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Home My WebLink About02- SUPPLEMENTAL APPLICATIONDEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street, Port Townsend, WA 98368 Tel: 360.379.21450 | Fax: 360.379.4451 Web: www.co. iefferson.wa. us/com munitvdevelopment E-mail: dcd@co.iefferson.wa.us SUPPLEMENTAL APPLICATION STORMIT/ATER MANAGEMENT PERMIT Applications for grading projects or land-disturbing activities which require a stormwater management permit shall include the following information. This information may also be provided on other diagrams, plans, studies, or attachments submitted with the project application. lf so, please indicate such on this permit application. The Administrator may waive specific submittal requirements determined to be unnecessary for review of the application. abltirl-R #PROJECT/APPLICANT NAME : 1 and ofSource of fill C..Jrl/ of fill2. Physical J and compaction consistent with the in the arn J.Building Le- >-^ n l.'\P-A -\It 4. Proposed surfacing material. Crv-*lr.,g-)\ Ci,,rl:rkr.\ +"p p Oj\ArV'g-\J- Proposed method(s) of drainage and erosion controt. fi/ I I t t'e f C,rJan ls - f- le O# Dt I 6lrr-rnun-Jev= 5. 6. Methods for restoration of the site. I flow of will remain unobstructed.7 that L 8. Demonstrate that erosion and sedimentation from outflow channels will be minimized by or and runoff will controlledthat adjacent property damage I that this application is being made with the full knowledge and consent of all owners of the affected (LANDOWNER oR SIGNATURE)(DATE) By the application form, the applicanUowner attests that the provided herein is true and correct to the best of their knowledge. I also property. G:\Pemitcenterlf{f#FoRMsTf#TADRD\Slomwats\stqmrater mgmt permit_FlNAl.doc RFr'. 1OnOnO14 Page 3 Code. ( DEPARTMENT OF COMMUNITY DE\TELOPMENT 621 Sheridan Street, Port Townsend, \(';\ 98368 'Iel: 360.379.4450 | Fax: 360.379.4451 \il.'eb: uu'w.co.iefferson.wa.us/communit],'development E-mail: dcd@co.iefferson.rva.us Scan the QR code to access the digitalform STORMWATER CALCUIATI ON WO RKSHEET PARCEL #eRo.trcr/eeelrclNT NAME DETERMTNING STORMWATER MANAGEMENT REQUIREMENTS: This stormwater calculation worksheet should be completed first to classify the proposal as "small," "medium," or "large." The size determines whether a Stormwater Site Plan is required in conjunction with a stand-alone stormwater management permit application, building permit application, or other land use approval application that involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan, if requ Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover (both vegetative and non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling, excavation, and compaction associated with stabilization of structures and road construction. Notive vegetation is vegetation comprised 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. PARCEL SIZE (I,E.. SITE) An acre contains 43,560 square feet. Multiply the acreage by this figure Size of parcel in square rc"t b"45, q27 sq/ft Size of p^r""t ?. LV ,"r"" 4 Cut D Fiil (cu/yd) sq/ft sq/ft sq/ft sq/ft sq/ft sqlft sq/ft Drainfield, septic tank, etc. Well, utilities, etc. Driveway, parking, roads, etc. Lawn. landscaping. etc. Other compacted surface, etc Temporary construction area Total Land Disturbance lndicate Total Volumes of Proposed: (lncludes =BMP fS.t: rilt Vql ) Answer the following two questions related to conversion of native vegetation: Calculate the total area to be cleared, graded, filled, excavated, and/or compacted for proposed development project. lnclude in this calculation the area to be cleared for: Construction siteforstructures 1, t Ob Does the project convert To acres or more of native vegetation to lawn or landscaped areas? Circle: Yes Does the project convert 2 lz acres or more of native vegetation to pasture? Circle: Yes stormwater Glc worksheet QR @de - REV 581/2019 page 1 of2 6 STORMWATER CALCULATIONS - IMPERVIOUS SURFACE lmperuious surfoce 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. Total New Total Existing TOTAL NEW + TOTAL EXISTING**This amount will be used to check total lot coverage. oo Sidewalks Patios Other NEW Structures (all roof area) Sidewalks Patios Solid Decks (without infi ltration below) Driveway, parking, roads, etc Other EXISTING Structures (all roof area) sq/ft Solid Decks sq/fi (without infiltration below; - Driveway, parking, roads, etc sq/ft Divide the total existinq impervious surface above by the size of the parcel and convert to a percentage.Yo DEVELOPMENT v. REDEVELOPMENT Does the site have > 35o/o or more existinq impervious surface?->.> + yes 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 41 and 8L, a stormwater site plan and a construction stormwater pollution prevention site plan (See Reference A1A and B14 for guidance).). - "Large" projects-those that must meet all 9 Minimum Requirements- must submit Worksheet A1 and 81, a stormwater site plan and a construction stormwater pollution prevention site plan (See Reference A1A and B14 for guidance). Large projects also may require engineering. See Worksheet L to determine additional large project requirements. F no The proposal is considered new development. Answer questions in Figure 2.4.L Flow Chart for New Development to determine project size (next page). APPLICANT SIGNATURE By signing the Stormwater Calculation Worksheet, I as the applicant/owner attest that the information provided herein to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners (ut'roowrurn REPRESENTATIvE srelurunr) and pro is true of the stormwater €lc worksheet QR @de - REV. 513112019 page 2 of 2 _sq/ft sq/ft -sq/ft Start Here Yee No Yes No This is a "large" project. Large projects refer to Worksheet L for submittal requirements. At a minimum, all large Project must submit Worksheet A1,81, and C or equivalent. Yec r ii,1!i if,,,: i-iLil.,1liil.;.1 i:r'ii i iir:t: i. Ir ili fl I f :" l."rii::. l.il1:l::i: I 'i i , t:1 , ,it:]1.J 4., +:' r:'; I ll 1".':.: if i-: l, No Complete "Small Flgure 2.4,1 -Flow Chartfor Determlnlng Requlrements for New Development Doesthe sitehave 35o/o ot mofe of existing impervious coverage? See Redevelopment Minimum Requirements urd Flow Chart (Figure 3.3)Does ths prcject convertt/tast* OImOr€ Of vegetation to lawn or landscaped areas, or convert 2.5 acres or more of nativo vegetationto PssflIre? Does the project result in 5,000 square feet, or greater, ofnewplus replaccd hard surface area? Yes Does the proiect result in 2,000 square feet, or greater, of new plus replaced hard surfaco area?All Minimum Requirements apply to thoncwand replaccd hard surfaces and convefted vegetation areas. Does the project have land disturbing activities of 7,000 square feet or greater? Minimum Requirements #1 through #5 apply to the new and rcplaoed hard surfaces and the Iand disturbed. Minimum Requirenrent #2 applies. Figure 2.4.1 Flow Chart for New Development Vofume I - Minimum Technical Requirenents - August 20 I 2 2-t0 F'act Shee