HomeMy WebLinkAboutBLD2001-00621 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 #: BLD01-00621 Received Date 10/30
SITE ADDRESS: 1001 DISCOVERY RIDGE RD Issue Date 12/4/2
PORT TOWNSEND, 98368 Expiration Date 12/4/:
APPLICANT: ROB VANDE WEGHE PHONE: (360)39.
117 NW THOMPSON RD
POULSBO WA 98370
SUBDIVISION: Block: Lot: 8
PARCEL NUMBER: 001195128 Section: 19 Township: 30 N Range: 01 W
CONTRACTOR: OWNER PHONE:
LOAN LENDER/
BOND HOLDER:
PROJECT DESCRIPTION SINGLE FAMILY RESIDENCE W/ATTACHED GARAGE
RE5RUIRED INSPECTIONS:
Rif Setbacks (Shoreline Setbacks): 69: „(2. /- J.
C Footings: 0 k c cr =tee '' / `�/91:9 7
[•.] Foundation:
U .
[ ] Underground Plumbing/Underground Insulation:
[ ] Shear Wall:
[ ] Framing/Plumbing:
[ ] Propane Tank/Lines:
[ ] Insulation:
[ ] Sheetrock:
[-] Final/Occupancy Approval: C• ]L .')
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 INSPECTION
Office Hours 9:00 a.m. -4:30 p.m.
SPECIAL CONDITIONS APPLY-SEE REVERSE
HOT LINE AVAILABLE 24 HOURS A DAY
SPECIAL CONDITIONS FOR CASE BLD01-00621
1.) The application was reviewed by the Jefferson County Department of Comm
Development staff on November 7, 2001 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
inspection, the following review and an investigativeD site
ESAs were confirmed to be present on the subject property:
SUSC aquifer recharge; landslide hazard area 1; Type 5 stream. porous geological
2.) Aquifer Recharge Areas in Jefferson County are characterized byJ o P
formations that allow percolation of the surface water into the soils and the underlying
zone of saturation. Aquifers are geologic formations that contain sufficient saturated
permeable material to yield significant quantities of water to wells and springs. Aquifers
serve as the source of drinking water within most of the rural portions of Jefferson County.
3.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic Aquifers
that promote rapid infiltration of recharge waters to groundwater aquifers.
4.) Geologically Hazardous Areas in Jefferson County are characterized byoc slope,
geologic material, and groundwater that may combine to create problems with slope
stability, Pe, soil type,
erosion, and water quality during and after construction or during natural events
such as earthquakes or severe rainstorms.
5.) A Type 5 Stream (Fish and Wildlife Habitat Area) has been identified on the
property. The stream will require a setback of 50-feet. The setback shall be measured
horizontally from the Ordinary subject
High Water MarkFish and Wildlife Habitat Areas
shall also have Buffers and Building Setbacks established.
6.) Buffers are areas that shall be maintained in their natural condition, however,
pruning or alteration of vegetation may be permitted as longand character
of the buffer are not diminished. e minor as the function
7.) Among the native conifer species which may be used in buffers or for re-
include, but are not limited to: Grand Fir(Aibes grandis), Sitka Spruce (Picea Si
Shore Pine (Pinus Contorta), Douglas Fir(Pseudotsuga Menziesii), Western Cedar
on
(Thuja Plicata), and Western Hemlock (Tsuga Heterophylla). tchensis),
Red
Among native tree species which may be used includes: Vine Maple (Acer Circin
Big-Leaf Maple (Acer Macrophyllum), Red Alder(Alnus Rubra), Pacific Madrone(Arbutus
Menziesii), Quaking Aspen (Populus Tremula), Black Cottonwood (Populus Tric ocarp
Bitter Cherry (Prunus Emarginata), Oregon White Oak
(Rhamnus Purshiana), Pacific Willow(Saliz Lasiandra), and Scouler's Willow(Quercus Garryana), Cascara
Shocarpa),
Scouleriana).
( aliz
Among the native shrub species which may be used are: Sevice-Berry Red Osier Dogwood (Cornus Stolonifera) Salal (Gaultheria Shallon),
(Amalanchier
Spray(Holodiscus Discolor), Indian Plum (Oemlaria Cerasiformis), Pacific Ninebark
Capitus), Red Flowering Currant(Ribes Sanguineum), Wild R ) Ocean
Nutkana), Swamp Rose (Rosa Pisocar a
Nutkana),
Ra Rose SnowberryPP ), Willows (Salix ss dry (Rosa
(Vaccinium Ovatum), (Symphoricarpos Albus), Evergreen Huckleberry
Red Huckleberry(Vaccinium Parvifolium).
