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HomeMy WebLinkAboutBLD2000-00539 !11i. BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 (800) 831-2678 PERMIT #: BLD00-00539 Received Date 08/16/2000 SITE ADDRESS: 65 CLEVELAND ST Issue Date 08/23/2000 PORT HADLOCK, 98339 Expiration Date 08/23/2001 APPLICANT: EARfY-E-KEEtf PHONE: PATRICIA A 1URNE rr PO BOX 3071 BREMERTON WA 98310 SUBDIVISION: IRONDALE AC TRACTS Block: Lot: T 73 PARCEL NUMBER: 962700075 Section: 07 Township: 29 N Range: 01 E CONTRACTOR: STICKS AND STONES CONSTg4J TI N PHONE: (360)732-5073 453 W HADLOCK 9 Uk� PORT HADLOCK WA 983 Contractor's License;..(\1STICKS000OKC Expires: 05/03/2001 LOAN LENDER/ / BOND HOLDER: PROJECT DESCRIPTION I/ic+ "{el�;1N,�- .-hRiec,"delve 10/(5/0 3 REQUIRE INSPECTIONS: SEQD.tings/Setbacks horelin/e Setbacks):2 O t2 ,& ( 2., )j [LFoundation: Ofc>/�.3�/�L�in:%/4 [ ] Underground Plumbing/Undergroundn Insulation: [ ] Shear Wall: [ ] Framing/Plumbing: [ ] Propane Tank/Lines: [ ] Insulation: [ ] Sheetrock: [ ] Final/Occupancy Approval: HEALTH DEPARTMENT APPROVAL REQUIRED PRIOR TO FINAL INSPECTION. THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. Inspector's Phone Hours 8:00 a.m. - 9:00 a.m. SPECIAL CONDITIONS MAY APPLY - SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD00-00539 Received Date 08/16/2000 SITE ADDRESS: 65 CLEVELAND ST Issue Date 08/23/2000 PORT HADLOCK, 98339 APPLICANT: PATRICIA BURNETT PHONE: (360)379-1988 65 CLEVELAND ST PORT HADLOCK WA 98339 SUBDIVISION: IRONDALE AC TRACTS Block: Lot: T 73 PARCEL NUMBER: 962700075 Section: 7 Township: 29 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION: ORIGINALLY GARAGE PERMIT - REVISED PERMIT TO RESIDENCE 10/15/03 REQUIRED INSPECTIONS: J [ 1 SETBACKS: (3 sseci S/2.9/0ee' ,-3-1 [ ] UFFER: II /� L [ ] Footing: e.8 S' e )too ,.T&I [ ] Foundation: paSSed t/.3 C 60 ,S [ ] Underground Plumbing:0/ 1,2 ->-'63 [ ] Underground Insulation: [ ] Shear Wall : [ ] Framing: f l Plumbing: `3/hJb'")�/ [ ] Propane ank/Lis: 0 lc 0 �^A 1 _\ [ ] Insulation 8f6( 1 1 Sheetrock: L //� c,,.eS-e�/�, ) ,v,e,�1, 6-/y-Oy [ ] Septic Sytem Final Approval: / 1 1 Zoning Final Approval: [A Final/Occupancy Approval: 10-q> O1 HEALTH DEPARTMENT APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS FOR CA, A BLD00-00539 • 1.) The application was reviewed by the Jefferson County Department of Community Development staff on October 20, 2003 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: Coastal SIPZ. 2.) Marine shorelines and islands are susceptible to a condition that is known as seawater intrusion. Seawater intrusion is a condition in which the saltwater/freshwater interface in an aquifer moves inland so that wells drilled on upland areas cannot obtain freshwater suitable for public consumption without significant additional treatment and cost. Maintaining a stable balance in the saltwater/freshwater interface is primarily a function of the rate of aquifer recharge (primarily through rainfall) and the rate of groundwater withdrawals (primarily through wells). The Washington Department of Ecology is the agency with statutory authority to regulate groundwater withdrawal for individual wells in Jefferson County. New development, redevelopment, and land use activities on islands and in close proximity to marine shorelines in particular should be developed in such a manner to maximize aquifer recharge and maintain the saltwater/freshwater balance to the maximum extent possible by infiltrating stormwater runoff so that it recharges the aquifer. 