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HomeMy WebLinkAboutPermit File BLD-2023-0162 2313 R Avenue (3) City of Anacortes Invoice/Permit#: BLD-2023-0162 904 6th Street Applied date: 03/20/2023 P.O.Box 547 Issue date: 04/12/2023 Anacortes, WA 98221-0547 Expire date: 10/08/2024 Mp 'e �..,'a (360) 293-1901 Job Address: 2313 R AVE Permit Type: Grading Permit ANACORTES WA 98221 Project: APN: Remarks: Remove asphalt parking lot at Skate Park. Owner: PARKS DEPT CITY OF ANACORTES Contractor: OWNER Address: PO BOX 547 Address: ANACORTES WA 98221-0547 Phone: 293-1918 Phone: License#: General Information: Fees: CUBIC_YARDS 75 Grading Plan Review Fee 23.50 Grade and Fill 37.00 Total Calculated: 60.50 Deposits/Receipts: 0.00 Total Due: 60.50 The issuance or granting of this permit shall not be construed to be a permit for,or approval of, any violation of this Code or any other ordinance or order of the City, of any state or federal law, or of any order, proclamation, guidance advice or decision of the Governor of this State.To the extent the issuance or granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or federal law, or order, proclamation, guidance advice or decision of the Governor of this State, this permit shall not authorize such work and shall not be valid. The building official is authorized to prevent occupancy or use of a structure where in violation of this Code, any other City ordinances of this jurisdiction or any other ordinance or executive order of the City,or of any state or federal law, or of any order, proclamation,guidance advice or decision of the Governor. The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect, inaccurate or incomplete information, or in violation of any City ordinance, regulation or order, state or federal law, or any order, proclamation, guidance or decision of the Governor.This permit becomes null and void if work or construction authorized is not commenced within 180 days or if construction work is suspended or abandoned for a period of 180 days at any time after work is commenced. I have read and a this application and know the same to be true and correct. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSU VV x o PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location: 904 6th Street, Anacortes WA 98821 %7�� Phone: (360)299-1984 o w� CLEARING & GRADING PERMIT APPLICATION 21 Clearing & Grading Permit o Submittal Requirement Checklist v — � a See pages 2-3 of this handout for information about each submittal item listed below. See Qu AMC Ch. 19.78 Clearing and Grading for review and approval criteria. p v 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 Drainage Report 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 Aced@citvofanacortes.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. • STORMWATER DRAINAGE REPORT. 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. Clearing&Grading Permit Application Updated November 2021 Page 3 of 14 Page left blank intentionally. Clearing&Grading Permit Application Updated November 2021 Page 4 of 14 FORM CG-1: CLEARING & GRADING PERMIT APPLICATION 1. PROPERTY INFORMATION Project Address(Street,Suite#): Assessor Parcel Number: 2313 R Ave P77984 Subdivision/Lot#: Zoning Designation: Lot area (size): Industrial 5,715 sq.ft. 2. PROJECT DESCRIPTION Project Summary: As part of the Ben Root Skate Park remodel project, City staff will be removing the existing parking lot prior to the contractor accessing the site. Total area of land disturbance: 5,715 sq.ft. Grading quantities: Imported material/fill 0 cubic yards Source: Excavated material/cut 75 cubic yards Disposal site:Lakeside Industries Total: 75 cubic yards 3. PROPERTY OWNER INFORMATION Name: City Of Anacortes Phone: 360/293-1918 Address(Street,City,State,Zip): Email Address: PO Box 547, Anacortes bobv@cityofanacortes.org 4. CONTRACTOR INFORMATION Name:*Same as Owner Phone: Contractor's Business Licenses State License#: UBI 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: S. CONTACT PERSON Select one person the city will contact for anything NX Applicant ❑X Property Owner ❑Contractor related to this project: Other(list below) Name: Phone: Bob Vaux 360/588-8233 Address(Street,City,State,Zip): Email Address: PO Box 547. Anacortes bobv@cityofanacortes.org 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: RW I understand that when a clearing and grading permit application is taken in over the counter it V does not mean the application has been deemed technically complete and sufficient for staff review. RWV I understand that if I submit incomplete, inaccurate, and/or erroneous information it will take the City longer to process my permits. RWV I 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. RWV 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. RW I understand and acknowledge that financial securities could be required as part of the work I am V completing and I agree to provide the items needed for the City to calculate these securities and to provide the securities themselves. RW I understand that if permits are reviewed concurrently such as SEPA, critical areas, or shoreline V permits, any required revisions to one permit may affect the entire plan set and could add costs and time to the project. I 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. Feb 22, '23 Signature Date Robert W. Vaux 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: 