Laserfiche WebLink
ZONING OFFICE USE ONLY ZONING OFFICE USE ONLY <br /> Project includes development within: (check all that apply) <br /> 1000' of a lake or pond k300' of lake, pond, river or stream ❑ 300' of a floodplain <br /> ❑ A floodplain ❑ 75' of a wetland ❑ A wetland ❑ The vegetative buffer zone <br /> Shoreland Water body: Wovaloe5:1\ Identification:l-o.k DNR designated?,Yes ❑No <br /> ❑ Wetland ❑ Shoreland wetland ❑Inland wetland ❑Wetland <2 acres <br /> ❑ Floodplain FEMA map panel: 55025C Flood zone: <br /> ❑Floodway ❑Flood fringe ❑General floodplain ❑Flood storage '%i43 f <br /> Lot <br /> Cxisting ❑ Existing non-conforming ❑New <br /> ` Via1'0$' co . d..( S <br /> Impervious Surface Calculations <br /> Area (square feet) <br /> Total Lot: feet): , Sq Ft <br /> Within 300' of <br /> ordinary high water <br /> mark Existing Additional Proposed Post Development <br /> Lot 5'7 p S R <br /> Primary building <br /> footprint <br /> Accessory building(s) <br /> Driveway <br /> Any other impervious i 0 5� <br /> Total impervious d' <br /> Percent impervious r //��� <br /> Project meets shoreland standards;';1► Yes ❑No Shoreland zoning permit denied: ❑Yeio <br /> Additional Dane County permits needed: \ <br /> ❑ Shoreland Erosion Control Permit ❑ Shoreland Mitigation Permit ❑Variance <br /> CI Floodplain development permit ❑ Zoning Permit ❑ <br /> Additional information required: 4 • _INE . t A ` y <br /> STATUS: ❑ Shoreland zoning permit and/or zoning permit issued contingent upon other permits <br /> Sh k r: an. .o ng per • i n ho for other permits <br /> Issued by ATLI Date 10 <br /> ssistant onmg •.mmistrator /'� <br /> H:\Zoning\Shoreland-Wetland Zoning\Chapter 11 Forms\DCPSHL_Application.docx Version 1.1 Created 12272013 <br />