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Dane County Land Conservation Division <br /> DINAP - "Do I NEED A PERMIT" <br /> General Information: <br /> Caller/Contact: Dale Clark Phone#: <br /> Landowner: G I U L I O TO N O N I Phone#: <br /> Contact email: blackbearenterprises @ yahoo.com <br /> Project Address: 8394 Kollath RD <br /> Location: Township: Springdale Sec: 26 1/4 SW <br /> Parcel#: 0607-263-9340-8 <br /> Project Description: Construct a 24' x 47' pool room addition to the existing SFR. <br /> Planned Size of Disturbance: 1 500 ft2 Planned Size of New Impervious: 1128 ft2 <br /> Land Conservation Division Response : <br /> Based on information above the project: ❑DOES* 1 DOES NOT require a permit <br /> Determination Made By: ❑JAH ❑JAS ❑JDB OJRT ❑RLS <br /> *Type of permit required: ❑EC as ❑SM ❑SE Liss <br /> I I Disturbance >4000 ft2 ❑Slopes> 12% ❑Excavate/Fill>400 yds3 <br /> nDisturbing 100' of ditch/channel 0125' New road/driveway ❑Shoreland Zone disturbance <br /> I I 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 /> any of the permit triggers of 14.45. <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 />