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Dane County Land Conservation Division <br /> DINAP - "Do I NEED A PERMIT" <br /> General Information: <br /> Caller/Contact: David Dehnert Phone#: 608-669-6068 <br /> Landowner: Same Phone#: Same <br /> Contact email: NA - Fax: 920-648-2509 <br /> Project Address: N6083 COUNTY HIGHWAY 0 <br /> Location:Township: Deerfield Sec: 24 _ % NE <br /> Parcel#: 0712-241-8001-0 <br /> Project Description: construction Of attach r ge <br /> Planned Size of Disturbance: <4000 ft2 Planned Size of New Impervious: <4000 ft2 <br /> Land Conservation Division Response : <br /> Based on information above the project: ['DOES* ✓❑DOES NOT require a permit <br /> Determination Made By: EiIAH ❑IAS fJDB DIRT ❑RI,S <br /> *'Type of permit required: DEC DES DSM OSE flss <br /> ❑Disturbance >4000 tt2 ❑Slopes> 12% ❑Excavate/Fill>400 yes' <br /> E3 Disturbing 100'of ditch/channel 0125' New road/driveway Oshoreland Zone disturbance <br /> ❑Addition of 20,000 ft2 New Imp. ❑Subdivision Plat/GSM ['Other: <br /> Basis for Determination: >300' from Koshkonong, >75' from wetland - Not SZ <br /> Project does not tripper Chapter 14 permit requirements due location and scope. <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 /> ZO/Z0 39 d M13SN00 UNV 1 00 3NVU SOLE-ON-809 SO:Zti 8002/LZ/0t <br />