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tee 19d6edIA-A 20/ 5.101411—vni(la) --- -ldf <br /> Storrnwater Management Questionnaire For <br /> Single Family Residential / Duplex / Small Projects <br /> Step 1: Fill in the Quantities below: <br /> The total amount of proposed hard surfaces(rooftop,pavement, etc.)for my project site is: S.F._ S.F. (Box1) <br /> The amount of existinghard surfaces on my project site that will be removed or replaced is: 1 S.F. (Box 2) <br /> The amount of net new hard surfaces on my site(proposed minus existing to be removed/replaced)is: 2/9 / ` S.F. (Box 3) <br /> Step 2: Evaluate the three statements below by selecting TRUE or FALSE: <br /> 1. The value of B.x 2+Box 3=Box 1, above. (circle one) Reserved for City of Everett Public Works Approval Stamp <br /> ANSWER: 421, or FALSE <br /> *If False,re-eva ua e your areas and try again. <br /> 2. The value in Box 1 above is 2,000 square feet or more. (circle one) <br /> ANSWER: iiarip or FALSE <br /> *If False,only complete General Information&Construction Storm water Plan. <br /> 3. The value in Box 3 above is less than 5,000 square feet. (circle one) <br /> ANSWER: 44 or FALSE <br /> *If False,submit an Engineered Drainage Report addressing MR#1-9. <br /> Step 3: Proceed with this entire Questionnaire if all 3 answers above are TRUE. <br /> General Information: <br /> Project Site Address: 0 2.7 1,K.0#0WAN AV5 <br /> Prepared By: <br /> Date Prepared: <br /> Existing Site Information: <br /> 1. Please describe the existing structures, hard surfaces,slopes,drainage patterns, drainage <br /> pipes,vegetation, etc. <br /> C'►F AED t..oi' w` 1;41244.t 4pA,E SYST t \ <br /> 2. Please provide the following quantities of existing hard surfaces in square feet: <br /> Existing Roof Area: 061, <br /> Existing Other Hard Surfaces (pavement,gravel,etc.): N/A <br /> Page 1 of 7 <br /> CITY OF EVERETT 13200 Cedar Street I Everett, WA 98201 I 425-257-8810 Ieverett :r <br />