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Final Plat ApplicationThurston County Environmental Health 2000 Lakeridge Dr. S.W. Olympia, WA 98502 786-5465 Vb~TER BACTERIOLOGICAL ANALYSIS SAMPLE COLLECTION: READ INSTRUCTIONS THOROUGHLY DATE COLLECTED TIME COLLECTED COUNTY NAME :j MONTH DAY YEAR `~> TYPE OF SYSTEM IF PUBLIC SYSTEM, COMPLETE: PUBLIC J INDIVIDUAL LD. N0. CIRCLE GROUP A B (serves only t residence) , NAME OF SYSTEM ~, i ::::. L.u ''"i SPECIFIC LOCATION WHERE SAMPLE COLLECTED (TELEPHONE NO •~ ~, r r_fi'i' '~*-'L DAY (~{r~ izy <<`'~' i'k?`.hr ;"(`s•... ,."~ (.f r c..tt~ ptL,:z;,,w3„ EVENING (.';~) ,% ~ / - `~t,:"~:<? SAMPLE COLLECTED BY: (Name) SYSTEM OWNER/MGR: (Name) ,rc.. _ _. r, r ~w SOURCE TYPE ^ GROUND WATER UNDER SURFACE INFLUENCE ;~ SURFACE ~7.WELL or ^ SPRING ^ PURCHASED or ^ COMBINATION WELL FIELD INTERTIE or OTHER SEND REPORT TO: {Print full Name, Address and Zip U ~~ • - - ~ "~ r iur• `' %.•''' '„s_ WASHINGTON TYPE OF SAMPLE (check only one in this column) Chlorinated (Hesidual:TotalFree) ^ ROUTINE ^ Filtered DRINKING WATER ~ ^ Untreated or Other ___ check treatment ^ REPEAT SAMPLE Lab # ~ Previous colifonn presence Date _ ^ RAW SOURCE WATER Source # ~ m ^ Total Cdifonn ~ ~ NEW CONSTRUCTION or REPAIRS ^ Fecal Coliform ^ OTHER (Specify) REMARKS: ~ (LAB USE ONLY) DRINKING WAT R RESULTS? ^ UNSATISFACTORY, coliforms present TISFACTORY REPEAT ^ E. Coll present ^ E. Coll absent ~ Coliforms absent SAMPLES REQUIRED ^ Fecal present ^ Fecal absent OTHER LABORATORY RESULTS TOTAL COLIFORM /100 ml E. COLT /100 ml FECAL COLIFORM /100 ml PLATE COUNT /ml ANOTHER SAMPLE REQUIRED SAMPLE NOT TESTED BECAUSE: TEST UNSUITABLE BECAUSE: ^ Sample too old ^ Confluent growth ^ Wrong container ^ TNTC ^ Incomplete form ^ Turbid culture i ^ Excess debris SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS LAB NO. (7 DIGITS) DATE, TIME RECEIVED _. x i ., E3 $Q'0 ti DATE REPORTED LABORATORY: .. i , _ ~~ WATER WELL REPORT i'i'u'i.'e'c'r Original & Ist copy -Ecology. 2nd copy -owner, 3rd copy -driller CpRStt11Ct10I1/1)CCYtRYttISSIOn ("x" in rirclrl O Construction Decommission ORIGINAL CONSTRUCTION Notice of Intent Ntttnber (.V ~ Z 4 '~ J ,Z (PROPOSED USE: ~.pomcstic ^ tndtutrial L1 Municipal I ^ DrWatcr ^ Irrigation ^Tcst Wrll ^Oth~7 PE OF WORK: Owner's number of well (if more than one) V' 1 ~_ ^New Wcll 0 Reconditioned Method: ^ Dug 0 Bored ^ Driven Deepened .Cable ^ Rotary ^ Jated_ DIMENSIONS: Diameter of well~_inchcs, drilled ft. Depth of completed well ft. CONSTRU ON DETAILS CLZtRE.'VT r7 52 ~`O ~iotice of Intent No. _ [;pique Ecology Weil ID Tag No. ~ F~ !a 1 Water Right Pern-it No. Property Owner Name ~S~ ODZ~ /t ~ Well Street Address ~~~ ~ tilt ~ n~t?~n lU~~t,f:~ City ~ ji~•%1M ,_ Cou/n~ty: /S jACa[IOt7N~1/4- 114 Sf~'~I/4 Sec f' .) Twn~ R ~ WM irrle or nor WWM E.at/t.ortg: Lat Deg Lat M'in/Scc (.t.t,r stilt REQUIRED) _ Long D d - Long MidScc Tax Parcel No_ ~~[ 1 7 f ~ ~ i C) 1 ~ ~ tB ~elded lliam. from ft. to ft. CONS'CRUC?IOK OR DECOMIt<i15SION PROCEDURE Iled• ^ Liner installed Diam. from ft. to ft Formation: Describe by rnlor, character, size of material and sauctun:, and the Diam. from 2 w ft kind and namrc of the material in each stratum ptroetrrtcd, with at least one ^ Tbrcaded entry for each change of information. Indicate all water encountered. irations: ^ Yts,~No (LSE ADDITIONAL SHEETS IF NECESSARY.) of perforator used MATERIAL FROM TO of pcrfs_in. byiin. and rm. of peels from ft. to ft. Screens: Ycs ^ ro ^ K-Pat Location Manufac cr's Namc Type Mudd No. Diam. Slot Size from ft. to ft. Diam. Slot Sizc from ft. to R. GraveUF'ilter packed: ^Yes ^ No ^ Sizc o(gravcUsand Materials placed Gram R. to fL Surface Seal: .yes ^ No To what depth? It Materials used in seal ~ Did any strata contain unusable water? ^Yes ^ ~o Type of water'? Depth of strata _ biethal of scaling strata off PUMP: Manufacturer's Name T,,,,,,. _ H.P. WATER LEVELS: Land-surface elevation about mean sea level ft. Static level ft. below top oC well Date Artesian pressure lbs. p~Y square inch Date Artesian water is controlled by WELL TESTS: Drawdown is amount water level is towered below static kvcl. Was a pump test made? ^Ycs ^ No !f yrs. by whom? Yield: ttalJmin. with R. drawdown afar hrs. Yield: ral./min. with ft. drawdown after hrs. Yield: eal.ltnin. with R. drawdown aRcr hr. Rrcnven data (dote taken a.c Zem when pump turned n~(warrrlrvrl mrru7rred from wel(top to water level) Time Water Level Time Water Level Timc Water Lrvcl DaG: of test Bailer test galJmin. with ft. dtawdown after hrs. Airtcst ealJmin. with stem set ai R. for hrs. Artesian (low c.p.m. Date Temperature of water Was a chemist analysis made? ^Yes ^ No Start Date /.