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Home My WebLink About2649 SUTTER ST; ; CBR2023-4661; PermitBuilding Permit Finaled Residential Permit Print Date: 03/06/2025 Job Address: 2649 SUTTER ST, CARLSBAD, CA 92010-7905 Permit Type : BLDG-Residential Work Class: Retaining Wall Parcel#: 1675112200 Track#: Valuation: $15,000.00 Lot#: Occupancy Group: Project#: #of Dwelling Units: Plan It: Bedrooms: Construction Type: Bathrooms: Orig. Plan Check#: Occupant Load: Plan Check #: Code Edition: Sprinkled: Project Title: Permit No: Status: (Cityof Carlsbad CBR2023-4661 Closed -Finaled Applied: 10/20/2023 Issued: 02/01/2024 Finaled Close Out: 03/06/2025 Final Inspection: 02/04/2025 INSPECTOR: de Roggenbuke, Dirk Alvarado, Tony Description: WALSH: DEMO AND REBUILD NEWlYPE 3 MASONRY RETAINING WALL (PER SAN DIEGO REGIONAL STANDARD DRAWINGS C-03, C-07, C-08) Applicant: Property Owner: KEVIN WALSH 2605 OCEANSIDE BLVD, # STE B OCEANSIDE, CA 92054-4585 (760) 214-8568 WALSH FAMILY TRUST 10-30-13 2649 SUTTER ST CARLSBAD, CA 92010-7905 FEE BUILDING PLAN CHECK BUILDING PLAN REVIEW -MINOR PROJECTS (LOE) BUILDING PLAN REVIEW -MINOR PROJECTS (PLN) RETAINING WALL -NON-ENGINEERED -CllY STANDARD SB1473 -GREEN BUILDING STATE STANDARDS FEE STRONG MOTION -RESIDENTIAL (SMIP) SWPPP INSPECTION TIER 1-Medium BLDG SWPPP PLAN REVIEW TIER 1 -Medium Total Fees: $930.40 Total Payments To Date: $930.40 Contractor: BATES BUILDING COMPANY 2605 OCEANSIDE BLVD, # STE B OCEANSIDE, CA 92054-4585 (760) 216-2710 Balance Due: AMOUNT $99.45 $197.00 $104.00 $153.00 $1.00 $1.95 $292.00 $82.00 $0.00 Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. Building Division Page 1 of 1 1635 Faraday Avenue, Carlsbad CA 92008-7314 I 442-339-2719 I 760-602-8560 f I www.carlsbadca.gov (_ City of Carlsbad RESIDENTIAL BUILDING PERMIT APPLICATION 8-1 Plan Check CBR207's-4bb\ Est. Value ----,-------- PC Deposit $qt/. Lf.S Date lO bobs J J JobAddress :ZG'-l°J 5°e,,1rrc£ Sr. Unit: _____ .APN: _________ _ CT/Project#: <;/lC Z "{//'I Lot #: ____ Year Built: ________ _ BRIEF DESCRIPTION OF WORK: 0 New SF : Living SF, ____ Deck SF, ___ Patio SF, ____ Garage SF __ _ Is this to create an Accessory Dwelling Unit? O Y e N New Fireplace? O YO N, if yes how many? ___ _ D Remodel: _____ .SF of affected area Is the area a conversion or change of use? 0 YO N □ Pool/Spa: ____ SF Additional Gas or Electrical Featu res? ___________ _ □Solar: ___ KW, ___ Modules, Mounted:0RoofOGround, Tilt: 0Y0 N, RMA:OY ON, Battery:OYC N, Panel Upgrade:OYON Electric Meter number: -----------0th er: APPLICANT (PRIMARY CONT~CT) Name: l{-tv1n w~r1? h Address: f} 0 ~ 1 'i"" II:/ I' fl PROPERTY OWNER Name: P<. le / t Al-'<ra WPi5 I, City: Ce-rrlf/;11cl State: C/.1 Zip: 'IZaiD Phone: {7u()) Zlft-YS--66 Email: 1-4. v 1 ,-, {? b~ f ~.sb,,,i, It/. Ct:lh""I Address: :lu'I? 'f1-1/Hr //. City: ~" r I 1/,11d State: ~A Zip: Phone:_ (ts-r) ~~z -Z/~8 Email: C 6 R r/ p.fh €7aMt I. c'",.,. DESIGN PROFESSIONAL CONTRACTOR OF RECORD Name: S~ vtl'1 C 1~~1ce Address: //0 { vPRJrw,, el t,V'I Y .JI' BusinessName: /Jt:f-f-eJ flne«:&nf: Come,ov ,. --, j Address: :) t, CJ 'S QC een fl ~ ;11,, I/~ City: (2a~11s1/.t State: C /II Zip: &/ 1tJ51 Phone: (71,,,0) 7 Iv· 1/ov City: (JC{t!n~cl~ State: CA Zip: lf!