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• <br /> LCD office use only <br /> Erosion Control Permit <br /> Simplified Application Checklist Permit Number. <br /> Date: <br /> Project Name: 3t28 WAu c.r_e <br /> Applicant <br /> Plan Requirement I NA Location in Plan-page number <br /> 1. NEjs Cn4Y+1Y Roos t Dr.( i c tXt sr 1,4 <br /> Detailed written description of how the site will be developed rt <br /> (narrative including scope of land disturbing activities and sequence of (a H)ous. 25--S 501,0,4-E FEe l. <br /> construction events) "' ri <br /> �EE EL t�t-► <br /> 2.* Plan drawing of site(of known scale and including:property lines,lot <br /> nt Arl. <br /> dimensions,limits of disturbed area limits of impervious area, ,. SEE <br /> 'land cover '' :?T <br /> type,natural and artificial water features,delineated wetland boundaries, <br /> location of all proposed erosion control practices) <br /> ih —: <br /> 3.* Direction of runoff flow Lt.' S (J o tLTw <br /> a:Kf <br /> (elevation contour lines or runoff arrows) �• , <br /> s ra P1.04J, <br /> 4. Size of area that drains onto site Lot <br /> (contributing drainage area) • <br /> - <br /> t.GC� VrHt�i-tiri opt >=xISTtac, lul�+C <br /> Provisions to prevent mud-tracking onto public thoroughfares ��}# 1 <br /> during construction(i.e.tracking pad or existing gravel drive) <br /> lJoi E; :.,.i Pi.43Ki <br /> 6 Provisions to prevent the delivery of sediment to stotmwater <br /> •conveyance system(i.e.inlet protection or stone weeper) 7 p p iY■LEi"s c STc(!M St tdEIZS <br /> 7• Proposed Erosion Control Practices i.txr“e-C S RvP E <br /> (list of erosion control practices) <br /> 6•* Proposed Start Date 54-PT. 'ci <br /> (date for installation of all erosion control practices and start of excavation) 4": <br /> 9- Proposed Stabilization Date y_•A Wo 0 y <br /> (date for placement of seed&mulch,sod or permanent surfacing.) <br /> :nom <br /> 10. Culvert sizes <br /> (existing and proposed culverts on or adjacent to the site) X MO Cu LV tctZ-.r S <br /> 11. Any other information necessary to reasonably determine the <br /> location,nature and condition of any physical or environmental X <br /> features of the site. <br /> Any proposed changes to the erosion control plan must be submitted and approved prior to implementation. <br /> Indicates information must always be included <br /> *Information to address the items above is available on the following Dane County websites: <br /> http://accessdane.co.dane.wi.us/html/parcelsearch.asp <br /> http://www.co.dane.wi.us/lwrd/permit/ <br /> E 'd OESt+ irLZ 809 ou[ 2utuaaut2u3 IeRo? e80 :60 60 SO 2n13 <br />