HomeMy WebLinkAboutBLD-2023-0277 - COMMERCIAL PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
Mailing Address: P.O. Box 547,Anacortes, WA 98221
Office Location:904 6th Street,Anacortes WA 98821
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W-04� Phone: 360 299-1984
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CLEARING & GRADING PERMIT APPLICATION
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ClearingGrading& Permit o
Submittal Requirement Checklist
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See pages 2-3 of this handout for information about each submittal item listed below. See
Qs AMC Ch. 19.78 Clearing and Grading for review and approval criteria. p
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✓ Clearing&Grading Permit Application Form
(FORM CG-1—attached)
Agent Authorization Form, if applicable
Critical Area Identification Form, if applicable
✓ Site Information
(FORM CG-2—attached)
✓ Stormwater Management Minimum Requirements Determination (FORM CG-3,attached)
Stormwater Site Plan
Clearing& Grading Plans (requirements listed on Form CG-4,attached)
Environmental Review(SEPA) checklist, if appliable
Subdivision Guarantee
Technical Reports
Other Required Permits
Copy of recorded survey
Required Number of Copies and Plan Size Application Fee
2 paper copies of each item above
Plans must be minimum 11" x 17",to scale, and legible See the Land Use Permit Fee
Schedule
1 reduced size copy(maximum size 11"X 17") of plans
Digital copy of the application and all submitted materials (flash
drive or to pced@cityofanacortes.org.)
Clearing&Grading Permit Application
Updated November 2021 Page 1 of 14
REQUIRED SUBMITTAL INFORMATION
Additional details on certain submittal items are provided below to ensure Applicants are fully aware
what City staff will be looking for when an application is submitted to the City.
• FORM CG-1: CLEARING & GRADING PERMIT APPLICATION FORM. Provides key information
about your project, including project details, property owner, contractor, and contact information.
• AGENT AUTHORIZATION FORM. Provide this completed form to authorize someone other
than the property owner to apply for permits.
• CRITICAL AREAS IDENTIFICATION FORM. Use this from to determine and/or identify if
critical areas or critical area buffers are located on or within 300 ft. of the development
area. If critical areas are determined to be present, a Critical Area Permit may be required.
• FORM CG-2: SITE INFORMATION FORM. Provides key information and asks questions about
site characteristics that are used to determine whether your project requires any other information
or additional permit applications to be submitted.
• FORM CG-3: STORMWATER MANAGEMENT MINIMUM REQUIREMENTS
DETERMINATION FORM. Most development within the City of Anacortes that involves
disruption of soils, or construction of buildings, streets, parking lots, etc. requires a Stormwater
review. Stormwater review requirements are based on either the amount of soil to be disturbed
(grading,vegetation removal), or the amount of hard surface that is created or replaced on a site
(building footprint, concrete, asphalt or gravel parking, sidewalk, etc.). Form CG-3 assists you in
determining the level of stormwater review(applicable Minimum Requirements) required for your
project.
• STORMWATER SITE PLAN. The Stormwater Site Plan is the comprehensive report containing all
of the technical information and analysis necessary for regulatory agencies to evaluate your
project for compliance with stormwater requirements. The level of stormwater review and
contents of the Stormwater Site Plan will vary with the type and size of the project, and individual
site characteristics. Use Form CG-3 to determine the level of stormwater review and then
complete the applicable Stormwater Minimum Requirements Form on the Public Works-
Engineering Department Forms website and provide required submittal items/plans.
• FORM CG-4: CLEARING & GRADING PLANS. Form CG-4 contains a list of all the items required
to be shown clearing and grading plans.
• SEPA CHECKLIST: Unless a project is categorically exempt, an environmental checklist is required
to be completed and submitted.
• SUBDIVISION GUARANTEE: A document prepared by a title insurance company documenting
the ownership and title of all interested parties in the development and that lists all encumbrances.
The certificate or report must be dated within 30 days prior to the submittal of a permit to the City.
Copies of all the encumbrances listed within the certificate or report must be provided.
• RECORDED PROPERTY BOUNDARY SURVEY: A recorded survey is required to define the limits
of the property subject to the application. All property corners must be staked/marked and visible.
