20200752 Ver 1_401 Application_20200608

DWR
mrlslon of Water Resources
Pre -Construction Notification (PCN) Form
April 11, 2020 Ver 3.1
Initial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned * Version#*
20200752 1
Is a payment required for this project?*
r No payment required What amout is owed?*
r Fee received r $240.00
r Fee needed - send electronic notification IT $570.00
Reviewing Office *
Winston-Salem Regional Office - (336) 776- Select Project Reviewer*
9800 Sue Homewood:eads\slhomewood
Information for Initial Review
1a. Name of project:
UT to Little Fisher River Restoration
1a. Who is the Primary Contact?*
Jake Byers
1b. Primary Contact Email:*
[e-mail]
Date Submitted
6/8/2020
Nearest Body of Water
Little Fisher River
Basin
Yadkin -Pee Dee
Water Classification
C
Site Coordinates
Latitude: Longitude:
36.479099-80.720611
A. Processing Information
County (or Counties) where the project is located:
Surry
Is this a NCDMS Project
r Yes IT No
Is this project a public transportation project?*
r Yes IT No
1a. Type(s) of approval sought from the Corps:
W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1c. Primary Contact Phone:*
[phone]
1b. What type(s) of permit(s) do you wish to seek authorization?

W Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual Permit
27 - Restoration
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
F- 401 Water Quality Certification - E)press
r Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
r Owner W Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Holder Family Limited Partners
2b. Deed book and page no.:
00713/0894
2c. Responsible party:
2d.Address
Street Address
149 Bartow Trl
Address Line 2
city
Mount Airy
Postal / Zip 0ode
27030
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2a. Name(s) on recorded deed:
Sleepy Creek Farms Mt Airy LLC
State / Rwince / Ifgion
NC
(buntry
United States
2f. Fax Number:
r Yes r No
r Yes r No

2b. Deed book and page no.:
01562/0281
2c. Responsible party:
2d.Address
Street Address
211 Sleepy Creek Trl
Address Line 2
City
Mount Airy
Postal / Zip Code
27030
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Jake Byers
3b. Business Name:
Ecosystem Planning and Restoration
3c.Address
Street Address
9 Old Weaver Farm Road
Address Line 2
City
Weaverville
Postal / Zip Code
28787
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Jake Byers
4b. Business Name:
Ecosystem Planning and Restoration
4c.Address
Street Address
9 Old Weaver Farm Road
Address Line 2
city
Weaverville
Postal / Zip (ode
28787
4d. Telephone Number:
[phone]
0. Email Address:*
[e-mail]
Agent Authorization Letter*
SleepyCreek_AgentAuthorization Form.pdf
Holder_AgentAuthorization Form_Signed. pdf
Fc -- Project Information and Prior Project History
1. Project Information
State / Province / legion
NC
Country
United States
2f. Fax Number:
State / Province / Rion
NC
Country
United States
3e. Fax Number:
State / Province / legion
NC
Country
United States
4e. Fax Number:
117.36KB
1.26MB

1b. Subdivision name:
(d appropriate)
1c. Nearest municipality/ town:
Mount Airy
2. Project Identification
2a. Property Identification Number:
Sleepy Creek Farms: 499901484707 -
Holder: 499902680754
2c. Project Address
Street Address
Dynasty Lane
Address tine 2
city
Mount Airy
Postal / Zip Code
27030
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Little Fisher River
3b. Water Resources Classification of nearest receiving water:*
C
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
Little Fisher River - 030401010703
4. Project Description and History
2b. Property size:
Sleepy Creek Farms: 58.66 acres - Holder:
56.7
State / Bovine / IRLgion
NC
Country
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
The project site is a degraded stream that has been adversely affected by cattle farming and land clearing. Many of the project streams lack a riparian buffer and cattle currently have
access to the majority of the site.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r No r Unknown
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
Fig_2_L T_Little_Fisher_USGS.pdf 267.85KB
4e. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
Fig _4_UT_Little_Fisher _Soils.pdf 259.51 KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.84 acres
4g. List the total estimated linear feet of all existing streams on the property:
4184 ft.
4h. Explain the purpose of the proposed project:*
This project is being implemented through the Western NC Stream Initiative program. The proposed project area has been adversely impacted by cattle farming and a lack of effective
riparian buffers. The UT to Little Fisher River restoration project will restore apprommately 3,659 linear feet of degraded stream. NRCS practice codes that will be utilized include 584
Structural, 580 Bank Stabilization, 395 Habitat, 578 Crossing, and 612 Riparian Buffer. In -stream structures will be installed to protect stream bed and banks and to improve aquatic
habitat. Riparian buffers will be replanted in native woody vegetation.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Tracked excavators will be used to shape stream banks, excavate the floodplain, install in -stream structures, and perform general grading. Skid steers and dump trucks will also be used
to move earth and materials.
4j. Please upload project drawings for the proposed project.
UT_LFR_AIISheets_Permitting.pdf 9AMB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No r Unknown
Comments:
Not verified
5b. If the Corps made a jurisdictional determination, what type of determination was made?

