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DCPSHL-2017-00039
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DCPSHL-2017-00039
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6/22/2017 11:17:56 AM
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Zoning Permits
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DCPSHL-2017-00039
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ZONING OFFICE USE ONLY ZONING OFFICE USE ONLY <br /> Project includes development within: (check all that apply) <br /> GKl000' of a lake or pond 300' of lake, pond, river or stream LI 300' of a floodplain <br /> ❑ A floodplain ❑ 75' of a wetland ❑ A wetland ❑ The vegetative buffer zone <br /> cliq Shoreland Water body: U(\riA Identification: 1 DNR designated? es ❑No <br /> ❑ Wetland ❑ Shoreland wetland ❑Inland wetland LI Wetland<2 acres <br /> ❑ Floodplain FEMA map panel: 55025C Flood zone: <br /> ❑Floodway ❑Flood fringe ❑General floodplain ❑Flood storage <br /> Lot <br /> ❑Existing ❑ Existing non-conforming ❑New <br /> Impervious Surface Calculations <br /> Area (square feet): do ` <br /> Total Lot: Otp Sq Ft <br /> Within 300' of <br /> ordinary high water <br /> mark Existing Additional Proposed Post Development <br /> Lot Sc=r t <br /> Primary building <br /> footprint (p <br /> Accessory building(s) <br /> • 6--S <br /> Driveway <br /> Any other impervious <br /> Total impervious <br /> Percent impervious 'I, ! ' J I • / et/ <br /> Project meets Shoreland standardslYes ❑No Shoreland zoning permit denied: ❑YesNo <br /> e <br /> Additional Dane County permits needed: \\ <br /> .NShoreland Erosion Control Permit ❑ Shoreland Mitigation Permit ❑Variance <br /> ❑Floodplain development permit Zoning Permit ❑ <br /> Additional information required: <br /> STATUS: ❑ Shoreland zoning permit and/or zoning permit issued contingent upon other permits <br /> Shoreland z•n' g permit on i ld for other permits <br /> —4 <br /> Issued by Date �O <br /> Assistant Zoning Administrator <br /> H:\Zoning\Shoreland-Wetland Zoning\Chapter 11 Forms\DCPSHL_Application.docx Version 1.1 Created 12272013 <br />
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