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2015, 01-26 Permit App: EGR-2014-0003 Land Disturbance Community Development Department (Staff Use Only) Permit Center SCtTYOF kane 1703 East Sprague Avenue,Suite B-3 PERMIT No.: Spokane Valley, WA 99206 Tel: (509) 720-5240 4000 v11aey Fax: (509)permitcenter@ s688-0037pokaneva)ley.orq CHECKLIST?: ❑Y ON Tim: LAND DISTURBANCE PERMIT APPLICATION STAFF USE: ❑ ENGINEERED GRADING 0 REGULAR GRADING 0 GRUBBING &CLEARING APPLICANT USE: SITE ADDRESS:12516 E 12TH AVE ASSESSORS PARCEL NO.:45223.9092,.9129,.9203,.9205 Project r_ '1`f 4,- .201 RECEIVED APPLICANT NAME:WHIPPLE CONSULTING ENGINEERS INC. ATTN:MARK KRIGBAUM PHONE:509-893-2617 EMAIL:MKRIGBAUM@WHIPPLECE.COM AEN [ ; CONTACT NAME(®SAME AS APPLICANT): PR �� 1N �R Lit' PHONE: EMAIL: C. REV. # i PROPERTY OWNER NAME:JJ&LJ LLC/ORINDA SPOKANE INVESTMENTS LLC ATTN:CRAIG JORGENS❑ CHECK IF APPLICANT MAILING ADDRESS:580 DALEWOOD DR. CITY:ORINDA STATE:CA ZIP:94563 PHONE: EMAIL: CELL: CONTRACTOR NAME: (®TBD): 0 CHECK IF APPLICANT MAILING ADDRESS: CITY: STATE: ZIP: PHONE: EMAIL: CELL: STATE LIC. NO.: EXPIRES: UBI: DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE: CONSTRUCTION OF OR IMPROVEMENTS TO PUBLIC STREETS WITH SEWER,WATER AND STORM DRAINAGE AND DRY UTILITIES FOR 38 SINGLE FAMILY RESIDENTIAL LOTS ESTIMATED QUANTITIES (CUBIC YD): CUT:10,000± FILL: IF CUT, PROVIDE DESTINATION OF SOIL:TBD BY CONTRACTOR START DATE:APRIL 1,2015 ESTIMATED COMPLETION DATE:OcTOBER 1,2015 • 4 (5141/41,c Tar WC 6, h4C- / / .CD /20/5 Updated March 2011 \\TIMON\public\WCE_ J- \2014 WCE PROJECTS\2014-1307 Jorgens-12th and Vercler-Eng.Phase 1 -12th(Ref 1266)\DOCUMENTS\Land Disturbance Permit Aq. ation.docx LAND DISTURBANCE (LD) PERMIT CHECKLIST t). e For Grading, Clearing and Grubbing work outside the Right-of-Way(ROI) Valley (For work within ROW need a ROW permit) Permit Center• 11703 E Sprague Ave Suite B-3+Spokane Valley WA 99206 509.688.0197♦ Fax: 509.688.0037 0 permitcenter@spokanevattey.org { Project Address: 12516 E 12th Ave Today's Date: January 20,2015 Project Descriptio • 9 _et .in e Famil Residential Subdivision, SUB-2014-0001 Signature: / ' "PP/ �^ tI C-% ti-C_ Print Name: Mark Kriqbaum The purpose of this ch ist is to gather information about the proposed project so to determine what land disturbance permit, if any, is required by the Spokane Valley Municipal Cole. Starting with Part 1 and working from top to bottom, please answer the folio twgiestio EL R The first"Yes"identifies the type of land disturbance (LD)permit required. RECEIVED • ,tom PART 1 —Is LD work exempted or already covered_?(SVMC 24.60.0201 If so then LD permit not needed.t ❑Yes ® No Does your project only have to do with emergency utility work; cemett✓ty.fir is 5Trinating septic tanks; digging out a basement; building a wall less than 4 feet high; disposal of refuse that is covered under other regulations; already permitted miningoqiww4,plo . . aggregate material(rock, sand,gravel, aggregate, or clay)ore tbfafo i gai• •• - under the direction of a licensed engineer or engineeringg ipM'tsts; tfipe thole exempted from a LD permit. _ PART 2—Engineered Grading Permit needed?(SVMC 24.50.030:2 sets plans,calcs etc.from Engineer) ®Yes ❑No Will this grading be for a short plat, subdivision or binding site plan? ❑Yes ®No Will any grading occur in a FEMA floodplain,wetland,wetland buffer, Fish and Wildlife habitat conservation area or geologically hazardous area? ®Yes ❑No Will the volume of excavation or fill for the project be over 500 cubic yards?(If checked Yes then a SEPA environmental checklist will need to be submitted for review) ©Yes ❑ No Will the grading create a base or support for a permanent structure? 0 Yes ®No Will the grading be for a driveway that Is longer than 75 feet? ❑Yes ® No Will any grading occur in a drainage channel or be for a water feature(like a perennial or intermittent pond)with a surface area greater than 500 square feet? ®Yes ❑No Will this grading result in the addition or replacement(excluding pavement maintenance)of 5,000 square feet or more of impervious surfaces or the disturbance of 1 acre or more land or the construction of new drywells or other underground injection control(UIC)facilities? ❑Yes ® No Will any excavations or fills have slopes at 2:1 (H:V)or steeper and heights greater than 2 1/2 feet? ❑Yes ®No Will any excavations or fills have slopes at 10:1 (H:V)or steeper and heights greater than 4 feet? PART 3—Regular Grading Permit needed?(SVMC 24.50.040: 1 set of plans showing grading and temporary erosion and sediment control; does not require engineering) ®Yes ❑ No Will the volume of excavation or fill be over 50 cubic yards on any one lot? ❑Yes ® No Will any excavations have slopes at 2:1 (H:V)or steeper or heights greater than 3 feet? ❑Yes ® No Will any fills have slopes at 2:1 (l-:V)or steeper or heights greater than 2 feet? PART 4—Grubbing and Clearing(G&C)Permit needed?(SVMC 24.50.050; 1 set of plans showing G&C and temporary erosion and sediment control;does not require engineering) ®Yes ❑ No Will the G&C work disturb 5,000 or more square feet of area or remove 7 or more trees? (Note that forest practices overseen by DNR or commercial agriculture are exempt) ❑Yes Ea No Will there be any clearing on slopes or neartin FEMA floodplains,wetlands,wetland buffers, Fish and Wildlife habitat conservation areas, geologically hazardous areas or erodible soils? If the answers to all of the questions above are `No"then a permit is not required for the proposed work.