Clearing&Grading Permit Application
Updated November 2021 Page 2 of 14
OTHER SUBMITTALS DETERMINED ON A CASE-BY-CASE BASIS
Following is a list of technical reports that will be required to be submitted to the City when certain
circumstances exist on or near a site an Applicant is planning on making improvements to. The general
triggers for each of the listed technical reports I provided below:
A. CRITICAL AREAS REPORTS: In general, Critical Area reports are required when wetlands
and/or streams are located on or near a site. Critical area mitigation plans may also be required,
depending on the project proposal. See Anacortes Municipal Code Ch. 19.70 for additional
information.
B. GEOTECHNICAL REPORT: In general, Geotechnical Reports are required when work is
proposed on or near slopes in excess of 15% and/or known landslide hazard areas. See
Anacortes Municipal Code Ch. 17.70 for additional information.
C. STORMWATER DRAINAGE REPORT: In general, Stormwater Drainage Reports are required
when an applicant is proposing to add or replace more than 2,000 square feet of impervious
surfaces. See Anacortes Municipal Code Ch. 19.76 for additional information.
OTHER PERMITS DETERMINED ON A CASE-BY-CASE BASIS
Following is a list of other permits that could be required in certain circumstances. The general triggers
for each of the listed permits is provided below.
A. RIGHT-OF-WAY PERMIT: A right-of-way permit is required anytime the public right-of-way is
disturbed or obstructed in any way by private development or the general public.
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FORM CG-1: CLEARING & GRADING PERMIT APPLICATION
1. PROPERTY INFORMATION
Project Address(Street,Suite#): Assessor Parcel Number:
116 O Avenue, Anacortes P55360 P55361 P3151 0
Subdivision/lot#: Zoning Designation: lot area (size):
Total of parcels 47,504 sf sq.ft.
2. PROJECT DESCRIPTION
Project Summary:
The Port proposes paving approximately 18,500 sf of existing gravel surface at 2nd Street and the entry to Curtis Wharf with hot mix
asphalt.The project would also include improvements to stormwater systems including new catch basins and conveyances.Finally,the
project would install a new rolling access gate to replace the existing rolling gate and an additional length of chain-link fence to connect
the security fences at Quiet Cove and Curtis Wharf(approximately 85 ft.)The proposed project would improve access and security at
Curtis Wharf and 2nd Street.
Total area of land disturbance: 23X0 sq.ft.
Grading quantities:
Imported material/fill 100 cubic yards Source: Engineer specified source
Excavated material/cut 60 cubic yards Disposal site:Appropriate disposal site
Total: 160 cubic yards
3. PROPERTY OWNER INFORMATION
Name: Port of Anacortes Phone: 360-293-3134
Address(Street,City,State,Zip): Email Address: kevin.anderson ortofancortes.com
100 Commercial Ave �p
4. CONTRACTOR INFORMATION
Name:* TBD Phone:
Contractor's Business Licenses State License#: City License#:
*All Contractors&Subcontractors must have a valid City
of Anacortes business license prior to doing work in the Expiration Date: Expiration Date:
City.
Address(Street,City,State,Zip): Email Address:
5. CONTACT PERSON
Select one person the city will contact for anything 0 Applicant El Property Owner El Contractor
related to this project: El Other(list below)
Name: Phone:
Kevin Anderson 360-770-5194
Address(Street,City,State,Zip): Email Address:
100 Commercial Ave, Anacortes, WA kevin.anderson@portofanacortes.com
98221
Clearing&Grading Permit Application
Updated November 2021 Page 5 of 14
7. ACKNOWLEDGEMENTS & SIGNATURE
Read and initial each of the following statements prior to signing this application:
kda I understand that when a clearing and grading permit application is taken in over the counter it
does not mean the application has been deemed technically complete and sufficient for staff
review.
kda understand that if I submit incomplete, inaccurate, and/or erroneous information it will take the
City longer to process my permits.
kda
understand and acknowledge that I could be responsible for providing as-built drawings (on paper or electronically) as part of the project,s final approval process.
kda I understand and acknowledge that Special Inspections could be required as part of my project, and
if needed I will be required to pay for the cost of these inspections.
kda I understand and acknowledge that financial securities could be required as part of the work I am
completing and I agree to provide the items needed for the City to calculate these securities and to
provide the securities themselves.
kda I understand that if permits are reviewed concurrently such as SEPA, critical areas, or shoreline
permits, any required revisions to one permit may affect the entire plan set and could add costs
and time to the project.
hereby declare that I am either the owner of the property listed on this application or the owner of
this property has authorized me to be their representative to act for them. I also declare under
penalty of perjury under the laws of the State of Washington that all of the statements and answers
contained herein, and the information submitted with this application form is in all respects, true,
correct, and complete to the best of knowledge and belief.