3.) The parcel is located within a coastal SIPZ (seawater intrusion protection zone)according to the County GIS map. There are voluntary and mandatory measures identified in the Jefferson County Seawater Intrusion Policy(Resolution 44-22, effective September 23, 2002)that apply to well drilling proposals and building permit applications on existing lots of record. A Coastal SIPZ is defined as: all islands and area within one-quarter mile of marine shoreline, but no history of chloride concentration above 100 mg/L in groundwater sources within 1000 feet. 4.) To help prevent seawater from intruding landward into underground aquifers, all new development activity on Marrowstone Island, Indian Island and within 1/4 mile of any marine shoreline shall be required to infiltrate all stormwater runoff onsite. 5.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 6.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: 1. Installation of a flow meter. 2. On-going well monitoring for chloride concentration. 3. Submittal of monitoring data to County. 7.) MANDATORY MEASURES FOCOASTAL SIPZ: • 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 8.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 9.) A flow meter shall be installed prior to final sign off of the building permit. 10.) The project shall adhere to the Best Management Practices (BMPs)to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 11.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act(SEPA)pursuant to WAC 197-11-800(1)(b)(i). 12.) This approval is for a single family residence only. 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. 13.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 14.) Not more than two (2) unlicensed or inoperable vehicles shall be stored on any lot less than one-half acre unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screeningshall meet the requirements of q s Unified Development Code (UDC) Section 6. Outdoor storage of thirteen (13)or more unlicensed or inoperable vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage)yard and allowed as a Permitted Use in Table 3-1 of the UDC, and such storage shall meet the requirements of UDC Section 4.10. In no case, shall any such unlicensed or inoperable vehiclesbe stored in an Environmentally Sensitive Area (ESA). 15.) Maximum lot coverage shall not exceed 25%. 16.) The building height is not to exceed 35 feet. 17.) Minimum setback from Cleveland Street right-of-way shall be 20 feet. Minimum setback from Oak Bay Road right-of-way shall be 20 feet. Minimum north property line setback shall be 5 feet. 18.) A building permit(BLD00-0539)for a garage was issued on August 23, 2003 Proponent is now changing use from garage to a single family residence. No change in footprint is proposed, therefore no MLA was required. A septic permit (SEP00-0123)was approved on October 3, 2003 for a 240 GPD system. I:\F_BLD_Permit_Buildng.rpt 10/29/19 •• BUILDING PERMIT APPLICAAON Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00539 Received Date: 8/16/2000 SITE ADDRESS: 65 CLEVELAND ST PORT HADLOCK, 98339 APPLICANT: LARRY E KEELE PHONE: (360)437-0619 PATRICIA A KEELE PO BOX 3071 BREMERTON WA 98310 SUBDIVISION: IRONDALE AC TRACTS Block: Lot: T 73 PARCEL NUMBER: 962700075 Section: 07 Township: 29 N Range: 01 E CONTRACTOR: STICKS AND STONES CONSTRUCTION PHONE: (360)732-5073 453 WASHINGTON LN PORT HADLOCK WA 98339 Contractor's License STICKSCOOOKC Expires 05/03/2001 ARCHITECT/ QUICK DESIGNS INC ENGINEER : 775 CONGER ST EUGENE OR 97402 PROJECT DESCRIPTION: 2 CAR GARAGE TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 7,800.00 ADD'L: HEAT TYPE: UH CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: 780 SHORELINE: CONST TYPE: DECK: SETBACK: . '` BANK HEIGHT: SEWAGE