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Dane County Land Conservation Division <br /> DINAP - "DO I NEED A PERMIT" <br /> General Information: <br /> Caller/Contact: David A Harris Phone#: 608.848.1365 h <br /> Landowner: same Phone#: 608.235.8415 cell <br /> Contact email: daveharris @tds.net <br /> Project Address: 6450 Purcell Rd. Belleville, WI 53508 <br /> Location:Township: Verona Sec: 36 1/4 SE <br /> Parcel #: 0608-364-9242-2 <br /> Project Description: Placement of pre-manufactured gazebo on existing ground. <br /> Fabric and washed stone will be placed under gazebo footprint. No earthwork will occur <br /> Planned Size of Disturbance: 0 ft2 Planned Size of New Impervious: 102 ft2 <br /> Land Conservation Division Response : <br /> Based on information above the project: ❑DOES* ✓❑DOES NOT require a permit <br /> Determination Made By: ❑JAH DJAS ❑JDB ❑JRT ✓❑RLS <br /> *Type of permit required: DEC as ❑SM ❑SE ❑SS <br /> ❑Disturbance >4000 ft2 ❑Slopes> 12% ❑Excavate/Fill>400 yds' <br /> ❑Disturbing 100' of ditch/channel 0125'New road/driveway ❑Shoreland Zone disturbance <br /> ❑Addition of 20,000 ft2 New Imp. ❑Subdivision Plat/CSM DOther: <br /> Basis for Determination: Fabric and washed stone will be placed under gazebo footprint. No earthwork will occur <br /> Activity does not meet the definition of "land disturbing activity" <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 />