The URL can be used to link to this page

Home My WebLink About16-17074 CITY OF ZEPHYRHILLS ' � 5335-8TH STREET (sis)�so-oozo 17074 BUILDING PERMIT SINGLE FAMILY RESIDENTIAL PERMIT INFORMATION LOCATION INFORMATION � Permit#:17074 Issued: 2/23/2016 Address: 6270 SILVERADO RANCH BLVD ' Permit Type: GENERAL BUILDING PERMIT ZEPHYRHILLS, FL. Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Sq. Feet: Est. Value: Book: Page: Cost: 644,792.10 Total Fees: 4,717.32 Subdivision: SILVERADO Amount Paid: 4,717.32 Date Paid: 2/23/2016 Parcel Number: 04-26-21-0010-03900-0000 CONTRACTOR INFORMATION OWNER INFORMATION Name: CORNERSTONE SOLUTIONS Name: DUNE FL LAND I SUB LLC Addr: 14620 BELLAMY BROTHERS BLVD Address: 2502 N ROCKY POINT DR STE 1050 DADE CITY FL 33525 TAMPA FL 33607-5995 Phone: (866)617-2235 Lic: Phone: 863-619-7103 Work Desc: CONSTRUCT CLUBHOUSE AMENITY CENTER 4,605 SQ FT � APPLICATION FEE$ � BUI DING FEE 2,097.56 E ECTRICAL FEE 214.43 PLUMBING FEE 296.70 I MECHANICAL FEE 207.69 FIRE PLAN REVIEW FEES 276.30 POLICE IMPACT FEE 750.62 I� FIRE IMPACT FEE 796.66 PUBLIC SAFETY 5% 77.36 �, , I � � � �� I 1� t ��-� �-'�� ?�-�c,��— Ins ections Re uired � FOOTER 2ND ROUGH P MB - INSULATION CE LI G FOOTER BOND DUCTS INSULATED SEWER MISC. ROUGH ELECTRIC LINTEL MISC MISC. 1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC. DUCTS INSTALLED WATER MISC DRIVEWAY PRE-SLAB SHEATHING MISC. MISC. CONSTRUCTION POLE FRAME MISC. MISC. REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the local government shall impose a fee of four times the amount of the feeimposed for the initial inspection or first reinspection,whichever is greater,for each such subsequent reinspection.REINSPECTION FEES: NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this properly that may be found in the public records of this county,,and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing,consult with your lender or an attorney before recording your notice of commencement." Complete Plans,Specifications and Must Accompany Application.All work shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. TRAC S SIGNATURE PERMIT OFFI PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER � o umn SQ. FEET PRICE MAIN OR LIVING: 4,605 $ 140.02 OTHER AREA UNDER ROOF: - $ 88.00 OTHER: - $ - VALUATION $ 644,792.10 , FEE SHEET $ 1,975.00 ADDRESS DRIVEWAY BUILDING: $ 2,014.50 ELECTRICAL: $ 444.38 PLUMBING: $ 296.25 MECHANICAL: $ 207.38 � SUB-TOTAL $ 2,962.50 TOTAL $ 2,962.50 SEW ER: WATER: IRRIGATION: $ - TOTAL: $ - WATER METER: IRRIGATION METER $ - FIRE DEPARTMENT FEES PLANS TOTAL: $ 276.30 INSPECTION TOTAL: PERMIT TOTAL TOTAL: $ 276.30 PUBLIC SAFETY IMPACT FEES POLICE $ 750.62 FIRE $ 796.66 5% $ 77.36 TOTAL: $ 1,624.64 SUB-TOTAL $ 4,863.44 PARK IMP'ACT FEES SIF'S: 100.0% $ - 1.0% $ - � TOTAL: $ - '� TIF'S: 99% $ - 1% $ - TOTAL: $ 4,863.44 � � ; I IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII illl lill . . I 2016007962 Pertnit No. Parcel ID No 04-26-21-0010-03900-0000 . i Rcpt:1741085 Rec: 10.00 NOTICE OF COMMENCEMENT DS: 0.00 IT: 0.00 State of Florida County ot Pasco 01/15/2016 L. K. , Dpty C 1 erk THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,and in accordance wi[h Chapter 713,Florida Statutes, the following infortnation is provided in this Notice of Commencement: 1 Descripuon of Property: Paroel Identification No. 04-26-21-0010-03900-0000 SVeetAddress: �f✓C.7•� J��i� �� y�L�,.b r Z-��1�N�l�S � �i�s'l 0 2. General Description of Improvement Amenity Center Club House,Pool and Hazdscape Features 3. Ovmer Information or Lessee infortnation if the Lessee contracted for the improvement• Silverado Community Development District Name �TAMPA FL 2502 N ROCKY POINT DR STE 1050 Address City ' State Interesl in Property: OWrtef PRULA S 0'NE IL,Ph D PRSCO CLERK & COMPTROLLEf Name of Fee Simple Tiueholder. � 01/15/2016 02:40 m 1 o f 1 (If ditferent from Ovmer listed above) _ \ OR BK �3�� PG ��5� Address City Stete a. conaaaor. Comerstone Solutions Group Name 14620 Bellamv Brothers Blvd Dade Cify R Address City State Contractors Telephone No.: 86�617-2235 3�� 5. Surety: Name i Address City State Amount of Bond: $ Telephone No.. 6. Lender Name Address City State - Lenders Telephone No.. 7 Persons within the State of Florida designated by the owner upon whom notices or other documents may be served as provided by Section 713.13(1)(aj(7),Florida Statutes: Name Address City State Telephone Number of Designated Person: 8. In addition to himself,the owner designates of_ to receive a copy of the Lienors Notice as provided in Section 713.73(1)(b),Florida Statu[es. Telephone Number of Person or Entity Designated by Owner 9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction and final payment lo the contractor,but will be one year from the date of recording unless a different date is specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFfER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITFI YOUR'LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT Under penalty of perjury,I declare that I have read lhe foregoing notice of commencement and that the facts stated therein are true to the best of my knowledge and belief. STATE OF FLORIDA '��ii��`� , /`� � COUNTY OF PASCO Signature of Owner or Lessee,or Owner's or Lessee's Author¢ed Office�r/Di�rectorlPartner/Mana�ger f _ l//(�ili�/1��/I /.1ay� �� ✓'�I�Pr`r/cJ�/`✓ . Signatory's Title/Office � � The foregoing insWmenl was acknowled�d�i�,�erfore me this�ay ofy�(�y20�by � 1.1�-�t� 1 Q�l �I�LW� � ' nas l�'V%1.l�,�4�1 � (type of authority,e.g.,officer,Wstee,attomey in fact)for U �l:J � (nam of ar(y on behalf of whom instrument was executed). Personally Kno � R Produced Identification❑ Notary Signature n^,� Type of Identficalfon Produced Name(Print) VLv� ►�w l�'t'"Y��'��,�- fFiECl�4 ° iVI00tVEY 4s��.