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Dane County Land Conservation Division <br /> DINAP • "Do I NEED A PERMIT" <br /> General Information: <br /> Caller/Contact: Brent- Eagle Carpentry Phone#: 608.370.2348 <br /> Landowner: Thomas & Mary Joan Tierney Phone#: <br /> Contact email: btlautenbachayahoo.com <br /> Project Address: 7448 Fish Lake Rd <br /> Location:Township: Roxbury Sec: 10 1/, SW <br /> Parcel#: 0907.103.9000.6 <br /> Project Description: Replacing a single-wide mobile home with a SFR <br /> Planned Size of Disturbance: "' 3500 ft2 Planned Size of New Impervious: ^' 2000 t <br /> Land Conservation Division Response : <br /> Based on information above the project: ODOES* ✓ODOES NOT require a permit <br /> Determination Made By: DAB DJAS DJDB DIRT Ig • S <br /> *Type of permit required: DEC DES OSM OSE DSS <br /> O Disturbance >4000 ft2 OSlopes> 12% DExcavate/Fill>400 yds3 <br /> D Disturbing 100'of ditch/channel 0125'New road/driveway Oshoreland Zone disturbance <br /> D Addition of 20,000 ft2 New Imp. OSubdivision Plat/CSM [,other: <br /> Basis for Determination: Slopes less than 12%,disturbance less than 4000 sq.ft.. Project covered under UDC. <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 />