8.) A vegetative buffer of 30-feet shall be permanently maintained from the top
Landslide Hazard Area. All buffers shall be measured perpendicularly from the
Landslide Hazard Area. or edge of the
9.) All construction activities shall not encroach upon the buffer. This includestop of the
preparation of materials.
10.) The applicant shall permanently separate the boundary the storage or
Buffer from the remainder of the subject propertythroughof the Landslide Hazard, Area
row, or any other prominent physical marking
11.) Criticalw, nioth Recharge Areas may req ire p installingtheUDC logs, trees, a hedge
approved by the Administrator.
quality degradation. The submitted proposal does not require additional aquifer
special protection measures to mitigate water
protection measures. However, during construction the project shall follow the Best
Management Practices (BMPs) and facility design standards as identified and defined
the Stormwater Management Manual for the Puget Sound Basin.
5 Stream), shall maintain a vegetative
12.) The identified Fish and Wildlife Habitat Area (Type in
buffer setback of 50-feet. The setback shall be measured horizontally from the
Ordinary
High Water Mark (OHWM) to the proposed single family residence with attache
d garage.
13.) An additional setback of five (5) feet is required from the edge of the buffer area to the
proposed single family residence with attached garage.
14.) A permanent physical separation along the boundary of the buffer area shall be installed
and permanently maintained. Such separation can include installing logs, trees, a
hedgerow, or any other prominent physical marking approved 15.) Buffer perimeters shall be marked with temporary signs at an in etrval of one per UDChe Ipa celror.
every one hundred (100) feet, whichever is less. Signs shall be in place prior to and
during construction activities. The sings shall contain the following statement: "Buffer-Do
Not Remove or Alter Existing Vegetation."
16.) A Small Parcel Erosion and Sediment ControlPlan has been submitted and approved by
the Department of Community Development. Once the subject permit has been issued
the applicant shall fully implement the provisions of the submitted plan and contact the
Jefferson County Department of Community Development to arrange a schedule to
inspect the property for plan compliance. A Certificate of Occupancy will not be issued
until the Department verifies plan compliance. No clearing for roadways or utilities shall
occur on the project site until clearing necessary for the installation of temporary
sedimentation and erosion control measures have been completed.
17.) 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).
18.) The site plan as submitted with the single family residence with attached garage building
application on October 30, 2001 has been reviewed for consistency under the UDC, and
has been approved by Jefferson County Department of Community Development. Any
modifications, changes, and/or additions to the stamped, approved site plan dated
November 19, 2001 shall be resubmitted for review and approval by Jefferson County
Department of Community Development.
19.) This approval is for a single family residence with attached garage 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.
20.) The parcel has been designated as RR 1:20 under the Jefferson County Comprehensive
Land Use Map effective August 28, 1998.
21.) The parcel was created through the Discover Bay Ridge Division V subdivision on October
25, 1999. The parcel is considered a legal non-conforming parcel.
22.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
23.) A geotechnical report was not required for this proposal.
24.) Potable water is supplied by the LUD#3 water system approved by DOH.
25.) Maximum lot coverage shall not exceed 25%.
26.) Minimum setback from private easement(Discovery Ridge Road) shall be 20 feet.
Minimum side and rear setbacks shall be 5 feet unless an environmentally sensitive area
(ESA) exists, then the stricter setback shall apply.
27.) The building height shall not exceed 35 feet.
28.) Discovery Ridge Road is a private road (P552).
29.) A septic permit(SEP01-0206) for a four bedroom system will be issued with the building
permit.
i:\F_BLD_Permit_Buildng.rpt
10/29/19
Detailed Plot map/Site plan -VandeWeghe Residence construction
Prepared by: Rob VandeWeghe. 1177 NW Thompson Road.Poulsbo WA 98370. 360-394-3796
Discovery Ridge Development.lot#8. Port Townsend
Tax parcel id 001 105 128
Scale 1 inch=50 feet:total parcel size=5.$ao
D 5 � Wli
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OCT 3 0 2C01
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De ck, 1 DEPT. OF COMMUNITY DEVE!OPMENT
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yo �,e7I le d co +
�o R T APPROVED
SITE PLAN
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NOV 1 9 2001
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JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
UNIFIED DEVELOPMENT CODE
TYPE I LAND USE PERMIT
APPLICANT: RAE
117OB NWV NDE THOMPSONWGHE RD
POULSBO WA 98370
DATE ISSUED: December 04, 2001
DATE EXPIRES: December 04, 2002
MLA NUMBER: MLA01-00552
PROJECT PLANNER: M FARFAN
PROJECT DESCRIPTION:
SINGLE FAMILY RESIDENCE W/ATTACHED GARAGE
PROJECT LOCATION:
Parcel number 001 195 128, Discovery Bay Ridge Div V, Lot 8 in Section 19, Township 30, Range 01 West, WM
located at Discovery Ridge Rd, Port Townsend, WA 98368
FINDINGS:
1.) The Administrator finds that this application complies with applicable provisions of the Unified Developmen
Code, all other applicable ordinances and regulations, and is consistent with the Jefferson County
Comprehensive Plan and Land Use map.
