials that clearly do not meet specifications or
require testing of materials that appear not to meet specifications.
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CROSS SLOPES
Local Service Roads and Rural Access Roads shall either be crowned at the centerline with -2%
cross slopes or have a continuous -2% cross slope from shoulder to shoulder. Stormwater
design must be taken into consideration when determining appropriate cross slope.
ROAD GRADE
Privately -maintained roads:
• Road grades shall not exceed 12% or require review without prior approval by the
appropriate Fire District.
• Roads grades exceeding 12% may require an improved roadway surface, either hot mix asphalt
(HMA) or bituminous surface treatment (BST).
• Road grades shall not exceed 15%.
EMERGENCY TURNAROUNDS
Turnaround area(s) are required and shall conform to the Public Works Department's adopted
design standards. See Exhibit C.
HORIZONTAL CLEARANCE TO OBSTRUCTIONS
For roads with a posted speed limit of 25 MPH or less, a 10 feet wide clear zone shall be
maintained between the edge of traveled way and any obstructions.
UTILITIES
Utility installations shall meet the requirements of the Jefferson County Code, Chapter 13.56
Utilities. Any utilities installed within the right-of-way require review and approval for
installation and location within the right-of-way as determined through the utility permit
process.
STREET LIGHTING
No street lighting is required. If the Applicant desires to install a street light, all costs associated
with the installation and maintenance are the responsibility of the Applicant and shall be
coordinated with the Jefferson County PUD#1.
ROAD APPROACHES
Road plans shall depict proposed road approaches (Exhibit D) to the private residences to be
served. Approaches shall be an integral part of the roadway and constructed at locations
acceptable to the parcel owner(s).
DRAINAGE, EROSION CONTROL, AND STORMWATER MANAGEMENT
The Jefferson County Unified Development Code, Section 18.30.070 Stormwater Management
Standards adopts the standards of the Washington Department of Ecology Stormwater
Management Manual for Western Washington (most current version).
A Stormwater Management Permit is required for projects that exceed 2,000 square feet of
impervious surface or 7,000 square feet of land -disturbing activity. See Exhibit E for comments
Page 4 of 6
from the Department of Community Development. The proponent shall contact the Jefferson
County Department of Community Development to discuss permit requirements and application
procedures:
Jefferson County Department of Community Development
612 Sheridan Street
Port Townsend, WA 98368
(360) 379 - 4450
MAINTENANCE AND NO PROTEST AGREEMENT
A Road & Stormwater Facility Maintenance and No Protest Agreement is required for this
facility on a public right-of-way.
Any privately maintained road and stormwater facility on public right-of-way shall be
maintained at the owners' expense and as outlined in the Road & Stormwater Facility
Maintenance and No Protest Agreement. A No Protest Agreement is required for any privately
maintained road on public right-of-way. The applicant has applied for a permit to construct a
privately -maintained gravel roadway on public right-of-way. The County Engineer has
recommended that this request be approved. It is recognized that this private road does not
meet current County road standards for a public roadway which would require a wider roadway
with an asphalt paved or bituminous surface. In consideration of the County agreeing to waive
the requirements to construct to full public road standards, the Grantor must also enter into an
agreement with the County not to protest the formation of a Road Improvement District (RID)
or other pro rata cost sharing mechanism to improve the roadway in the future should
improvements become necessary whether proposed by petition or by resolution of the Board
of County Commissioners or by both petition and resolution. The Grantor(s) further agree to
join in any proposed petition for such road improvements. See Exhibit F for this Agreement.
ROADWAY CONSTRUCTION DOCUMENTATION, CERTIFICATION, AND MONUMENTATION
Construction Documentation
The applicant shall provide the Public Works Department with complete road plans in electronic
format to scale on 11x17 inch paper.. Following completion of roadway construction, the
proponent shall submit to Public Works complete "As -Built" or "As Constructed" record
drawings. The drawings shall reflect any changes made to the original design. The proponent
or designee shall keep detailed records of the as constructed locations of all surface and
subsurface facilities to be included on the record As -Built or As -Constructed drawings.
Construction Certification
Certain items will need to be inspected during construction of these roadways. These
requirements will be identified once complete plans have been submitted to Public Works for
review.
Following completion of roadway construction the proponent shall submit to Public Works a
letter, affixed with the professional stamp of the Engineer of Record, certifying that the
Page 5 of 6
roadway and stormwater management facilities have been constructed in accordance with the
design plans and specifications and all applicable federal, state and local agency requirements.
PERMIT
This report is not a Permit.
After the review and approval of all documents, plans, and/or reports required by this report,
and within three (3) years from the date of Board of County Commissioners approval of this
report, and prior to initiating construction, the applicant shall be issued a permit by the Public
Works Department. This Permit specifically outlines the arrangement between the applicant
and the County for work on public right-of-way by the applicant. The Permit will specify
insurance and bonding requirements, general provisions, and other requirements that are
applicable for work to be performed in County right-of-way. The Permit, once issued, will be
valid for one year from the date it is issued. The road right-of-way will not be considered to be
opened until all conditions of the permit are met and the permit is finalized. A sample copy of a
Permit is attached as Exhibit G.
OTHER PERMITS
Other permits and/or environmental review may be required for this project per Jefferson
County Unified Development Code (UDC). Any questions concerning the necessity of other
permits and/or environmental review and the processes should be directed to the Jefferson
County Department of Community Development, 612 Sheridan Street, Port Townsend, WA
98368, Phone (360) 379-4450.
RECOMMENDATION:
Public Works recommends that this request to open County right-of-way to the standards and
requirements listed above be approved. This recommendation will be forwarded to the
Jefferson County Board of County Commissioners for approval by way of Resolution (Draft
Exhibit H). Once completed, inspected and all permit conditions met, the permit will be put in a
'Final' status is road will be considered to be opened but will be privately maintained and
not bepofne part of ttk�Gounty road system
Mont inders, P. . Dat
Public Works Director / County Engineer
Page 6 of 6
EXHIBIT A
RECEIVED
AUG - 3 2021 ti
N
Jefferson County Public Works
Department of Public Works
623 Sheridan St, Port Townsend, WA98368 1 360-385-9160
�SHINo
OPEN RIGHT-OF-WAY PERMIT APPLICATION
Office use ant L I
Permit #
Receipt # 1Q l uj5
Check # -12Aa-
Date paid 8 31adq;La
Mile post
$945.00 Fee
Make check payable to Jefferson County. Additional fees will apply per ordinance 02-0312-12.
Applicant Information
Property Owner
Phone Email
Mailin Address
City, State, ZipR� w �833
vn
Designation of Agent (P// out only if applicable)
Designated Agent
Phone Email
Mailing Address
City, State, Zip
Project Information _�
Purpose for r quest to open right-af-way: -zWJ q '� has doe& & 3 �j
i►�5'r 7. 5-eovc sus&—'wi . I r.. _ '7hiv1:14- v,ma L,.'uLnL G ee'..n �►.
Name of road/right-of-way fo lje opened: N. (21['Tmby�g Aw,_
Total length of right-of-way to be opened: 1 1 5,L)
Property parcel number(s): fi2 —(!.2 ^ b
Name of plat where road is located: -2(1 s lU7L
Attach any recorded surveys (list volumeand page numbers):
Nearest cross street: 5 _
Other permits associated with this request (e.g. septic, building, stormwater):
Will you be installing any utilities within the right-of-way?
Site Map
Attach a site plan or plat map that identifies the right-of-way to be opened and the parcels you own. The map
must include the cross street access point, access location to the applicant's property, and scale.
Acknowledgements and Signature
By signing the application form, the undersigned Applicant attests that the information provided herein is true and correct
to the best of his/her knowledge and agrees to all conditions on the permit. The Applicant also certifies that this application
is being made with the full knowledge and consent of all owners of the affected property. Any material falsehood or any
omission of material fact made by the Applicant/Owner with respect to this application packet may result in this permit being
null and void.
The Applicant has read this disclaimer and signs and dates it below.
Li 3
Property Owner or Designated AI(ejft Signature Date
Application continued on next page. Page 1 of 2
EXHIBIT B
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EXHIBIT E
Terat Duff
From: David W. Johnson
Sent: Tuesday, September 28, 2021 8:23 AM
To: Terry Duff
Cc: David W. Johnson
Subject: Open Right of Way Application - LiLi Mei Raiguel
Attachments: Medium Stormwater Packet for print and fillable pdf.pdf; $ Permit Application
Fillable.pdf
Terry,
This is in response to your letter dated August 19, 2021 regard comments on an application to open a road right of way
on or adjacent to parcel 962112310. The applicant will need to apply for the Stormwater Management permit with DCD.
Attached are the forms. Fees are $534.35. Let me know if you have any other questions.
Thanks, and sorry for the delay on this.
David Wayne Joh-rtison -'LEED AP - axe.— fOboirhfrood rieveiopiirne Y,
Ir'terlm Piarnirg Manager — Associate Pianfner
Departmeat of Community Developren`rt (DCD')
Jefferson Couaty
360.379.4465
EFFECTIVE TUESDAY 6/1/2021 DCD WILL BE OPEC TO THE PUBLIC. M-Th 9:00-12:00 & 1:00-
4:30
liI i.� 1iVii°r maintain i?i71ll2C7' i'J.51Jm—, interaction rail--d recommends end 51-heduling on opp i11mneor to me with
stgf. . DCO wiJI/no longer b Cicrepti�i;^ .bLij ' i�7 ci p �icutio s � drop of �i (��1;- his r/i 1Si` SC'reiufP on
v o r' 9 r� y I.I /
op.poi.ntment wfth1f'r0nr1 miff, to submit, A r'1 osk and 5'1C!A.1 cEi>Ciin !ng Is required.
Please visit our website htt s: www,co,ieferson.wa.us dcd to see how we can best serve you during this time,
• Email:dcd@co.ieFFerson.wa.us
• Phone:360-379-4450
• Mail: 621 Sheridan St.; Port Townsend, WA 98368
Mission: To preserve and enhance the quality of life in Jefferson County by promoting a vibrant economy, sound
communities and a healthy environment.
`0 SAVE PAPER - Please do not print this e-mail unless absolutely necessary
All e-moil rnoy be considered subject to the Public Records Act and os 5uch may be disclosed to o third-porty requester.
S 1UARE
:�'•.� ;��; •.� 5.�.�y ram•.
�lYM �• Y a./ L�M�v �ti� 1 NR Iry VY. � ram,. Mom- w
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DEPARTMEI f OF COMMUNITY DEVELOPMENT
6,IF SIhcrrclanSrrCcr, flort" oNvrt5e;nd' WA �Y)K%R
.� Td:31ir)_S74'.-4450' bax: 301379114451
Wcb: y& w.tsr.ir[h omw2mis/enmi.nunin"Ic-Vulr
�ys�l ! G�0
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; 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
Related Application #s:
Site Information
Assessor Tax Parcel Number:
Site Address and/or Directions to Property:
Access (name of street(s)) from which access will be gained:
Present use of property:
Description of Work (include proposed uses):
Wastewater - Sewage
Building Permit #
MLA #
This property is served by Port Townsend or Port Ludlow sewer system? YES
If not served by sewer identified above, identify type of septic system below:
Type of Sewage System Serving Property:
Septic Septic Permit #:
Community Septic Name of System: Case #:
Are other residences connected to the septic system?
