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DCPSHL-2015-00016
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DCPSHL-2015-00016
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Zoning Permits
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DCPSHL-2015-00016
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ZONING OFFICE USE ONLY ZONING OFFICE USE ONLY <br /> Project includes development within: (check all that apply) <br /> 000' of a lake or pond ,4500' of lake,pond, river or stream El 300' of a floodplain <br /> ❑ A floodplain ❑ 75' of a wetland ❑ A wetland ❑ The vegetative buffer zone <br /> Shoreland Water body: \� SO Identification: 1—e,d,e, DNR designate s ❑No <br /> ❑ Wetland El Shoreland wetland ❑Inland wetland ❑Wetland<2 acres <br /> ❑ Floodplain FEMA map panel: 55025C Flood zone: <br /> ❑Floodway ❑Flood fringe ❑General floodplain ❑Flood storage <br /> Lot <br /> .\Existing ❑ Existing non-conforming ❑New <br /> Impervious Surface Calculations <br /> Area (square feet): Sq Ft <br /> Total Lot: <br /> Within 300' of <br /> ordinary high water <br /> mark Existing Additional Proposed Post Development <br /> Lot <br /> Primary building <br /> footprint <br /> Accessory building(s) <br /> Driveway <br /> Any other impervious <br /> Total impervious L/ �� ) <br /> Percent impervious / <br /> Project meets shoreland standards:&Yes ❑No Shoreland zoning permit denied: ❑Ye o <br /> Additional Dane County permits needed: <br /> Shoreland Erosion Control Permit ❑ Shoreland Mitigation Permit ❑Variance <br /> ❑Floodplain development permit Aroning Permit ❑ <br /> Additional information required: - - <br /> STATUS: ❑ Shoreland zoning permit and/or zoning permit issued contingent upon other permits <br /> - t' •• d z. •: ; ,•ermit on h Id for other permits <br /> Issued <br /> b sistan any gAdmuus or Dat= ! 3� _ <br /> H:\Zoning\Shoreland-Wetland Zoning\Chapter 11 Forms\DCPSHL_Application.docx Version 1.1 Created 12272013 <br />
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