~ - /3 ` Cr / Complett~d Date lr~• ,~ - ~l f` WILL CONSTRUCTION CF.RTIFiCATi01\: 1 constructed andlor accept responsibility for constuction oC this well, and its compliance with all Washington wel{ construction standards. Materials~d and t ottnation reported above are true to ~b~es~t.knowledge 6t:lief. ~rillrr ~ ' ' ~ E'`j ~~~ Drilling Coln ~~~=~C~ f~~~ • ~ ~ , ,n ^Ene ncer ^Traioee N 1 n PAY DrilledEngineer~i'raitrce Signature~~A~~ ~'^ Address ~ -~ u`? '~` 's~,~ Driller or Trainee License No. l ~ 1`~ City, State, Ztp ~~ "~ A f.~ rA ~1 ~r'SC r',o Contractor s S jt j•~ N+ ~ ~r.~~ _ ~'3 _Cl~ If trainee, licetged drillers Registration 1\0. e SrgndttrrY and I.tCenSC n0. Ecology is an Equal Opportunity Employer. ECY 050-1-20 (Rev 4/Ill ) ~'l~~~ject I''c)l~t 945 113th Ave Se Olympia, WA 98501 February 23, 2005 Attn: Tami Merriman City of Yelm 105 Yelm Avenue West Yelm, Washington 08597 RE: Summary of how Developer has met all conditions of approval. Ms. Merriman; The following summarizes Project Fore's compliance of the required conditions, of Preliminary Plat Approval dated October 14, 2003, for Final Plat Approval of Buckhorn Estates -Plat, SUB-03-8346-YL. Condition #• Lot Size and Setback :' Driveway entrances for Lots 15 & 16 have been designed, constructed and landscaped for entrance within the cul-de-sac (see as-bunts). Open Space 2,~ An Open Space area 13,942 sq. ft is provided (10,498 required). ~! Open Space Engineered plans have been submitted, area constructed, and certified for the Open Space improvement plan in compliance with Chapter 16.14.050. 15Y The Open Space shall be/is dedicated to the City of Yelm. Schools ~:' A Mitigation Agreement with the Yehn Community School District has been recorded, and a copy of the recorded Agreement is submitted. Mitigation fees will be paid at issuance of Building Permit. Transportation i.6:' Frontage improvements "Neighborhood Collector"and Interior Streets "Local Access" have been engineer designed, constructed, and certified in accordance with the City of Yehn guidelines. 4~: A Waiver of Protest to defer the extension of the frontage improvements for Mountain View Road from the northern entrance of the subdivision to the northern property line has been/will be signed. Notice of this deferral shall be/is shown on the face of the plat map, and in the Covenants of the plat. ~ r y .. ' 8. ' Providing for continuation of 89th Ave SE has been will be signed for the street "Future Road ~I'~ - Connection" as per YMC Chapter 16.16.060, 16.16.090, and 16.16.110. / Mitigation for transportation impacts through payment of the Transportation Facility Charge (TFC} per ,~' unit which is payable at time of building permit issuance. Page 1 of 3 Sewer ,10~ The S.T.E.P. System has been extended from Sprague Road and Mountain View Road intersection to the - north to the subdivision and into the subdivision to serve the 21 Lots. The S.T.E.P. System has been designed, constructed, and certified in accordance to City of Yelm standards. The As-built plans have been submitted to the Community Development Department for review and final approval. .~11. A Waiver of Protest to defer the extension of the sewer line from the northern entrance of the subdivision to the northern property line has been/will be signed. Notice of this deferral shall be/is shown on the face of the plat map, and in the Covenants of the plat. 12. One Sewer connection and inspection fees per residential Lot shall be paid at the time of building permit issuance. 