r Preliminary r Approved r Not Verified r Unknown r NIA
Corps AID Number:
Sc. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company: Ecosystem Planning and Restoration
Other:
5d1. Jurisdictional determination upload
Fig_3_LFF_Little_ Fisher_ Aquatic_Resources.pdf 315.6KB
6. Future Project Plans
6a. Is this a phased project?*
r Yes r No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
W Wetlands W Streams -tributaries
r Open Waters F Pond Construction
2. Wetland Impacts
F Buffers
a. Site #* (?) 2a1 Reason (?) 2b. Impact type * (?) 2c. Type of W.* 2d. W. name * 2e. Forested* 2f. Type of 2g. Impact
Jurisdicition*(?) area*
V-C Floodplain benching P Headwater Forest W-C Yes DWR 0.006
(acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.006
2g. Total Wetland Impact
0.006
2h. Comments:
Impacts to Wetland C will be minimal. The other wetlands near the project site will not be impacted.
3. Stream Impacts
V
3a. Reason for impact (?)
3b.lmpact type *
3c. Type of impact*
3d. S. name*
3e. Stream Type*
Type of
3gSwidth *
3h. ImpactM
❑
�[3f.
urisdiction*
length*
S1
Restoration
Permanent
Bank Stabilization IF
to Little Fisher
Perennial
DWR
12
2,880
Average (feet)
(linear feet)
S2
Restoration
Permanent
Bank Stabilization
UT2
Perennial
DWR
4
73
Average (feet)
(linearfeet)
S3
Restoration
Permanent
Bank Stabilization J
UT3
Perennial
DWR
9
85
Average (feet)
(lir�rfeet)
�
Restoration
Permanent
Bank Stabilization J
UT4
Perennial
DWR
6
40
Average (feet)
(linearfeet)
3i. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts:
3,078
3i. Total stream and ditch impacts:
200
3j. Comments:
3i. Total temporary stream impacts:
0

E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Restoration and bank stabilization techniques will follow natural channel design principles. Native material and vegetation will be used for construction.
Work will be performed in the dry as a pump around operation will be used.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Stream crossings will be constructed and maintained to avoid further eroding banks during and after construction. A pump around operation will be
used to ensure that work is performed in the dry.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
r' Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Compensatory mitigation is not required for stream restoration projects.
F. itormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
r Yes f• No
If no, explain why:
Surry County is not located in an area with Riparian Buffer Protection Rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
2b. Does this project meet the requirements for low density projects as defined in 15ANCAC 02H .1003(2)?
r Yes r No
Comments:
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r Yes r No
1b. If you answered "yes" to the above, does the project require preparation of an environmental document pursuant to the requirements of the National or State (North Carolina)
Environmental Policy Act (NEPA/SEPA)? *
r Yes r No
Comments:*
Applicable databases were searched and any results have been included.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
The project will not result in additional development after construction is completed.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*

