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Dane County Land Conservation Division <br /> DINAP - "Do I NEED A PERMIT" <br /> General Information: <br /> Caller/Contact: Cliff Rucks Phone#: <br /> Landowner: Scott & Ann Nottestad Phone#: <br /> Contact email: trucks @gmail.corn <br /> Project Address: Hwy W. <br /> Location: Township: Christiana Sec: 18 / SW <br /> Parcel#: 0612-183-8380-0 <br /> Project Description: New Single Family Residence and Septic System. Grading outside the house <br /> footprint will be less than 4,000 sq. ft. Not in Shoreland zone. <br /> Planned Size of Disturbance: -6,000 ft2 Planned Size of New Impervious: -4,000 ft2 <br /> Land Conservation Division Response : <br /> Based on information above the project: ❑DOES* ✓❑DOES NOT require a permit <br /> Determination Made By: ❑JAH ❑JAS DDB ❑JRT ❑RLS AJM <br /> *Type of permit required: EEC LIES ❑SM ❑SE ❑SS <br /> ❑Disturbance >4000 ft2 ❑Slopes> 12% ❑Excavate/Fill>400 yds3 <br /> ❑Disturbing 100' of ditch/channel 0125' New road/driveway ❑Shoreland Zone disturbance <br /> El Addition of 20,000 ft2 New Imp. ❑Subdivision Plat/CSM ❑Other: <br /> Basis for Determination: House and Septic are covered under the UDC. Driveway is existing gravel drive, may add to <br /> the gravel, but no land disturbance associated with that. If the driveway exceeds 125'of disturbance or grading <br /> (both for the driveway and outside the house)is greater than 4,000 sq feet it will require an Erosion Control Permit. <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 />