�i�► MY COMMISSION#FF153818 ""'?o�� EXPIW�S August 24,2018 (407)388•0163 FlbfldaNOttl 9gry�Ce.com wpdata/bcslnoticecommencemenl�c0530 • ��ac��, ° � � ' ��p� STAT�OF Fl�ORI4�A,COU�JTY OF PA�CO � � ' �� THIS IS TO CERTiFY THAT TNE FOREGOING IS A � TRUE P,ND CORRECT COPY OF THE DOCUMENT � ; � ON FILE OR OF PUBLIC RECORD IN THIS OFFICE � � fn�oitive�rw�r s WITNES MY HAND AND O�FICIA,L SEALTHIyS s°'� � � �DAY OF " G'�� . �'� ' PAULA S.O'NEIL, LERK&CO PTROLLER t�� BY �- D�PUTY CLERK ��`��,��„O�`o� , � � � � ADDRESSING DEPARTMENT GIS /ADDRESSING �: __ PASCO COUNTY GOVT. CENTER , � 8731 CITIZENS DRIVE, SUITE 310 � � NEW PORT RICHEY, FL 34654 • � ,' Phone: (727) 815-7154 http://pascocou ntyfl.net/ January 11, 2016 Welcome from the Pasco County Addressing Staff, Please be advised that the following address has been assigned: Address Number/Roadway Name: 6270 Silverado Ranch Blvd. Zephyrhills, FL 33541 Parcel: 04 26 21 0010 03900 0000 **PLEASE NOTE: IF THIS ADDRESS IS FOR A CORNER LOT, OR IF THE SITE PLAN CHANGES AT A LATER DATE, THE ADDRESS IS SUBJECT TO CHANGE. IT IS YOUR RESPONSIBILITY TO PROVIDE ADDITIONAL COPIES OF THIS RECEIPT � WHEN NECESSARY. If you have any questions regarding your address, please feel free to contact me at: (727) 815-7154. Sincerely, �a�tc �iUa� Pam Walton Addressing/GIS Analyst ,s�e: . . _�:��:�� %o�� i1�o� Cornerstone� Construction Division 14620 Bellamy Brothers Boulevard Dade City,Florida 33525 (866)617-2235 fax(866)929-6998 www.cornerstonesolutionsgroup.com August 3,2015 City of Zephyrhills Building Department 5335 8�' Street Zephyrhills, FL 33542 RE: Contractor Certificate Requirement Authorizations Please be advised that I, Eric Meister, President of Hardscapes 2, Inc. hereby authorizes the following employees to sign/pick up permits: Mark Whitaker B. Shane Byrd John Steele If you have any questions regarding this authorization,please let me know. Thank you, Eric eister President Hardscapes 2, Inc. d/b/a Cornerstone Solutions Group 14620 Bellamy Brothers Blvd. Dade City, FL 33525 emeister(cr�,cornerstonesolutions�rou�.com Phone: 866.617.2235 Fax: 866-929-6998 � �B' � ' ' • • - • � • - n �' •- • .�- • ' • �- •" •� • ' ' ' • • ' • � ' ' • �0' ' ' � 0� • ' ��' 0 �O dU�4 • � a�aaso-oozo City of Zephyrhills Permit Application Fax-813-780-0021 Building Department f Date Received phone Contact for Permittin 866 617 -- 2235 Owner's Name MetfO D2V210 ment Grou Owner Phone Number �813)288-8078 Owner's Address 2502 North Rocky Point Dr.,Suite 1050,Tampa,FL 33607 Owner Phone Number Fee Simple Titleholder Name DUNE FL LAND I SUB LLC Owner Phone Number Fee Simple Titleholder Address 2502 N ROCKY POINT DR STE 1050,TAMPA FL 33607-5995 JOB ADDRESS 6270 Siiverado Ranch Blvd.Zephyrhiils,FL 33541 LOT# � SUBDIVISION Silverado PARCEL ID# 04-26-21-0010-03900-0000 (OBTAINED FROM PROPERTY TAX NOTiCE) WORK PROPOSED e NEW CONSTR e ADD/ALT � SIGN � � DEMOLISH INSTALL REPAIR PROPOSED USE 0 SFR � COMM 0 OTHER TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL � Amenity Center Club H DESCRIPTION OF WORK BUILDING SIZE Single Story SQ FOOTAG 4,605 HEIGHT 37�-3° TT'TIT1�1"7TT1"TTrTI'7T9Tr TTrTrTriTTrl"ITTITrr'7TrrlTrr �BUILDING $ 600,000 VALUATION OF TOTAL CONSTRUCTION DELECTRICAL $ 90,000 AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. OPLUMBING $ 30,000 n /�/ ' �� V � �MECHANICAL $ 60,000 VALUATION OF MECHANICAL INSTALLATION � �GAS � ROOFING Q SPECIALTY � OTHER V FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO � � -�F-�F-F-HI--F�1--f--F-1�-�1--��E-�--E-1�-�1--F�1--1-�F-F-1-1-1--�1--i--1-1--1-f-a--f-1--F�1--�1--��1--i--F-�-�--F-f--1-H�1--1-�1--FI--�� BUILDER —" /J COMPANY Cornerstone Solutions Group SIGNATURE „/ REGISTERED Y/ N FEE CURREN Y/N Address 14 0 ellamy Bros. Blvd, Dade City, FL 33525 License# CGC1515492 ELECTRICIAN �'�V COMPANY Mand Electric Inc. SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address 1809 Bella Largo Lane. Tampa FL 33618 License# EC13004396 PLUMBER �! _ /f COMPANY Alpine Plumbing SIGNATURE .7i�s� REGISTERED Y/ N FEE CURREN Y/N Address 8 13 Gunn Highway. Odessa FL 33556 �icense# CFC57035 MECHANICAL , � COMPANY One Stop Cooling&Heating SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address 72 5 Sandcove Ct. Ste# 1 Winter Park FL 32792 L.icense# CAC032444 OTHER COMPANY SIGNATURE REGISTERED Y/ N FEE CURREN Y/N Address License# IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIt11111111ttI11111111111ttI111 RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects COMMERCIAL Attach(3)compiete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster Site Work Permit for all new projects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. ****PROPERTY SURVEY required for all NEW construction. ..{-i-1..��..{-�f--��-f-1-1..�1-{..1..1-1--�4a-1-1..1..1-1..4-1--4�-1-��1..�1..1-�1..4�.1--�f--�1-1--1-i-f�-��1..�1..1-�1..4�1..{-{..