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For Office Use Only <br /> Erosion Control Permit <br /> Simplified Application Checklist Permit Number: (C9-0 -- 0 <br /> Date: .3.4 -5/ l Co <br /> Project Name: C {- _ /V\AC3,,.t-rf`S -SNg1`) <br /> Plan Requirements X Location of Information: <br /> Page Number or Attachment <br /> 1. Narrative describing the proposed project EC (neRute5 <br /> — Ex ava•fe AQA, <br /> — Pak Shed <br /> -- RM44C4t) Ateo, East Of Sued <br /> Res4-06,c fl c \ <br /> 2.* Site plan(of known scale that includes:property lines,disturbed area limits, <br /> impervious area limits(existing and proposed),natural and artificial water <br /> features,100-yr flood plain,delineated wetland boundaries,location of all pll�CC <br /> proposed erosion control practices) C l 1t <br /> NOTE: Grading within 5'of the property line requires department approval <br /> 3. * Contours(existing and proposed) / Q <br /> J 110.CI\4 <br /> 4. * Watershed size for each drainage area rn1 A <br /> (include area draining to the site and within project boundaries) �/ ' 0 - (F -1- A C- . <br /> 5. Tracking control <br /> (provisions to prevent mud-tracking onto public streets and roads during � EX�sI, Gr�ej Oe`v g <br /> construction,e.g.tracking pad or existing gravel drive) 1` l <br /> 6. Sediment control practices to protect stormwater facilities or <br /> storm sewer inlets,existing and proposed,on or adjacent to the % Ne .Skie:-1-S <br /> site(e.g.inlet protection or stone weeper) <br /> 7. Proposed erosion control practices <br /> (list of erosion control practices) <br /> �ee�Ci_ <br /> 8. Proposed start date 4/5//f <br /> (date for installation of all erosion control practices and start of land disturbing 5/16 <br /> activity) <br /> 9. Proposed stabilization date <br /> (date for placement of seed&mulch,sod or permanent surfacing) 10/5/16 <br /> 10. Culvert sizes <br /> (existing and proposed culverts on or adjacent to the site) tt <br /> 11. Any other information necessary to reasonably determine the N <br /> location,nature and condition of any physical or environmental �A <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/lwrviewer/ <br /> https://wred-Iwrd.countvofdane.com/ <br /> Revised 03.21.2016 <br />