r Yes r Nor WA
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?*
r Yes r No
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
r Yes r No
5g. Does this project involve bridge maintenance or removal?
r Yes r No
5h. Does this project involve the construction/installation of a wind turbine(s)?'
r Yes r No
r Unknown
51. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
NC Natural Heritage Program GIS Data updated May 2011
NC NHP project report (attached)
hftps://www.fm.gov/raleigh/species/cntylist/stokes.html
Consultation Documentation Upload
UT_LFR_NHP_Report.pdf 902.46KB
UT_LFR_IPaC_Results.pdf 283.97KB
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NOAA Essential Fish Habitat Mapper
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NC State Historic Preservation Office HPOWEB (attached)
7c. Historic or Prehistoric Information Upload
UT_LFR_NCHPO Table.pdf
UT_LFR_NCHPO_Map.pdf
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-yearfloodplain?*
r Yes r No
8c. What source(s) did you use to make the floodplain determination?*
National Flood Hazard Layer FIRMette (attached)
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
110.55KB
314.13KB
U

FEMA_Firmette_Ur_Little _Fisher.pdf
405.03KB
UT Little Fisher Stream Forms.pdf
3MB
Ur Little Fisher Wetland Forms.pdf
9.04MB
Fig_1_UT_Little_Fisher _Vicinity.pdf
334.76KB
Fig_5_Uf_Little_Fisher _FEMA.pdf
320.82KB
Fig_6_UT_Little _Fisher _Property_Map.pdf
303.03KB
Ui_LFR_NCWRC_Lttr.pdf
2MB
UT_LFR_PhotoLog.pdf
4.16MB
Ui_LFR_USFWS_Lttr.pdf
2MB
Signature
® By checking the box and signing below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Jacob Byers
Signature
Date
6/8/2020

UNITED STATES DEPARTMENT OF AGRICULTURE
NATURAL RESOURCES CONSERVATION SERVICE 01119
CLIENT AUTHORIZATION FOR RELEASE OF RECORDS
Authorization to Release Information to another Person or Entity
This form is to be completed by a client (requestor) who is authorizing information relating to
him/herself to be released to another person or entity, pursuant to USDA Natural Resources
Conservation Service (NRCS) General Manual Title 120- Administrative Services and Section 1619 of
the 2008 Farm Bill, as amended.
I, A&A4tn I-��djt authorize the USDA-NRCS
to release the followind information relating to me:
All information contained in my cooperator case file.
OR
Specific information contained in my cooperator case file as checked below:
Conservation Plan
Q Schedule of Operations
Environmental Compliance
© Certified and/or official wetland determination and related information.
(F) Other specific information listed here:
Conservation Plan Map, NRCS-CPA-52, Request for Cultural Resources Review
(NC-ECS-01), EQIP Application status, NRCS-CPA-1200, NRCS-CPA-1155,
NRCS-CPA-1156, NRCS-CPA-1202, NRCS-CPA-1245, NRCS-CPA-1236
The above information may only be released to the following individuals or entities:
1 Resource Institute, Inc 5
2 All Federal, State, and Local agencies
3.
13
A
7
W
The information may be released to the above individuals/entities until
Full name of requestor:i
b
Current address:
Signature: a.000c a t244A* Date:
By signing this document, I certify that I have read the above information and understand that 1) releasing
this information is voluntary, 2) NRCS cannot protect the confidentiality of released information, and 3)
False statements are punishable by law.
Save As Print Reset Form
USDA is an equal opportunity provider, employer and lender. Page 2 of 2

