20090474 Ver 1_More Info Received_20090623

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. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non404, other) (acres)
Tem ora T
W1 ®P ? T Roadway fill, Tidal Freshwater ? Yes ® Corps 0.003
riprap Marsh ® No ? DWQ (142 sq.ft.)
W2 ® P ? T Roadway fill, Tidal Freshwater ? Yes ® Corps 0.005
riprap Marsh ® No ? DWQ (218 sq.ft.) .
W3 ® P ? T Roadway fill, Tidal Freshwater ? Yes ® Corps 0.001
riprap Marsh ® No ? DWQ (4 sq.ft.)
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts 0.008
(364 sq. ft.)
2h. Comments: B-4594, Bridge No. 44: Impacts are for fill placement at new bridge end bent locations and are necessary for
guard rail installation.

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. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
St ® P E3 T Fill (rip-rap) UT to Jones Bay ® PER
?INT ® Corps
®DWQ 25 18
S2 ® P ? T Fill (rip-rap) UT to Jones Bay ® PER
? INT ® Corps
® DWQ 25 38
? PER ? Corps
S3 ? P ? T ? INT ? DWQ
? PER ? Corps
S4 ? P ? T ? INT ? DWQ
? PER ? Corps
S5 ? P ? T ? INT ? DWQ
[I PER ? Corps
El P ? T
S6
? INT
? DWQ
3h. Total stream and tributary impacts 56
3i. Comments: Impacts occur from rip-rap placed as fill along the toe of slope at north side of bridge, along jurisdictional
lateral ditches that are tributaries to the UT to Jones Bay.
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PCN Form - Version 1.3 December 10, 2008 Version