2.) The application was reviewed by the Jefferson County Department of Community Development staff on
November 7, 2001 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions o
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: SUSC
aquifer recharge; landslide hazard area 1; Type 5 stream.
3.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow
percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic
formations that contain sufficient saturated permeable material to yield significant quantities of water to wells
and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson
County.
4.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid
infiltration of recharge waters to groundwater aquifers.
5.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and
groundwater that may combine to create problems with slope stability, erosion, and water quality during and
after construction or during natural events such as earthquakes or severe rainstorms.
6.) A Type 5 Stream (Fish and Wildlife Habitat Area) has been identified on the subject property. The stream will
require a setback of 50-feet. The setback shall be measured horizontally from the Ordinary High Water Mark
(OHWM). Fish and Wildlife Habitat Areas shall also have Buffers and Building Setbacks established.
7.) Buffers are areas that shall be maintained in their natural condition, however, minor pruning or alteration of
vegetation may be permitted as long as the function and character of the buffer are not diminished.
8.) Among the native conifer species which may be used in buffers or for re-vegetation include, but are not limited
to: Grand Fir(Aibes grandis), Sitka Spruce (Picea Sitchensis), Shore Pine (Pinus Contorta), Douglas Fir
(Pseudotsuga Menziesii), Western Red Cedar(Thuja Plicata), and Western Hemlock (Tsuga Heterophylla).
Among native tree species which may be used includes: Vine Maple (Acer Circinatum), Big-Leaf Maple (Acer
Macrophyllum), Red Alder(Alnus Rubra), Pacific Madrone (Arbutus Menziesii), Quaking Aspen (Populus
Tremula), Black Cottonwood (Populus Trichocarpa), Bitter Cherry (Prunus Emarginata), Oregon White Oak
(Quercus Garryana), Cascara (Rhamnus Purshiana), Pacific Willow (Saliz Lasiandra), and Scouler's Willow
(Saliz Scouleriana).
Among the native shrub species which may be used are: Sevice-Berry (Amalanchier Alnifolia), Red Osier
Dogwood (Cornus Stolonifera) Salal (Gaultheria Shallon), Ocean Spray (Holodiscus Discolor), Indian Plum
(Oemlaria Cerasiformis), Pacific Ninebark (Physocarpus Capitus), Red Flowering Currant(Ribes Sanguineum),
Wild Rose (Rosa Nutkana), Swamp Rose (Rosa Pisocarpa), Willows (Salix ssp.), Red Elderberry (Sambucus
Racemosa), Snowberry (Symphoricarpos Albus), Evergreen Huckleberry (Vaccinium Ovatum), Red
Huckleberry (Vaccinium Parvifolium).
9.) 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).
10.) The site plan as submitted with the single family residence with attached garage building application on Octobe
30, 2001 has been reviewed for consistency under the UDC, and has been approved by Jefferson County
Department of Community Development. Any modifications, changes, and/or additions to the stamped,
approved site plan dated November 19, 2001 shall be resubmitted for review and approval by Jefferson County
Department of Community Development.
11.) This approval is for a single family residence with attached garage 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.
12.) The parcel has been designated as RR 1:20 under the Jefferson County Comprehensive Land Use Map
effective August 28, 1998.
13.) The parcel was created through the Discover Bay Ridge Division V subdivision on October 25, 1999. The
parcel is considered a legal non-conforming parcel.
14.) A geotechnical report was not required for this proposal.
15.) Potable water is supplied by the LUD#3 water system approved by DOH.
16.) Discovery Ridge Road is a private road (P552).
17.) A septic permit (SEP01-0206) for a four bedroom system will be issued with the building permit.
CONDITIONS:
1.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the Landslide Hazard
Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area.
