20211870 Ver 1_ePCN Application_20211221

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Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
December 6, 2021 Ver 4.2
Initial Review
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?*
Yes No
Change only if needed.
BIMS # Assigned*
20211870
Is a payment required for this project?
No payment required
Fee received
Fee needed - send electronic notification
Reviewing Office*
Winston-Salem Regional Office - (336) 776-
9800
Information for Initial Review
1a. Name of project:
Sugishita Project
1a. Who is the Primary Contact?*
Glen Sullivan
1 b. Primary Contact Email:*
[e-mail]
Date Submitted
12/21/2021
Nearest Body of Water
Pine Swamp Creek
Basin
New
Water Classification
QTr
Site Coordinates
Latitude:
36.466347
A. Processing Information
County (or Counties) where the project is located:
Allegheny
Is this a NCDMS Project
Yes No
Longitude:
-81.118219
Is this project a public transportation project?*
Yes No
1a. Type(s) of approval sought from the Corps:
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Version# *
1
What amout is owed?*
$240.00
$570.00
Select Project Reviewer*
Sue Homewood:eads\slhomewood
1c. Primary Contact Phone:*
[phone]

Has this PCN previously been submitted?*
Yes
No
1 b. What type(s) of permit(s) do you wish to seek authorization?
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit (NWP) Number: 13 - Bank Stabilization
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
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:
1f. Is this an after -the -fact permit application?*
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1 h. Is the project located in any of NC's twenty coastal counties?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
1d. Who is applying for the permit?
Owner Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
SUGISHITA LIVING TRUST
2b. Deed book and page no.:
418/994
2c. Contact Person:
Tim Sugishita
2d.Address
Street Address
340 Rock House Lane
Address Line 2
City
Sparta
Postal / Zip Code
28675
2e. Telephone Number:
[phone]
2g. Email Address:
[e-mail]
401 Water Quality Certification - Express
Riparian Buffer Authorization
State / Province / Region
NC
Country
us
2f. Fax Number:
Yes No
Yes No
U

4. Agent/Consultant (if applicable)
4a. Name:
Glen Sullivan
4b. Business Name:
Foggy Mountain Nursery
4c.Address
Street Address
2251 Ed Little Road
Address Line 2
City
Creston
Postal / Zip Code
28615
4d. Telephone Number:
[phone]
4f. Email Address:"
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1 b. Subdivision name:
(if appropriate)
BROOK VIEW
1c. Nearest municipality / town:
Sparta
2. Project Identification
2a. Property Identification Number:
3979656280
2c. Project Address
Street Address
340 Rock House Lane
Address Line 2
City
Sparta
Postal / Zip Code
28675
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Pine Swamp Creek
3b. Water Resources Classification of nearest receiving water:*
C;Tr
3c. What river basin(s) is your project located in?*
New
3d. Please provide the 12-digit HUC in which the project is located.
050500010404
4. Project Description and History
State / Province / Region
NC
Country
US
4e. Fax Number:
2b. Property size:
11.59
State / Province / Region
NC
Country
US
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 located along Pine Swamp Creek south of Sparta NC. Landcover in the area consists of mixed hardwood conifer, managed herbaceous cover, and mixed
upland hardwoods. The property is used as a permanent dwelling for landowners and their family. Surrounding land use is primarily rural residential with some agricultural use. Creek
banks
at the property are moderately to severely eroded due to the lack of vegetative buffer along stream.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?
Yes No Unknown
4f. List the total estimated acreage of all existing wetlands on the property:
0
u

4g. List the total estimated linear feet of all existing streams on the property:
1040 If of Pine Swamp Creek
4h. Explain the purpose of the proposed project: *
To repair and stabilize eroding banks by re-establishing proper bank profiles through bank reshaping and with 5 in -stream structures and to improve water quality. To improve habitat for
aquatic fauna and to improve the overall condition of the riparian areas at the site.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
Eroding banks will be reshaped to approximately 2:1, or flatter and planted with native vegetation. Five (5) J Hook rock vanes will be constructed to divert the thalwag back to the center of
the
stream. During construction a track hoe will do the work from the bank, although the track hoe may have to access the stream to construct the end of the J Hook rock vanes. After
construction the
bank will be seeded with native grass seed and sloped bank will be covered with erosion control matting and anchored with live stakes and landscape staples. Flat areas will be seeded
and mulched with straw. All areas will be planted with live stakes (Silky Willow, Salix Sericea) (Silky Dogwood, Corpus amomum) (Elderberry, Sambucus canadensis) along with native
rhododendron mtnlaurel and riverbirch.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
6. Future Project Plans
6a. Is this a phased project?*
Yes 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
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries Buffers
Open Waters Pond Construction
3. Stream Impacts
3a. Reason for impact (?)
3b.lmpact type*
3c. Type of impact*
3d. S. name*
3e. Stream Type*
3f. Type of
3g. S. width*
3h. Impact
(?)
Jurisdiction*
length*
S1
Stabilization
Permanent
Bank Stabilization
Pine Swamp Creek
Perennial
Both
21
990
Average (feet)
(linear feet)
S2
J Hook Rock Vane
Permanent
Bank Stabilization J
Pine Swamp Creek
Perennial
Both
21
10
Average (feet)
(linear feet)
S3
J Hook Rock Vane
Permanent
Bank Stabilization J
Pine Swamp Creek
Perennial
Both
21
10
Average (feet)
pinear feet)
S4
J Hook Rock Vane
Permanent
Bank Stabilization
Pine Swamp Creek
Perennial
Both
21
10
Average (feet)
(linear feet)
S5
J Hook Rock Vane
Permanent
Bank Stabilization
Pine Swam P Creek
Perennial
Both
21
10
Average (feet)
(linear feet)
S6
J Hook Rock Vane
Permanent
Bank Stabilization
Pine Swamp Creek
ferennial
Both
21
10
Average (feet)
(linear feet)
31. Total jurisdictional ditch impact in square feet:
0