-ta~'-1 Phone: f-Juo) 2 / t; ~ 2 710 Email: f<a n e s CC /Pi" cl~ re . C,.(11'>'1 Email: a cl w, ,;.., t? 6«l116u1 /ti. cgn,,, Architect State License: __ £r_2_1_°1 ______ _ CSLB License #: ( O°) 34' I L( Class:_g _____ _ Carlsbad Business License# (Required): @,LOS~ r:3 -I Z. ~z, APPLJCANT CERTIFJCA TION: I certify that I hove read the oppllcatlon and stote agree to comply with all City ordinances ond State lows relating to building construe • n. NAME (PRINT): :G'(A_\1\.-~-t-..t'""? 1635 Faraday Ave Carlsbad, CA 92008 Ph ; 442-339-2719 Email: Buildjng@carlsbadca.gov REV. 04122 THIS PAGE REQUIRED AT PERMIT ISSUANCE PLAN CHECK NUMBER: ______ _ A BUILDING PERMIT CAN BE ISSUED TO EITHER A STATE LICENSED CONTRACTOR OR A PROPERTY OWNER. IF THE PERSON SIGNING THIS FORM IS AN AGENT FOR EITHER ENTITY AN AUTHORIZATION FORM OR LETTER IS REQUIRED PRIOR TO PERMIT ISSUANCE. (OPTION A): LICENSED CONTRACTOR DECLARATION: I herebyaf firm underpenal tyof perjury that I am licensed underpro0sionsof Chapter9 ( commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. I also affirm underpenaltyof perjuryoneof the following declarations(CHOOSE ONE): 0 I have and will maintain a certificate of consent to self-Insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the work which this permit Is issued. Policy No. ___________________________________________ _ ~R- ~I have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. My workers' compensation Insurance carrier and policy number are: lnsur11nc:eComp11ny Name: ~k~--'~«~c...-f_~S~Q .. ~~~~~• ""-=-+---------=------• Polley No. L WC, CO 3 9: 07::cZ I Expiration Date: t, ! 1 ~c,e Mr'\'oc:c Z-i2'.!l -0~ , 0 Certificate of Exemption: I certify that In the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation Laws of California. WARNING: Failure to secure workers compensation coveraJe Is unlawful and shall subject an employer to crlmlnal penaltres and clvll fines up to $100,000.00, In addition the to the cost of compensation, dama1es as provided for In Section 3706 of the Labor Code, Interest and attorney's fees. CONSTRUCTION LENDING AGENCY, IF ANY: I hereby affirm that there is a construction lending agency for the performance of the work this permit is Issued (Sec. 3097 (I) Civil Code). Lender's Name: _______________________ Lender's Address: ______________________ _ CONTRACTOR CERTIFICATION: The applicant certifies that all documents and plans clearly and accurately show all existing and propos~ buildln&s, structures. access roads, and utilitles/utlllty easements. All proposed modifications and/or additions are clearly label~ on the site plan. Any potentlally existing detall within these plans Inconsistent with the site plan are not approved for construction and may be required to be altered or removed. The city's approval of the application Is based on the pre that the submltt~ documents and plans show the correct dimensions of; the property, buildings, structures