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Dane County Land Conservation Division <br /> DINAP - "Do I NEED A PERMIT" <br /> General Information: <br /> Caller/Contact: Jim Campbell Phone#: 608-225-8194 <br /> Landowner: Mark Libetrau Phone#: <br /> Contact email: jcampbellsignaturehomes @charter.net <br /> Project Address: None <br /> Location: Township: Springdale Sec: 6 '/4 NW <br /> Parcel#: 0607-062-8785-0 • <br /> Project Description: Construct new single family residence and driveway. <br /> Planned Size of Disturbance: 3000 ft2 Planned Size of New Impervious: Unknown ft2 <br /> Land Conservation Division Response : <br /> Based on information above the project: ❑DOES* ✓IDOES NOT require a permit <br /> Determination Made By: ❑JAH ❑JAS ❑JDB rdJRT ❑RLS <br /> *Type of permit required: DEC ES I ISM ❑SE I SS <br /> ❑Disturbance >4000 ft2 ❑Slopes> 12% ❑Excavate/Fill>400 yds3 <br /> ❑Disturbing 100' of ditch/channel ]125' New road/driveway ❑Shoreland Zone disturbance <br /> ❑Addition of 20,000 ft2 New Imp. I 1Subdivision Plat/CSM ❑Other: <br /> Basis for Determination: Property is not located in a shoreland district per navigability determination <br /> by Cami Peterson. SFR and septic exempt from EC permit requirements, total <br /> disturbance outside these areas will be limited to less than 4000 square feet. <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 />