31. Total permanent stream impacts:
1,040
3i. Total temporary stream impacts:
0
31. Total stream and ditch impacts:
1040
3j. Comments:
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:
This project will stabilize 1040 If of eroding stream bank, reduce stream bank erosion, reduce in -stream sediment loads and improve in -stream aquatic
habitats. Stream aesthetics will be improved with the establishment of a well vegetated and functioning riparian zone.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
During construction, equipment will only access the stream when absolutely necessary. For this project, it is anticipated that most of the track hoe work
can be accomplished from the top of the bank. However, equipment may need access the stream during the construction when no other construction
alternative exists. Soil disturbance will be limited to what can seeded and stabilized in one day. Banks will be seeded, and coir matting will be placed and
anchored with wooden stakes. Flat areas will be seeded and covered with straw.
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?
Yes No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
F. Stormwater 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?
Yes No
If no, explain why:
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
Yes No
Comments:
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
Yes No
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)? *
Yes No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?
Yes No
3b. If you answered "no," provide a short narrative description.

4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
Yes No N/A
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?*
Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
Yes No
5d. Is another Federal agency involved?*
Yes No
5e. Is this a DOT project located within Division's 1-8?
Yes No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
Yes No
5g. Does this project involve bridge maintenance or removal?
Yes No
5g(1). If yes, have you inspected the bridge for signs of bat use such as staining, guano, bats, etc.?
Yes No
If you answered "Yes" to 5g(1), did you discover any signs of bat use?
Yes No Unknown
5h. Does this project involve the construction/installation of a wind turbine(s)?*
Yes No
Unknown
5i. 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.?
Yes No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
www.fws.gov/nc-es/es/countyfr.html
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?
Yes No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?
ocean.floridamarine.org/efh_coral/ims/viewer.htm
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?*
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
www.hpo.ncdcr.gov/nrlist.htm
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8b. If yes, explain how project meets FEMA requirements:
The project will not impede flood waters.
8c. What source(s) did you use to make the floodplain determination?*
msc.fema.gov/portal/search#searchresultsanchor
Miscellaneous

Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one file when
possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
agent authorization. pdf
114.58KB
J-hook structure.pdf
195.56KB
pics.pdf
571.84KB
sheet1.pdf
230.03KB
sheet2.pdf
217.8KB
SodaPDF-converted-NC_ Glade _Valley _20160630_TMorth_geo.pdf
15.95MB
topo2 (1).pdf
85.44KB
File must be PDF or KMZ
Comments
Signature
By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief'; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• 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:
Glen Sullivan
Signature
Date
12/21 /2021

6160FIJ�designate Glen Sullivan of Foggy Mountain
Nursery to act as my duly authorized agent concerning all US Army Corps of
Engineers and NC DENR permitting regarding the stream bank restoration project
on my property in County, NC.
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J-HOOK STRUCTURE
J-Hook structures
main function is to
prevent back
eddying and
erosion of banks.
These structures
reduce near bank
stress while
increasing shear
stress and sediment
movement through
the center of the
stream. Fish
habitat is created
near and around
the structure.
This structure is located downstream of the point where the stream flow encounters the streambank
at acute angles. The structure starts at bankfull, slopes down, and points upstream. The length of a
structure can span 1/2 to 1/3 of baseflow channel width while the slope can range from 2 — 20%.
Rock size depends on the size of stream. Generally, heavier and flatter rocks greater than 1 to 2
tons are recommended. Building longer and flatter structures are preferred for maximum length of
streambank protection and habitat creation.
Footer rocks are an
important component
of this structure. They
are placed downstream
of the top rock to
prevent the structure
from sinking into a
scour hole. All the top
rocks must touch each
other except the last
two or three rocks.
These rocks are spaced
1/2 of the rock diameter
to converge stream
flow; thus, creating a
large scour hole to
dissipate energy and for
aquatic habitat_

J-HOOK STRUCTURE showing plan, profile, and cross sectign views
CROSS-SECTION VIEW
Modified by Madelyn T. Martinez from Dave Rosgen

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