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For Office Use Only <br /> Erosion Control Permit <br /> Simplified Application Checklist Permit Number: <br /> Date: <br /> Project Name: House <br /> Plan Requirements X Location of Information: <br /> Page Number or Attachment <br /> 1. Narrative describing the proposed project Replace existing house with a new house at a <br /> different location. OLD HOUSE: has been burned; <br /> we will push the basement walls into the hole; <br /> filled in with fill and top soil and reseeded. <br /> BARN: structure has been removed; we will <br /> remove concrete pad. NEW HOUSE: build house(by <br /> Cleary Building Corp.)in the 100x 150ft envelope <br /> indicated on the attached map. <br /> 2. * Site plan (of known scale that includes:property lines,disturbed area limits, See attached map. Proposed impervious area for <br /> impervious area limits(existing and proposed), natural and artificial water NEW HOUSE 3,637 ft'z which is smaller than the <br /> features, 100-yr flood plain,delineated wetland boundaries, location of all barn s existing concrete pad. <br /> proposed erosion control practices) <br /> NOTE.' Grading within 5'of the property line requires department approval <br /> 3. * Contours (existing and proposed) See attached map. <br /> 4. * Watershed size for each drainage area drainage will remain same as previously with the <br /> (include area draining to the site and within project boundaries) new house shifting to the north - 20 ft from <br /> where the old barn was located. <br /> 5. Tracking control all material will be kept on site and the current <br /> (provisions to prevent mud-tracking onto public streets and roads during driveway will be used to access the site. <br /> construction,e.g.tracking pad or existing gravel drive) <br /> 6. Sediment control practices to protect stormwater facilities or n/a <br /> storm sewer inlets, existing and proposed,on or adjacent to the <br /> site(e.g. inlet protection or stone weeper) <br /> 7. Proposed erosion control practices All disrupted areas are flat. All disrupted <br /> (list of erosion control practices) areas will be seeded and mulched as soon as <br /> completed. If any steeper slope are exposed <br /> during construction, we will stabilize them right <br /> away with seed and double mesh erosion matting. <br /> 8. Proposed start date We would remove the barn concrete immediately and <br /> (date for installation of all erosion control practices and start of land disturbing once the new house is approved by Dane County, <br /> activity) then we would begin the new building - 5/1/21 <br /> 9. Proposed stabilization date -7/15/21 <br /> (date for placement of seed&mulch,sod or permanent surfacing) <br /> 10. Culvert sizes n/a <br /> (existing and proposed culverts on or adjacent to the site) <br /> 11. Any other information necessary to reasonably determine the New house site is outside of the flood zone. <br /> location, nature and condition of any physical or environmental Please see attached Land Use Intent Application <br /> Form awaiting approval. <br /> features of the site <br /> Note: Any proposed changes to the erosion control plan must be submitted and approved prior to <br /> implementation. The permit will expire on the stabilization date indicated in the plan (see checklist item #9). <br /> * The following Dane County websites may be useful in addressing the above checklist items: <br /> http://accessdane.co.dane.wi.us/html/public.asp <br /> https://dcimapapps.countyofdane.com/lwrviewer/ <br /> https://wred-Iwrd.countyofdane.com/ <br /> Revised 10.16.2017 <br />