Additions or repairs to sewage system:
Is it a complete or partial system installation: Complete Partial
Has a reserve drainfield been designated? Yes 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:
T
The authorized agent/representative is the primary contact for all project -related questions and correspondence. The County will mail
/ e-mail requests and information about the application to the authorized agent/representative and will copy (cc) the owner noted
below. The authorized agent/representative is responsible for communicating the information to all parties involved with the
application. It is the responsibility of the authorized agent/representative and owner to ensure their mai Ibox accepts County email (i.e.,
County email is not blocked or sent to "iunk mail").
Applicant/Property Owner Information
Property Owner:
Name:
Address:
Phone #;
E-mail Address:
Please contact Authorized Agent/Representative with project info. (select only one).
Property Owner Signature:
Date:
Note: For projects with multiple owners, attach a separate sheet with each owner(s) information and signatures.
Applicant: Authorized Agent/Representative (if otherthan owner)
Name:
Address:
Phone #:
E-mail Address:
Professional:
Is this an Authorized Agent/Representative for this project?
NO YES
Engineer
Architect Surveyor Contractor
Consultant
Name:
License #
Address:
Phone #:
E-mail Address:
Professional:
Is this an Authorized Agent/Representative for this project?
NO YES
Engineer
Architect Surveyor Contractor
Consultant
Name:
License #
Address:
Phone #:
E-mail Address:
Professional:
Is this an Authorized Agent/Representative for this project?
NO YES
Engineer
Architect Surveyor Contractor
Consultant
Name:
License #
Address:
Phone #:
E-mail Address:
By signing this application form, the owner/agent attests that the information provided herein, and in any attachments, is true and
correct to the best of his or her knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with
respect to this application packet may result in making any issued permit null and void.
I further agree to that all activities I intend to undertake or complete associated with this permit will be performed in compliance with
all applicable federal, state and county laws and regulations and I agree to provide access and right of entry to Jefferson County and its
employees, representatives or agents for the sole purpose of application review and any required later inspections. Applicant may
request notice of the County's intent to enter upon the property for visits related to this application and subsequent permit issuance.
Signature: Print Name:
Date:
o:s
was Start HERE! A guide to using stormwater forms
Step 1 All projects must read and complete the Stormwater Calculation Worksheet.
Step 2 Use the quantities reported in this worksheet to determine which minimum requirements apply to your project
and what forms will be required using the "Flow Chart for Determining Minimum Requirements."
Step 2.1
Step 2.1
Small Projects may submit the Worksheet S Small Project Certification sheet. Applicants who are able to sign the
certification may STOP HERE. Submit the Stormwater Calculation Worksheet and Worksheet "S" with your appli-
cation. No additional submittal is necessary.
Medium Projects must complete worksheets Al, B1, and C or equivalent. Large Projects refer to Worksheet L to
determine applicable worksheets are required or if a state -licensed engineer must prepare the submittal.
A Note on Engineered Stormwater Submittal:
-Many applicants complete stormwater submittal forms independently without professional expertise. For example, full
dispersion, if feasible on the site (See Worksheet C), is typically easiest to implement for many different surface types such as
roof, driveway, patio etc.
-Applicants may opt to submit an engineered stormwater plan even if it isn't required. This option may be attractive to those who
are unsure how some of the requirements will be achieved on the site.ln some instances, engineering will be required. Certain
Large projects must be engineered (See Worksheet Q. Gathering information on infiltration feasibility may need an engineer's
expertise. Or, sites with greater than 15% slopes may require applicants hire a geologist to recommend if a drainage method is
appropriate. Discharging directly to a marine water via tightline must be engineered. If you cannot do full dispersion on parcels
larger than 5 acres, engineering is required. In other instances, site constraints will require an engineered design.
-Jefferson County staff may assist by providing and/or explaining Department of Ecology Stormwater Management Manual
Circle one: The project requires or the applicant elects to submit an engineered stormwater plan. The plan is attached hereto
with minimum requirement narrative, drawings, calculation, modeling output, construction pollution prevention
Sol
plan, and site plan.
If you answered YES above, STOP, no further submittal is required. Otherwise, proceed with the following steps.
Step 3 Complete Worksheet Al Medium/Large Project Report and Stormwater Site Plan or equivalent.
Step 3.1
Step 4
Complete Worksheet C to determine which BMPs are possible and appropriate for your site. Circle the first BMP
that is feasible (i.e. none of the infeasibility criteria is checked) for each surface type. Circle the corresponding
BMP on Worksheet Al.
Complete Worksheet B1 Medium/Large Project Construction Pollution Prevention Plan and Worksheet B2
Construction Site Plan or equivalent.
A Note on Commercial Projects:
Jefferson County Public Works (JCPW) reviews commercial projects and charges a review fee. JCPW may charge additional
fees for any required inspections.
• Any commercial projects proposing infiltration facilities may complete Worksheet E—Infiltration Test. Grain size analysis may
be used instead of PIT. Commercial projects may elect to use BMP T5.10A and would not need a PIT, just a soil evaluation.
■ Any development for cottage industries may require a commercial public works review if full dispersion is infeasible.
DEPARTMENT OF COMMUNITY DbEVELOPMEw
6,2Tsli(:ad'am•Srmut,v(.)vr Fni�n_;rn]ti.V,V"\98368
Gil: 36f1'.:379,44i,f.1 I Fav 36417IX445t
Weh:l�fiYSY,fT st±r�fr•�ya.u.lcommu (L-yS1Sl:,prywnr
irta& du&f&isutt Scan the QR
code to access
® the digital form
PARCEL# PROJECT/APPLICANT NAME:
DETERMINING STORMINATER 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 acres An acre contains 43,560 square feet. Multiply the acreage by this figure.
Size of parcel in square feet
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 of plant species, other than noxious weeds, which reasonably could have been expected
to naturally occur on the site. Examples include species such as Douglas fir, western hemlock, western red cedar, alder, big -leaf
maple, and vine maple; shrubs such as willow, elderberry, salmonberry, and salal; herbaceous plants such as sword fern, foam
flower, and fireweed.
LAND DISTURBING ACTIVITY. CONVERSION OF NATIVE VEGETATION AND VOLUME OF CUTIFILL
Calculate the total area to be cleared, graded, filled,
excavated, and/or compacted for proposed development
project. Include in this calculation the area to be cleared for:
Construction site for structures
Drainfield, septic tank, etc.
Well, utilities, etc.
Driveway, parking, roads, etc.
Lawn, landscaping, etc.
Other compacted surface, etc..
Temporary construction area
Total Land Disturbance
sq/ft
sq/ft
sq/ft
sq/ft
sq/ft
sq/ft
sq/ft
Answer the following two questions related to
conversion of native vegetation:
Does the project convert % acres or more of
native vegetation to lawn or landscaped areas?
Circle: Yes No
Does the project convert 2 % acres or more of
native vegetation to pasture?
Circle: Yes No
Indicate Total Volumes of Proposed:
(Includes BMP T5 13 Fill Volume)
sq/ft Cut
Fill (cu/yd)
stormwater calc worksheet OR code — REV. 5/31/2019 page 1 of 2
STORMWATER CALCULATIONS — IMPERVIOUS SURFACE
Impervious surface is a hard surface that either prevents or slows the entry of water into the soil 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.
NEW
Structures (all roof area) sglft
Sidewalks sglft
Patios
Solid Decks
(without infiltration below)
Driveway, parking, roads, etc
Other
Total New
TOTAL NEW + TOTAL EXISTING*
EXISTING
Structures (all roof area) sq/ft
Sidewalks sq/ft
sq/ft I Patios
sq/ft
sgfft
sq/ft
sglft
sq/ft
Solid Decks sq/ft
(without infiltration below)
Driveway, parking, roads, etc sq/ft
Other
Total Existing
Sglft
sglft
sq/ft *This amount will be used to check total lot coverage
DEVELOPMENT v. REDEVELOPMENT
Divide the total existin ♦ Does the site have > 35% or more .♦ no
impervious surface above by the existing impervious surface?
size of the parcel and convert to
a percentage. %
The proposal is considered new development. Answer
YeS questions in Figure 2.4.1 Flow Chart for New
Development to determine project size (next page).
The proposal is considered redevelopment Answer
questions in Figure 2.4.2. Flow Chart for
Redevelopment to determine project size (next page).
Applicants for "small" projects must comply only with Minimum Requirement #2—Construction Stormwater Pollution Prevention.
Please submit the Small Project Certification (Worksheet "s). 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 (SWPPP) Best Management Practices (BMPs) Fact Sheet.
— Applicants for "medium" projects —those that must meet only Minimum Requirements #1 through #5 must submit Worksheet Al
and B1, a stormwater site plan and a construction stormwater pollution prevention site plan (See Reference A1A and B1A for
guidance).).
— "Large" projects —those that must meet all 9 Minimum Requirements— must submit Worksheet Al and 131, a stormwater site plan
and a construction stormwater pollution prevention site plan (See Reference A1A and B1A for guidance). Large projects also may
require engineering. See Worksheet L to determine additional large project requirements.
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.
(LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) (DATE)
stormwater calc worksheet QR code — REV. 5/31/2019 page 2 of 2
Figure 2A.I Flog Chart for New Developrnrnt
itert Here
Does the site have
35% or more of
existing impervious
coverage?
No
Does the project
result in 5,000
square feet, .or
greater, of new plus
replaced hard
surface area?
Yes
All Minimum
Requirements apply
to the new .and
replaced hard surfaces
and .converted
vegetation areas.
This is a "lame" project_
l.arge projects refer to
Worksheet L for submittal
See Redevelopment
Yes
Minimum
Requirements and
Flow Chart
Does the project convert
(Figure 3.3)
'/a acres or more of
vegetation to lawn or
landscaped areas, or
No convert 2.5 acres or more
of native vegetation to
pasture?
Does the project
Yea No
result in 2,000 square
feet, or greater, of
new plus replaced
hard surface area?
Yes
� No --
Minimum Requirements
Does the project have
#1 through #5 apply to
land disturbing
new and replaced
activities of 7,000
hard surfaces and the
Yes
square feet or greater?
land disturbed.
requirements, At a I No
mionimum9 all large Project
must submit Worksheet
At, BI, and C or Minimum
equivalent Requirement 42 1
applies. I
Complete "Small" l'Cet111ir aion W01
P ti)J(iL:[ ItiIIl1J I()I�i.il�' (,i)I1.}[[U,-Iillt] h011UtH111
Figure 2.4.1— Flow Chart for Determining Requlrernents for New Development
Volume I— Minimum Technical Requirements —August 2012,
2-10
Fact Sheet
Figure 2,4.2 flow Can for Rednt4opment
Does the project result in 2;000 square feet, or more,.of new plus replaced hard surface area? OR
Does the land.disturbing activity total 7,000 square feet or greater?
Yes - --•• No I
Minimum Requirements #1 through #5 apply to Minimum Requirements #2 applies.
the new and replaced 'hard surfaces and the land
disturbed.
Next Question
Does the project add 5,000 square feet cr more of new hard surfaces?
OR
Convert 3/a acres or more. of vegetation to lawn or landscaped areas?
OR
Convert 2.5 acres or more of native vegetation to pasture?