231 3 'R' Ave PARCEL P77984 NUMBER(S) 2. PROJECT SITE INFORMATION A. Is work within the City's right-of-way proposed? If yes, you will be required OYES ONO 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)? DYES ONO C. Are there critical areas (wetlands, streams, fish &wildlife conservation DYES ONO 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 submitted. D. Is this project subject to the SEPA process? If yes,you will be required to OYES ONO submit a SEPA checklist. If you have already completed the SEPA process, list the permit number SPR-2023-0001 here: 202300766 3. REQUIRED SIGNATURE I 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. Feb 22, '23 Signature Date Robert W. Vaux 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: 231 3 'R' Ave PARCEL NUMBER(S) P77984 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 Updated November 2021 Page 8 of 14 LAND DISTURBANCE Description Total (SF) 5,715 Total Area of Land disturbing activity 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 0 0 0 0 Surface Area (Sidewalks, paths, patios,etc.) Pollution Generating Hard Surface 5,715 5,715 0 0 Area (Driveways, parking areas, etc.) Total Hard Surface 57715 Site Size 5,715 Existing impervious surface 100 /o coverage (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 ❑ Minimum Requirements #1-9. ❑ Minimum Requirements #1-5. ❑ Minimum Requirement#2. Clearing&Grading Permit Application Updated November 2021 Page 9 of 14 FLOW CHART DETERMINING REQUIREMENTS FOR NEW DEVELOPMENT Start Here Does the site have 35% Yes See Redevelopment Minimum or more of existing No Requirements and Flow Chart impervious coverage? (Figure 1-2.4.2). No Does the project convert%4 IF 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 IF 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. IF Does the project have land Minimum Requirements#1 disturbing activities of 7,000 through#5 apply to the new Yes square feet or greater? and replaced hard surfaces and the land disturbed. iNa Minimum Requirement#2 applies. Figure 1-2.4.1 Flow Chart for Determining Requirements for New Development DEPARTMENT OF Revised June2015 ECOLOGY Please see http:11Www.ecy.wa.gov/copyright.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 �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 3/4 acres or more of vegetation to lawn or landscaped areas? OR Convert 2.5 acres or more of native vegetation to pasture? Yes No All Minimum Requirements apply Next Question Is this a road to the new hard surfaces and the related project? No converted vegetation areas. Yes Does the project add 5,000 square feet or more of new hard surfaces? 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 requirements. does the value of the proposed improvements hard surfaces within -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 hard surfaces and converted vegetation areas. Yes Figure 1-2.4.2 Flow Chart for Determining Requirements for Redevelopment DEPARTMENT OF Revised June2015 ECOLOGY Please see http:11Www.ecy.wa.gov/copyright.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. • 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 Cover sheet must contain all of the following: • Vicinity Map • 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 • Percent impervious surfaces Scale and North Arrow Property features Location, identification, and dimensions of all property lines and easements. II 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 slopes) and their associated buffers. Location of Ordinary High Water Mark and shoreline jurisdiction limits (if adjacent to a shoreline). 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). 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 Updated November 2021 Page 12 of 14 Clearing & Grading Details Show appropriate elements of the Construction SWPPP, including: 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. Indicate proposed area(s) of disturbance. Show location of clearing limits and clearing limits fencing Show existing and proposed contours and site elevations(i.e.finished grades) at 5-foot minimum increments. The horizontal and vertical control datum must be clearly shown. Show corner elevations (existing and proposed) of the site and lot. Use contour lines or arrows to show direction and percent (%) slope(s). Extend contours onto adjacent properties and show proposed transitions. Include a Cross Section Plan (show dimensions of original and proposed grading) at key locations across the site. Structures Location, identification, dimensions and size of all existing and proposed buildings and other structures. Location of structures on adjacent properties within 20'of the site boundary. Location of existing and proposed retaining walls, rockeries, and fences. Location, identification, and dimensions of all setbacks. Utilities & Easements Location and dimensions of existing and proposed stormwater, sanitary sewer, potable water, and fiber lines/facilities. All wells and septic systems located on or near the project site must also be identified. Landscaping 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 ,proposed. Show the location of existing trees to be retained in conformance with AMC 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, including the specifications and maintenance procedures of any soil amendments. 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