2.) All construction activities shall not encroach upon the buffer. This includes the storage or preparation of
materials.
3.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder
of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking
approved by the UDC Administrator.
4.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water quality degradation.
The submitted proposal does not require additional aquifer protection measures. However, during construction
the project shall follow the Best Management Practices (BMPs) and facility design standards as identified and
defined in the Stormwater Management Manual for the Puget Sound Basin.
5.) The identified Fish and Wildlife Habitat Area (Type 5 Stream), shall maintain a vegetative buffer setback of
50-feet. The setback shall be measured horizontally from the Ordinary High Water Mark (OHWM) to the
proposed single family residence with attached garage.
6.) An additional setback of five (5) feet is required from the edge of the buffer area to the proposed single family
residence with attached garage.
7.) A permanent physical separation along the boundary of the buffer area shall be installed and permanently
maintained. Such separation can include installing logs, trees, a hedgerow, or any other prominent physical
marking approved by the UDC Administrator.
8.) Buffer perimeters shall be marked with temporary signs at an interval of one per parcel or every one hundred
(100) feet, whichever is less. Signs shall be in place prior to and during construction activities. The sings shall
contain the following statement: "Buffer- Do Not Remove or Alter Existing Vegetation."
9.) A Small Parcel Erosion and Sediment ControlPlan has been submitted and approved by the Department of
Community Development. Once the subject permit has been issued the applicant shall fully implement the
provisions of the submitted plan and contact the Jefferson County Department of Community Development to
arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued
until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site
until clearing necessary for the installation of temporary sedimentation and erosion control measures have been
completed.
10.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence.
11.) Maximum lot coverage shall not exceed 25%.
12.) Minimum setback from private easement (Discovery Ridge Road) shall be 20 feet. Minimum side and rear
setbacks shall be 5 feet unless an environmentally sensitive area (ESA) exists, then the stricter setback shall
apply.
13.) The building height shall not exceed 35 feet.
NOTICE: This permit does not excuse the proponent from complying with other local, state, and federal
ordinances, regulations, or statutes applicable to the proposed development.
Development pursuant to this permit shall be undertaken subject to the applicable development and performance
standards of the Jefferson County Unified Development Code.
If during excavation or development of the site an area of potential archaeological significance is uncovered, all
activity in the immediate area shall be halted, and the Administrator shall be notified at once.
The Federal Endangered Species Act rules to protect threatened Chinook and Summer-run Chum salmon
became effective on January 8, 2001. Bull trout have been listed as threatened since early 2000. Under the ESA,
any person may bring lawsuit against any individual or agency that"takes"listed species (defined as causing
harm, harassing, or damaging habitat for the listed species). In addition, the National Marine Fisheries Service
can levy penalties. All areas in Jefferson County are included as"critical habitat"for a listed species.
Development of property along any marine shoreline, freshwater shoreline, or floodplains could harm habitat if
protective measures are not taken. To minimize the potential to damage habitat, all property owners developing
adjacent to marine shoreline, freshwater shoreline, or floodplains are advised to do the following:
-Set back buildings, utilities and roads as far as possible from surface waters(streams, rivers, lakes, marine
waters), or at least 150 feet from the edge of the water
-All development activities should avoid unstable slopes, wetlands, and forested areas near surface waters
- Remove minimal vegetation for site development, especially large trees
-Allow trees that have fallen into surface waters to remain there
- Infiltrate stormwater from buildings and driveways onsite through drywells rather than discharging directly into
surface waters or roadside ditches
Any individual, group, or agency can bring suit for a listed species "taking," even if you are in compliance with
Jefferson County development codes. The risk of a lawsuit against you can be reduced by consulting with a
professional fisheries habitat biologist, and following the recommendations for site development provided by the
biologist. For more information, contact the National Marine Fisheries Service in Seattle at (206)526-6613,or the
U.S. Fish and Wildlife Service at(503) 231-6121.
APPEALS:
Pursuant to RCW 36.70C, the applicant or any aggrieved party may appeal this final decision to Jefferson County
Superior Court within twenty-one(21) calendar days of the date of issuance of this land use decision. For more
information related to judical appeals see UDC Section 8.5.2.