Yes
All Minimum Requirements apply to the
new hard surfaces and the converted
vegetation areas.
Next No
Question
Is this a road
related project?
Yes
No
Does the project add 5,000 square feet or more of new hard surfaces?
Yes
Do new hard surfaces add 50% or
more to the existing hard surfaces
within the project limits?
No -- --- ,Yes
■
No additional
requirements
No
Is the total of new plus replaced hard .surfaces
5;000 square feet or more, AND does the value
of the proposed improvements — including
interior improvements — exceed 50% of the
assessed value (or replacement value) of the
existing site improvements?
Yes
All Minimum Requirements apply to the new and
replaced hard surfaces and ,converted vegetation areas.
No
No additional
requirements
Figure 2.4.2 — Flow Chart for [determining Requirements for Redevelopment
I
This is alarge" proje�- .. ge pr lea> re er W Work -sheet 1. for
56m t al requiremenK At a minimum, all large Projea. m uo suhrnit
t r1i. i,
plume—Znimt►m cnrea �2equiremenrs — August 2012
2-11
DEPNRTMENT OF COMMUNITY DEVELOPMENT
62i Strendan Street. Fart Townsend, WA.9,&W
Tef. 3W 3,79,44601 Fax. 360-379441
Web:: ►y�M ca efisan.�a.u�lr�anrr�ur� tyd�ue{aprnent
E-rt :@O: �t;d' co. ers . rra.ua
CONSTRUCTION STORMWATER POLLUTION PREVENTION
Rest Management Practices (BMPs) Fact Sheet
For "small" projects (as determined through the Stormwater Calculation Worksheet), submit Worksheet
"S" Small Project Certification. Additionally, the applicant shall consider the twelve Construction
Stormwater Pollution Prevention elements and implement applicable BMPs. A set of useful BMPs for
typical rural residential construction is attached There is no additional submittal required as part of the
permit application.
For "medium" and "large" projects, applicants must submit a Construction Stormwater Pollution
Prevention Plan (SWPPP) and a Stormwater Site Plan (applicants may use Worksheet B1 or equivalent)
The following twelve elements must be considered for Construction Stormwater Pollution Prevention
before and during the construction phase of the project:
1. Mark Clearing Limits
7.
Protect Drain Inlets
2. Establish Construction Access
8
Stabilize Channels and Outlets
3. Control Flow Rates
9.
Control Pollutants
4. Install Sediment Controls
10
Control De -Watering
5 Stabilize Soils
11.
Maintain Best Management Practices
6. Protect Slopes
12.
Manage The Project
Each of the twelve elements is described in more detail below:
1. Mark Clearing Limits
By minimizing the limits of clearing on the site, a builder can minimize stormwater runoff and provide
effective control of pollution.
2. Establish Construction Access
Much of the sediment that leaves a construction site does so on the wheels of delivery and construction
vehicles that drive off a project site. Construction access must be limited to a single location and a
properly constructed Stabilized Construction Entrance (BMP C105) should be included on the site.
Control Flow Rates
Stormwater that leaves a project site unimpeded may exceed the capacity of the existing stormwater
control facilities downstream and may contain sediment that may be deposited as the velocity of the
runoff decreases. Stormwater protection on a construction site should include measures to control the
flow rate of runoff from the site. This can be done by installing a Sediment Trap (BMP C240) or other
measure that will impede the flow of water off a construction site.
4 Install Sediment Controls
In addition to limiting the rate of stormwater flow off a construction site, measures should be put in place
to treat the runoff and remove sediment. Limiting of the cleared area (Element 1) will assist in this effort,
but there will be exposed soils that may move with the runoff. Suggested BMPs for controlling sediment
include Straw Wattles (BMPC235), Brush Barrier (BMP C231), Gravel Filter Berm (BMP C232), and Silt
Fence (BMP C233). Installation of a Sediment Trap (Element 3) is an additional sediment control feature.
construction Pollution Prevention Page 1 of 3 5/31/2019
Stabilize Soils
An additional measure that can minimize sediment transport in runoff is to stabilize soils on the site with
mulch or some other covering. This will limit the amount of soil that is exposed to rainfall, thus limiting the
sediment that could potentially leave the site. BMPs that could be used for this include Mulching (BMP
C121), Nets and Blankets (BMP C122), and Plastic Covering (BMP C123). During periods of dry weather
dust can become a problem and sediment could be transported from the site in high winds. BMP C140
Dust Control should be followed to limit loss of soils in windy conditions.
6. Protect Slopes
If the cleared area includes slopes of 3:1 (Horizontal: Vertical) or steeper, the slopes should be protected
to limit runoff. If the slopes are not protected, rills and gullies may form, transporting sediment to the
lower elevations and potentially off the construction site. The slopes should be graded to minimize
erosion and runoff at the downstream end of the slopes, and runoff should be collected and treated The
following BMPs could be used Surface Roughening (BMP C130), Interceptor Dike and Swale (BMP
C200), and Pipe Slope Drains (BMP C204).
Protect Drain Inlets
Runoff from urban construction sites often discharges into existing stormwater collection systems Water
enters the collection system through drain inlets. If there are drain inlets downstream of a construction
site, they should be protected using BMP C220 Storm Drain Inlet Protection.
Stabilize Channels and Outlets
Any temporary on -site channels or ditches that are used to control runoff should be stabilized to prevent
erosion in the channel. BMP C202 Channel Lining and BMP C209 Outlet Protection should be used.
9. Control Pollutants
The best way to control pollution is to limit the source of pollution. Construction debris should be
maintained in a safe location. Vehicle maintenance on the construction site should be minimized and any
spill should be promptly cleaned up Concrete spillage should be kept to a minimum and cleaning of the
concrete trucks after they have unloaded should be done in an area that will not drain off site (see BMP
C151 Concrete Handling).
10. Control Dewatering
In some cases, excavation for the foundation or below ground structures will encounter ground water
This water must be removed (dewatered) from the excavation. Discharge of this ground water must be
treated in a manner that will not cause damage downstream due to flow rates or added pollution. There
are no specific BMP identified for this activity, but the water should be handled with care to assure that
soils or other pollutants are not added to this flow.
11. Maintain BMPs
Installation of the appropriate BMPs is not adequate to completely control stormwater runoff. The BMPs
that have been installed on the project must be inspected and maintained during the duration of the
construction project. In addition, the temporary controls that were installed for construction should be
removed within 30 days of completion of the work. Typically, once construction has been completed, the
temporary facilities are not maintained, and by removing the facilities, it will ensure that these won't fail
and discharge water or sediment that had been previously trapped or contained.
12 Manage the Project
Management of a project has four aspects:
1. Phasing construction to prevent transportation of runoff and sediment,
2 Limiting the work during seasons where large amounts of rainfall could be anticipated,
3. Coordination with Utilities and other Contractors, and
4 Inspection and Monitoring.
All of these for aspects are important and must be followed to ensure a project that will have minimal
impact on the environment. Volume II of the Manual contains additional BMPs that could be used on -site.
The applicant is encouraged to review the Manual to see if other BMPs may be applicable to, or more
useful on, a particular site.
construction Pollution Prevention Page 2 of 3 5131/2019
Best Management Practices from 2014 Ecology Stormwater
Management Manual
The following BMPs for Construction Stormwater Pollution Prevention are
sediment and erosion control measures for the construction phase of typical
rural residential development. Some projects may not require implementation of
all of these BMPsy others may require additional measures not listed here.
CUck an the MIR to leam more aboid each MP's Purpose and desk ri'_
II-4.1 Source Control BMPs BMIP C0M: CeycmW Warr„su,a area
MOP Ural: Prcienrim Nanw-Al Veze Ellan.
H,III? C 992, B3uff& zocees
P1MPC110k. High V'isiimillc
BIM? CI.5, 5labiRrA Cas 5ft-w -M E uwcre /
Exk
049P C1(] , ILheO Wash
WAPC107, Cam mwdon Roadfarkin Area
Staw-liz ion
BLIP C" 17A. !Dmwam and Pegymment Seedin
B,-% W CV21 LIculching!
E$6'lL' (-'M2 Nets and Riankets
A CG23• Plastic Covering
6MP C124. Saddit
13MP C 125: Tomiling ! C OM tinLj
€ MP CI26- Pulyway lamide c PAM4 for Sail
Epxki n Pr lion
OOP 039- Surface 1orWlccning
OMFCI31 __Gtadieai Terraces
OOP C 140, Dust Conyol
OMe Clot}. Materials on Hand
ONIP C IS I: Concrae Handling
MP C 152: Saoctdting and Surfacing Pollution
prevention
&UP C I J3: Matetial DefivM, StoqgE and
-., t
SW CI0: Cgri e 4 Erugiing and Ses,£trr er7 C
C aftpl L
&MP C" I fil: Smiling
11-4.2 Runoff Con reyance an (I Treaimen t RM Ps
gmp CM-10trumf Dkkg aAd Swale
13MP C29 Cass -Lined Cols
OMP C2K Clcanr t.an"rir�
OMP M3: Wstar Fars
OMP C2(A, Kim Slnm Drain,
�iB P C?€I : subsesdase !]roaafrt
8MV Level IS
RIM (�W;.161yggbo Sat Nk `f S®
Ge�rt�x¢rl a; Check Dam
BMP C w_ (ft-tdCI f'rou"im
RMP C7.21, Storm ®rain Inlet Protction
BNIP C ul — anesli Hatrrie�r
BMP C232: Grawl Filter Hevrn
OMP C 233: Silt Fence
BMP C234, %'gged Striv
W"P C235: WaBeEes
13MP CM,ymgwtive Filtraaion
RME 0419• Sedinwnt Tracts
QN4P C241: Tsxt3WnW Scadiragnt Pond
13MP C251, Coratruction Storvnwwr Fil ratign
construction Pollution Prevention Page 3 of 3 5/31/2019
Worksheet Al
Medium & Large Project Report
iWinilm um Req uliiremer,t # I, iPre pa ria tiar7 of St, ormw ater Sate P I an
Complete the following:
LlSubmit a site plan demunstrating the project. Refer to REFERENCE AlA for examples of Best Management
Practices (BMP's) that you can use. Remember that all site plans submitted for the project must be consistent
and accurate.
Describe both existing and proposed site conditions for the following items as applicable in the space below each
bullet point. Attach additional pages if needed.
Minimum Requirement # 2 : Construction Stormwater Pollution Prevention
A SWPPP is designed to be a stand-alone document that addresses construction stormwater management concerns. This
document is required to be kept by the contractor performing the work at the jobsite for reference and update during
the life of the project. Construction BMP's must be indicated on the stormwater site plan. REFERENCE 131A includes
diagrams of common BMP's that may be used on the site plan.
❑ My completed SWPPP (WORKSHEET 131 or equivalent) is included in this application packet!
Minimum Requirement # 3 : Source Control of Pollution (not construction related)
The intent of source control is to prevent stormwater from coming in contact with pollutants. Source control BMPs
can be operational or structural in nature. A roof over a material storage area is an example of a structural source
control BMP. Washing your vehicle on the lawn rather than in the street is an operational BMP. This requirement
is generally not applicable to Single Family Residences (SFRs); however, ways to minimize pollution from moving
downstream should be considered during the design phase of every project. Specifications on standard source control
BMPs that are applicable to various commercial and industrial -type facilities can be found in Volume IV of the 2014
Stormwater Management Manual for Western Washington (SWMMWW) (continued on page 2).
page 1 or 6
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Worksheet Al
J
,f Medium & Large Project Report
Minimum Requiiirement # 3 : Sau.rce Control -of Pollution �,candnu edf from page 1�
Check one of the following boxes that best represents your project with regards to MR #3.