Kevin Anderson Digitally signed by Kevin Anderson
Date:2023.05.04 10:34:25-0700'
Signature Date
Printed Name
Clearing&Grading Permit Application
Updated November 2021 Page 6 of 14
FORM CG-2: SITE INFORMATION
1. PROPERTY WHERE WORK IS OCCURRING
ADDRESS: 116 O Ave
PARCEL
NUMBER(S)
P55360 P55361 P3151 0
2. PROJECT SITE INFORMATION
A. Is work within the City's right-of-way proposed? If yes, you will be required ® YES 1:1 NO
to submit a right-of-way permit application.
If you have already submitted a ROW permit, list the permit number here:
B. Is the property located within 200' of a shoreline (marine waters or a lake)? ® YES 1:1 NO
C. Are there critical areas (wetlands, streams, fish &wildlife conservation ® YES 1:1 NO
areas, geologically hazardous areas) or buffers on or abutting(within 300-
feet of)the project site? If yes, a critical areas report will likely need to be See SSDP 2023-0002
submitted.
D. Is this project subject to the SEPA process? If yes, you will be required to ❑ YES ® NO
submit a SEPA checklist.
If you have already completed the SEPA process, list the it number SEPA Exempt per WAC
y y permit num 197-11-800(2)(d)(vii)and(viii)
here:
3. REQUIRED SIGNATURE
hereby declare that I am either the owner of the property listed on this application or the owner of
this property has authorized me to be their representative to act for them. I also declare under penalty
of perjury under the laws of the State of Washington that all of the statements and answers contained
herein, and the information submitted with this application form is in all respects, true, correct, and
complete to the best of knowledge and belief.
Kevin Anderson Digitally signed by Kevin Anderson
Date:2023.05.04 10:34:51 -0700'
Signature Date
Printed Name
Clearing&Grading Permit Application
Updated November 2021 Page 7 of 14
FORM CG-3: STORMWATER MANAGEMENT MINIMUM
REQUIREMENTS DETERMINATION
1. PROPERTY WHERE WORK IS OCCURRING
ADDRESS: 116 O Ave
PARCEL NUMBER(s) P55360 P55361 P31510
2. GENERAL INFORMATION
Most development within the City of Anacortes that involves disruption of soils,or construction of buildings,
streets, parking lots,etc. requires a Stormwater review. Stormwater review requirements are based on either
the amount of soil to be disturbed (grading,vegetation removal),or the amount of hard surface that is created
or replaced on a site(building footprint,concrete,asphalt or gravel parking,sidewalk,etc.)
This form is largely targeted for small projects and single family residences. For larger projects and more
information please refer to the Anacortes Municipal Code(Chapter 19.76 Stormwater Management)and the
latest Washington State Department of Ecology Stormwater Management Manual for Western Washington
(Ecology Manual).
3. LAND DISTURBANCE AND HARD SURFACE AREA CALCULATION
Please calculate your project's area of land disturbing activity and hard surface amount;guidance is provided on
the next page of this document. Use your project"s total hard surface calculation to follow the flow chart(s) in this
packet and determine the level of stormwater management required for you project.
When determining your permit level or if stormwater thresholds are met or exceeded the entire project must be
considered. A project is that portion of a property, properties, or right of way subject to land disturbing activities,
new hard surfaces and replaced hard surfaces. The hard surface on your property will determine the storm water
utility fees and the stormwater general facility charge. All new or replaced hard surfaces should be accounted for.
Below are excerpts from the Anacortes Municipal Code and Ecology Manual that may assist you in preparing this
information.
"Hard surface area"means an impervious surface, a permeable pavement, or a vegetated roof.
"Impervious surface"means a non-vegetated surface area which either prevents or retards the entry of water into
the soil mantle as under natural conditions prior to development. A non-vegetated 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.
