20221790 Ver 1_revised impacts table_20230123

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below
for your project (check all that apply):
❑ Buffers ❑ Open Waters ❑ Pond Construction
X Wetlands X Streams — tributaries
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
Wetland impact
number
Permanent (P) or
Temporary (T)
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1 P
Excavation
Unknown
No
DWQ
0.04
W2 T
Excavation
Unknown
No
DWQ
0.2
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:
0.24
2h. Comments:
Permanent wetland impacts are based on an assumed average stream bed width of 3.5 feet multiplied by 418 LF. A previously permitted 20 LF
wetland impact for a road culvert is included in this impact area. Temporary wetland impacts for construction of the restored stream are estimated to
be 20 feet wide and 418 LF.
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.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 P
Stabilization
UT to Thompson River
PER
DWQ
8
212
S2 -
Choose one
-
-
S3 -
Choose one
-
-
S4 -
Choose one
-
-
S5 -
Choose one
-
-
S6 -
Choose one
-
-
3h. Total stream and tributary impacts
212
3i. Comments:
Total proposed stream restoration length is 630 LF; stream impacts are reduced by the 418 LF of stream bed to be constructed within an existing
wetland.
Page 4 of 10
PCN Form — Version 1.4 January 2009