Mutual Agreement
for
Stream Stabilization/Restoration Project
Resource Institute, Inc. (RI) is a non-profit organization that assists organizations and
individuals in carrying out projects to protect natural and human resources while promoting
economic development. RI can assist with projects in a variety of ways, including, but not limited
to, fund-raising, administering project funds, and contracting for services needed to complete a
project. RI has recently adopted projects associated with the USDA -MRCS EQIP program such
as the Western NC Stream Initiative and RCPP to help fanners and landowners address eroding
stream banks that are negatively affecting them through loss of property, hazards for livestock,
sediment transport into a stream and degraded aquatic habitat. The farmer/landowner has either
initiated an application for assistance through USDA/NRCS's EQIP program or has already signed
an agreement/contract for assistance with USDA/NRCS's EQIP program. RI's role is to help
attain the funding for the design, construction oversight and unmet construction needs of the work
for sites with current EQIP program agreements/contracts through USDA/NRCS.
RI will assist the farmer/landowner by helping to address issues related to managing and
contracting for the required design, planning, permitting and construction work for stream
enhancement practices on the site, as well as necessary structure work, and bank stabilization. RI's
objective is to help address current water quality degradation issues; however, work cannot be
guaranteed for acts of nature related to flood events or beyond the one year work warranty
given by the contractor. RI is working with NRCS, Conservation Districts, or other local unit of
government and the farmers/landowners to help reduce those impacts as much as possible.
In providing services to the farmer/landowner on this tract of land for stream
restoration/stabilization activities to be performed we thereby mutually agree to the following
items:
1. The farmer/landowner will allow ingress and egress for all activities related to the stream
restoration/stabilization such as: surveys, engineering, construction, monitoring, etc. for
RI and its agents.
2. Farmer/landowner will follow the contractual guidance in the EQIP program with USDA,
NRCS. This includes maintaining eligibility for individuals and/or entities if applicable.
3. Farmer/landowner will allow NRCS to provide RI with a copy of the associated NRCS
EQIP, application, contract and/or contract modifications, and appendix for the purpose of
allowing RI to share with RI's other funders in an effort to help obtain matching dollars.
This is consistent with the 1619 policy and RI's role as a NRCS Conservation Cooperator
assisting USDA-NRCS with technical and/or financial assistance through a cooperative
agreement. This is also consistent with the Participant/Landowner Acknowledgement
and/or the NRCS - Client Authorization for Release of Record form.

4. The farmer/landowner will assign payments for stream restoration/stabilization related
items/practices in the federal contract to Resource Institute using form CCC-36 within 15
days of the completion of construction for these items/practices.
5. Farmer/landowner will sign the NRCS-CPA-1245 within 15 days of notification to sign
this form to allow payment of the completed items/practices. (Initial/date)
6. RI will serve as the financial manager for all funds related to the stream
restoration/stabilization activities received for the project. This includes providing the
farmer/landowner (federal contract participant) with a receipt corresponding to the federal
funds received related to the stream restoration/stabilization practices/items. Note: The
federal funds received are based upon a payment schedule rate for the average cost.
7. RI will provide project management services such as, obtaining the technical resources,
bidding and contracting of project elements, and project construction oversight.
8. RI will work with farmers/landowners to resolve differences between construction costs
and payment schedule rates.
9. RI will also provide a local representative to assist with project management and to serve
as a liaison with NRCS/SWCD personnel, RI and the contract participant. Your RI
Representative contact info is listed below:
RI Representative Name:.
County
Stream Name
(Phone):
Stream Length
,ltlbe n 9,Av e-y- �T2nUYt.� pr[net� VI/�(IL.C� 4
Participant/landowner Print Name & itle Participant/landowner Signature
ei u n
Date
S3G -3 a•o-A4 07 1
Phone Number
.rim ha /suit SG C
Email Address
Chairman, Resource Institute RC&D, Inc. Date

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. NA PLAN NO. NA PARCEL ID: 499902680754
STREET ADDRESS: Haystack Road
Mount Airy NC 27030
Please print:
Property Owner: Holder Family Limited Partners
Property Owner:
The undersigned, registered property owner(s) of the above noted property, do hereby authorize
Jacob Byers of Ecosystem Planning and Restoration
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
149 Bartow Road, Mount Airy, NC 27030
Telephone: 33(o 5,ZC—Z&77
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature Aulliorized Signature
Date: /, - '/ a J Date: Y