DISPOSAL: ALTpi,f1:-) WATER SYSTEM: PWELL PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWA_T,ER: YES NO AREA Exist: Exist: Wetland VI; Erosion l',, Prop: Prop: Seismic Ne Streams 'N Total: Total: Flood Way Flood Plane Cvk.; F&W Landslide ' t.' Routing Date: Shoreline quifer Forest: Commercial ts,, Rural 1 t 1-'r xim.it - Plat C dons Type Amount Paid By: Date: Receipt: Approve Permit $153.25 MAM 08/16/00 33535 Plan Check $45.98 MAM 08/16/00 33535 Ay State Building Code $4.50 MAM 08/16/00 33535 - Total: $203.73 g f e,A Wa AA Ol' ?1, $\e is\F_BLD_App_Bld.rpt 10/29/99 110 BUILDING PERMIT APPLICATION CA 255 Revviewiew T Tyype: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD00-00539 Received Date: 8/16/2000 SITE ADDRESS: 65 CLEVELAND ST PORT HADLOCK, 98339 OWNER: PATRICIA BURNETT PHONE: (360)379-1988 65 CLEVELAND ST PORT HADLOCK WA 98339 SUBDIVISION: IRONDALE AC TRACTS Block: Lot: T 73 PARCEL NUMBER: 962700075 Section: 7 Township: 29 N Range: 01 E CONTRACTOR: STICKS AND STONES CONSTRUCTION PHONE: (360)301-1375 453 WASHINGTON LN r PORT HADLOCK WA 98339 l�1 Contractor's License STIC $04,•OKC Expires 05/03/2004 REPRESENTATIVE: BLAKE UNDERWOOD k PHONE: (360)732-5073 453 WASHINGTON LANE PORT HADLOCK WA 98339 PROJECT DESCRIPTIO1 ORIGINALLY GARAGE PERMIT- REVISED PERMIT TO RESIDENCE 10/15/03 TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 780 VALUATION 50,918.00 ADD'L: HEAT TYPE: PRO CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: SHORELINE: CONST TYPE: GARAGE: 0 SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: 1 Prop: 1 Seismic Streams Total: 1 Total: 1 Flood Way Floodplain Routing Date: F&W Landslide Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Permit $153.25 MAM 08/16/00 33535 Plan Check $45.98 MAM 08/16/00 33535 State Building Code $4.50 MAM 08/16/00 33535 Renewal $56.00 ZAN 08/20/01 30145 Renewal $94.00 ZAN 07/31/02 49245 Permit $490.50 ZAN 10/15/03 60181 Plan Check $37246 ZAN 10/15/03 60181 Potable Water Application $51.00 ZAN 10/15/03 60181 Total: $1,267.69 BUILDING PERMIT APPLICA ON Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00539 Received Date: 8/16/2000 SITE ADDRESS: 65 CLEVELAND ST PORT HADLOCK, 98339 APPLICANT: PHONE: (360)437`0611' PATRICIA A G(KWET T PO BOX 3071 37/9—inf/ BREMERTON WA 98310 SUBDIVISION: IRON DALE AC TRACTS Block: Lot: T 73 PARCEL NUMBER: 962700075 Section: 07 Township: 29 N Range: 01 E CONTRACTOR: STICKS AND STONES CONSTRUCTION PHONE: (360)732-5073 453 WASHINGTON LN PORT HADLOCK WA 98339 Contractor's License STICKSCOOOKC Expires 05/03/2001 ARCHITECT/ QUICK DESIGNS INC ENGINEER : 775 CONGER ST EUGENE OR 97402 PROJECT DESCRIPTION: 2=eltiftMGE QgliatilFer 4 ( C1 115/0/03 TYPE OF WORK GAR"Q y� SQUARE FOOTAGE: TYPE OF IMP 'NEW MAIN: VALUATION „W""'" ADD'L: HEAT TYPE: UH '-' PilitCODE �-- EDITION: 1997/li Q HEAT BASE: HEAT TYPE: OCCUPANCY: o OCCUPANCY: O� UNHEATED: # OF STORIES: OTHER: CONST TYPE: GARAGE: 780 SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: Prop: Seismic Streams Total: Total: Flood Way Flood Plane F&W Landslide Routing Date: Shoreline Aquifer Forest: Commercial Rural Pr ximlt Plat Conditions Type Amount Paid By: Date: Keceipt: Approveate Permit $153.25 MAM 08/16/00 33535 Plan Check $45.98 MAM 08/16/00 33535 A`' ii ID 0 v State Building Code $4.50 MAM 08/16/00 33535 Total: $203.73 if U 4r 2000 Jafferzori Cc r.ty Planning L 2.4.:,2i Lai. t iici is\F_BLD_App_Bld.rpt 10/29/99 • Jefferson Canty Deinirtment of Comnuity Develounient �gsoN % 821 Sheridan Street,Port Townsend WA 88388[3501378-4450 .c.a t r3 0 PErmo? A - . . �s � Pc5 cn $ING Project Description: wilding Type: ,0 6k04 Project Type: Frame Type: Building Single Family �' /New / Wood T Garage Attached( etache ❑ Addition ❑ Steel ❑ Modular ❑ Alteration/Remodel ❑ Concrete ❑ Commercial ❑ Repair ❑ Masonry ❑ Multi-family/#of Units ❑ Demolition ❑ Other. ❑ Industrial ❑ Other. Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing: Existing: ❑ Sewer ❑Community System ❑ Electricity ❑ Oil Proposed: _I___ Proposed: + ❑ Individual System ❑ Woodstove oit Propane Total: Total: l If not sewer,fill out the following: ❑ Heat Pump i 0(1.5103 ❑ Conventional 0-Alternative ❑ Other Permit# SEP C.l L Z.. Water Supply: . Private well ❑ Two Party Well❑ Public:Name of water system: Square Footage: For Office Use Only Main Floor - UPC.OCCUPANCY GROUP 2ND Floor ase=fee (43• / `,3� �j °•50 3rd Floor (U I , Ffan.Chc'rk fee 4/8 in/ o . l e 2 72 ` b Htd Basement v '/ State Sur F, fee `3-6\ I e Unhtd Basement Subtotal ( a Garage/Carport -7 a , Pot Vtlater Review fee o ' get, Decks 911/Rd Approach fee A Commercial TOTAL -: - C 0 J n /, 3 giiff' Industrial Receipt# t_ : ' _ c 6(110 l Other CAsh/Check# -- 1 C 1f OV. ,,J/' Total Valuation: Initials =-' -(' f" 2 Or Date S71� ' '-C) / "1',p( 71� 9 3 r3 Estimated Cost: /2.,00 P--k 1 G If within 200' of the Shoreline, Distance to Bank or Ordinary High Water Mark ft.Bank Height ft. By signing the application form,the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attomey's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and it's employees,representatives or agents for the purpose of application review and anyrequired later inspections. Access and right of entry to cant's property shall be requested and shall occur during regular business hours. Signature: Date: 0224' © • Jottersa=Colt1 Maimed of canmmulty Development �„i c°t, 621 Sherklae Street,PsiTo►Nn�d WA 88368 CW0]378-4450 ti permet A n 0 0 S , ocQt00 Project Description: Building Type: Project Type: Frame Type: Single Family ❑ New P Wood ❑ Garage Attached/Detached ❑ Addition ❑ Steel O Modular 1 Alteration/Remodel ❑ Concrete ❑ Commercial ❑ Repair 0 Masonry t] Multi-family/#of Units 0 Demolition 0 Other. ❑ Industrial ❑ Other: Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing: 0 Existing: 0 ❑ Sewer ❑ Community System ❑ Electricity 0 Oil Proposed: / Proposed: / id Individual System ❑ Woodstove ,Propane Total: Total: If not sewer,fill out the following: ❑ Heat Pump ❑ Conventional ❑ Alternative ❑ Other Permit# SEP Water Supply: / Private well ❑ Two Party Well❑ Public:Name of water system: Square Footage: For Office Use Only Main Floor 1 so Consistency Review 47.00 2ND Floor Base fee 3rd Floor Plan Check fee—65% Htd Basement State Surcharge fee Unhtd Basement Subtotal Garage/Carport Pot Water Review fee Decks 911/Rd Approach fee Commercial TOTAL Industrial Receipt# Other Cash/Check# Total Valuation: Initials Or Date it Estimated Cost ` CO©0 �= If within 200'of the Shoreline, Distance to Bank or Ordinary High Water Mark ft Bank Height ft. By signing the application form,the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and it's employees,representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. c... ) Signature _ X.C.Q____9____Q______ Date: 9. — ) .) -- 0 OVER-IP- H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01 • STORMWATER CALCULATIONS Owner/Applicant: t—BNCYy `CRlZ1� I ❑ PROPOSED LAND DISTURBING ACTIVITY Site Address: toy cteveiaAAA ¶,*. Drainfield area cleared sq.ft. 1AixtAkoc IA . `iV)::;1 Driveway Length (CV ft. X Width i b ft. 9 Digit Parcel Identification No.: q(o2 l`OC Old = Total Driveway two sq.ft. Permit Number: Clearing and Grading for Site Development PLOT PLAN (Well/Structures/Utilities/etc.) sq.ft. 180 sq.ft. INDICATE the following