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DCPSHL-2017-00028
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DCPSHL-2017-00028
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6/19/2017 4:02:22 PM
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6/7/2017 3:06:46 PM
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Zoning Permits
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DCPSHL-2017-00028
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ZONING OFFICE USE ONLY ZONING OFFICE USE ONLY <br /> Project includes development within: (check all that apply) <br /> 1000' of a lake or pond 300' of lake, pond, river or stream 300' of a floodplain <br /> ❑ A floodplain ❑ 75' of a wetland ❑ A wetland ❑ The vegetative buffer zone <br /> Shoreland Water body: IdentificationMoVLc., DNR designated? Yes ❑No <br /> ❑ Wetland ❑ Shoreland wetland ❑Inland wetland ❑Wetland<2 acres \\ <br /> ❑ Floodplain FEMA map panel: 55025C Flood zone: <br /> ❑Floodway ❑Flood fringe ❑General floodplain ❑Flood storage <br /> Lot <br /> 'xisting ❑ Existing non-conforming ❑New <br /> Impervious Surface Calculations <br /> Area (square feet): Sq Ft <br /> Total Lot: �3j <br /> Within 300' of <br /> ordinary high water <br /> mark Existing Additional Proposed Post Development <br /> Lot <br /> Primary building <br /> footprint <br /> Accessory building(s) <br /> Driveway °1 p <br /> Any other impervious <br /> Total impervious c l 3 Q (1 0 Sc'k 1 <br /> Percent impervious r/¢ 5 t Yk <br /> Project meets shoreland standards: gYes ❑No Shoreland zoning permit denied: ❑Yes)1N-No <br /> Additional Dane County permits needed: <br /> Shoreland Erosion Control Permit Shoreland Mitigation Permit ❑Variance <br /> ❑Floodplain development permit Ii Zoning Permit 1St `f � �ro-�"►�,� <br /> Additional information required: <br /> STATUS: ❑ Shoreland zoning permit and/or zoning permit issued contingent upon other permits <br /> Sh• el. + • zoning peil it on hold for other permits <br /> Issued byl f Date S/3�� <br /> Assistant sning A. inistrator <br /> H:\Zoning\Shoreland-Wetland Zoning\Chapter 11 Forms\DCPSHL Application.docx Version 1.1 Created 12272013 <br />
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