UNITED STATES DEPARTMENT OF AGRICULTURE
NATURAL RESOURCES CONSERVATION SERVICE 01119
CLIENT AUTHORIZATION FOR RELEASE OF RECORDS
Authorization to Release Information to another Person or Entity
This form is to be completed by a client (requestor) who is authorizing information relating to
him/herself to be released to another person or entity, pursuant to USDA Natural Resources
Conservation Service (NRCS) General Manual Title 120- Administrative Services and Section 1619 of
the 2008 Farm Bill. as amended.
I, , authorize the USDA-NRCS
to release the following information relating to me:
All information contained in my cooperator case file.
OR
❑ Specific information contained in my cooperator case file as checked below:
Conservation Plan
E) Schedule of Operations
Q Environmental Compliance
Q Certified and/or official wetland determination and related information.
Other specific information listed here:
Conservation Plan Map, NRCS-CPA-52, Request for Cultural Resources Review
(NC-ECS-01), EQIP Application status, NRCS-CPA-1200, NRCS-CPA-1155,
NRCS-CPA-1156, NRCS-CPA-1202, NRCS-CPA-1245, NRCS-CPA-1236
The above information may only be released to the following individuals or entities:
1 Resource Institute, Inc 5
2 All Federal, State, and Local agencies 6
3.
H
7.
11
The information may be released to the above individuals/entities unti
Full name of requestor:
Current address:
Signature: GJIM., W.�6D�Qn�� Date: 5 -aa -010 9LO
By signing this document, I certify that I have read the above information and understand that 1) releasing
this information is voluntary, 2) NRCS cannot protect the confidentiality of released information, and 3)
False statements are punishable by law.
USDA is an equal opportunity provider, employer and lender. Page 2 of 2

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT No. _NA PLAN No. NA PARCEL ID: 499901484707
STREET ADDRESS: Laurel Springs Church Road
Mount Ajry NC 27030
Please print:
Property Owner: _Sleepy Creek Farms Mt Airy LLC
Property Owner:
The undersigned, registered property owner(s) of the above noted property, do hereby authorize
Jacob Byers of Ecosystem Planning and
Restoration
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
211 Sleepy Creek Trl, Mount Airy, NC 27030
Telephone: 33(o'110 - 5NLe
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
-O�AA., W
Authorized Signature ^ n Authorized Signature
Date: 5I ml aQ p� � Date:

Mutual Agreement
for
Stream Stabilization/Restoration Project
Resource Institute, Inc. (RI) is a non-profit organization that assists organizations and
individuals in carrying out projects to protect natural and human resources while promoting
economic development. RI can assist with projects in a variety of ways, including, but not limited
to, fund-raising, administering project funds, and contracting for services needed to complete a
project. RI has recently adopted projects associated with the USDA-NRCS EQIP program such
as the Western NC Stream Initiative and RCPP to help farmers and landowners address eroding
stream banks that are negatively affecting them through loss of property, hazards for livestock,
sediment transport into a stream and degraded aquatic habitat. The farmer/landowner has either
initiated an application for assistance through USDA/NRCS's EQIP program or has already signed
an agreement/contract for assistance with USDA/NRCS's EQIP program. RI's role is to help
attain the funding for the design, construction oversight and unmet construction needs of the work
for sites with current EQIP program agreements/contracts through USDA/NRCS.
RI will assist the farmer/landowner by helping to address issues related to managing and
contracting for the required design, planning, permitting and construction work for stream
enhancement practices on the site, as well as necessary structure work, and bank stabilization. RI's
objective is to help address current water quality degradation issues; however, work cannot be
guaranteed for acts of nature related to flood events or beyond the one year work warranty
given by the contractor. RI is working with NRCS, Conservation Districts, or other local unit of
government and the farmers/landowners to help reduce those impacts as much as possible.
In providing services to the farmer/landowner on this tract of land for stream
restoration/stabilization activities to be performed we thereby mutually agree to the following
items:
1. The farmer/landowner will allow ingress and egress for all activities related to the stream
restoration/stabilization such as: surveys, engineering, construction, monitoring, etc. for
RI and its agents.
2. Farmer/landowner will follow the contractual guidance in the EQIP program with USDA,
NRCS. This includes maintaining eligibility for individuals and/or entities if applicable.
3. Farmer/landowner will allow NRCS to provide RI with a copy of the associated NRCS
EQIP, application, contract and/or contract modifications, and appendix for the purpose of
allowing RI to share with RI's other funders in an effort to help obtain matching dollars.
This is consistent with the 1619 policy and RI's role as a NRCS Conservation Cooperator
assisting USDA-NRCS with technical and/or financial assistance through a cooperative
agreement. This is also consistent with the Participant/Landowner Acknowledgement
and/or the NRCS - Client Authorization for Release of Record form.

