20171388 Ver 2_Repair Modification_20171206

430TOTAL407
TOTAL

Page 2
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Stream Bank Repairson MallardCreek Upstream of East
Mallard Creek Church Road.

Project Summary Sheet
Project Name:
Applicant Name and Address:
Telephone Number:
Type of Request:
Included Attachments:
Check if applicable:
County: Nearest City/Town:
Waterway: River Basin:
H.U.C.: USGS Quad Name:
Property Size (acres):Approx. Size of Jurisdiction on Site (acres):
Site Coordinates (in decimal degrees):
Project Location:
Site Description:
Impact Summary (if applicable):
Stream Channel
Open WaterWetland
Intermittent and/or UnimportantPerennial and/or Important
(acres)(acres)
NWP
Aquatic FunctionAquatic Function
#
Temp.Perm.Temp.Perm.
Temp. Perm. Temp. Perm.
lfaclfaclfaclfAc
Total
Total Permanent Impact to Waters of the U.S. (lf/acres)387/0.0152
Total Temporary Impact to Waters of the U.S. (lf/acres)20/0.009
Kimley-Horn Contact:Direct Number:
Email:

Pre-Construction Notification (PCN) Form
A. Applicant Information

. Total wetland impacts

4f. Total open water impacts
5f. Total

Total buffer impacts

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