13.' The existing on-site septic (sewage) system has been abandoned per Article IV Rules and Regulations of ~' the Thurston County Board of Health Governing Disposal of sewage, and the existing home shall be/ has been connected to City sewer. Documented of abandonment of existing system is enclosed. Water 14: The Watermain has been extended from Sprague Road and Mountain View Road intersection to the l% north to the subdivision and into the subdivision to serve the 21 Lots. The Water System has been designed, constructed, and certified in accordance to City of Yelm standards. The As-built plans have been submitted to the Community Development Department for review and final approval 15. A Waiver of Protest to defer the extension of the water line from the northern entrance of the subdivision to the northern properly line has been/will be signed. Notice of this deferral shall be/is shown on the face of the plat map, and in the Covenants of the plat. lb. One Water connection fee per residential Lot shall be paid at the time of building permit issuance. 17.;% The existing on-site well has been abandoned per Department of Ecology standards, and documentation has been will be submitted to Thurston County Health Department, and the existing home has been connected to City water. Documented of abandonment of existing system is enclosed. L8: Non-Applicable. No water rights. (19:/ An irrigation system has been designed, installed, and certified on the as-built plans for the irrigation of the Open Space and Landscape strip areas. The As-built plans have been submitted to the Community Development Department for review and final approval. Storm water 20. Designs have been submitted, constructed, and certified for all storm water facilities in accordance with the DOE Storm Water Manual, as adopted by the City of Yehn. A final storm water report along with the as-built construction drawings are submitted. X21. All roof drain runoff is designed for infiltrating, and shall be infiltrated onto each lot. Infiltration shall be accomplished utilizing individual drywells as a condition of building permit issuance. X22. A Storm Water Operation and Maintenance Plan is submitted to the Yelm Community Development Department for approval prior to Final Plat approval. ~. The Storm Water system is held in common by the Homeowners. The Homeowners Agreement includes provisions for the assessment of fees against individual lots for the maintenance and repair of the system. Page 2 of 3 Fire 24. All hydrants meet City minimum standards. 2~5.~ Afire hydrant designed plan has been submitted, installed, and certified in accordance with the Community Development. The As-built plans have been submitted to the Community Development Department for review and final approval. Street Li tinQ Z6. A Street Lighting designed plan has been submitted, installed, and certified in accordance with the Community Development Guidelines. The As-built plans have been submitted to the Community Development Department for review and final approval. Landscaping 27. A designed plan has been submitted, installed, and certified for the landscaping and irrigation plan in accordance with the Yehn Community Development Guidelines. The As-built plans have been submitted to the Community Development Department for review and final approval. Environmental 28. Compliance with the mitigation conditions of the MDNS issued on August 13, 2003 is being met. The mitigation fees for the Yehn School District and the Transportation Facility Charge are payable at time of building permit issuance. Subdivision Name and Property Addresses L~9. A plat map has been issued to the Yelm addressing officer, and the addresses received and placed on the plat map. General Public Works 3A. The grading plan was submitted and approved prior to any on-site grading. Sincerely, Barry Howard Owner/President Project Fore Page 3 of 3 City of Yelm Community Development Department FINAL PLAT APPLICATION Fee: $750.W tIn addition anyprofessional service charoes per Resolution #358) 355 APPOINTMENT REQUIRED FOR APPLICATION SUBMITTAL -Please ca11 458-3835 Subdivision ~I O r e Quc_~C i~at'rl ~~: fc~°t~5 Case # and Name of Preliminary Plat Approval ~ ~ ~-~ ~ V 3 ' d3 _ $~4°fvv ~- ~ 1.-- Tax Parcel Number(s) Z I ~ ~ ~ ~ 1 ~". t © l SUBDIVIDER SURVEYOR r der? ~ ~e } t=o ce - 3c.,r r~ ~~4esz;,:< trod (3 i ~~ i~- vy1 ~= l4ssdc: i ems. @..s Name y4 5 i 1.3'l-' !~ ~' e S E Address Q t y we ~ i ~ . ll~la c7 L`~S ~ I (3~c~,~~~z .. ~r3T2 ~10~ - 40 3f~ Phone Fax E-mail PROPERTY OWNER(S) ~R o i r=C T" tv ~ ~ Name 5~vnc /-~s Address ~:sbc~~/cc~e ~ Phone Fax E-mail Name ~vrv~ s. m~~k~~ SL~vI Address C~.L~~ c~~ ~ S ~ rfl11~ `~f'.5 :3 L ~ ~c~ 74~ - 1 ~~ t `74~ - Iv2¢32 Phone Fax E-Mail ENGINEER zM ~~~. ~- Kn~i ~ v~~~ b~~~ Name t ~-345" S.s ~ wyc~c.