❑ My project is a Single Family Residence (SFR) and after considering operational and structural measures to prevent
stormwater from coming in contact with pollutants, I have:
❑ determined this MR to not be applicable. ❑ made appropriate adjustments to my project.
❑ My project is not a SFR and after reviewing Vol. IV of the SWMMWW, I have determined that this MR is not
applicable because of the following reason:
❑ My project is not a SFR and after reviewing Vol. IV of the SWMMWW, I have determined that the following source
control BMPs are applicable to my project and shall be incorporated into the project design and operation.
page 2 of 6
Worksheet Al
Medium & Large Project Report
M. in, r;�muitm Req [u Irem emt # 4 : R,reserwa bon, of INat-u;ra E G ra ii,nage ys®rems
Creating new drainage patterns results in more site disturbance and more potential for erosion and sedimentation during
and after construction. to the maximum extent possible, proponents must 1) maintain the natural on -site drainage
pattern and concentrated discharge location at the downstream property boundary, and 2) prevent erosion at and
downstream of the discharge location.
NOTE: All outfalls require energy dissipation. See Table 4.5.1 in Vol. V of the SWMMWW for minimum design standards
for rock protection at outfalls.
Choose the option below that best describes your project:
The project site does not currently have any intermittent, seasonal, or continuous concentrated water
moving across any part of the property and the proposed improvements to the site will not create new
concentrated flow paths or not discharging to existing drainage systems.
❑ The project site has existing concentrated flow drainage systems and outfalls. (NOTE: These items must
be graphically shown on the Site Plan or equivalent, to include: type, slope, dimensions, channel lining,
direction of flow, buffer, etc.) Select below how it will be addressed.
This project will not alter the existing drainage system in any way. If the existing outfall(s) show
signs of erosion and scour, energy dissipation measures will be installed or improved upon.
Construction activity of any kind will not occur within at least 10 ft. of the edge of the channelized
flow. BMP C102: BUFFER ZONES will be implemented during the life of the project to include visible
flagging or other demarcation technique.
The existing concentrated drainage system traversing the property will be impacted as part
of this project, as described in the space below and shown on the site plans. Engineering
calculations are required that show the altered drainage design can accommodate the existing
flows and the added runoff contributed by the project.
page 3 of 6
Worksheet Al
Medium & Large Project Report
L�'S,1l;titi��
i€.,iin, FJi u,mi ., Req u! i; rem e, n I # 5 : 0in-site Starmwa-W,r Uainage rme,r iZ
On -site stormwater management techniques shall be implemented where possible to accommodate the permanently
added stormwater runoff being generated by development. Some on -site stormwater management techniques provide
better stormwater detention and treatment than others; however, they are not always appropriate for use due to varying
individual site characteristics. Therefore, techniques are presented to applicants on the next pages in a hierarchical order
and shall be considered for use in the order listed. The first technique on the list that is determined to be possible shall
be implemented. See WORKSHEET C to determine which techniques are feasible.
Runoff from developments occurring in drainage basins that drain directly or indirectly to a creek require a higher level
of stormwater management, thus, the techniques are presented in three lists below:
All propemies ss+ill be in one of tfiese three categories:
❑My project is located in a drainage subbasin that ❑ My Project will discharge to a subasin draining to
drains to directly or indirectly to freshwater. salt water, Dosewallips River, or Hoh River.
PROCEED to Page 5 to use LEST ##1. PROCEED to Page 6 to use LIST #3.
❑My project is a large project. Refer to Worksheet L. If full dispersion isn't feasible, use LIST ##1
(List #2 and List #1 are the same except raingardens are not permitted in List #2).
page 4 of 6
Worksheet Al
Medium & Large Project Report
.M.1 n i m Li.m Req ,fiir.ement # 3 :.Oin-5iite 5t-o:rtmrW.ateir i` . a:nagement (contnued)
I LIST If ` : Applicable to projects that directly or indirectly drain to freshwater. a
For each category below, proceed through the LIST from top down. Use WORKSHEET C to determine if the BMP
can be used. If number 1 on the list is not possible, document why on WORKSHEET C and move down to number
2, and so on.
INSTRUCTIONS: Check the first o 'on that will work for Each Categorg Below:
Category A: Lawn and Landscape Area
r~ j My project does not have disturbed soils not covered by impervious
u surfaces.
1. Post -Construction Soil Quality and Depth
Disturbed soils shall be amended (BMP T5.13: ).
calesof B; ROOFS
My project does not have Roof areas.
❑ 1. Full Dispersion (BMP T5.30)
OR
Downspout Full Infiltration (BMP T5.10A)
2. Rain Garden (LARGE PROJECTS CANNOT USE)
(BMP T5.14A)
3. Downspout Dispersion System (BMP T5.1013)
4. Perforated Stub -Out Connection (BMP T5.10)
5. Each BMP above is infeasible, see WORKSHEET C. STOP,
COMPLETE AND SUBMIT WORKSHEET B1. NO OTHER
INFORMATION REQUIRED AT THIS TIME.
Category C: Other Hard Surfaces, erg. gravel and paved
driveways, solid decks and patios without infiltration below
❑ My project does not have Other Hard Surface areas
1. Full dispersion (BMP T5.30)
n 2. Permeable Pavement (BMP T5.15)
�J OR
Rain Garden (LARGE PROJECTS CANNOT USE) (BMP T5.14A)
3. Sheet Flow Dispersion (BMP T5.12)
OR
Concentrated Flow Dispersion (BMP T5.11)
�J 4. Each item above is infeasible, see WORKSHEET C. STOP.
1 COMPLETE AND SUBMIT WORKSHEET B1. NO OTHER
INFORMATION REQUIRED AT THIS TIME.
(�Ir_)
.
1 Worksheet Al
Medium & Large Project Report
fail i r, I n LJ [T) Req uire.ment # 5 : On site 'Starmwater PA -art agernen, t ,t ca.ntinu�ed)
UST # 3 :Applicable to project that discharges to a subbasin draining to saltwater, the DosewaIli ps River, or the Hoh
River,
INSTRUCTIONS: For each category, choose one option. Use Worksheet C to determine if the BMP can be used on the
site.
Category A: i_a,{in and Landscape Areas
1-1 My project does not have disturbed soils not covered by impervious surfaces.
1. Post -Construction Soil Quality and Depth
Disturbed soils shall be amended (BMP T5.13: ).
CaftgDry W ROOfs
My project does not have Roof areas.
❑ 1. Downspout Full Infiltration (BMP T5.10A)
*Optional - may elect to install BMP T5.14A Rain Garden*
❑ 2. BMP T5.1013: Downspout Dispersion System
❑ 3. BMP T5.10C: Perforated Stub -Out Connection
4. Each BMP above is infeasible, see WORKSHEET C.
Category C: Other Hard Surfaces
My project does not have Other Hard Surface areas
*Optional - may elect to install BMP T5.15: Permeable Pavement OR BMP T5.14A:
Rain Garden*
1. BMP T5.12: Sheet Flow Dispersion
2. BMP T5.11: Concentrated Flow Dispersion
3. Each item above is infeasible, see WORKSHEET C. STOP. COMPLETE AND SUBMIT
WORKSHEET B1. NO OTHER INFORMATION REQUIRED ATTHIS TIME.
page 6 of 6
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Worksheet B1
Construction Protection: Medium and large Projects
(SWPPP: Stormwater Pollution Prevention Plan)
Submit a site plan demonstrating the construction protective measures or best management practices that will
be used for the project during the construction phase.
Refer to REFERENCE 131A for examples of Construction Best Management Practices (BMP's) that you can use. The
activities that take place during construction are the highest risk for stormwater problems such as erosion and
sediment control (you may need to provide an additional site plan with greater detail for stormwater features. If so,
make sure it is consistent with the primary site plan. Remember that all site plans submitted for the project must
be consistent and accurate).
Element la Preserve Vegetation, / Mark Clearing Limits
The goal of this element is to preserve native vegetation and to clearly show the limits of disturbance.
Choose any of the following that apply:
FiThe perimeter of the area to be cleared shall be marked prior to clearing operation with visible flagging, orange
plastic barrier fencing and/or orange silt fencing as shown on the SWPPP site plan. Vehicles will only be allowed
in the areas to be graded, so no compaction of the undeveloped areas will occur. If this option is selected check
the BMPS you will use below:
Ll c lo, Preservin IaEurat ❑ C1102 Buffer C 103 High YWh _
Ag tin Zones Fence
❑ It is necessary to disturb the entire property during this project due to existing site conditions, property
constraints, and proposed design. I understand that all disturbed land not covered by hard surface at the end of
the project is subject to soil amendment requirements per BMP T5.13 Post -Construction Soil Quality and Depth.
The site was cleared as part of clearing activity that is subject to an enforcement action and will be re -vegetated.
Restoration may be necessary to comply with Critical Area Regulations or stormwater requirements. Buffer Zones-
BMP C102 may apply if Critical Areas exist on -site and buffer zones shall be protected.
Element 2: Construction Access
The goal of this element is to provide a stabilized construction entrance/exit to prevent or reduce or sediment
track out.
Choose one of the following:
The driveway to the construction area already exists and will be used for construction access. All equipment and
vehicles will be restricted to staying on that existing impervious surface. If sediment is tracked off site, the road-
way will be cleaned thoroughly at the end of each day.
A stabilized construction entrance will be installed prior to any vehicles entering the site, at the location
shown on the SWPPP site plan. If sediment is tracked off site, the roadway will be cleaned thoroughly at the end
of each day. If this option is selected check the BMPS you will use below:
C10tabilized ❑ pff, wli�ei ❑ CJ_CQa5trucUQn
Construction Er�trar�ce 1, Wash R-oad IParking Area
Exit Stabilization
page 1 of 6
N1
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Worksheet B1
*ell--,- Construction Protection: Medium and Large Projects
���r�:iat� (SWPPP. Stormwater Pollution Prevention Plan)
Element 3: Control flow Fates
The goal of this element is to construct retention or detention facilities when necessary to protect properties
and waterways downstream of development sites from erosion and turbid discharges.
This element does not apply to my project because (check any that apply):
Site is mildly sloped (<5%),
There are no individually sloped sections greater than 10%,
The bulk of the project is scheduled to occur during dry season (May 1-Sept 30)
Hement 4-. Sediment Control
The goal of this element is to construct sediment control BMPS that minimize sediment discharges from the
site.
Select one of the two statements applicable to the project.
❑ The site has already been stabilized and re -vegetated.
Sediment control BMPS shall be placed at the locations shown on the SWPPP Site Plan. If this option is selected
check the BMPS you will use below:
C23I Brush Barrier C233 Silt Pence ❑ 235 Wattles
C232.Grave1Fi1wr C234 Vegetated
Berm Strrp
Element 5; Stabilize Soils
The goal of this element is to stabilize exposed and unworked soils by implementing erosion control BMPS.
Select one of the three statements applicable to the project.
