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I <br /> Dane County Land Conservation Division <br /> DINAP - "Do I NEED A PERMIT" <br /> General Information: <br /> Caller/Contact: Brad Kruckenbert Phone#: 608-741-5320 <br /> Landowner: Same Phone#: <br /> Contact email: bkruckenbert @mooseracing.com <br /> Project Address: 173 Bublitz RD <br /> Location: Township: Albion Sec: 31 v, NW <br /> Parcel #: 0512-312-9680-0 <br /> Project Description: Construct a 30' x 30' detached garage. <br /> Planned Size of Disturbance: <4000 ft2 Planned Size of New Impervious: 900 ft2 <br /> Land Conservation Division Response : <br /> Based on information above the project: ❑DOES* ,DOES NOT require a permit <br /> Determination Made By: ❑JAH DAS DDB 0 'T ❑RLS <br /> *Type of permit required: DEC DES ❑SM DSE ❑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 /> ❑Addition of 20,000 ft2 New Imp. ❑Subdivision Plat/CSM ❑Other: <br /> Basis for Determination: Project is not located in a shoreland zone and does not meet <br /> permit triggers of 14.45. The ponds adjacent to the site are not listed as <br /> navigable by DNR and therefore not regulated. <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 />