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Dane County Land Conservation Division <br /> DINAP - "Do I NEED A PERMIT" <br /> General Information: <br /> Caller/Contact: Wally Hershey Phone#: ((00`6) `I y y`1°k 1 <br /> Landowner: Donald Esser Phone#: <br /> Contact email: whitetailI(a)hotmail.com (Wally H.) <br /> Project Address: 1446 Hwy. 92 <br /> Location: Township: Primrose Sec: 2 1/4 SE <br /> Parcel#: 0507-024-8880-8 <br /> Project Description: Replacement of existing residence with a new foundation/basement and <br /> residence. <br /> Planned Size of Disturbance: < 4000 ft2 Planned Size of New Impervious: n.a. 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 QI• S <br /> *Type of permit required: ❑EC LIES ❑SM ❑SE ❑SS <br /> ❑Disturbance >4000 ft2 nSlopes> 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: Disturbance is less than 4000 sq.ft and greater than 300'from a navigable stream <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 />