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For Office Use Only <br /> Erosion Control Permit <br /> Simplified Application Checklist Permit Number: <br /> Date: <br /> Project Name: Hellenbrand Shed <br /> Plan Requirements X Location of Information: <br /> Page Number or Attachment <br /> • <br /> 1. Narrative describing the proposed project 1. Install silt fence downslope of project <br /> 2. Excavator cut/fill for grade <br /> 3. Footings poured/walls <br /> 4. Construction of building <br /> y5. Landscaping around building <br /> 2. * Site plan(of known scale that includes:property lines,disturbed area limits, Attached <br /> impervious area limits(existing and proposed), natural and artificial water <br /> features, 100-yr flood plain,delineated wetland boundaries,location of all ✓ <br /> proposed erosion control practices) <br /> NOTE: Grading within 5'of the property line requires department approval <br /> 3. * Contours(existing and proposed) Attached <br /> 4. * Watershed size for each drainage area 5.5 Acres <br /> (include area draining to the site and within project boundaries) ✓ <br /> 5. Tracking control Owner will reuse demo concrete on site for <br /> (provisions to prevent mud-tracking onto public streets and roads during ✓ tracking control <br /> construction,e.g.tracking pad or existing gravel drive) <br /> 6. Sediment control practices to protect stormwater facilities or Constructed grassed waterways and diversions are <br /> storm sewer inlets,existing and proposed, on or adjacent to the " stable outlets for farmstead <br /> site(e.g.inlet protection or stone weeper) <br /> 7. Proposed erosion control practices Silt fence, tracking pad <br /> (list of erosion control practices) <br /> 8. Proposed start date 5/15/16 <br /> (date for installation of all erosion control practices and start of land disturbing 1 •.( <br /> activity) <br /> 9. Proposed stabilization date 11/15/16 <br /> (date for placement of seed&mulch,sod or permanent surfacing) 7 <br /> 10. Culvert sizes (2) 5' concrete highway culverts 350' downstream <br /> (existing and proposed culverts on or adjacent to the site) ✓ <br /> 11. Any other information necessary to reasonably determine the Obtain ZP after EC <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.countvofdane.com/Iwrviewer/ <br /> https://wred-lwrd.countyofdane.com/ <br /> Revised 03.21.2016 <br />