and their setbacks from property lines and from one anoth • oads/ea men ts, and utilities. The existing and proposed use of each bulldlng as stated Is true and correct; all easements and other encumbrances to development have bee el own and el~ as well as all on-site aradlng/slte preparation. All Improvements existing on the property were completed In accordance with all regulations In existence e of th Ir cons tr en, unless otherwise not~. NAME (PRINT): ~ V;v-~f 6 SIGNATUR Note: If the person slJnlng above Is an authorized agent for the contra -OR- (OPTION B): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's License Law for the following reason: 0 I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). -OR- DI, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). -OR- DI am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason: A D, 0 FORM 8-61 •owner Builder Acknowledgement and Verification Form" Is required for any permit issued to a property owner. By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the Improvements covered by this permit, I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed In Its entirety by licensed contractors./ understand that a copy of theappllca.blelaw, Section 7044 of the Business and Professions Code, isavai/ableuponrequestwhen this application is submitted orat the following Web site: http://www.leginfo.ca.gov/calaw.html. OWNER CERT/FICA T/ON: The applicant certifies that all documents and plans clearly and accurately show all existing and proposed buildings, structures, access roads, and utilities/utility easements. All proposed modifications and/or additions are clearly label~ on the site plan. Any potentially exlstln& detail within these plans Inconsistent with the site plan are not approved for construction and may be requlr~ to be alter~ or removed. The city's approval of the application Is based on the premise that the submltt~ documents and plans show th1t correct dimensions of; the property, buildings. structures and their setbacks from property lines and from one another; access roads/easements, and utllitles. The existing and proposed use of each building as stated Is true and correct; all easements and other encumbrances to development have been accurately shown and labeled as well as all on-site gradlna/slte preparation. All Improvements existing on the oroperty were completed In accordance with all regulations In existence at the time of their construction, unless otherwise noted. NAME (PRINT): _________ SIGN: _________ DATE: _____ _ Note: If the erson sf nln above Is an authorized a ent for the ro e owner Include form B-62 sf ned b owner. 