4. The farmer/landowner will assign payments for stream restoration/stabilization related
items/practices in the federal contract to Resource Institute using form CCC-36 within 15
days of the completion of construction for these items/practices.
5. Farmer/landowner will sign the NRCS-CPA-1245 within 15 days of notification to sign
this form to allow payment of the completed items/practices. (Initial/date)
6. RI will serve as the financial manager for all funds related to the stream
restoration/stabilization activities received for the project. This includes providing the
farmer/landowner (federal contract participant) with a receipt corresponding to the federal
funds received related to the stream restoration/stabilization practices/items. Note: The
federal funds received are based upon a payment schedule rate for the average cost.
7. RI will provide project management services such as, obtaining the technical resources,
bidding and contracting of project elements, and project construction oversight.
8. RI will work with farmers/landowners to resolve differences between construction costs
and payment schedule rates.
9. RI will also provide a local representative to assist with project management and to serve
as a liaison with NRCS/SWCD personnel, RI and the contract participant. Your RI
Representative contact info is listed below:
RI Representative Name:_
County
Stream Name
(Phone):
Stream Length
I W n UW` O OPOQW�
Participant/landowner Print Name & Title Participant/landowner Signature
5-aa- �a�
Date
Phone Number
Chairman, Resource Institute RC&D, Inc.
gmot; l.can�
Email Address
Date