��1.. Directions: Fill out application completely Owner&Contractor sign back of application,notarized if over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) " Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs if shingies Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) Driveways-Not over Counter if on public roadways..needs ROW NOTICE OF DEED RES?R1CT10NS: The undersigned understands fhat this permit may be subject�to"deed"restrictians" which may be more restrictive than Caunty regulatians. The undersigned assumes responsibility for campliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIEB: If the owner has hired a contractor or corttractors to undertake work, they may be required to be ficensed in accordance with state and locaf regulations. If the contractor is not (icensed as required by (aw, both the awner and cantractar may be cited for a misdemeanor vialation under state law If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact#he Pasco Cotanty Building Inspection Division—Licensing Section at 727-847- 8009 Furthermare, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portians of the "cantractor Block° of this application for which they will be responsibfe. !f you, as the awner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPCtRTATt�N tMPACTIUTILITIES IMPACT AtVD RESQURCE RECQVERY FEES: The undersigned understands that Transportation impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasca County Ordinsnce number 89-07 and 90-0'7, as amended. The undersigned also understands, that such fees, as may be due, wi[I be identified at the time of permitting It is further understaod that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "cerEificate af occupancy° or fina! power release lf the project does not invalve a cer[ificate af occupancy or final power release, the fees must be paid prior to permit issuance Furthermore, if Pasco County Water/Sewer Impact fees are due,they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CUNSTRUCTION LIEN LAW{Chapter 713, Florida Statutes, as amended}: If valuation of work is$2,500.00 or rttore, f certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien L.aw—Homeowner's Protection Guide" prepared by the Florida Department af Agriculture and Consumer Affairs. If the applicant is someone other than the"owner", f certify that ( have obtained a copy of the above described document and promise in good faith to deliver it to the"owner" prior to commencement. CONTRACTdR'S/OWNER'S AFFIDAVtT. I eertify thaf a11 the information in this applicatian is accurate and that al[wark will be done in compliance with all applicable laws regulating canstruction, zvning and land development. Applicatian is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that a(( work wili be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. ! also certify that I understand #hat the regulations of other government agencies may apply ta the in#ended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to• - Department of Ertviranmenta! Frotection-Cypress Bayheads, Wetland Areas and Environmentaily Sensitive Lands,Water/Wastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. � - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. - Qepartment af Health & Rehabilitative Services/Environmental F4eafth Unit-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. - Federal Aviation Autharity-Runways. I understand that the follawing restrictions apply to the use of fill. - Use of fil! is not allowed in Flood Zone"V" unfess expressly permitted - 1f the fiil materiai is fo be used in Flood Zone "A", if is understood that a drainage plan addressing a "compensating volume" will be submi#ted a# time of permitting which is prepared by a professional engineer licensed by the State of Florida. - If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that filf will be used only to fi!!the area within the stem wall - if fll material is to be used in any area, I certify that use of such ftll wii( not adverse(y affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditians af the building permit issued under the attached permit app[icatian, far lats less than one {1} acre which are elevated by fill, an engineered drainage plan is required. If I am the AGEN7 FOR THE OWNER, ! promise in good faith to inform the owner of the permitting conditions set farth in this affidavit prior to commencing construction. I understand that a separate permit rrray be required for electrical work, plumbing, signs, wells, pools, air canditioning, gas, or other installatians not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and no#as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official fram thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued sha{{ become invalid unless the worK authorized by such permit is cammenced within six months af permit issuance, or if work authorized by the permit is suspended ar abandoned for a period of six(6) months after the time the work is commenced. An extension may be requestec4, in writing, fram the Building Official for a period not to exceed ninety {90} days and wi11 demanstrate justifiable cause for fhe extension If work ceases for ninety(90) consecutive days, the job is considered abandoned. 