information. Total Land Disturbance sq.ft. Draw entire parcel to scale. Indicate scale of plot plan: One inch equals ❑ IMPERVIOUS SURFACE Proposed Structures (all roof area) sq.ft. ❑ 1. North arrow Existing Structures (all roof area) ) sq.ft. 0 2. All property boundaries and dimensions Sidewalks sq.ft. 0 3. Names of adjacent streets Concrete Patios sq.ft. ❑ 4. Driveway/s & parking spaces Proposed: 0 5. Major features such as ravines, Driveway Length /00 ft. seasonal creeks, bodies of water, etc. X Width i 0 ft. ❑ 6. Septic tank, drainfield and reserve area location, = Total Driveway /000 sq.ft. existing or proposed, and distance to Total Impervious Surface sq.ft. closest structure G 7. Sewer lines The Stormwater Manual sets forth the following Small Parcel Minimum Requirements: • 8. Wells and/or water lines • Construction Access Route Stabilization: ❑ 9. Neighboring wells within 150 feet Construction vehicle access shall be, whenever feasible, limited to one route. Access points shall be stabilized with ❑ 10. Paved surfaces (patios) quarry spells or crushed rock to minimize the tracking of ❑ 11. Structures, existing and/or proposed sediment onto public roads. If sediment is inadvertently transported onto public roads, roads shall be cleaned ❑ 12. Setbacks (distances to property thoroughly at the end of the day by shoveling or sweeping. Street washing should only be done after the bulk of the boundaries, structures, banks, sediment has been removed by sweeping. and shorelines) • Stabilization of Exposed Soil: All exposed and unworried soil shall be stabilized by sodding, ❑ 1 3. Easements for access or utilities seeding, mulching, plastic covering, application of gravel base ❑ 14. Arrows showing direction of slope-- on roads and driveways, or other appropriate means within seven days during the period from May 1 to September 30 assume an elevation of 100 feet at one and within two days during the period from October 1 to April lot corner and indicate the other lot 30. Mulch shall be applied to a minimum depth of two inches. • Protection of Adjacent Properties: corner elevations in relation to it Adjacent properties shall be protected from sediment deposition by appropriate use of vegetative buffer strips, sediment barriers or filters, dikes, mulching, or by a FOR APPLICATIONS ADJOINING SHORELINES, combination of these measures and other appropriate Best Management Practices (BMPs). INDICATE: • Maintenance: ❑ 15. Ordinary high water mark All erosion and sediment control BMPs shall be regularly inspected and maintained to ensure continued performance of ❑ 16. Top of bank, if over 10 feet high their intended function. 0 17. Slope of bank in degrees • Other Appropriate BMPs as required by Jefferson County to mitigate the effects of increased runoff shall be applied. H:\HOME\PLNCNTR\FORMS\PLOTPLN.FRM9/97 y • • Gc(1Q![.CCO Gam:JJ ppl.. 0J-ii JUICK INCDE7srGNs PAcF Q2 r 1 G i 1 i . /We 7 _. _ ______ .....r,o, sv,,E. .z.. 1.4€.1"34',5 6°'V.1 N V 1 V 1 / r \ \ I 1 g i a 1 IIIIIII I 2 i f !I; f i t 0 i \ 1 ! ! Pi 0 Jf 8 \ .\ � 1 i 1� 1 r a \ rr' f / i 0 \ j ra �, ` \L 7 f z 0 V. N = el '. \ 17 \\ 4. �� L 'i L'1 DM YE 41 U 'o '� _ i _ g. c s� • 20.7 fin I S zrn „ !` \\`7\ NI I Hi i fa z \\ t p r ?' \ I :4n law en z NI N N i \ , ...,......./ , Te 29Gd 3133? n.idtrl 505LZ69096 h0 :0T 00©GIST?E2 • Jefferson County Department of Community Development r ON co 621 Sheridan Street,Port Townsend WA 98368 (360) 379-4450 G� ,,.,„ , „ -, Universal Plot Plan Fill in the following blanks as completely as possible: Project Description: C-c-7w5=6 iicr i o k ,n% 2._ C-.i if 6;+rcvc}Z. 9 Digit Parcel Identification Number (from your tax statement): :70 e.)