"Replaced impervious surface"means,for structures, the removal and replacement of impervious surfaces down to
the foundation. For other impervious surfaces, the removal down to bare soil or base course and replacement.
Clearing&Grading Permit Application
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LAND DISTURBANCE
Description TotalsF
( )
Total Area of land disturbing Y activit 23,000
Total area converted from vegetation to 0
lawn or landscaped areas
HARD SURFACE AREA CALCULATION
Existing Removed Proposed Proposed
Description (SF) (SF) Replaced New
(SF) (SF)
Non Pollution Generating Hard 21459
Surface Area
(Sidewalks, paths, patios,etc.)
Pollution Generating Hard Surface 23X0 23X0
Area
(Driveways, parking areas,etc.)
Total Hard Surface 23�000 23 000
1 1
Site Size 25,459
Existing impervious surface
coverage
% 100 %
(sq.ft. hard surface/site size)
Use the information in the above table to navigate the flow chart(s) on the next page and
determine the applicable stormwater management minimum requirements for your
project. Then complete the applicable Stormwater Minimum Requirements Form on the
Public Works - Engineering Department Forms website and provide required submittal
items/plans.
Check applicable box Minimum Requirements Determination
0 Minimum Requirements#1-9.
Minimum Requirements#1-5.
1:1 Minimum Requirement#2.
Clearing&Grading Permit Application
Updated November 2021 Page 9 of 14
FLOW CHART DETERMINING REQUIREMENTS FOR NEW DEVELOPMENT
Start Here
IF
Does the site have 35% Yes See Redevelopment Minimum
or more of existing 10 Requirements and Flow Chart
impervious coverage? (Figure 1-2.4.2).
No
Does the project convert Y4
acres or more of vegetation to
Does the project result in lawn or landscaped areas, or
5,000 square feet, or No convert 2.5 acres or more of
greater, of new plus native vegetation to pasture?
replaced hard surface
area?
No
Yes
Yes Does the project result in 2,000
square feet, or greater, of new plus
All Minimum Requirements replaced hard surface area?
apply to the new and replaced
hard surfaces and converted Yes/ No
vegetation areas.
Does the project have land
Minimum Requirements#1 disturbing activities of 7,000
through#5 apply to the new square feet or greater?
p
and replaced hard surfaces Yes
and the land disturbed. No
Minimum Requirement#2
applies.
Sao Figure 1-2.4.1
Flow Chart for Determining Requirements for
"VOWN New Development
DEPARTMENT OF Reprised June2015
ECOLOGY Please see http:11Wvvw.ecy.wa.govlcopyright.html for copyright notice including permissions,
State of Washington limitation of liability,and disclaimer.
Clearing&Grading Permit Application
Updated November 2021 Page 10 of 14
FLOW CHART DETERMINING REQUIREMENTS FOR REDEVELOPMENT
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 IF No
Minimum Requirements#1 through#5
apply to the new and replaced hard Minimum Requirement#2 applies.
surfaces and the land disturbed.
Next Question
Does the project add 5,000 square feet or more of new hard surfaces?
OR
Convert Y4 acres or more of vegetation to lawn or landscaped areas?
OR
Convert 2.5 acres or more of native vegetation to pasture?
IF Yes No
All Minimum Requirements apply Next Question Is this a road
to the new hard surfaces and the No
converted vegetation areas. related project?
Yes
Does the project add 5,000 square feet or more of new hard surfaces?
IF Yes
No Is the total of new plus replaced hard surfaces
Do the new hard 5,000 square feet or more,
surfaces add 50% or No No additional No AND
more to the existing does the value of the proposed improvements
hard surfaces within requirements. -including interior improvements-exceed
the project limits? 50% of the assessed value (or replacement
value)of the existing site improvements?
Yes" All Minimum Requirements apply to the new and replaced 4-J
hard surfaces and converted vegetation areas. Yes
who Figure 1-2.4.2
Flow Chart for Determining Requirements for
"VOWN Redevelopment
DEPARTMENT OF Reprised June2015
ECOLOGY Please see http:11Wvvw.ecy.wa.govlcopyright.html for copyright notice including permissions,
State of Washington limitation of liability,and disclaimer.
Clearing&Grading Permit Application
Updated November 2021 Page 11 of 14
FORM CG-4: CLEARING & GRADING PLAN REQUIREMENTS
1. GENERAL INFORMATION
This form is intended to assist applicants in creating complete, code compliant clearing and grading plans.