1NARNING TO OWNER: YOUR FAiLURE TO RECORD A NOTtCE OF COMMENCEMENT MAY RESll�T IN Yt)UR PAYING TWICE FOR IMPROVEMENTS TfJ YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTC}RNEY BEFORE RECORDING Yt�UR Nt?TtCE QF COMMENCEMENT. FLORIDA JURAT(F.S.117.03 OWAIER OR AGEt+i�' � GON3RAGT .,,r� � Subscribed and swor � _ 'ed before me this Subscrihed an • o Grc7 t 4�""t�fra � e�t3�e�ore me this 1 2/3/16 by 2/3/16 by Gran Parra I Who islare personally known to me or haslhave produced Who isJare personaily known to me or haslhave produced as idenfificatian. as identifcatian. � � � ��L Notary Public �r� Notary Public G mmission No. Ca mission No. Name of tJatary typed,printed or sfamped Name of Notary typed,prinfed ar stamped � �q� `,`�„'�Y� <4RY:yg�, MARlE RENEE RENO �,A�e:%$-, MARIE RENEE RENQ ;�?� ,�-. :Ar �- Commission#FF 176i86 � �,,. �� Commission#FF 176186 ;�. ,. Expires November 27,2018 :�,�,�a; Expires November 27,2018 ;�e,.H ,+ Q.� ��F f�,.� BSndsdShrui�n Faininautance8o0.385•7049 �%�o��°.+� 8lrrdeG Ttw Tra�Fain inevsanca 860.385d0i9 � �• Y / ' City of Zephyrhills BUILDING PLAN REVIEW CONIMENTS ,\ Contractor/Homeowner: ��1�� \� CJ�" �— �\' Date Received: L� � Site: /�/�,�`��C't`��s�� Permit Type: ' / _ - � Approved w/no comments:❑ Approved w/the below comments: ❑ Denied w/the below comxnents: ❑ This comment sheet shall be kept with the perniit and/or plans. B' – Date Contractor and/or Homeowner �}- � �,e d j`�zz��, (Required when comments are present) �.v, �-z�- P1� . . 6270 Silverado Ranch Blvd-Clubhouse Center 4,605 sq ft- Cornerstone Solution Contractor o umn SQ. FEET PRICE MAIN OR LIVING: 4,605 $ 140.02 OTHER AREA UNDER ROOF: - $ 88.00 OTHER: - $ - VALUATION $ 644,792.10 FEE SHEET $ 1,978.00 ADDRESS $ 40.00 DRIVEWAY $ 40.00 BUILDING: $ 2,097.56 ELECTRICAL: $ 214.43 PLUMBING: $ 296.70 MECHANICAL: $ 207.69 SUB-TOTAL $ 2,816.38 TOTAL $ 2,876.38 SEWER: county WATER: county IRRIGATION: $ - TOTAL: $ - WATER METER: county IRRIGATION METER $ - FIRE DEPARTMENT FEES PLANS TOTAL: $ 276.30 � INSPECTION TOTAL: PERMIT TOTAL TOTAL: $ 276.30 PUBLIC SAFETY IMPACT FEES POLICE $ 750.62 FIRE $ 796.66 5% $ 77.36 TOTAL: $ 1,624.64 SUB-TOTAL $ 4,717.32 PARK IMPACT FEES n/a SIF'S: n/a 100.0% $ - 1.0°/a $ - TOTAL: $ - T I F'S: n/a 99% $ - 1% $ - TOTAL: $ 4,717.32 '� 1 l I . ' ��aeo�Ecr�oil:��`��`=�- NOTICE OF INTENT ��o� �� - TO USE �� ' "'` �� NPDES GENERIC PERMIT FOR STORMWATER � �� F�OR AI� DISCHARGE FROM LARGE AND SMALL �_ _ _ _ _ _ _ _ _ _ _ _ `_ _ _ _ . CONSTRUCTION ACTIVITIES (RULE 62-621.300(4), F.A.C.) You must submit this completed Notice of Intent(NOI)form to the Department to get coverage under the Generic Permit for Stormwater Discharge from Large and Small Construction Activities provided in subsection 62-621.300(4), F.A.C. The Generic Permit document[DEP Document 62-621.300(4)(a)]tells you what construction activity qualifies for coverage,how you obtain and terminate coverage,what you must do to minimize pollution from your construction site,and what conditions apply to your project to use the generic permit. You must submit the appropriate generic permit fee, as specified in paragraph 62-4.050(4)(d),F.A.C.,with this NOI Form to obtain permit coverage. You must read and understand the requirements of the generic permit document and the attached instructions before completing this NOI form. Please print or type information in the appropriate areas below. For construction activities also requiring an Individual Environmental Resource Permit (ERP), under Chapter 62- 330,F.A.C.: If your construction activities are already authorized by a valid Individual ERP issued by the Denartment,Water Mana�ement District or a Delegated Local Government, you may also elect to use this NOI form to provide the required notice of commencement of construction, in lieu of Form 62-330.350(1) ("Construction Commencement Notice"). Do you wish to also provide notice of commencement of construction activities authorized under an Individual ERP permit through the use of this form? ❑Yes ❑No I. IDENTIFICATION NUMBER: A.Facility ID(if renewing coverage): FLR20AK26-002 B.ERP Permit Number*(if applicable): C.ERP Permitting Agency(if applicable): *If the ERP permit authorizes phased construction,please also indicate which phase. I II. STORMWATER POLLUTION PREVENTION PLAN(SWPPP)DEVELOPED AND READY TO BE IMPLEMENTED: �Yes ❑No *If No,you mav not submit your NOI at this time. III. APPLICANT INFORMATION: A. Operator Name: The Keamey Companies *ERP Permittee Name(if different than"Operator"),if applicable: B.Operator Status: p C.Address: 9625 Wes Kearney Way D.City: Riverview E.State: FL F.Zip Code: 33578 0506 G.Responsible Authority: Brian Seeger Page 1 of 6 DEP Form 62-621300(4)(b) � Effective Date: 02/10/2015 . � , . H.Responsible Authority's Phone No.: (813)927-2006 , I.Responsible Authority's Fax No.: II J.Responsible Authority's E-mail Address: seeger@thekearneycompanies.com ! N. PROJECT/STTE LOCATION INFORMATION: A.ProjectName: Siiverado Ranch Subdivision Phases 2,3&4 B.Project Address/Location: Eiland Blvd&Silverado Ranch Blvd C.City: Zephyrhills D.State: FL E.Zip Code: 33541 F.County: Pasco G.Latitude: 28 ° 14 ' 56 " Longitude: -8 ° 13 ' 7 " H.Is the site located on Indian Country Lands? ❑Yes 0 No I.Water Management District: SWFWMD J.Project Contact:Brian Seeger K.Project Contact's Phone No.: (813)379-3830 L.Project Contact's Fax No.: (813)421-8022 M.Project Contact's E-mail Address: seeger@thekearneycompanies.com N.Additional E-mail correspondence,optional: SSpurlock@thekearneycompanies.com V. PROJECT/SITE ACTNITY INFORMATION: A.Indicate whether the �i Large Construction(Project will