-1 Site Address 911#: (c5 Road Name: -Ae. e- ..1. T Zip Code: q(6;3 ( Legal Description �,_L ' Subdivision Name: eL ..k< t rests. Block: Lot(s): Pov- oti c .73 Section: '1 Township: 2`1 K Range: 1 e Parcel Size (acres or square footage): .5 A CCt Property Owner: Phone: Mg dress: Applicant/Occupant: Phone: (if different from owner) Mailing Address: Authorized Rep:, Phone: Mailing Address: 4 5`3 W Asti 094 Mtn, H c_G‘4sct-- ie<ICA General Contractor: S-T%Ly—S ki4tN St��S 411e.s. ( (°C3) 2—5 0 Or Manufactured Home Installer: Phone: Mailing Address: 45 ihl rtSKi .64 , t .t.c>c. iNi A 11*53'1 Contractor's State License Number: ate: SYicKSc000ke oat 40- 602 034 2q4 0 0 Septic Designer: Phone: 3S' jig h e.e-Vudtc) l60 452- F Soo Mailing Address: Architect:/Engineer: Phone: Quicic- De.c tc 1+4c_4 '_143 — 305 Mailing Address: "7 75 Cti rj r Sr. -'Jc L OR— 9 7' =`Z Loan Lender/General Phone: Contractor's Bond Holder:`,t, 35-2_47i,.c I e c�:cs [v,s. Ct,,,r„e�„� Mailing Address: ® Pc Box `c$(o F'oul5cor. \NIA - c/%31 G FOR OFFICE USE ONLY Fire District: Planning Area: School District: Zone: 1/00 H:\home\pincntr\forms\universal plot plan • , U Jefferson County Department of Community Development ' 621 Sheridan Street, Port Townsend, WA 98368 CRITICAL AREAS QUESTIONNAIRE Applicant Name L 61A(Y9 k... -c 1 Building Application Land Use Application Shoreline Application On-site Sewage Application _ Subdivision Application Other: 1 . Is there any standing or running water on the surface of the )< Yes _ No property or on any nearby property at any time during the year? If YES, please describe: Ase... cEA-cLI 2. Has any portion of the property or any nearby property ever been — Yes X No identified as a wetland or swamp? If YES, please describe: Set ja t i&cheek L'a- ek- -fie,,., JsF E'^9 14144-ErivI9 3. Are any willows, skunk cabbage, alders, or cottonwoods present X Yes _ No on your property or adjacent properties? If YES, please describe: 7 ,ena1\ Co. opt vc, -S 4. Are there any indications on any portion of the property or on any _ YES X No nearby property of rockslides, earthflows, mudflows, or landslides? If YES, please describe: 5. Please indicate which line best represents the steepest slope found on your property. (Check appropriate box) 9 9 4 9 O 0 ❑ / iiii , ♦♦ ,� ♦� ii iiii ♦♦ '� iiii i i ♦ i♦ ,, -.� iiii ♦ ♦ ♦ �1,,,/ E ��. ----7.0 / / / / /iiii♦ ♦ , .- //iiii♦ ♦ ' �/iiii♦♦ ♦�� . -�♦� �� _ ,ii/////,,'..--' - uiii,,,'- '�_ - �ua♦�i..� _'____- - _5=_= ---_______________Q (Questionnaire Continues on Back) Page 1 of 2 • 6. Does the site have steep slopes with little to no vegetation? YES No If YES, please describe: 7. Does the site contain high percentages of silt and/or very fine YES NO sand? If YES, please describe: 8. Does the site contain ground water seepage or springs near the YES NO surface of the ground? If YES, please describe: By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save, indemnify and hold harmless Jefferson County against all liabilities, judgments, court costs, reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and it's employees, representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. Signature - Date FOR OFFICE USE ONLY ❑ Wetlands ❑ Seismic CRITICAL AREAS ON OR E Aquifer Recharge Area (zone ) ❑ Fish & Wildlife Area 1 IMMEDIATELY ADJACENT TO SITE: ❑ Frequently Flooded Area ❑ Fish & Wildlife Area 2 ❑ Erosion ❑ Landslide ❑Seismic ❑ Commercial Forest Section Township North Range Parcel Number: Parcel Size: Comprehensive Plan Land Use Designation: Reviewed by: Community Plan: Date: Page 2 of 2 h:\home\pincntr\forms\car.doc 1/00