U DZAdministrato
W
APPROVED — o
LTi
SITE PL�all Plot ma, -VandeWeghc Residence construction o o
Ot�1•cry Rid_ - Development. lot#8.Port Townsend w '
r parcel id. 001 105 128 c o z
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52
BUILDING,PERVIIT APPLICATION PA,
ype: I
Jefferson County Department of Community Developmer'itI
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00621 Received Date: 10/30/2001
SITE ADDRESS: loo‘ DISCOVERY RIDGE RD
PORT TOWNSEND, 98368
OWNER: ROB VANDE WEGHE PHONE: (360)394-3796
117 NW THOMPSON RD
POULSBO WA 98370
SUBDIVISION: Block: Lot: 8
PARCEL NUMBER: 001195128 Section: 19 Township: 30 N Range: 01 W
CONTRACTOR: OWNER PHONE:
REPRESENTATIVE(S):
PROJECT DESCRIPTIO SINGLE FAMILY RESIDENCE W/ATTACHED GARAGE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 1,563
VALUATION 206,639.00 ADD'L: 1,735 HEAT TYPE: EEE
CODE EDITION: 1997 HEAT BASE: HEAT TYPE: WOD
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 768 SHORELINE:
CONST TYPE: DECK: 741 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PUD PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: Exist: Wetland Erosion
Prop: 4 Prop: 3 Seismic Streams
Total: 4 Total: 3 Flood Way Floodplain
F&W Landslide
Routing Date: id
'�( i 1 Shoreline Aquifer
r_'i Forest: Commercial Rural
Proximity,y Plat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,592.95 MAM 10/30/01 42359
Plan Check $477.89 MAM 10/30/01 42359PPROVED ,
State Building Code $4.50 MAM 10/30/01 42359 ,
Potable Water Application $30.00 MAM 10/30/01 42359 JUL, z 1
L, U 001
Total: $2,105.34 JE E N COUN
DEPT.OF M NITY E ENT
SIGNATUR :
b
lN c �j
ifin:°,14kc%°�� JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT O/ 621 Sheridan Street • Port Townsend • Washington 98368OCr 3 2001
NCs360/379-4450 800/831-2678 360/379-4451 Fax
JBUILDING PERMIT APPLICATIOnN EOM'' oNDEVELEPT. OF COMMUNITY DEVELOPMENT
Projescription: i/c1n t t}-Q L t ,S�ciy.0_, W~Stogy /c'=�,l r t , 1-4-Af Tou Ai'$,B�uildpe: Project Type: Frame Type:
V Sinily + New /Wood
✓Gattache /Detached Addition Steel
M Alteration/Remodel Concrete
Coial Repair Masonry
Mily/#of Units Demolition Other:
11 InOtBedro Bathrooms: Type of Sewage Disposal: Type of Heat:
Choose one:
Existing: Existing: Sewer . Community System ✓Electricity Oil
Proposed: y Proposed: Z. C ✓Individual System ✓Woodstove Propane
Total: Y Total: 2. If not sewer,fill out the following: Heat Pump L •
Conventional .: Alternative Other
Permit# SEP 11\")R""
Water Supply:Private well Two Party Well _ Public:Name of water system: t UM •
Square Footage: //�� For Office Use Only
Main Floor I s6 3 'ID !R,O 4 UBC OCCUPANCY GROUP
2N D Floor (1-3r •L�U Base fee 15q 2 .q5
3rd Floor Plan Check fee 477 - C
Htd Basement State Surcharge fee `T• SO —
Unhtd Basement , I OO Subtotal 2-015m- J�
Garage/Carport ,,Lack Pot Water Review fee „N- 08
Decks 91 (35-2 t &c ) 911/R Approach fee 0-9 - 06
Commercial TOTAL .9'( �4�•p�"T"-
Industrial ` Receipt# T� �
Other O(p��1 Cash/Check# �tn(n
Total Valuation: Initials l�` e.
Or Date I415°/°t/
Estimated Cost: 7-O /�,�,k eA 39
•0� 9-17335'
If within 200' of the Shoreline, ��ttl/ (.tJ O� a
Distance to Bank or Ordinary High Water Mark ft. Bank Height ft.
I �
l3v 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 'ht 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 app ant's property or structure shall be requested and shall occur during regular business hours.
Signature: Date: to I.2d c, I,
II::I-TOME\PLNCNTR FOBI.DG\FORMS LDpermit.Applicationl/2000
APPROVED
STORMWATER PLAN
JEFFERSON COUNTY NOV 1 9 ZOQt
STORMWATER MANAGEMENT ORDINANCE
SMALL PARCEL EROSION AND SEDIMENT N $ • ;r ��� • Co
EROSION AND SEDIMENT CONTROL W Q!�"4 4 'i Y
Property Owner: "1,6- Telephone: 3 3 Y 3 6
Address: l fV� i �xaa /o�lf4r, w11-0
Assessor's Parcel Number: Col l9 c (2,,E
Building Permit or Septic Permit Application Number(if applicable):
Brief Project Description: ) c4,1L r.tV� )CI
M,� j.:
J,
•
Site Location: Si ��t,�,l , � /Zoa�� (OL l� .04A,
Person Responsible for BMP Installation and Maintenance: tq Uct Lt_.% 2 .