disturb 5 or more acres of land,Fee$400) project is Large or Small Construction(check only � Small Construction(Project will disturb between 1 and 4.99 acres of land,Fee$250) one): B Approximate total area of land disturbance from commencement through completion of construction: 44•2$ acres C.SWPPP Location: � ❑Address in Part III above ❑� Address in Part IV above ❑ Other address(specify below) D.SWPPP Address: E.City: F.State: G.Zip Code: H.Construction Period: I Start Date: 04/27/2016 Completion Date: 10/31/2016 VI. DEWATERING INFORMATION: A. Will dewatering operations be performed as part of the construction activities? ❑ No ❑ Yes - If yes,com lete below.If no,ski this art and go to Part VII. B. Is the project site currently identified as contaminated,or is there a site within 500 feet of the dewatering project identified as contaminated by a DEP or EPA cleanup/restoration program?You may use the Quick Link to DEP's Contamination Locator Map(CLM)and DEP's Institutional Controls Registry(ICR)Web Viewer to determine cleanup restoration status.You may access the CLM at:http://weba s.de .state.fl.us/DepClnu /welcome.do or Page 2 of 6 DEP Form 62-621300(4)(b) Effective Date: 02/10/2015 � . http://ca.dep.state.fl.us/mapdirect/?focus=contamlocator.The ICR may be accessed at: http://www.dep.state.fl.us/waste/categories/brownfields/pages/ICR.htm,or http://ca.dep.state.fl.us/mapdirecd?focus=icr ❑ YES Continue to VI.C,below. ❑ NO Continue to Part VII. C. Has the site been remediated? ❑ YES Continue to Part VII. ❑ NO Continue to VI.D,below. D. Are the pollutants of concern(i.e.contamination)present in ground water at the dewatering project site at concentrations equal to or exceeding the surface water criteria in Rule 62-302.530? ❑ YES Dewatering activities do not qualify for coverage under this generic permit. However,the site may qualify for coverage under Rule 62-621.300(1),F.A.C.,or under an individual wastewater permit on the appropriate form listed in Rule 62-620.910,F.A.C. ❑NO Continue to Part VII. VII. DISCHARGE INFORMATION: A.MS4 Operator Name(if applicable): B.Receiving WaterName: HILLSBOROUGH RIVER V III.CERTI FICATI ON 1: , I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system or those persons directly responsible for gathering the information,the information submitted is,to the best of my knowledge and belief,true,accurate and complete. I am aware that there are significant penalties for submitting false information,including the possibility of fine and imprisonment for knowing violations. If providing notice of commencement of construction as required by an Individual Environmental Resource Permit,I also certify that I am authorized by the Permittee(identified in Part III.A.,above),to commence construction activities authorized by the ERP Permit(identified in Part I.B.,above). Responsible Authority Name and Official Title(Type or Print): Brian Seeger,Senior Project Manager 3i'�a,y�i$pec�p,Y April 25,2016 Responsible Authority Signature: Date Signed: � � Signatory requirements are contained in Rule 62-620.305,F.A.C. Page 3 of 6 DEP Form 62-621300(4)(b) Effective Date: 02/10/2015 r � • ' INSTRUCTIONS—DEP FORM 62-621.300(4)(b) NOTICE OF INTENT(NOI)TO USE GENERIC PERMIT FOR STORMWATER DISCHARGE FROM LARGE AND SMALL CONSTRUCTION ACTNITIES Who Must File an NOI: You must file the NOI and obtain coverage under the Construction Generic Permit if you discharge stormwater associated with large or small construction activities to surface waters of the State,including through a Municipal Separate Storm Sewer System(MS4),http://www.dep.state.fl.us/water/stormwater/npdes/docs/all_ms4_by_county.pdf. Where to File NOI: The Department encourages the electronic submission of NOIs using the Deparhnent's Interactive Notice of Intent(iNOI) available at http://www.fldepportal.com/go/. NOIs also may be submitted by paper copy to the following address: NPDES Stormwater Notices Center,MS#3585 Florida Department of Environmental Protection 2600 Blair Stone Road Tallahassee,Florida 32399-2400 Permit Fee: Permit fees for large and small construction activities to be covered under the generic permit are specified in paragraph 62- 4.050(4)(d),F.A.C.and available on our http://www.dep.state.fl.us/water/stormwater/npdes/fees.htm. You must submit the appropriate generic permit fee(either for large 5+acres$400 or small 1-4.99 acres$250 construction activities)with the completed NOI to obtain coverage under the generic permit. Generic permit coverage will not be granted without payment of the appropriate permit fee. If the NOI is submitted electronically,the permit fee must be paid on-line by credit card or check. If the NOI is submitted using a paper copy,the permit fee must be paid by either check or money order made payable to. "Florida Department of Environmental Protection". Part I—Identification Number: If you are renewing coverage,please enter the project's DEP identification number(generic permit coverage number)if known. If this is a new project without an ID number then leave this item blank.If you know your ERP Permit Number or ERP Permitting Agency(if applicable)please identify it here,if not then leave these items blank. Part II—Stormwater Pollution Prevention Plan(SWPPP)Completed: Check the box to indicate whether you have completed your Stormwater Pollution Prevention Plan. You must complete your SWPPP and be ready to implement it before submitting your NOI. Part III—Applicant Information: Item A.: Provide the legal name of the person,firm,contractor,public organization or other legal entity that owns or operates the construction activity described in this NOI. The operator is the legal entity that has authority to control those activities at the project necessary to ensure compliance with the terms and conditions of the generic permit. Item B.: Enter the appropriate one letter code from the list below to indicate the legal status of the operator: F=Federal;S=State;P=Private;M=Public(other than federal or state);O=Other Items C.