My project will ensure the following:
• Soil stockpiles will be located within the disturbed area shown on the SWPPP Site Plan.
• Soil excavated for the foundation will be backfilled against the foundation and graded to drain away from the
building.
• No soils shall remain exposed and unworked for more than 7 days from May 1 to September 30 or more than
2 days from October 1 to April 30.
• Once the disturbed landscape areas are graded, the grass areas will be amended.
• All stockpiles will be covered with plastic or burlap if left unworked.
This element does not apply to my project because:
My project must implement specific BMP's to ensure compliance. (Check BMP's you will use on the next page).
page 2of6
Worksheet B1
Construction Protection: Medium and Large Projects
(SWPPP: Stormwater Pollution Prevention Plan)
❑ C120 Tem2orary & ❑ C1; 22 islets & lsklZiceros ❑ C124 ScddEip,-, ❑ c. l .f 1 r
Plat-m-am:ent d;ir� "Eexr
❑ C L2I Mtvkhci ❑ C123 PllasU- c Cove ❑ CE25-fomoiu ❑ Cuq Dust Controt
Cyr pasta-n .
❑ C235 Walties
Element 6-. Protect Slopes
The goal of this element is to design and construct cut -and -fill slopes in a manner to minimize erosion.
Select one of the two statements applicable to the project.
❑ No cut slopes over 4 feet high or slopes steeper than 2 feet horizontal to 1 foot vertical, and no fill slopes over
4 feet high will exceed 3 feet horizontal to 1 foot vertical. Therefore, there is no requirement for additional
engineered slope protection.
❑ The above checkbox is not checked. My submittal is designed by a licensed geologist to protect slopes. Based on
the licensed professionals recommendation (please attach their evaluation), the following BMP's will be used:
❑ C120'€ asa • & Permanent ❑ C245 SuWsurface
eedin Brains
❑ QN4 Pive3_119vt Drains ❑ C206 Level; _S=a der
Element 7. Protect Permanent again Inlets
❑ C207 Check Datins
❑ 0208, Triangular "silt Dike
i`Geol:extile-Encased Check Darn)
The goal of this element is to protect storm drain inlets during construction to prevent stormwater runoff from
entering the conveyance system without being filtered or treated.
Select one of the three statements applicable to the project.
❑ The site has open ditches in the right-of-way or private road right-of-way.
❑ There are no catch basins on or near the site.
❑ Catch basins on the site or immediately off site in the right-of-way are shown on the SWPPP Site Plan. Storm drain
inlet protection shall be installed. If this option is selected check the BMPS you will use below:
❑ C22Q Storm rain Lniet F'rn ection
page 3 of 6
Worksheet 61
,r 7 w Construction Protection: Medium and Large Projects
y , (SWPPP: Stormwater Pollution Prevention Plan)
5IfltiL'i�
�EI�:rrr�in �� it aiiil ,'v ; uae� ci Outlets
The goal of this element is to design, construct, and stabilize on -site conveyance channels to prevent erosion
from entering existing stormwater outfalls and conveyance systems.
Select one of the three statements applicable to the project.
❑ Construction will occur during the dry weather. No storm drainage channels or ditches shall be constructed either
temporary or permanent.
❑ There are no existing or proposed stormwater conveyance channels on the project site.
❑ A wattle shall be placed at the end of the swale to prevent erosion at the outlet of the swale. If this option is
selected check the BMPS you will use below:
❑ C202 Cktanme1.LWW_ ❑ C207 Check Dams
Element 9, Control Pollutants
❑ CZG9 Outlet >gc,6oA ❑ C235 prattles
The goal of this element is to design, install, implement and maintain BMPs to minimize the discharge of
pollutants from material storage areas, fuel handling, equipment cleaning, management of waste materials, etc.
This element does not apply to my project because (circle any that apply - If any box is unchecked this element applies.
❑ There will be no concrete work,
❑ There will be no sawcutting work,
❑ There will be no hazardous materials on -site,
❑ There will be no fertilizer or pesticide application,
❑ There will be no heavy equipment associated with this project,
❑ There will be no pressure washing, equipment maintenance or dewatering
If one or more of the checkboxes above are unchecked. Any and all pollutants, chemicals, liquid products and other
materials that have the potential to pose a threat to human health or the environment will be covered, contained, and
protected from vandalism. All such products shall be kept under cover in a secure location on -site. Concrete handling
shall follow BMP C151 C154. If this option is selected check the BMPS you will use below:
❑ C151 Concrete Handling ❑ C152 Sawcuffina and Surfacing
Pollution Prevent' do
❑ C153 Material Delivery, Stora a and Containme t ❑ Cf 54 Concrete Washput Area
page 4of6
Worksheet B1
Construction Protection: Medium and large Projects
(SWPPP: 5tormwater Pollution PZe ntion Plan)
IEllement 10: Control De -watering
The goal of this element is to handle turbid or contaminated water from dewatering (removal of water)
separately from stormwater.
Select one of the two statements applicable to the project.
No dewatering of the site is anticipated.
Dewatering of the site is anticipated. If this option is selected check the BMPS you
will use below:
C203 Water -Bass [] C235 �e et�i s� 'i$traE� .n [] C266 Level_ SpLead
Element 11: Maintain Best Management Practices
The goal of this element is to maintain and repair all temporary and permanent erosion and sediment control
BMPs to assure continued performance.
Describe the steps you will take:
❑Best Management Practices or BMPS shall be inspected and maintained during construction and removed within
30 days after the County Inspector or determines that the site is stabilized, provided that they may be removed
when they are no longer needed.
Element 12: M.ana,ge the Project
The goal of this element is to ensure that the owner and those performing the site work comply with the
SWPPP and properly coordinate to ensure that all BMPS are deployed at the proper time to achieve full
compliance with county regulations throughout the project.
The SWPPP will be implemented at all times. If applicable to the project, erosion control BMPS will be
implemented in the following sequence:
1. Mark clearing limits
2. Install stabilized construction entrance
3. Install protection for existing drainage systems and permanent drain inlets
4. Establish staging areas for storage and handling polluted material and BMPS
5. Install sediment control BMPS
6. Grade and install stabilization measures for disturbed areas
7. Maintain BMPS until site stabilization, at which time they may be removed
page 5 of 6
CAN
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Worksheet B1
1
Construction Protection. Medium and Large Projects
(SWPPP: Storrnwater Pollution Prevention Plan)
Iri�(a
E i e m elr>>t 1 : iP,raitect taw Tim,mipac t > EVeliop- m nT . iPs
The goal of this element is to protect permanent stormwater management BMPs from siltation and compaction
during construction. The permanent stormwater management BMPs used for runoff from roofs and other hard
surfaces include: full dispersion, roof downspout full infiltration or dispersion systems, perforated stubout
connections, rain gardens, bioretention systems, permeable pavement, sheetflow dispersion, and concentrated
flow dispersion.
Methods that will be used to protect permanent stormwater management BMPs include:
Sequencing the construction in a fashion to install these permanent BMPs at the latter part of the
construction grading operations,
❑ Excluding equipment from the BMPs and the associated areas,
❑Using the erosion and sedimentation control BMPs listed below to protect facilities such as drywells,
raingardens, permeable pavement, or bioretention from accumulating sediment during construction and
before site restoration. If this option is selected check the BMPS you will use below:
❑ C1012 Buffer Zone
C233 Silt Fence
C231 Brush Barrier
Applicant or Representative Signature
C:103 ffitLVisib4lity Fence
❑ C234 Vegetated_Rr%
Other
page 6 of 6
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£.. - What's the best option for your site? • �
Minimum Requirement #5 (ors -site Stormwater Martagementl
The following tables summarize the criteria that can be used to justify why you cannot use various s ormwater
management best management practices (BMPs) for consideration for Minimum Requirement #5. This information is also
included under the detailed descriptions of each BMP in the Department of Ecology's Stormwater Management Manual for
Western Washington (SWMMWW [2014]). Where any inconsistencies or lack of clarity exists, the requirements in the main
text of the SWMMWW shall be applied.
HOW TO USE:
Evaluate the feasibility of the BMPs in priority order based on Worksheet Al page 5 (List #1) or 6 (List #3) or
Worksheet L for Large Projects (List #2). Only one criterion needs to be selected for a BMP before evaluating the
next on the list.
Lawn and Landscaped Areas
and Reason why the BMP will not work on site. Additional Comments
Applicable If needed
Lists
Post -construction Lawn and landscape area is on till slopes greater than 33
Soil Quality ❑
and Depth percent.
(BMP T5.13
SWMMWW Volume V. Siting and design criteria cannot be achieved on site
Section 5 3) �J
List #1, #2 and #3
17 None of the above boxes are checked. This is the BMP that must be used for lawn and landscaped areas. On
WorksheetA1, indicate that this will be the BMP used. CONTINUE to complete the form for other surface types
applicable to the project. If none, STOP,
Roofs
and Reason why the BMP will not work on site. Additional Comments
Applicable If needed
Lists
A 65 to 10 ratio of forested or native vegetation area to
impervious area cannot be achieved.
BMP T5.30,
SWMMVWVvolume V, A minimum forested or native vegetation flowpath length of
Section 5 3 100 feet (25 feet for sheet flow from a non-native pervious
List #1 and #2 surface) and protected by easement cannot be achieved.
Siting and design criteria cannot be achieved on site
None of the above boxes are checked. This is the BMP that must be used for roofs. On Worksheet Al. indicate that
this will be the BMP used. CONTINUE to complete the form for other surface types applicable to the project. If none,
i ownspout Dull
There is an alternatie septic system on this lot or an adjacent
Infiltration
lot (mound, sand filter pressure distribution, Glendon, aerobic
BMP T5
treatment unit). Therefore, there is not at least 3 feet or
Volu10A.
SWMMWW Volume
more of permeable soil from the proposed final grade to the
p P P
III, Section 3 1.1
seasonal high groundwater table or other impermeable layer.
List #1, #2
There is not at least 1 foot or more of permeable soil from
El the
and #3
proposed bottom of the infiltration system to the seasonal
high groundwater table or other impermeable layer
Worksheet C
I What's the best option for your site?
Roofs (cont.)
BM and
Reason why the RMP will not work on site.
Additional Comments
Applicable
If needed
Lists
Downspout Full
Slopes steeper than 25% or less than 200' from slope
Infiltration
❑ steeper than 40%.
(coat.)
Siting and design criteria cannot be achieved on site
BMP T5.10A,
SWMMVWV Volume
None of the above boxes are checked. This is the BMP that must be used for roofs. On Worksheet Al, indicate that
this will be the BMP used. CONTINUE to complete the form for other surface types applicable to the project. If none,
STOP.
Note. Criteria with setback distances are as measured from the
Bioretention or
bottom edge of the bioretention soil mix.
Rain Gardens
Citation of any of the following infeasibility criteria must be
BMP T7 30 or T5 14A
based on an evaluation of site -specific conditions and a written
SWMMVVW Volume V,
recommendation from an appropriate licensed professional (e g ,
Section 7 4
engineer, geologist, hydrogeologist):
Where professional geotechnical evaluation recommends
infiltration not be used due to reasonable concerns about
List #1 (both)
erosion, slope failure, or down -gradient flooding.
and List #2
(bioretention
Within an area whose ground water drains into an erosion
only)
hazard, or landslide hazard area.