Address: 1 aS
Telephone: "")- 1
�9 }�
1. Describe/check the Best Management Practices (BMPs) that you will implement during land
disturbing activities or construction to control erosion and prevent sediment from entering water
bodies (marine waters, streams. rivers, lakes, or wetlands) or impacting adjacent property or
roads. Please check the measures you plan to implement and show their approximate location on
the site plan. You may also propose measures other than those listed. Attach additional sheets, if
more space is required.
j Stabilize construction access route. Limit construction vehicles to one route .if-foasihle�
Provide a stabilized construction access by applying quarry spall alias crushed rock'
to minimize tracking sediment onto roads. (See attached illustration from ater
Management Manual.) If sediment is transported onto roads, they will be cleaned
thoroughly.
Q� Mlinimi7e the extent of land disturbing activity and preserve existing vegetation.
Preserve buffers of well-established vegetation between disturbed areas and property
boundaries, roads, water bodies, and designated critical areas (wetlands, fish and wildlife
habitat areas, landslide or erosion hazard area, etc.).
--)--) Errc n
SPESC Instructions—Short Form i I
Revised June 3, 1999 i
3 �4 ,T v ., n� 5 J
� LJ J
ur� ,vUNTY
DEPT. OF COMMUNITY DEVELOPMENT
• .nr,n .
I It.' HROSION AND SEDIMENT CONTROL WORKSHEET
T'.�3ksu t whlik2se.ciq {ing fo that only areas that are actively being worked are uncovered.
a.
[] Start and complete land disturbing activities and stabilize the site between April 1 and
September 30. Stabilization means that disturbed areas will have well-established plant
cover or be landscaped to minimize erosion.
tad Stabilize exposed soil Exposed and unworked soil will be cov ed within 2 days between
October 1 and March 31 and within 7 days between April 1 and September 30.
[x] Cover exposed soil with a minimum of 2 inches of stra or hay or other material
approved for this purpose.
Cover soil stockpiles with plastic sheeting and locate away from water bodies, roads,
and property lines.
Pit' Place gravel base on roads,driveways,and parking areas after clearing and subgrade
preparation.
Protect adjacent properties and water bodies from sediment'deposition:
pg Place straw or hay bales in ditches and drainage ways down slope from areas
of land disturbing activity to filter runoff before it leaves the project site or enters
water bodies. (See attached illustrations from Stormwater Mana4ement Manual.)
[ ] Install a filter fence down slope from areas of land disturbing activity to filter runoff
before it leaves the project site or enters water bodies. (See attached illustration from
Stormwater Management Manual.)
Regularly inspect and maintain all BMPs especially after stones events.
[ Describe other erosion and sediment control Best Management Practices. Be specific
as to design and specifications.
9 �
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IT
SPESC Instructions—Short Form _ OCT 3 0 2001
Revised June 3, 1999
•
JEFFEhSUN C,;UNTY
DEPT. OF COMMUNITY DEVELOPMENT'
•
EROSION AND SEDIMENT CONTROL WORKSHEET
2. Describe how disturbed areas will be permanently stabilized(seeded, landscaped, apply gravel base
to roadways, etc.)
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3. Describe how runoff from impervious surfaces will be controlled (disperse to vegetated areas to
infiltrate,dry well,infiltration trench,route runoff to existing drainage facilities,etc.).
.
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OCT 3 N°1
SPESC Instructions—Short Form ""E"
._IRevised June 3, 199s9 , DEPT. OF COMMIlNITY�tVEOPMENj
5
� L
EROSION AND SEDIMENT CONTROL WORKSREET
4. Specify your construction sequence. Describe the timing of all land disturbing activities (clearing
and grading, construction, installation of drainage facilities, lancscaping, etc.) and Best
Management Practices. Describe proposed maintenance of BMPs.
I
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The Best Management Practices proposed above will be implemented to control erosion, sediment, and
stormwater 'ff. I will notify the Permit Center for inspections as required.
Signature Owner/Agent..J— Date
SPESC Instructions—Short Form
Revised June 3, 1999 OCT 3 2�0� "J
6
CCUNTY
OF CC,.1%.,.