USGS The National Map: Orthoimagery. Data refreshed April, 2019.
National Flood Hazard Layer FIRMette
0 500 1,000 1,500 2,000250Feet
Ü80°43'28.36"W 36°29'5.67"N 80°42'50.90"W 36°28'36.74"N
SEE FIS REPORT FOR DETAILED LEGEND AND INDEX MAP FOR FIRM PANEL LAYOUT
SPECIAL FLOODHAZARD AR EAS
Without Base Flood Elevation (BFE)Zone A, V, A99With BFE or Depth Zone AE, AO, AH, VE, AR
Regulator y Floodway
0.2% Annual Chance Flood Hazard, Areasof 1% annual chance flood with averagedepth less than one foot or with drainageareas of less than one square mile Zone X
Future Conditions 1% AnnualChance Flood Hazard Zone XArea with Reduced Flood Risk due toLevee. See Notes.Zone X
Area with Flood Risk due to Levee Zone D
NO SCREE N Area of Minimal Flood Hazard Zone X
Area of Undetermined Flood Hazard Zone D
Channel, Culver t, or Storm SewerLevee, Dike, or Floodwall
Cross Sections with 1% Annual Chance17.5 Water Surface ElevationCoastal Transect
Coastal Transect BaselineProfile BaselineHydrographic Feature
Base Flood Elevation Line (BFE)
Effective LOMRs
Limit of StudyJurisdiction Boundar y
Digital Data Available
No Digital Data Available
Unmapped
This map complies with FEMA's standards for the use of digital flood maps if it is not void as described below. The basemap shown complies with FEMA's basemap accuracy standards
The flood hazard information is derived directly from theauthoritative NFHL web ser vices provided by FEMA. This mapwas exported on 6/3/2020 at 11:42:55 AM and does notreflect changes or amendments subsequent to this date andtime. The NFHL and effective information may change orbecome superseded by new data over time.
This map image is void if the one or more of the following mapelements do not appear: basemap imagery, flood zone labels,legend, scale bar, map creation date, community identifiers,FIRM panel number, and FIRM effective date. Map images forunmapped and unmodernized areas cannot be used forregulatory purposes.
Legend
OTHER AREAS OFFLOOD HAZARD
OTHER AREAS
GENERALSTRUCTURES
OTHERFEATURES
MAP PANELS
8
1:6,000
B 20.2
The pin displayed on the map is an approximate point selected by the user and does not represent an authoritative proper ty location.
^_
Sources: Esri, HERE, Garmin, USGS, Intermap, INCREMENT P, NRCan, EsriJapan, METI, Esri China (Hong Kong), Esri Korea, Esri (Thailand), NGCC, (c)OpenStreetMap contributors, and the GIS User Community
UT to LITTLE FISHER RIVERSTREAM RESTORATION
SURRY COUNTY, NC
Vicinity Map
1 inch = 2,000 feet FIGURE 1 date:APR 2020
#
0 2,000 4,0001,000
Feet
^_Project Location
Project Area
Stream Centerline
^_^_£¤US-52
£¤US-421
£¤US-601£¤US-21
£¤US-52-BUS
£¤US-21-BUS
§¨¦I-77
§¨¦I-74
Project Location
Surry County, NCNorth Carolina
Project Location
Project Location
prepared by:EPR
^_
USGS The National Map: National Boundaries Dataset, 3DEP ElevationProgram, Geographic Names Information System, National HydrographyDataset, National Land Cover Database, National Structures Dataset, andNational Transportation Dataset; USGS Global Ecosystems; U.S. CensusBureau TIGER/Line data; USFS Road Data; Natural Earth Data; U.S.Department of State Humanitarian Information Unit; and NOAA NationalCenters for Environmental Information, U.S. Coastal Relief Model. Datarefreshed February, 2020.
UT to LITTLE FISHER RIVERSTREAM RESTORATION
SURRY COUNTY, NC
USGS MAP
1 inch = 1,000 feet FIGURE 2 date:APR 2020
#
0 1,000 2,000500
Feet
^_Project Location
Project Area
Stream Centerline
prepared by: EPR
Dobson QuadrangleNorth Carolina - Surry County7.5-Minute Series
Project Location
NC Center for Geographic Information & Analysis
UT to LITTLE FISHER RIVERSTREAM RESTORATION
SURRY COUNTY, NC
AQUATIC RESOURCES MAP
1 inch = 250 feet FIGURE 3 date:APR 2019
#
0 250 500125
Feet
Existing Wetlands
Project Area
Parcel Boundary
Stream Centerline
prepared by: EPR
UT to Little FisherReach 1
UT to Little FisherReach 2
W-D
S-5
S-2
S-4
S-3
W-C
S-1
W-B
W-A
FeD2
BbC
FeC2
FeC2
FeD2
FeB2
BbC
CsA
FeD2
FeC2
NC Center for Geographic Information & Analysis
UT to LITTLE FISHER RIVERSTREAM RESTORATION
SURRY COUNTY, NC
SOILS MAP
1 inch = 250 feet FIGURE 4 date:APR 2020
#
0 250 500125
Feet
Project Area
Soils
BbC-Braddock fine sandy loam (8-15%)
CsA-Colvard and Suches (0-3%, occasionally flooded)
FeB2-Fairview sandy clay loam (2-8%, moderately eroded)
FeC2-Fairview sandy clay loam (8-15%)
FeD2-Fairview sandy clay loam (15-25%)
prepared by: EPR
Zone AE
Zone XAREA OF MINIMAL FLOOD HAZARD3710498800Jeff. 8/18/2009
3711408000Jeff. 8/18/2009
NC Center for Geographic Information & Analysis
UT to LITTLE FISHER RIVERSTREAM RESTORATION
SURRY COUNTY, NC
FEMA Floodplain Map
1 inch = 500 feet FIGURE 4 date:APR 2020
#
0 500 1,000250
Feet
Project Area
Stream Centerline
FEMA Flood Zones
Zone AE
FIRM Panels
prepared by: EPR
NC Center for Geographic Information & Analysis
UT to LITTLE FISHER RIVERSTREAM RESTORATION
SURRY COUNTY, NC
PROPERTY MAP
1 inch = 250 feet FIGURE 6 date:APR 2020
#
0 250 500125
Feet
Project Area
Stream Centerline
Parcel Boundary
prepared by: EPR
S-1
S-2
Sleepy Creek Farms Mt. Airy LLCPIN: 499901484707 Holder Family Limited PartnersPIN: 499902680754
S&T Nichols Farm LLCPIN: 499900573256
Jarrell, Randall Dean and Donna SmithPIN: 499901472110
Tolbert, Carl A and Linda TPIN: 499900384472
S-3
S-4
S-5
UT to Little FisherReach 2
UT to Little FisherReach 1