CC Where the only area available for siting would threaten the
safety or reliability of pre-existing underground utilities, pre-
existing underground storage tanks, pre-existing structures,
or pre-existing road or parking lot surfaces.
❑Where the only area available for siting does not allow for
a safe overflow pathway to stormwater drainage system or
private storm sewer system
Where there is a lack of usable space for bioretention areas
at re -development sites, or where there is insufficient space
within the existing public right-of-way on public road projects.
❑Where infiltrating water would threaten existing below grade
basements
ElWhere infiltrating water would threaten shoreline structures
such as bulkheads
Werksheet C
•..L What's the best option for your site?
Roofs (cunt.)
BMP and Reason why the BMP will not work on site. Additional Comments
Applicable
Lists
If needed
tsIoreten'tiora
Rain Garden
(cunt.)
The following criteria can be cited as reasons for infeasibility
without further justification (though some require professional
services to make the observation):
❑Within setback provided for BMP T7 30 (SWMMWW Volume
V, Section 7 4)
Where they are not compatible with surrounding drainage
system as determined by the county (e.g., project drains to
an existing stormwater collection system whose elevation
or location precludes connection to a properly functioning
bioretention area).
❑Where land for bioretention is within an erosion hazard, or
landslide hazard area (as defined by PAMC 15.20)
Where the site cannot be reasonably designed to locate
bioretention areas on slopes less than 8 percent
Within 50 feet from the top of slopes that are greater than 20
percent and over 10 feet of vertical relief.
BMP T7 30 or T5 14A
SWMMVVW Volume V, For properties with known soil or groundwater contamination
Section 7.4 (typically federal Superfund sites or state cleanup sites under
the Model Toxics Control Act [MTCA]):
Within 100 feet of an area known to have deep soil
contamination.
Where groundwater modeling indicates infiltration
will likely increase or change the direction of the
migration of pollutants in the groundwater
Wherever surface soils have been found to be
contaminated unless those soils are removed within
10 horizontal feet from the infiltration area.
D Within 100 feet of a closed or active landfill
Within 10 feet of an underground storage tank and
❑
connecting underground pipes when the capacity of the tank
and pipe system is 1,100 gallons or less. As used in these
criteria, an underground storage tank means any tank used
to store petroleum products, chemicals, or liquid hazardous
wastes of which 10 percent or more of the storage volume
(including volume in the connecting piping system) is
beneath the ground surface
Within 100 feet of an underground storage tank and
connecting underground pipes when the capacity of the tank
and Pipe system is greater than 1.100 oaiIon s.
N
Worksheet C
�--�� What's the best option foryoursite?
'S'l1;Cal
Roofs (cont.)
BMP and
Reason why the BMP will not work on site.
Additional Comments
Applicable
If needed
Lists
Where the minimum vertical separation of 1 foot to the
seasonal high groundwater or other impermeable layer would
not be achieved below bioretention that would serve a drainag
area less than the above thresholds
Where field testing indicates potential bioretention/rain
garden sites have a measured (a k.a , initial) native soil
saturated hydraulic conductivity less than 0.30 inches per
hour. A small-scale or large-scale PIT in accordance with
SWMMWW Volume III, Section 3.3.6 (or an alternative
small scale test specified by the local government) shall
be used to demonstrate infeasibility of bioretention areas
If the measured native soil infiltration rate is less than 0.30
in/hour, bioretention/rain garden BMPs are not required
to be evaluated as an option in List #1 or List #2. In these
i
slow draining soils, a bioretention area with an underdrain
may be used to treat pollution -generating surfaces to help
(cost.)
meet Minimum Requirement #6, Runoff Treatment. If the
underdrain is elevated within a base course of gravel, it will
also provide some modest flow reduction benefit that will help
achieve Minimum Requirement #7.
❑Where the minimum vertical separation of 3 feet to the
seasonal high groundwater elevation or other impermeable
layer would not be achieved below bioretention that would
serve a drainage area that exceeds the following thresholds
(and cannot reasonably be broken down into amounts
smaller than indicated):
o 5,000 square feet of pollution -generating impervious
surface (PGIS)
o 10,000 square feet of impervious area
o 0.75 acres of lawn and landscape.
r� Any area where these facilities are prohibited by an approved
u cleanup plan under the state MTCA or Federal Superfund
Law, or an environmental covenant under Chapter 64.70
RC W.
Within 100 feet of a drinking water well, or a spring used for
drinking water supply
BMP and
Applicable
Lists
Worksheet C
What's the best option for your site?
Roofs (cant.)
Reason why the BMP will not work on site. Additional Comments
If needed
Within 10 feet of small on -site sewage disposal drainfield,
including reserve areas, and grey water reuse systems. For
setbacks from a "large on -site sewage disposal system," see
Chapter 246-272B WAC.
None of the above boxes are checked. This is the BMP that must be used for roofs. On WorksheetA1, indicate that
this will be the BMP used. CONTINUE to complete the form for other surface types applicable to the project. If none,
STOP.
Downspout
For splash blocks, a vegetated flowpath at least 50 feet in
Dispersion
length from the downspout to the downstream property line,
Systems
structure, stream, wetland, slope over 15 percent, or other
impervious surface is not feasible.
BMP T5.108
SWMMVWV Volume
ill, Section 3 1 2
For trenches, a vegetated flowpath of at least 25 feet in
between the outlet of the trench and any property line,
List #1, #2
structure, stream, wetland, or impervious surface is not
and #3
feasible. A vegetated flowpath of at least 50 feet between the
outlet of the trench and any slope steeper than 15 percent is
not feasible.
❑ Siting and design criteria cannot be achieved on site.
None of the above boxes are checked. This is the BMP that must be used for roofs. On Worksheet Al, indicate that
this will be the BMP used. CONTINUE to complete the form for other surface types applicable to the project. If none,
STOP
Perforated
For sites with septic systems, the only location available for
❑
Stub -Out
the perforated portion of the pipe is located up -gradient of
Connections
the drainfield primary and reserve areas. This requirement
can be waived if site topography will clearlyprohibit flows
BMP T5 10C
from intersecting the drainfield or where site conditions (soil
SWMMWW Volume
permeability, distance between systems, etc.) indicate that
III, Section 3.1.3
this is unnecessary.
There is a mound, sandfilter, Glenden or aerobic treatment
List #1, #2
device on this or an adjacent lot. Therefore, there is not at
and #3
least 1 foot of permeable soil from the proposed bottom (final
grade) of the perforated stub -out connection trench to the
highest estimated groundwater table or other impermeable
layer
❑The
only location available for the perforated stub -out
connection is under impervious or heavily compacted soils.
❑ The only location available is on or above slopes greater than
20%
Siting and desiqn criteria cannot be achieved on site
None of the above boxes are checked. This is the BMP that must be used for roofs. On Worksheet Al, indicate that
this will be the BMP used. CONTINUE to complete the form for other surface types applicable to the project, If none,
STOP.
Worksheet G
1f; Wthe best option for your site?
7hat's
1,sIr
Other Hard Surfaces
BMP and
Reason why the BMP will not work on site.
Additional Comments
Applicable
If needed
Lists
Full Dispersion
A 65 to 10 ratio of forested or native vegetation area to
D
impervious area cannot be achieved.
BMP T5.30
swMMWW volume
V. Section 5 3
A minimum forested or native vegetation flowpath length of
❑
100 feet (25 feet for sheet flow from a non-native pervious
List #1 and #2
surface) cannot be achieved
Siting and design criteria cannot be achieved on site
None of the above boxes are checked. This is the BMP that must be used for hard surfaces. On Worksheet Al,
indicate that this will be the BMP used. CONTINUE to complete the form for other surface types applicable to the
project. If none, STOP.
Citation of any of the following infeasibility criteria must be
based on an evaluation of site -specific conditions and a written
recommendation from an appropriate licensed professional (e g ,
engineer, geologist, hydrogeologist):
professional geotechnical evaluation recommends
❑Where
infiltration not be used due to reasonable concerns about
erosion, slope failure, or downgradient flooding.
permeable
Pavement
❑ Within an area whose ground water drains into an erosion
hazard, or landslide hazard area
BMP T5.15,
SWMMwwvolume
Where infiltrating and ponded water below the new permeable
V, Section 5 3
pavement area would compromise adjacent impervious
List #1 and #2
pavements
* Note that
Where infiltrating water below a new permeable pavement
Raingardens
area would threaten existing below grade basements
may be used
in lieu of
Where infiltrating water would threaten shoreline structures
permeable
LJ such as bulkheads
pavement if
subject to
El Down slope of steep, erosion prone areas that are likely to
El
List #1.
sediment to the area of pervious pavement.
❑Where fill soils are used that can become unstable when
saturated
❑Excessively steep slopes where water within the aggregate
base layer or at the subgrade surface cannot be controlled
by detention structures and may cause erosion and structural
failure, or where surface runoff velocities may preclude
adequate infiltration at the pavement surface.
Worksheet C
•�y � What's the best option for your site?
Other Hard Surfaces (cont.)
BMP and Reason why the RMP will not work on site. Applicable Additional Comments
Lists I If needed
Permeable
Pavement
(cont.)
BMP T5 15,
SWMMVVVV Vol-
ume V, Section
5.3
* Note that
Raingardens
may be used
in lieu of
permeable
pavement if
subject to
List #1.
❑ Where permeable pavements cannot provide sufficient
strength to support heavy loads at industrial facilities such
as ports.
❑ Where installation of permeable pavement would threaten
the safety or reliability of pre-existing underground utilities,
per -existing underground storage tanks, or pre-existing road
subgrades
The following criteria can be cited as reasons for infeasibility without
further justification (though some require professional services to
make the observation):
ElWithin an area designated as an erosion hazard, or
landslide hazard.
FWithin 50 feet from the top of slopes that are greater than
20 percent.
For properties with known soil or groundwater
El
contamination (typically federal Superfund sites or state
cleanup sites under MTCA):
• Within 100 feet of an area known to have deep soil
contamination.
• Where groundwater modeling indicates infiltration
will likely increase or change the direction of the
migration of pollutants in the groundwater.
• Wherever surface soils have been found to be
contaminated unless those soils are removed
within 10 horizontal feet from the infiltration area
• Any area where these facilities are prohibited by
an approved cleanup plan under the state MTCA
or Federal Superfund Law, or an environmental
covenant under Chapter 64.70 RCW.
❑ Within 100 feet of a closed or active landfill.
EWithin 100 feet of a drinking water well, or a spring used
for drinking water supply, if the pavement is a pollution -
generating surface.
Worksheet C
J
,f What's the best option for your site?
Other Hard Surfaces (cont.)
PuP and
Reason why the BMP will not work on site.
Additional Comments
Applicable
If needed
Lists
Within 10 feet of a small on -site sewage disposal drainfield,
including reserve areas, and grey water reuse systems. For
setbacks from a "large on -site sewage disposal system,"
see Chapter 246-272B WAC.
❑Within 10 feet of any underground storage tank and
connecting underground pipes, regardless of tank size As
used in these criteria, an underground storage tank means
any tank used to store petroleum products, chemicals, or
liquid hazardous wastes of which 10 percent or more of the
storage volume (including volume in the connecting piping
system) is beneath the ground surface.