163S Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 Email: Building@carlsbadca.gov 2 REV. 04/22 PERMIT INSPECTION HISTORY for (CBR2023-4661) Permit Type: BLDG-Residential Application Date: 10/20/2023 Owner: TRUST WALSH FAMILY TRUST 10-30-13 Work Class: Retaining Wall Issue Date: 02/01/2024 Subdivision: CARLSBAD TCT#84-35 UNIT#01 Address: 2649 SUTTER ST Status: Closed -Finaled Expiration Date: 11/12/2024 IVR Number: 52710 CARLSBAD, CA 92010-7905 Scheduled Date 05/16/2024 02/04/2025 Actual Inspection Type Start Date Inspection No. Inspection Status Primary Inspector 05/16/2024 BLDG-14 248652-2024 Passed Tony Alvarado Frame/Steel/Bolting/We lding (Decks) Checklist Item COMMENTS BLDG-Building Deficiency Underground, retaining wall, moisture, resistive, mastic product,, perforated, drain pipe, filter fabric sock verified OK. BLDG-21 248816-2024 Passed Tony Alvarado U nderg roundflJnderflo or Plumbing Checklist Item COMMENTS BLDG-Building Deficiency Underground, retaining wall, moisture, resistive, mastic product,, perforated, drain pipe, filter fabric sock verified OK. BLDG-SW-Inspection 248817-2024 Partial Pass Tony Alvarado Checklist Item COMMENTS Are erosion control BMPs functioning properly? Are perimeter control BMPs maintained? Is the entrance stabilized to prevent tracking? Have sediments been tracked on to the street? Has trash/debris accumulated throughout the site? Are portable restrooms properly positioned? Do portable restrooms have secondary containment? 02/04/2025 BLDG-Final Inspection 275194-2025 Passed Dirk de Roggenbuke Checklist Item COMMENTS BLDG-Building Deficiency BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Structural Final BLDG-Electrical Final Thursday, March 6, 2025 Reinspection Inspection Complete Passed Yes Complete Passed Yes Reinspection Incomplete Passed Yes Yes Yes Yes Yes Yes Yes Complete Passed Yes Yes Yes Yes Yes Page 3 of3 PERMIT INSPECTION HISTORY for (CBR2023-4661) Pe rmit Type: BLDG-Residential Application Date: 10/20/2023 Owner: TRUST WALSH FAMILY TRUST 10-30-13 Work Class: Retaining Wall Issue Date: 02/01/2024 Subdivision: CARLSBAD TCT#84-35 UNIT#01 Status: Closed -Finaled Expiration Date: 11/12/2024 IVR Number: 52710 Address: 2649 SUTTER ST CARLSBAD, CA 92010-7905 Scheduled Date Actual Inspection Type Start Date Inspection No. Inspection Status Primary Inspector Reinspection Inspection 05/09/2024 Checklist Item BLDG-Building Deficiency COMMENTS May 2, 2024: 1. Type Ill, city standard approved, retaining wall. 2. flat, no slope-backfill, no slope surcharge, per engineered, plans and city details specifications, for foundation, steel reinforcement size, type, and placement - approved. BLDG-SW-Inspection Checklist Item 247327-2024 COMMENTS Partial Pass Tony Alvarado Are erosion control BMPs functioning properly? Are perimeter control BMPs maintained? Is the entrance stabilized lo prevent tracking? Have sediments been tracked on lo the street? Has trash/debris accumulated throughout the site? Are portable restrooms properly positioned? Do portable restrooms have secondary containment? 