20180814 Ver 1_More Info Received_20180802

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4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then indivii ualiy list all open water impacts below.
4a.
Open water
impact number
Permanent (P) or
Temporary T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01
Choose one
Choose
02
Choose one
Choose
03
Choose one
Choose
04
Choose one
Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
(acres)
Flooded Filled
Excavated Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
5f. Total:
5g. Comments: NIA
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a. Project is in which protected basin?
❑X Neuse ❑ Tar -Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number–
Permanent (P) or
T
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet)
6g.
Zone 2
impact
(square
feet
—Temporary
B1 P
Walk, dock,and abutments
Buffalo Creek & Robertson's Pond
No
502
2,147
B2 P
Boat Launch
Buffalo Creek & Robertson's Pond
No
346
B3 P
Mill Concrete pad
Buffalo Creek & Robertson's Pond
No
480
B4 T
Construction Access
Buffalo Creek & Robertson's Pond
No
3.708
6,448
B5 P
Permitted Phase I Walkway
Buffalo Creek & Robertson's Pond
No
80
176
B6
Yes/No
6h. Total Buffer Impacts:
5,116
8,771
6i. Comments: B1: permanent concrete nature Walks and two boardwalk abutments. B2: boat launch B3: mill concrete pad B4: Construction access
to install improvements with adjacent areas re -vegetated; B5: Permitted Phase I permanent Impacts
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