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A <br /> Dane County Land Conservation Division <br /> DINAP - "Do I NEED A PERMIT" <br /> General Information: <br /> Caller/Contact: ViC Pulvemiacher Phone#: 608.712.3540 <br /> Landowner: n.a. Phone#: <br /> Contact email: info©pulvermacher.net <br /> Project Address: Autumn Pond Lot 1 <br /> Location: Township: Springfield Sec: 31 y4 NW <br /> Parcel#: 0808-312-0001-0 <br /> Project Description: Construction of new SFR in the secondary shoreland zone. Project <br /> will be completed in phases and have no more than 4000 sq. ft disturbed at any one time. <br /> Planned Size of Disturbance: <4000 f& Planned Size of New Impervious: n.a. ft2 <br /> Land Conservation Division Response : <br /> Based on information above the project: DOES* ✓DDOES NOT require a permit <br /> Determination Made By: UTAH DAS ❑JDB DJRT RLS <br /> *Type of permit required: DEC DES DSM ESE DSS <br /> ❑Disturbance >4000 ft2 ESlopes> 12% DExcavate/Fill>400 yds3 <br /> ❑Disturbing 100' of ditch/channel 0125' New road/driveway EShoreland Zone disturbance <br /> LI Addition of 20,000 ft2 New Imp. EiSubdivision Plat/CSM tg Other: <br /> Basis for Determination: Project area is in the secondary shoreland zone and does not <br /> require a permit as long as work is completed in phases. No disturbance can <br /> exceed 4000 sq. ft. <br /> Permit determination based upon information provided by caller/landowner. Changes in project size, scope or <br /> location may trigger changes to permit requirements. It is the responsibility of the owner to ensure all required <br /> permits have been obtained prior to commencing work. <br />