05/09/2024 BLDG-66 Grout Checklist Item 248003-2024 COMMENTS BLDG-Building Deficiency BLOG-SW-Inspection Checklist Item 248004-20;24 COMMENTS Are erosion control BMPs functioning properly? Are perimeter control BMPs maintained? Is the entrance stabilized to prevent tracking? Have sediments been tracked on to the street? Has trash/debris accumulated throughout the site? Are portable restrooms properly positioned? Do portable restrooms have secondary containment? Passed Tony Alvarado Partial Pass Tony Alvarado Thursday, March 6, 2025 Passed Yes Re Inspection Incomplete Passed Yes Yes Yes Yes Yes Yes Yes Complete Passed Yes Relnspectlon Incomplete Passed Yes Yes Yes Yes Yes Yes Yes Page 2 of 3 Building Permit Inspection History Finaled ( City of Carlsbad PERMIT INSPECTION HISTORY for (CBR2023-4661) Permit Type: BLDG-Residential Application Date: 10/20/2023 Owner: TRUST WALSH FAMILY TRUST 10-30-13 Work Class: Retaining Wall Issue Date: 02/01/2024 Subdivision: CARLSBAD TCT#84-35 UNIT#01 Status: Closed -Finaled Expiration Date: 11/12/2024 IVR Number: 52710 Address: 2649 SUTTER ST CARLSBAD, CA 92010-7905 Scheduled Date Actual Inspection Type Start Date Inspection No. Inspection Primary Inspector Status 05/01/2024 05/01/2024 BLDG-11 246985-2024 Partial Pass Tony Alvarado Foundatlon/Ftg/Piers (Rebar) Checklist Item BLDG-Building Deficiency COMMENTS 1. Type 111, city standard approved, retaining wall. 2. flat, no slope-backfill, no slope surcharge, per engineered, plans and city details specifications, for foundation, steel reinforcement size, type, and placement - approved. BLDG-SW-Inspection Checklist Item 247191-2024 COMMENTS Partial Pass Tony Alvarado Are erosion control BMPs functioning properly? Are perimeter control BMPs maintained? Is the entrance stabilized to prevent tracking? Have sediments been tracked on to the street? Has trash/debris accumulated throughout the site? Are portable restrooms properly positioned? Do portable restrooms have secondary containment? 05/02/2024 05/02/2024 BLDG-11 247194-2024 Passed Tony Alvarado Thursday, March 6, 2025 Foundation/Ftg/Plers (Rebar) Checklist Item BLDG-Building Deficiency COMMENTS May 2, 2024: 1. Type Ill, city standard approved, retaining wall. 2. flat, no slope-backfill, no slope surcharge, per engineered, plans and city details specifications, for foundation, steel reinforcement size, type, and placement- approved. BLDG-12 Steel/Bond Beam 247326-2024 Passed Tony Alvarado Reinspection Inspection Reinspection Incomplete Passed Yes Re inspection Incomplete Passed Yes Yes Yes Yes Yes Yes Yes Complete Passed Yes Complete Page 1 of 3 STORM WATER POLLUTION PREVENTION NOTES 1. All NECESSARY EQUIPMENT ANO MAlERIAI.S SHAU. BE AVAII.ABl...E ON SITE TO FAOUTA.lE RAPID INSTAL.LATION (F EROSION ANO SEDIMENT CONlROL BMPs WHEN RAIN IS EMINENT. 2. THE OY!tlER/CONTRACTOR SHAl.l RESTORE AU. EROSION COflROL DE"'1CES TO WORl<lNG ORDER TO THE SATISFACTION OF THE OTY lta'ECTOR AFTER EA.Of RUN-Off PROOUONG RAINFALI- 3. THE ~ER/CONlRACTOR SHAl.l INST AU. ADOfllOOAI. EROSl<ll CONlROL MEASURES AS MAY BE REQUIRED BY lHE CITY INSP£CT<Jl DUE 10 INCOWPl..£T£ GRACING <PERATIONS OR UNF'CflESEEN CROJMSTANCES \IHCH MAY ARISE. 4. A.1.L RDIOVA.BI.£ PROTECll\'E DEVICES SHA.I.I.. BE IN PLACE AT lHE END OF EACH wmoNG DAY 'MlEN 1HE FIVE (5) OAY RAIN PROOAIJUTY FORECAST EXCEIDS FORTY PECENT { 40X). SILT AND OlHER DEBRIS SHAU. BE REMOW AFTER EACH RAJNFAU... 5. AU.. GRAVEL BAGS SHALL CONTAIN 3/4 INCH MINIMUM A~GAlE 6. ADEQUATE EROSlctl AND SEDIWElff CONlROL AND PERIME1tR PROTECTION BEST MANAGEMENT PRACTICE MEASURES MUST BE INSTALLED ANO MAINTAINED. 