—F.: Provide the complete mailing address of the operator,including city,state and zip code. Page 4 of 6 DEP Form 62-621300(4)(b) Effective Date: 02/10/2015 � � . � Items G.—J.: Provide the name,telephone and fax number(including area code)and E-mail address of the person authorized to submit this NOI on behalf of the operator(e.g.,Jane Smith,President of Smith Construction Company on behalf of the operator,Smith Construction Company;John Doe,Public Works Director on behalf of the operator,City of Townsville;etc.). This should be the same person as indicated in the certification in Part VI. Part IV—Project/Site Location Information: Items A.—E.: Enter the official or legal name and complete street address,including city,state and zip code of the project. Do not provide a P.O.Box number as the street address. If it lacks a street address,describe the project site location(e.g., intersection of State Road 1 and Smith Street). Item F.: Enter the county in which the project is located. Item G.: Enter the latitude and longitude,in degrees-minutes-seconds format,of the approximate center of the project. Item H.: Indicate whether the project is located on Indian Country Lands. If the project is located on Indian Lands you may not use this generic permit. Instead,you must apply to the http://cfpub.epa.gov/npdes/stormwater/const.cfin(EPA)for coverage. Item I.: Enter the appropriate five or six letter code from the list below to indicate the http://www.dep.state.fl.us/secretary/watman/default.htm in which your project is located: NWFWIVID=Northwest Florida Water Management District SRWMD = Suwannee River Water Management District SFWMD = South Florida Water Management District SWFWMD =Southwest Florida Water Management District SJRWMD =St.John's River Water Management District Items J.—M.: Enter the name,telephone and fax number(including area code)and E-mail address of the project contact person. The project contact is the person who is thoroughly familiar with the project,the facts reported in this NOI and who can be contacted by the Department if necessary. Item N.:Enter additional E-mail correspondence as needed to receive permit related documentation. (Optional) Part V—Project/Site Activity Information: Item A.:Check the appropriate box to indicate whether the project involves large construction activity or small construction activity. Check one box only. "Large Construction Activity"means construction activity resulting in the disturbance of five(5)or more acres of total land area. Large construction activity also includes the disturbance of less than five acres of total land area that is part of a larger common plan of development or sale such as a subdivision that will ultimately disturb five acres or more. "Small Construction Activity"means construction activity resulting in the disturbance of equal to or greater than one(1) acre and less than five(5)acres of total land area. Small construction activity also includes the disturbance of less than one acre of total land area that is part of a larger common plan of development or sale that will ultimately disturb equal to or greater than one acre and less than five acres. Item B.:Provide the approacimate total area of land disturbance,in acres,that the project will involve from commencement of construction through completion: Items C.-G.: Indicate the location where the Stormwater Pollution Prevention Plan(SWPPP)can be viewed. Provide the address where the SWPPP can be viewed if other than as provided in Parts II or III of the NOI. Note that to be eligible for coverage under the generic permit,the SWPPP must have been prepared prior to filing this NOI. Item H.: Enter the estimated construction start and completion dates in the MM/DD/YY format. Page 5 of 6 DEP Form 62-621300(4)(b) Effective Date: 02/10/2015 The Kea�ney Cornpan�es, �.�C, S'l"�1��161�1fATEl� POLLUTlO� PRE1/E�T�O� P�Q1� , IA1Sf'ECTION i DA7'E: � ,`�..� � INSP6CT,E'DBY; �� ,��-�.�'��,�,,... � PROJECT: ��...l,J _�1 ,'f�� \i.f�1,��c,�� . WFATHEl2: � �l��`�, `w 4 (Vote:An inspection mast be conducted wifhin forty-eight(48)hours of '!2"or greater rain evenf i�umber of Days Since Last Rainfali — � ArYtount of Last Rainfai[ --�—� lncttes ' � A-STORM WA7ER POLLUTION PREVENTION PLAN ,,...�� 1 Does fhe project have an appra Permi? Yes.,�.-{�do) If No Con�acfed l � �'��,��";�°�to secure copy ofi permit. ��+�� 2 Is the erosion and sediment contro[system installed as shown the approved plan"". (Yes o) If�io What steps need to be taken to correct the condition? 3 Is erosion being controlled on the s'ite?��o) , If Pdo What problems were noted? What steps were taken to correct the situation? ,,-.�..�--�� 4 Is sediment being contained on the"sifie�(Yes�!