20110297 Ver 1_More Info Received_20110405

C. Proposed impacts inventory MOSAIC VILLAGE - DWQ #11-0297
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
E] Wetlands (R Streams - tributaries ? Buffers ? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of impact Type of wetland Forested Type of jurisdiction Area of
number Corps (404,10) or impact
Permanent (P) or DWQ (401, other) (acres)
Temporary T
W1 P Culvert Headwater No -404/401 .02 ac
W2 Choose one Choose one Yes/No
W3 Choose one Choose one Yes/No
W4 Choose one Choose one Yes/No
W5 Choose one Choose one Yes/No
W6 Choose one Choose one Yes/No
2g. Total Wetland Impacts: .02 ac
Zh. Comments' Wetland is saturated sidestream bench in bottom of trapezoidal
stormwater channel.
3. Stream Impacts
if there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 39.
Stream impact Type of impact Stream name Perennial (PER) or Type of Average Impact
number intermittent (INT)7 jurisdiction stream length
Permanent (P) or width (linear
Temporary (T) (feet) feet)
S1 P Culvert UT Irwin Creek INT •401/404 2 feet 170.61
SZ Choose one
S3 Choose one
S4 Chccse one
S5 Choose one
S6 Choose one
3h. Total stream and tribu tary impacts 170.61
3i. Comments: Stream is an impaired urban intermittent stream which flows out of a culvert and into
another culvert. Entire upstream drainage area is comprised of stormwater inlets and
culverts. Aquatic life was not observed.
r?Jt
APR 0 5
2011
MW-WATER(U&p
SAND S1nRpIlYATpZ BRANCH
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PCN Form - Version 1.4 January 2009