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Erosion Control Permit For Office Use Only <br /> Simplified Application Checklist Permit Number: t ` o 1- <br /> Date: f ,�-5/t { ) <br /> Project Name: Cj\ L. SC Ci1,1 �I rf <br /> Plan Requirements X Location of Information: <br /> Page Number or Attachment <br /> 1. Narrative describing the proposed project a a pt..) CO-J442:24/j) <br /> a -e 5 i-o�e:�-L4-i°w -F i2 s(,�/�ba�'1. <br /> c. fte-01 2. * Site plan (of known scale that includes: property lines,disturbed area limits, / d <br /> impervious area limits(existing and proposed), natural and artificial water <br /> features, 100-yr flood plain,delineated wetland boundaries, location of all ( -1)M 0 n�-O` <br /> proposed erosion control practices) <br /> NOTE: Grading within 5'of the properly line requires department approval <br /> - 3, * Contours(existing and proposed) <br /> Seed eCc2 <br /> l4. * Watershed size for each drainage area <br /> (include area draining to the site and within project boundaries) ‘. �. ; C A C_ <br /> 5. Tracking control --T ��� <br /> (provisions to prevent mud-tracking onto public streets and roads during l CJ1L- -lam C. <br /> construction,e.g.tracking pad or existing gravel drive) Sac 6,..)S4 20`v�Q, .k \' c9 p °^ <br /> 6. Sediment control practices to protect stormwater facilities or � G—� ��.L f <br /> storm sewer inlets, existing and proposed, on or adjacent to the <br /> site(e.g. inlet protection or stone weeper) _ <br /> 7. Proposed erosion control practices L / Ste�o <br /> (list of erosion control practices) <br /> �'`J w`I c �r L� <br /> ✓-'"-- fddLe4 gLope d, - <br /> L-<)t 4- �„..,clock Se f I> c Pea <br /> 8. Proposed start date �� -16?(date for installation of all erosion control practices and start of land disturbing <br /> activity) <br /> g. Proposed stabilization date <br /> (date for placement of seed&mulch,sod or permanent surfacing) l_-7 0- 3 0 - I Co 10. Culvert sizes <br /> (existing and proposed culverts on or adjacent to the site) i� \ D. X 01 C t&,P <br /> 11. Any other information necessary to reasonably determine the <br /> location, nature and condition of any physical or environmental <br /> features of the site <br /> Note: Any proposed changes to the erosion control plan must be submitted and approved prior to <br /> implementation. The permit will expire on the stabilization date indicated in the plan (see checklist item#9). <br /> * The following Dane County websites may be useful in addressing the above checklist items: <br /> http://accessdane.co.dane.wi.us/html/public.asp -( <br /> https://dcimapapps.countyofdane.com/Iwrviewer/ ` �- <br /> https://wred-Iwrd.countyofdane.com/ �-- <br /> ,. . <br /> 'i" Revised 03.21.2016 <br />