(No) If No What problems were noted? What steps were taken to correct the situafion? 5 ls the potential for•turhidty in adjacent streams/wet[ands minimiz d?�}1 0} !f fVo What problems were noted? � What steps were taken to correct the situation? Recommended Changes to the SWPPP: Reason for Changes: B-INSPECT30N�F INSTALLEb FACILITIES � Silt Fence _� No Action Required,_Requires Repair,_Requires Replacert�ent Location(s) 2 Sediment Basins � 1Vo Action Required,_Requires Repair,_Requires Replacement Location(s) 3 Check Dams � No Action Required,�f2equires Repair,,_,.Requires Replacement � Location(s) � 4 Dewatering ,_,No Action Required,_Requires Repair,,_Requires Replacement Location(s) 5 Other �No Action Required,_Requires Repair,,,,,`Requires Replacement Location(s) ..�.� ""°yz�' � �� i'��1 ��..��'�, �� / ��`"�� Signatura/Date � �"`� i � - I I °V'�� I��°uv��q ��a��uvu��, �.B��d ��'�ff��d �A"9"�� 1L1L4.D�'��6� ��[�II�91i°Q�h� �1L�aG�i ➢�➢S��'��1 DATE: pl�a INSPECTED 6Y: U �1`� ��`��.� �_ I PROJECT; �'j��.�� WEATNER: �� iVote:An inspecfion must be conducfed within forty-eight(48)hours of '12"or greater rain evenY Number of Days Since Last Rainfall ��Amount of Las4 Rainfall � Inches � A-STORfIIi WA7ER POLLUTIQI�PREV�AI'FI09�PLAP� 1 Does the project ha�e an approved Permif? es)1 0) If No Contacted to secure copy of permit. 2 Is the erosion and sediment control system installed as shown on the approved plans? es)/ o) If P�o What steps need to be taken to correct the candition? 3 !s erosion 6eing controlled on fhe si e? es) o) If No What ptoblems were noted? What sfeps were taken to correct the situation? � Is sediment being contained on the�'site� es)1 0) If No What problems were note What steps were taken to correct the situation? � 5 Is'the potenfial for•turbidty in adjacent streamslweflands minimized (Yes (No) It t�o What problems were noted? . What steps were taken to correct the situation? Recommended Changes to the SWPPP: Reason for Changes: B-fNSP�C7[OPV OP INSTALLED FACILITIES 1 Silt Fence �I�to Action Required,_Requires Repair,�Requires f2eplacement Location(s) 2 Sediment Basins • o Action Required,_Rsquires Repair,_Requires Replacement Location(s) 3 Check Aams No Action Required,,_,Requires Repair,_Requires Replacement Location(s) 4 Dewafering ,_,No Action Required,,_,Requires Repair,_Requires Replacemenf Location(s) 5 Ofher � o AcEion Required,_Requires Repair,^Requires Replacement L.ocation(s) 1 C S -C. 1 2,� ��+�/ Signature/Date 7f'�� I��a�u��y c��ae�s, .�.Q..�a �1C��B �@9�a�'��t ��I�'Q4�9 ��➢�6� �1��a� � ➢P�SB��`�� D.4TE: �/ INSPECTED BY: t �. - "' S l ✓ PROJECT: _�i�,t�6�,�} � WF.l1THER: ��. C' Nofe:An inspection musf be conducted within forty-eight(48)hours of '/z"or greafer rain evenf I�umbet'of Days Since Last Rainfall ' �L Amoun4 of Last Rairtfall lnches ' A-STORNI WATER POLLUTIOhI PREVENTION PLAN �� 4 Does the project have an approved ermif_ s}1 ") if No Contacted S #o secure copy of permit. 2 ls the erosion and sediment controi sysfem installed as shown on the approveci plans (Ye— s_} o) [f f�o What steps need to be taken to correct fhe condition? 3 Is erosion being controlled on the site?�(?�.1�(f�°) lf No What problems were noted? What steps were taken to correct the situation? 4 Is sediment being contained on fhe site (Yes / o) If No Whaf problems were noted? ' What steps were taken to correctthe situation? r� 5 Is fihe goten#ia!for•turhidty in adjacenfi streamslwetlands minim'ize?{Yes)! o) lf No What probfems were noted? What steps were taken to correct the sifuation? � Recommended Changes to the SWPPP: Reason for Changes: B-1N5PECTfON OF If�STALLEp FACIL.I7iES 1 Siit Fence �No Action Required,_Requires Repair,JRequires F2eplacement Location(s) 2 Sediment Basins No Action Required,_Rsquires Repair,�Requires Replacement Location(s) 3 Check Dams ✓No Action Required,_Requires Repair,_Requires Replacement Lacafion(s) 4 Qewatering �'i�lo Action Required,_Requires Ftepair,,_,Requires Replacemenf Location(s) � 5 Other _No Action Required,uFtequires Repair,�Requires Replacement Location(s} F � -. � �-�c � � 2. Signature 1 Date( ' t _ _ � . - �'I�e f��r��y ��uv�p��u�u��, L��o ��'��➢ ��'�� I��V� ��1�9�� p�Q� OV��f��9 )ATE: �� , %� INSPECTED BY.• �E� �� ROJECT: ��r�d� ' WEATHER: �� dote:An inspection musfi be conducted within forty-eight(48)hours of '/Z'or greater rain evenfi dumber of Days Since Last Rainfal( �fa'/.� Amount of Last Rainfail �� Inches �-STORM WATER POLLUTIOP!PREVEf�TION PLAf� 1 Does the project have an approved Permit (Yes (f�o) If iVo Contacted to secure copy of permit. 2 Is the erosion and sediment control sysfem installed as shown on the approved plans? Yes (No) If No What steps need to be taken to correct the condition? 3 Is erosion being controlled on the site? es /(i�o) if No What problems were noted? What steps were taken to correct the situation? , 4 Is sediment being contained on the si4e?(Yes (No) � ' if No What problems were noted? What steps were taken to correct the situation? 5 Is the potential fior turbidty in adjacent streams/wefilands minimized? Yes !(No) Ifi No What problems were noted? What steps were taken to correct the situation? Recommended Changes to the SWPPP: Reason for Changes: B-Ii�SPECTIOt�OF INSTALLED FACILITIES 1 Silt Fence �Action Required,_Requires Repair,_Requires Replacement Location(s) ' 2 Sediment Basins ' No Action Required,_Requires Repair,_Requires Replacement Location(s) 3 Check Dams No Action Required,_Requires Repair,`Requires Replacement Location(s) 4 Dewatering _No Action Required;_Requires Repair,_Requires Replacement Location(s) 5 Other ' No Action Required,_Requires Repair,_Requires Replacement Location(s) �..