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Dane County Land Conservation Division <br /> DINAP - "Do I NEED A PERMIT" <br /> General Information: <br /> Caller/Contact: Can Dahl Phone#: 608.764.5270 <br /> Landowner: same Phone#: <br /> Contact email: kcdahl @verizon.net <br /> Project Address: 3637 EARLWYN RD COTTAGE GROVE, WI 53527 <br /> Location:Township: Cottage Grove Sec: 26 v, NW <br /> Parcel#: 0711-262-8500-6 <br /> Project Description: Partial demolition, remodel and enlargement of existing SFR <br /> Planned Size of Disturbance: < 4000 ft2 Planned Size of New Impervious: <1000 ft2 <br /> Land Conservation Division Response: <br /> Based on information above the project: DOES* DOES NOT require a permit <br /> Determination Made By: DJAH D1AS DJDB DJRT DRLS <br /> *Type of permit required: DEC DES DSM DSE DSS <br /> ❑Disturbance >4000 ft2 ['Slopes> 12% DExcavate/Fill>400 yds3 <br /> Disturbing 100' of ditch/channel 0125'New road/driveway ['Moreland Zone disturbance <br /> D Addition of 20,000 ft2 New Imp. ❑Subdivision Plat/CSM ❑Other: <br /> Basis for Determination: Project area lies in the secondary shoreland zone and does <br /> not trigger erosion control requirements of DCCO Chapter 14 or 11 <br /> 9/25/07 <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 />