7. THE OTY INSPECTOR SHAl.l HAVE Tl-IE AUlliORITY TO Al.ml lHIS Pl.AN DURING OR BEFCH: CONSTRUCTION AS NEEDED TO ENSURE COMPLIANCE Wl1H CITY STORM WATER QUALITY REGULATIONS. OWNER'S CERTIFic.AIB: I UNDERSTAND ANO ACOIO'M.EDGE lHAT I MUST: (1) IIPI.EMENT l£ST MAHAGEIEH PRACTICES (!IMPS) DURING ~CTKJI ACTI\.f!IES TO 11£ WAlOWW EXTENT PRAC11CAII£ TO AYall Tl£ IIOBIUZAllCli OF P0.1.UTAHlS SIJOi AS SEDIMENT NID TO AvatJ lliE DPOSlJRE OF STCJ'!lol WATER TO <XHi1RlJC1KW REJ..Alll) PCllUTAHTS; AN!) (2) ADHERE TO. AND AT All 1ll£S, lnlPL Y llllH lH1S aTY APPRCMD TIER I CONS1RIJCllON S'IIPPP THROUQiOJT lHE DURA 1ION OF lHE COISlRIJCTIQj ACTI'Jl'IES UNTIL 1llE CONS1RUC1ION 'MlRK IS COMPl£l! AND APPRO',{D BY lHE OlY ~AD. 0¥iiER(s)/~~ ~~'; NAMI?Y~ A ~ w~ i/, /z~ DWNER(S)/O'MIDfs MDT Nlf. (S1GNA1VRE) DAlE E-29 STORM WATER COMPLIANCE FORM TIER 1 CONSTRUCTION SWPPP E-29 CB ___ _ SW BEST MANAGEMENT PRACTICES (BMP} saECTlON TABLE Emoionrartml SedimeillCornlllll'a Traclq tmSamw..r ~~and ..... -OndlN'I ,....._-f'llUcllCawolllll'a i I j l 1 .., .,. 'I, 'O 'O !I Ii ! 5i f Ii Ii " I .; s s I ::IE z l-i z i £ ~-i ; 1 l j g' j Best Managemeot Pndce' ~ . 8-a.,. 0 I . -fj .~ I ,= E ~!i u u if i .., .. : l~ ti (BMP) Oesaiption ➔ j 'g l m ~~ cS j 5.,. Q ~ ~ ;i ~; -8 •s ~i;' C '.:: ~ go 0:;: .. ii i .a i~ I . IX ~I J:j .l:!. :ro .!! 5i t ii J; t • j '8 :.; :2[ I §. lu i !l 111, l! 1 ~5 I] -l ~ & Ji i.t .. ~ -!5 ;; In 6 ~~ U>C: U, C o-in ~~ DI "'"" Q. ><J "'"' "' c,,sQf,~➔ ,._ m ... -.., .,. .., <O ,._ m 0 N .., ,._ .., T N .., .,. "' s .!, I ~ I I I ~ ~ I I ~ T I l J, J, J, I I I I Cl:ll'IIINdi::l/cijy .., {rl Ill Ill Ill Ill Ill I!: I!: z z z z i i j i i Q-odlno/Sftl Oisttltbmce T,....,...,.,,._,.,,,, X X St""""'""' X Ccnaeta/ ~t Sallalttlno Ca,cnt■ f1Qtwaili; )( X Paw,Q C«,wlt/Pk>e lnltG!ation Stua:o/llortcr Wane Waste D...,,_, Slaaa,nJI nv °""'1 Areo EN•-t Mmitonance and Fuellna Hamrdcua Substance Uae "'~""'"" Dewoterina Site Accesa Acroa D.-1 Other CllsU: Instructions: 1. Oleck the box ta the left of all appl~ constructlan actlYlty ( fht column) apected to OOC11r CMlng construction. 2. Loccted ~g the top of the BIii' TClble i. a fist of BMP's with it's ~ California Stcrmwater ~lty Aseoclatlon (CAS0A) ~atlon number. O,ooae one ti' mtl'e BIIP's 'PJ intend to use OJmg constniction hm the lisl 01eck lhe boi whon, lhe c:ho,,ei, octMty row lnt.necb with the 1111P c:dumn. 3. Ret. to the CASQA ca1sbuctlon honcllook far lnl'armatlon cm detala of the choson 811'1 md how to apply thn to the projocl SHOW THE LOCATIONS OF ALJ.. CHOSEN BMPs ABOVE ON THE PROJECTS STTE Pf.AN/EROSION CONTROL Pf.AN. SEE THf REVERSE SIDE OF THIS SHEET FOR A SAMPLE EROSION CONTROL Pt.AN. PROJECT INFORMATION Sita~ 2649 SUTTER ST. "--r's Pcnel Number. 167-511-22-00 Ernergs1cy Contact: ~ • , . / / /, Nime: f /'()VI> W It 5' 24 Hour Phm,,/76 0 J 3~e7. li5'1 Conatructlon Threat to Storm Water ~ality (a.ec. Box) □ M£DCUM tx{LOW . i ~-.i g~ li g' NC "0 :i:::11 <O I i ~ ii ~! bo !i is U:11 m I i Page 1 of 1 REV 02/16