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Dane County Land Conservation Division <br /> DINAP - "DO I NEED A PERMIT" <br /> General Information: <br /> Caller/Contact: Dan Kippley Phone#: 608-643 4639 <br /> Landowner: Vincent Breunig Phone#: <br /> Contact email: dan C!kipcc.com <br /> Project Address: 8232 Jade Drive <br /> Location: Township: Roxbury Sec: 2 1/4 SE <br /> Parcel#: 0907-024-0567-6 <br /> Project Description: Construct a 22' x 24' addition to the existing SFR. <br /> Planned Size of Disturbance: <2000 ft2 Planned Size of New Impervious: 528 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 ❑JDB ✓❑JRT ❑RLS <br /> *Type of permit required: DEC DES ❑SM USE ❑SS <br /> ❑Disturbance >4000 ft2 ❑Slopes> 12% ❑Excavate/Fill>400 yds3 <br /> ❑Disturbing 100' of ditch/channel 0125' New road/driveway OShoreland Zone disturbance <br /> ❑Addition of 20,000 ft2 New Imp. ❑Subdivision Plat/CSM ❑Other: <br /> Basis for Determination: Project is located in the secondary shoreland zone and does <br /> not meet the permit triggers of 11 .05(3)(b). <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 />