~ L3 i v~c~ Address S.~ifie 3~L Tulcw,~c~ . l~lFl4 y~ i~f; L2Gr) z~~.~ ~z7~ Phone Fax E-Mail LAND USE BREAKDOWN (Calculate to the Nearest Hundredth) Total Acreage Number of Single Family Residential Lots Number of Commercial Lots Smallest Lot Area Total Acreage in Open Space Length in Public Streets Length in Private Streets 4.i~i 21 • ( Q:, i '~l9"L~ Number of MuRifamiy Residential Lots Number of Industrial Lots V Average Lot Area d•+ 1 Fee in Lieu of Open Space t~ Total Acreage in Publ'~c Streets I + rr• Total Acreage in Private Streets All of the information on the reverse side of this application is required to be filed at the time of final plat submittal unless a written waiver from the planner or engineer accompanies the application. After this othce has received written acknowledgment from all departments required to sign the plat, the legislative body will be so advised and a date for a public meeting will be set for their consideration. ~d • vV Fee 3~/ ~ f e~ Date Received o.. ]OS Yelm Avenue West (360) 458-3835 ppgax 479 (360) 458-3144 FAX Yelm, WA 98597 www.ciyelm.wa.us City of Yelm 105 Yelm Avenue West P.O. Box 479 Yelm, Washington 98597 (360) 458-3244 FINAL PLAT PROCESS lSubmit four copies of the plat map to building official for addressing. 2. Submit Final Punch List Application to the Community Development Department. 3. Punchlist items addressed either by correction or entering into "Agreement for completion of Improvements and Repairs" with City of Yelm. Plat owner submits request to City for proposed items in agreement, along with estimated value. Final Plat Package (Items 1 - 3 above must be complete prior to application) Completed application form with appropriate documentation and fee. Make an appointment to submit your application - (360) 458-3835 11 copies of final plat map and 1 11X17 copy. (see Yelm Municipal Code 16.12.220- 16.12.280). Maps must be folded, rolled maps will not be accepted. Documents requiring recording must be formatted consistent with Thurston County requirements (attached.) City staff will check the required box for all documents that are applicable to the individual plat. Along with this list, staff will provide the applicant with approved sample documents. The applicant must submit the appropriate document(s) or the application will be considered incomplete. Documents /Lot Closures - 4 copies Plat Certificate, date not to exceed 30 days prior to submittal :~~IVarranty Agreement for all improvements Bills of Sale (water and sewer) Deferral Agreement - Waiver of Protest Storm Water Maintenance Agreement ter Rights Agreement Homeowners Agreement Summary of how all City Council conditions of approval and SEPA mitigation have been met. ~ID Segregation Applicatio Documentation of Well/Se ic/ rainfield Abandonment ~chool Mitigation Agreeme As-Builts f Latecomers Payment Open Space Fee City fees ~- Any additional items required per Final Plat Application Checklist R:~Forms & Procedures~Final Plat~Final Plat Process.dot Page 1 of 2 9/01 Upon staff's determination that the final plat application is complete, the information will be distributed to the reviewing departments. In approximately three weeks all comments and corrections will be returned to the project engineer for action. Following review and approval that the final plat conforms to all applicable regulations and the conditions of approval have been satisfied the plat will be forwarded to the Planning Commission for review and a recommendation to the City Council (YMC 16.12.300). After the City Council's receipt of the Planning Commission recommendation the Council will schedule the final plat for action at the next City Council meeting. Upon City Council approval, the Mayor will sign the final plat. Following the Mayor's signature the final plat will be signed by all required departments, and forwarded to Thurston County Auditor's Office for recording, as per YMC 16.12.320. As per YMC 16.04.150, the City of Yelm's policy is to issue one building permit (if available) after City Council approval and prior to recording of said plat. Latecomer agreements for water and/or sewer can be prepared and considered by the City after final plat approval. 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