❑ At multi -level parking garages, and over culverts and
bridges
❑ Where the site design cannot avoid putting pavement
Permeable
in areas likely to have long-term excessive sediment
Pavement
deposition after construction (e.g , construction and
(cont.)
landscaping material yards).
BM T5 15,
SWMMWW
Where the site cannot reasonably be designed to have a
Volume v,
porous asphalt surface at less than 5 percent slope, or a
Section 5 3
pervious concrete surface at less than 10 percent slope, or
a permeable interlocking concrete pavement surface (where
appropriate) at less than 12 percent slope. Grid systems
Note that
upper slope limit can range from 6 to 12 percent-, check with
Raingardens
manufacturer and local supplier.
may be used
in lieu of
Where the subgrade soils below a pollution -generating
permeable
permeable pavement (e.g., road or parking lot) do not
pavement if
meet the soil suitability criteria for providing treatment
subject to
See soil suitability criteria for treatment in the SWMMWW
List #1.
Volume III, Section 3.3.7. Note: In these instances, the
county may approve installation of a 6 inch sand filter layer
meeting county specifications for treatment as a condition of
construction
❑
Where underlying soils are unsuitable for supporting traffic
loads when saturated Soils meeting a California Bearing
Ratio of 5 percent are considered suitable for residential
access roads.
❑
Where replacing existing impervious surfaces unless the
existing surface is a non -pollution generating surface over
an outwash soil with a saturated hydraulic conductivity of 4
inches er hour or oreater.
Worksheet C
�e_ What's the best option for your site?
f'S�fl?tiLUti
Other Hard Surfaces (coat.)
BMP and Reason why the BMP will not work on site. Additional Comments
Applicable
Lists If needed
❑ Where appropriate field testing indicates soils have a
measured (a.k.a., initial) subgrade soil saturated hydraulic
conductivity less than 0.3 inches per hour Only small-
scale PIT or large-scale PIT methods in accordance with
SWMMWW Volume III, Section 3 3 6 (or an alternative small
scale test specified by the local government) shall be used to
evaluate infeasibility of permeable pavement areas (Note: In
these instances, unless other infeasibility restrictions apply,
roads and parking lots may be built with an underdrain,
preferably elevated within the base course, if flow control
benefits are desired.)
❑ Roads that receive more than very low traffic volumes, and
areas having more than very low truck traffic. Roads with
a projected average daily traffic volume of 400 vehicles
or less are very low volume roads (AASHTO 2001) (U.S.
Department of Transportation, 2013) Areas with very low
Permeable
truck traffic volumes are roads and other areas not subject
Pavement
to through truck traffic but may receive up to weekly use by
(coat)
utility trucks (e.g., garbage, recycling), daily school bus use,
BMP T5 15,
and multiple daily use by pick-up trucks, mail/parcel delivery
SvvMMVWv
trucks, and maintenance vehicles- Note: This infeasibility
Volume V.
criterion does not extend to sidewalks and other non -traffic
Section 5 3
bearing surfaces associated with the collector or arterial.
* Note that
Raingardens
At sites defined as "high -use sites" (refer to the Glossary in
may be used
the SWMMWW Volume 1).
in lieu of
permeable
jJ
In areas with "industrial activity" as identified in 40 CFR
pavement if
i��!!
122 26(b)(14).
subject to
List #1.
I`�
Where the risk of concentrated pollutant spills is more likely
El
such as gas stations, truck stops, and industrial chemical
storage sites
❑Where routine, heavy applications of sand occur in frequent
snow zones to maintain traction during weeks of snow and
ice accumulation
ElWhere the seasonal high groundwater or an underlying
impermeable/low permeable layer would create saturated
conditions within 1 foot of the bottom of the lowest gravel
base course.
None of the above boxes are checked- This is the BMP that must be used for hard surfaces. On WorksheetA1,
E indicate that this will be the BMP used- (List #1 may use Raingardens in lieu of Permeable Pavement)- CONTINUE to
complete the form for other surface types applicable to the project. If none, STOP.
Worksheet C
r What's the best option for your site?
Other Hard Surfaces Jc.ont.)
BMP and Reason why the BMP will not work on site. Additional Comments
Applicable If needed
Lists
Note: Criteria with setbaR antes are as measureV from the
bottom edge of the bioretention soil mix
Citation of any of the following infeasibility criteria must be
based on an evaluation of site -specific conditions and a written
recommendation from an appropriate licensed professional (e.g.,
engineer, geologist, hydrogeologist):
Where professional geotechnical evaluation recommends
infiltration not be used due to reasonable concerns about
erosion, slope failure, or down -gradient flooding.
❑
Within an area whose ground water drains into an erosion
hazard, or landslide hazard area.
Bioretention or
Rain Gardens
❑
Where the only area available for siting would threaten the
safety or reliability of pre-existing underground utilities, pre-
SWMMWW Volume V,
existing underground storage tanks, pre-existing structures,
Section 7 4
or pre-existing road or parking lot surfaces.
List #1 (both)
and List #2
❑
Where the only area available for siting does not allow for
(bioretention
a safe overflow pathway to stormwater drainage system or
only)
private storm sewer system
Where there is a lack of usable space for bioretention areas
❑
at re -development sites, or where there is insufficient space
within the existing public right-of-way on public road projects.
❑Where infiltrating water would threaten existing below grade
basements.
❑Where infiltrating water would threaten shoreline structures
such as bulkheads
The following criteria can be cited as reasons for infeasibility
without further justification (though some require professional
services to make the observation):
❑Within setback provided for BMP T7.30 (SWMMWW Volume
V, Section 7 4)
Where they are not compatible with surrounding drainage
❑
system as determined by the county (e.g , project drains to
an existing stormwater collection system whose elevation
or location precludes connection to a properly functioning
bioretention area).
HE
Worksheet C
•�_ �- What's the hest option for your site?
Other Ward Surfaces (cunt.)
and Reason why the BNIP will not work on site. Additional Comments
Applicable
Lists If needed
vvnere Lana for Dioretention is within an erosion hazard, or
landslide hazard area (as defined by PAMC 15 20).
(1 Where the site cannot be reasonably designed to locate
l! bioretention areas on slopes less than 8 percent.
❑Within 50 feet from the top of slopes that are greater than 20
percent and over 10 feet of vertical relief.
❑For properties with known soil or groundwater contamination
(typically federal Superfund sites or state cleanup sites under
the Model Toxics Control Act [MTCA]):
• Within 100 feet of an area known to have deep soil
contamination
Bioretention or
• Where groundwater modeling indicates infiltration
Rain Gardens
will likely increase or change the direction of the
(cont.)
migration of pollutants in the groundwater
• Wherever surface soils have been found to be
BMP T
WMMVWV V
Volume V.
contaminated unless those soils are removed within
Section 7 a
10 horizontal feet from the infiltration area.
Within 100 feet of a closed or active landfill.
Within 10 feet of an underground storage tank and
connecting underground pipes when the capacity of the tank
and pipe system is 1,100 gallons or less. As used in these
criteria, an underground storage tank means any tank used
to store petroleum products, chemicals, or liquid hazardous
wastes of which 10 percent or more of the storage volume
(including volume in the connecting piping system) is
beneath the ground surface.
❑Within 100 feet of an underground storage tank and
connecting underground pipes when the capacity of the tank
and pipe system is greater than 1,100 gallons.
Where the minimum vertical separation of 1 foot to the
seasonal high groundwater or other impermeable layer
would not be achieved below bioretention that would serve a
drainage area less than the above thresholds
ff
orksheet C
What's the best option for your site?
Other Hard Surfaces {cont.)
BMP and
Reason why the BMP will not work on site.
Additional Comments
Applicable
If needed
Lists
here field testing indicates potential bioretention/rain ❑
garden sites have a measured (a.k.a., initial) native soil
saturated hydraulic conductivity less than 0.30 inches per
hour. A small-scale or large-scale PIT in accordance with
SWMMWW Volume III, Section 3.3.6 (or an alternative
small scale test specified by the local government) shall
be used to demonstrate infeasibility of bioretention areas
If the measured native soil infiltration rate is less than 0.30
in/hour, bioretention/rain garden BMPs are not required
to be evaluated as an option in List #1 or List #2. In these
slow draining soils, a bioretention area with an underdrain
may be used to treat pollution -generating surfaces to help
meet Minimum Requirement #6, Runoff Treatment. If the
underdrain is elevated within a base course of gravel, it will
also provide some modest flow reduction benefit that will help
achieve Minimum Requirement #7.
'ioretention or
lain Gardens
Where the minimum vertical separation of 3 feet to the
❑
(cont.)
seasonal high groundwater elevation or other impermeable
layer would not be achieved below bioretention that would
BMP T
SWMMWW Volume V,
V
serve a drainage area that exceeds the following thresholds
Section 7 4
(and cannot reasonably be broken down into amounts
smaller than indicated):
o 5,000 square feet of pollution -generating impervious
surface (PGIS)
o 10,000 square feet of impervious area
o 0.75 acres of lawn and landscape
❑Any area where these facilities are prohibited by an approved
cleanup plan under the state MTCA or Federal Superfund
Law, or an environmental covenant under Chapter 64.70
RCW.
Within 100 feet of a drinking water well, or a spring used for
drinking water supply.
{--1 Within 10 feet of small on -site sewage disposal drainfield,
�J including reserve areas, and grey water reuse systems For
setbacks from a "large on -site sewage disposal system," see
Chapter 246-272B WAC.
None of the above boxes are checked. This is the BMP that must be used for hard surfaces. On Worksheet Al,
indicate that this will be the BMP used. CONTINUE to complete the form for other surface types applicable to the
project. If none, STOP.
12
N. (, 0
Worksheet C
1
What's the best option for your site?
Other Hard Surfaces (cont.)
BMP and
Reason why the BMP will not work on site.
Additional Comments
Applicable
If needed
Lists
Sheet Floy
❑ Positive drainage for sheet flow runoff cannot be achieved.
Dispers'-
❑ Area to be dispersed (e g., driveway, patio) cannot be graded
BMP T5 12,
SWMMWW Volume
to have less than a 15 percent slope.
V, Section 5 3
List #1, #2
For flat to moderately sloped areas, at least a 10 foot -wide
❑
and #3
vegetation buffer for dispersion of the adjacent 20 feet of
contributing surface cannot be achieved. For variably sloped
areas, at least a 25 foot vegetated flowpath between berms
cannot be achieved.
Siting and design criteria cannot be achieved on site.
None of the above boxes are checked. This is the BMP that must be used for hard surfaces. On WorksheetA1,
❑ indicate that this will be the BMP used. CONTINUE to complete the form for other surface types applicable to the
project. If none, STOP.
Concentrate.
❑ A minimum 3 foot length of rock pad and 50 foot flowpath
Flow
OR a dispersion trench and 25 foot flowpath for every 700
Dispersion
sq. ft. of drainage area followed with applicable setbacks
cannot be achieved.
BMP T5.11,
SWMMWW Volume
More than 700 sq ft drainage area drains to any dispersion
V, Section 5.3
❑ device.
List #1, #2
and #3
Siting and design criteria cannot be achieved on site
None of the above
boxes are checked. This is the BMP that must be used for hard surfaces. On Worksheet All,
❑ indicate that this will be the BMP used. CONTINUE to complete the form for other surface types applicable to the
project. If none, STOP.
