DARDAN Impact Table 09-10-24.pdf

Page 4 of 10
PCN Form – Version 1.4 January 2009
C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
Wetlands 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.
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
W2
W3
W4
W5
W6
2g.Total Wetland Impacts:
2h. Comments:
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
S2
S3
S4
S5
S6
3h. Total stream and tributary impacts
3i. Comments:
Land Clearing Bottomland Hardwood Forest Yes Corps 0.05
Yes/No -
Yes/No -
Yes/No -
Yes/No -
Yes/No -
0.05
The wetland impacts are proposed for the connection to the preexisting sanitary sewer located on the property. The area will be restored to pre-exisitng
conditions.
Culvert S-1 INT Corps 3.12 139
S-1 3.12 129
278
T
-
-
-
-
-
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
P
T
-
-
-
-
Dewatering
Choose one
Choose one
Choose one
Choose one
INT
-
-
-
-
Corps
-
-
-
-