To the right of the Requirements column is space for you to list the sheet number of the plan set where
the listed information is shown.
0 Minimum Plan Size: 11"x 17" and drawn in an engineering scale.
2. INFORMATION REQUIRED ON ALL SITE PLANS
✓or N/A PAGE#ON
PLANS
X Cover sheet must contain all of the following: C01
0 Vicinity Map
0 Name of the project
• Name, address, and telephone number of owner and agent(s)
• Name,address,and telephone number of Applicant(if different from
the owner)
• Zoning designation of the site
• Area, in square feet and acreage, of the project site
0 Percent impervious surfaces
X Scale and North Arrow All sheets
Property features
X Location, identification, and dimensions of all property lines and easements. CO3
All easements shown on the title report, Record of Survey, or plat must be
dimensioned and shown.
Location and dimensions of existing critical areas (wetlands, streams, steep
X slopes) and their associated buffers. CO3
Location of Ordinary High Water Mark and shoreline jurisdiction limits (if
adjacent to a shoreline). 0O3
X adJ
NA Identify any erosion or landslide hazard areas as well as any potential
unstable slopes greater than 15%. (Percentage%slope=Rise(drop in height)
divided by Run (distance) multiplied by 100).
NA Show the location, type and size of existing significant trees and native
vegetation.
• Significant tree means deciduous and evergreen trees greater than 6" in
diameter at 5'above grade.
Native vegetation means vegetation composed of plant species,other than
noxious weeds, that are indigenous to the coastal region of the Pacific
Northwest and which reasonable could have been expected to occur on the
site. Examples include trees such as Douglas fir,Western Hemlock,Western
Red Cedar, Alter, Big-Leaf Maple, and Vine Maple; shrubs such as willow,
elderberry, salmonberry, and salal; and herbaceous plants such as sword
fern,foam flower, and fireweed.
Clearing&Grading Permit Application
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Clearing& Grading Details
Show appropriate elements of the Construction SWPPP, including:
X CO3
a. Areas of vegetation to be preserved; clearing limits
b. Drainage ditches and swales (existing/proposed)
c. Construction access
d. Temporary and permanent stormwater retention or detention
facilities; sediment and erosion controls; slope protection, etc.
e. Infiltration systems (existing/proposed)
See the Stormwater Management Requirements handout for other
requirements.
X Indicate proposed area(s) of disturbance. C04
X Show location of clearing limits and clearing limits fencing CO3
X Show existing and proposed contours and site elevations(i.e.finished grades) All sheets
at 5-foot minimum increments. The horizontal and vertical control datum
must be clearly shown.
X Show corner elevations (existing and proposed) of the site and lot. All Sheets
X Use contour lines or arrows to show direction and percent (%) slope(s). CO3
X Extend contours onto adjacent properties and show proposed transitions. All sheets
Include a Cross Section Plan (show dimensions of original and proposed
X locations across the site. C06
grading) at key
Structures
Location, identification, dimensions and size of all existing and proposed
buildings and other structures.
CO3
X Location of structures on adjacent properties within 20'of the site boundary. CO3
X Location of existing and proposed retaining walls, rockeries, and fences. CO3
NA Location, identification, and dimensions of all setbacks.
Utilities & Easements
X Location and dimensions of existing and proposed stormwater, sanitary CO3
sewer, potable water, and fiber lines/facilities. All wells and septic systems
located on or near the project site must also be identified.
Landscaping
NA Show the location and design of vegetation areas to be preserved and
planted,and a plant list to include the location,number,size and type of plant
material by botanical and common name.
Location of irrigation system if a permanent or temporary system is
NA proposed.
Show the location of existing trees to be retained in conformance with AMC
NA 16.50, and tree protection measures to be implemented, when applicable.
Clearing&Grading Permit Application
Updated November 2021 Page 13 of 14
Provide a maintenance plan for any infiltration-based stormwater best
management practices (BMPs) built as part of the landscaping design,
NA including the specifications and maintenance procedures of any soil
amendments.
NA Show new trees to be planted and tree unit credit calculations, in
conformance with AMC 16.50 Tree preservation, when applicable
Clearing&Grading Permit Application
Updated November 2021 Page 14 of 14