13
EXHIBIT F
When recorded please return to:
Jefferson County Department of Public Works
623 Sheridan Street
Port Townsend, WA 98368
ROAD & STORMWATER FACILITY
MAINTENANCE & NO PROTEST AGREEMENT
This MAINTENANCE AGREEMENT is made this day of _ , 2021 by
hereinafter GUARANTOR and
Jefferson County, a municipal corporation, hereinafter GUARANTEE.
1.0 RECITALS
1.1 GUARANTOR is the owner of certain real property in the Plat of Irondale No. 5, Section 34,
Township 30 N, Range 1 West, W.M., Jefferson County, Washington; Volume 2 of Plats, Page
135, identified as Block 123, Lots 28 - 33, Assessor's Parcel Number 962112310, and referred to
in this Agreement as the PROPERTY.
1.2 In conjunction with the GUARANTOR'S development of the PROPERTY under Jefferson
County Open Right -of -Way Application RAP21-00081, GUARANTEE has required and
GUARANTOR has agreed to construct a road and stormwater facility which includes collection,
conveyance, treatment, and infiltration facilities. The road and stormwater facility is described and
shown on a construction drawing for GUARANTOR'S development of the PROPERTY that is on
file with the appropriate agency, division, employee, or representative of Jefferson County.
1.3 As a condition of development approval, GUARANTOR has agreed to enter into this
Maintenance Agreement ensuring that the road and stormwater facility will be constructed and
maintained in accordance with the approved plans.
1.4 Any agreement to establish a Road Improvement District (RID) for the improvement of the
public, platted rights of way adjacent to or adjoining the parcel(s) listed above are subject to the
terms and conditions of this Agreement
The establishment of a Road Improvement District (RID) may be formed in which the owners and
successors hereby waive their right to protest said RID except as to the method of assessment.
2.0 CONSTRUCTION AND MAINTENANCE
GUARANTOR agrees to construct and maintain a road and stormwater facility as shown on the
construction drawings described above. The road and stormwater facility shall be maintained and
preserved by GUARANTOR until such time as GUARANTOR, its heirs, successors, or assigns
and GUARANTEE agree that the facility should be dismantled, altered, abandoned, or removed.
3.0 NO REMOVAL
No part of the road and/or stormwater facility shall be dismantled, altered, or removed except as
necessary for maintenance, repair or replacement.
Page 1 of 3
4.0 NO PROTEST — IMPROVEMENT DISTRICT
GUARANTOR covenants and agrees that at any time a Road Improvement District (RID),
including but not limited to a Local Improvement District (LID), Utility Local
Improvement District (ULID), or any other pro rata sharing of costs to construct, improve
the public, platted rights of way to the parcel(s) listed above is formed and the parcel(s)
are subject to a RID or within the service area of a RID, then the owners and successors in
interest as their interests as they may appear of the parcels hereby waive their right of
protest to said RID except as to the method of assessment
4.0 DISPUTE RESOLUTION
If a dispute arises between the parties to this Agreement regarding the road and stormwater
facility, GUARANTOR shall attempt to negotiate an appropriate resolution with GUARANTEE
represented by the Jefferson County Engineer. If the dispute cannot be resolved at that level,
GUARANTOR may file an appeal with the Jefferson County Hearing Examiner as provided for in
the Jefferson County Unified Development Code.
5.0 ENFORCEMENT
This Agreement may be enforced by GUARANTEE in law or equity against GUARANTOR, its
heirs, successors and assigns.
6.0 SUCCESSORS AND ASSIGNS
This Agreement shall run with the PROPERTY and be binding on GUARANTOR, its heirs,
successors and assigns.
7.0 NOTICE
GUARANTOR shall file this Agreement with the Jefferson County Auditor.
DATED this day of , 2021
GUARANTOR
STATE OF WASHINGTON
ss
COUNTY OF
On this day personally appeared before me & to me
known to be the individuals described in and who executed the foregoing instrument, and acknowledged that they
signed the same as their free and voluntary act and deed, for the uses and purposes therein mentioned.
GIVEN under my hand and official seal this day of
Page 2 of 3
Notary Public in and for the State of Washington
residing at
MY COMMISSION EXPIRES
ACCEPTED for JEFFERSON COUNTY by:
Monte Reinders, P.E. Date
Jefferson County Public Works Director / County Engineer
STATE OF WASHINGTON
ss
COUNTY OF
On this day personally appeared before me to me known to be the individual described
in and who executed the foregoing instrument, and. acknowledged that he signed the same as his free and voluntary
act and deed, for the uses and purposes therein mentioned.
GIVEN under my hand and official seal this day of ,
Notary Public in and for the State of Washington
residing at
MY COMMISSION EXPIRES
Page 3 of 3
EXHIBIT G
4'�ACCEL/�> Conditions Associated With
Case #: RAP2021-00081
9/8/2021
9:04:52AM
Condition Status llpdated
Code Title Hold Status Changed By Tag Date By
0701 PERMIT ON SITE None NOT M 1=T 8/ 19/2021 TLD
This permit must be located on site when any work encompassed by the permit is being performed. Failure to do so may
result in suspension of all work.
1007
ROW SURVEY None NOT MET 8/19/2021
TLD
The segment of Pittsburg Ave. to be opened shall be built on the platted centerline per the Local Access Road Standard
Typical Section. The right-of-way shall be located and the centerline staked by a surveyor licensed in the State of
Washington.
1010
SIGHT BRUSHING None NOT MET 8/19/2021
TLD
The applicant shall be responsible for maintaining all vegetation to provide for the adequate sight distance adjacent to this
road approach.
1011
RESPONSIBLE Norte NOT MET 9/8/2021
TLD
eel
The applicant shall be responsible for the cost to mpah9' and all damage to the roadway and rights -of -way, including
public
the integrity of all survey monuments or boundai�r�aTer's.
1019
CRUSHED SURFACING None NOT MET 8/19/2021
TLD
The approach to the applicant's property must have a minimum of 3 inches of crushed rock per WSDOT Standard Spec
9-03.9(3), starting from the edge of the road and extending back a minimum of 20 feet for the full width of the access and its
radius.
1021
DEVELOPMENT MITIGATIVE MEASURES None NOT MET 8/19/2021
TLD
This permit is issued in conjunction with any mitigative measures assigned to this project through the development process.
1037
SURFACE WATER None NOT MET 8/19/2021
TLD
The grade of the approach shall follow the crown of the road to the ditch, and be such that no surface water is directed onto
the new segment of platted Pittsburg Ave.
1039
NO PROTEST STORMWATER AGREEMENT None NOT MET 8/19/2021
TLD
The Applicant must sign, record and return to Public Works the Road & Stormwater Facility Maintenance
&Protest
Agreement.
1039
STORMWTAERASBUILT LETTER None NOT MET 8/19/2021
TLD
Following completion of roadway construction, the Applicant shall submit to Public Works a Lett d with the
professional stamp of the Engineer of Record, certifying that the roadway and stormwater mamae t facilities have been
constructed in accordance with the design plans and specifications and all applicable federal,' and local requirements.
1039
AS BUILT None NOT MET 8/19/2021
TLD
Following completion of roadway construction, the applicant shall submit to Public Works complete "As -Built" or
"As -Constructed" record drawings that reflect any changes made to the approved plans.
1045
RAP ONLY None NOT MET 8/19/2021
TLD
This approval is for opening a segment of Pittsburg Ave. approximately 350' from W. Island View Ave. southerly for a
distance of approximately 150', and for aroad approach to the Applicant's parcel only and does not constitute approval of
other activities within the right of way or on this parcel. Any future permits on this site are subject to review for consistency
with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits.
1065 PRE -CON None NOT MET 8/19/2021 TLD
Applicant must give Jefferson County Public Wor,�pce (360-385-9159) a minimum of 7 working days notice prior to
beginning work. An on -site pre-construil,04 c e_t'ienGe shall be scheduled by the applicant and will include Public Works
and the contractor who will be perfor niirk. Prior to this meeting, any utility locate marks shall be done (Call 811-48
hours before you dig).
9140 P-PRIVATE ROAD APPROACH: 4} None NOT MET 8/19/2021 TLD
The Applicant may install a private road approach off the newly extended and constructed roadway to their parcel as shown
on the approved plans dated
9220 P-OPEN ROW None NOT MET 8/19/2021 TLD
The Applicant has permission to open a portion of platted Pittsburg Ave. approximately 350 feet from the intersection of W.
Island View Ave. southerly a distance of approximately 150 feet, in accordance with the Jefferson Count Public Works
Engiener's Report and approved plans dated . The Engineer's Report specifies a road standard for a Local Access
Road which will not be paved thus not meet the criteria to become a County Road or maintained by Jefferson County.
Page 1 of 1 CaseConditions..rpt
EXHIBIT H
STATE OF WASHINGTON
COUNTY OF JEFFERSON
In the Matter of a Resolution }
to Construct a Road and Utilities on a ) Resolution No.
Portion of Public Right of Way j
Known as Pittsburg Ave.
WHEREAS, an application to construct roads and utilities on public right-of-way has been
submitted by Leil-ei Mae Raiguel for the purpose of providing access to their property, and
WHEREAS, said development will require opening approximately 150 feet of platted Pittsburg
Ave., and
WHEREAS, the Revised Code of Washington (RCW) 36.75 and 36.80 places the supervision of
right of way, including the development of road standards, under purview of the County Engineer, acting
under the supervision and authority of the Board of County Commissioners, and
WHEREAS, the applicant has proposed to construct roads to a standard less than what would be
required for public roads, and
WHEREAS, the County Engineer has examined the right of way and the existing road system and
the potential for future development and recommends that this request be approved provided the
standards described in the County Engineer's report dated
are followed, and
WHEREAS, the applicant will be responsible for the maintenance of this section of roadway and
it is understood that the County will not be responsible for maintenance of this section of roadway and
that it will not be added to the official County Road log until such time as the road is improved to public
road standards and added to the County Road Log through Board action, and
WHEREAS, in lieu of requiring the road to be constructed to full public road standards at this
time, the applicant will be required to sign a no protest agreement waiving rights, except as to the
method of assessment, to protest formation of a pro-rata cost sharing arrangement such as a Road
Improvement District (RID) should it become necessary in the future to upgrade this road, whether
proposed by petition or a resolution of the Board of County Commissioners,
NOW, THEREFORE BE IT RESOLVED, that applicant shall be granted permission to open the following
right of way:
Platted Pittsburg Ave. from its intersection with W. Island View Ave. southerly for approximately
150 feet.
BE IT FURTHER RESOLVED, that roads shall be constructed in general conformance with the standards
recommended in the County Engineer's report dated
BE IT FINALLY RESOLVED, that prior to performing construction the applicant shall receive any and all
necessary permits including a permit from the Department of Public Works specifying any conditions
that will be required by the County Engineer to ensure that said standards are met and that the
applicant shall pay any inspection costs incurred by the Public Works Department to ensure that these
standards are met.
ADOPTED this day of
ATTEST:
Carolyn Galloway
Deputy Clerk of the Board
—. 2021.
JEFFERSON COUNTY
BOARD OF COMMISSIONERS
Kate Dean, Chair
Heidi Eisenhour, Member
Greg Brotherton, Member