�._--_.._.. -� r�..�� , �-/� �.� ., �� Signatur Date � `�0�� I��uv�y ��u�p��u�u��, �.��a �°��f�� FG�A'�'�6� f��,�.�`�0�1� pl��`�DOo�� G'L�G�� D��G��V� �,m_�.,� 7ATE: , ��'" ��' lIVSPECTED BY: ,=��''�'� � `��"� �ROJECT: s:/t/�e�''•d�'� WEATMER: %!�� I �lote:An inspection must be conducted within forty-eight(48)hours of '/z' or greater rain event �lumber of Days Since Last Rainfall �`� Amount of Las�Rainfall �� Inches 4-STORM WATER POLLU'flOfV PREVE�ITIOfV PLA�I 1 Does the project have an approved Permi (Yes)/(f�o) If No Contacted to secure copy of permit. 2 Is the erosion and sediment control system insfialled as shown on fhe approved plans? Ye�(No) if No What steps need to be taken to correct the condition? 3 Is erosion being controlled on fihe site (Yes /(i�o) If No What problems were note ? What steps were taken to correct the situation? , 4 Is sediment being contained on fihe site (Ye /(No) If No What problems were noted? Wliat steps were taken to correct the situation? 5 Is the potential for fiurbidty in adjacent streams/wetlands minimized (Yes) �(No) If�lo What problems were noted? What steps were taken to correct the situation? Recommended Changes to fihe SWPPP: Reason for Changes: B-I�ISPECTIOi�OF IIVSTALLED FACILITIES 1 Silt Fence a' No Action Required,_Requires Repair,_Requires Replacement Location(s) 2 Sedimenfi Basins �o Action Required,_Requires Repair,_Requires Replacement Location(s) 3 Check Dams � No Action Required,_Requires Repair,_Requires Replacement Location(s) 4 Dewatering �Action Required,_Requires Repair,_Requires Replacement Location(s) 5 Other �No Action Required,_Requires Repair,_Requires Replacement Location(s) �� ..�._. �..� I �1��' Si� natur /Da�e . �'f�e ��a�u��y ��u�p��u��9 L�L�o ��`�� `�� f��I�I�M`PO��! f�f�C�%L�`I�DOo� pI�Q� , D��G��`0�� 7ATE: � �� INSPECTED BY: /��. ��' I 'ROJECT: �`f�er/�t�� WE,�THER: �/�74�y I �ote:An inspection must be conducfied wifihin forty-eight(48) hours of '/2'or greafier rain event / �lumber of Aays Since Last Rainfal( ��.4 Amount of Last F2ainfall � Inches i 4-STORM WATER POLLUTION PREVEf�TIO1V PLA�I 1 Does the project have an approved Permit? es) (No) - If No Contacted to secure copy of permit. 2 Is the erosion and sediment control sysfiem installed as shown on fhe approved plans? es) (No} If No What steps need to be taken to correct the condition? 3 Is erosion being controlled on fihe site? �1(i�o) If iVo What problems were noted? ' What steps were taken to correct the situation? . 4 Is sediment being contained on the site. (Yes /(i�o) If fVo What problems were noted? , What steps were taken to correct the situation? 5 Is the pofienfiial for turbidty in adjacent streamslwe4lands minimized (Yes) o} Ifi No What problems were noted? What steps were taken to correct the situation? ' Recommended Changes to the SWPPP: � Reason for Changes: B-INSPECTION OF INSTALLED FACILITIES 1 Silt Fence _No Action Required,�' Requires Repair,_Requires Replacement Location(s) �'�e.,o�6rs Nvga�L�.4 �s+s ��9�� r�o�✓�°� 2 Sedimenfi Basins No Action Required,_Requires Repair,_Requires Replacement Location(s) 3 Check Dams �' No Action Required,_Requires Repair,_Requires Replacement Location(s) 4 Dewatering _No Action Required,_Requires Repair,_Requires Replacement Location(s) 5 Other =No Action Required,_Requires Repair,_Requires Replacement < � Location(s) _ --- �----- ... ---- .� '"��Ae�''�'"6�r,� � a�/� � �� Sig fiure afie , I ; . `�I�� a��y ��ov�p��m�uc��, I�f��o �'�'��If� F��'�'I�B� ��'��I� f�G��FIf��9�DOo I� f��Ql� �V��I��O�(� I )ATE: � /,� /( INSPECTED BY: "—`�-- �`aa ��j' 'ROJECT: ��'',:•f��g�� WEATHER: �,��y ��.(l,U � I dote:An inspecfion must be conducted within forty-eight(48)hours of '/2'or greater rain event i dumber of Days Since Last Rainfall R��.�- Amount of Last Rainfall �� Inches ! �-STORM WATER POLLUTION PREVENTION PLAN 1 Does the project have an approved Permi . (Yes)/(No) - If No Contacted to secure copy of permit. 2 Is the erosion and sedimenfi control sysfem installed as shown on fhe approved plans (Yes) (i�o) If No What steps need to be taken to correct the condition? 3 Is erosion being controlled on the site (Yes)/ No) If Mo What problems were no e . What steps were taken to correct the situation? . 4 Is sediment being contained on the site (Yes o) If iVo What problems were note ? ' What steps were taken to correct the situation? r 5 Is the potential for turbidty in adjacent streams/wetlands minimized?(Yes)/(iVo) If No What problems were noted? What steps were taken to correct the situation? Recommended Changes to the SWPPP: - Reason for Changes: B-INSPECTIOi�OF IfVSTALLED FACILITIES , 1 Silt Fence _ o Action Required,_Requires Repair,_Requires Replacement Location(s) �c�,r��-r� ure••� �c?�.r�lc�i�a��' o Action Re uired,_Re uires Re air,_Re uires Re lacement 2 Sediment Basins q q P a p Location(s) ` � 3 Check Dams " No Action Required,_Requires Repair,_Requires Replacement ' � Location(s) 4 Dewatering � No Action Required,�Requires Repair,_Requires Replacement Location(s) 5 Ofher _No Action Required,_Requires Repair,_Requires Replacement Location(s) - �,�._____.. �+ -/ _ � I �l ✓ �� Si natu /Date �