20221583 Ver 1_ePCN Application_20221104

DWR
Division of Water Resources
Initial Review
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
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.
Pre -Filing Meeting Date Request was submitted on:
9/16/2022
BIMS # Assigned* Version#*
20221583 1
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
What amout is owed?*
$240.00
$570.00
Select Project Reviewer*
Sue Homewood:eads\slhomewood
la. Name of project:
UT to Cooks Creek Stream Restoration Project
la. Who is the Primary Contact?*
Charles Anderson
1 b. Primary Contact Email: * lc. Primary Contact Phone: *
[e-mail] [phone]
Date Submitted
11/4/2022
Nearest Body of Water
Cooks Creek
Basin
Yadkin-PeeDee
Water Classification
C
Site Coordinates
Latitude:
36.466949
A. Processing Information
Longitude:
-80.713915
County (or Counties) where the project is located:
Surry
Is this a NCDMS Project
Yes No
Is this project a public transportation project?*
Yes No

la. 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)
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)
lc. Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit (NWP) Number: 27 - Restoration
NWP Numbers (for multiple NWPS):
ld. 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
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
lg. 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
ld. 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:
Griffith, William J. and Griffith, Hollie Jones
2b. Deed book and page no.:
Book 01588, page 0133
2c. Contact Person:
2d. Address
Street Address
141 Challenger Ln
Address Line 2
City
Mt. Airy
Postal /Zip Code
27030
401 Water Quality Certification - Express
Riparian Buffer Authorization
State / Province / Region
NC
Country
United States
Yes No
Yes No

2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address: *
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Charles Anderson
3b. Business Name:
Resource Institute Inc.
3c. Address
Street Address
2631 Reynolda Rd
Address Line 2
City
Winston-Salem
Postal / Zip Code
27106
3d. Telephone Number:
[phone]
3f. Email Address: *
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Scott King
4b. Business Name:
Ecosystem Planning and Restoration (EPR)
4c. Address
Street Address
204 Stone Ridge Blvd.
Address Line 2
City
Asheville
Postal / Zip Code
28804
4d. Telephone Number:
[phone]
4f. Email Address: *
[e-mail]
C. Project Information and Prior Project History
State / Province / Region
NC
Country
United States
3e. Fax Number:
State / Province / Region
NC
Country
United States
4e. Fax Number:
1. Project Information
1b. Subdivision name:
(if appropriate)
lc. Nearest municipality / town:
Mt. Airy, NC
2. Project Identification
2a. Property Identification Number:
499900534595
2b. Property size:
35.95

2c. Project Address
Street Address
Haystack Rd (no street number given but immediately adjacent to 729 Haystack Rd)
Address Line 2
City State / Province / Region
Mt. Airy NC
Postal / Zip Code Country
27030 United States
3. Surface Waters
3a. Name of the nearest body of water to proposed project: *
Cooks Creek
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.
030401010704
4. Project Description and History
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 site is currently an active livestock pasture. It has five eroding, degraded tributaries to Cooks Creek running through it (existing the site flowing to the southeast) along with numerous,
fairly small, adjacent riparian wetlands. The site is largely cleared and consists of pasture grasses, though many areas alongside the streams are grown up in shrubs (as well as a relative
few trees). The site is located in a predominantly rural area of Surry County and is surrounded by numerous agricultural and silvicultural operations as well as a golf course to the north.
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:
2.059
4g. List the total estimated linear feet of all existing streams on the property:
3,505
4h. Explain the purpose of the proposed project: *
The project goals are to improve stability, habitat, and water quality through the restoration of degraded streams and the planting of native riparian buffers. The project will involve Priority 2
stream restoration to help restore floodplain connectivity and appropriate planform geometry the main stem (UT1) and two of its larger tributaries (UT2 and UT4). Additionally, stream
enhancement methods will be conducted on two smaller tributaries (UT3 and UT5) to stabilize the channels and improve bedform diversity.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The project involves the restoration of degraded, eroding streams running through an active livestock pasture and the subsequent fencing out of livestock and the replanting of buffers.
More specifically, in -stream structures such as rock cross vanes, J-hooks, log rollers, woody riffles, and geo-lifts will be used in the channels to provide stability and bedform diversity and
improve aquatic habitat diversity. All sections of riparian buffers not currently forested will be replanted in native woody vegetation. 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 the earth and materials.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No
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:
N/A
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
6. Future Project Plans
Scott King, PWS
Ecosystem Planning and Restoration (EPR)
6a. Is this a phased project?*
Yes • No
Unknown

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?
N/A
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
Wetlands
Open Waters
2. Wetland Impacts
Streams -tributaries
Pond Construction
Buffers
2a. Site #* (?)
2a1 Reason (?)
2b. Impact type*(?)
2c. Type of W.*
2d. W. name
2e. Forested*
2f. Type of Jurisdicition*
(?)
2g. Impact
area*
W-A
stream restoration
T
Bottomland Hardwood Forest
W-A
No
Both
0.009
(acres)
W-B
stream restoration
P
Bottomland Hardwood Forest
W-B
No
Both
0.070
(acres)
W-B
stream restoration
T
Bottomland Hardwood Forest
W-B
No
Both
0.445
(acres)
W-C
stream restoration
P
Bottomland Hardwood Forest
W-C
No
Both
0.020
(acres)
W-C
stream restoration
T
Bottomland Hardwood Forest
W-C
No
Both
0.307
(acres)
W-D
stream restoration
P
Bottomland Hardwood Forest
W-D
No
Both
0.025
(acres)
W-D
stream restoration
T
Bottomland Hardwood Forest
W-D
No
Both
0.320
(acres)
W-E
stream restoration
T
Bottomland Hardwood Forest
W-E
No
Both
0.025
(acres)
W-F
stream restoration
P
Bottomland Hardwood Forest
W-F
No
Both
0.022
(acres)
W-F
stream restoration
T
Bottomland Hardwood Forest
W-F
No
Both
0.061
(acres)
W-G
stream restoration
P
Bottomland Hardwood Forest
W-G
No
Both
0.005
(acres)
W-G
stream restoration
T
Bottomland Hardwood Forest
W-G
No
Both
0.006
(acres)
W-H
stream restoration
P
Bottomland Hardwood Forest
W-H
No
Both
0.003
(acres)
W-H
stream restoration
T
Bottomland Hardwood Forest
W-H
No
Both
0.011
(acres)
W-I
stream restoration
P
Bottomland Hardwood Forest
W-I
No
Both
0.005
(acres)
W-I
stream restoration
T
Bottomland Hardwood Forest
W-I
No
Both
0.019
(acres)
W-J
stream restoration
T
Headwater Forest
W-J
No
Both
0.242
(acres)
W-K
stream restoration
T
Bottomland Hardwood Forest
W-K
No
Both
0.032
(acres)
W-L
stream restoration
T
Bottomland Hardwood Forest
W-L
No
Both
0.021
(acres)
W-M
stream restoration
P
Bottomland Hardwood Forest
W-M
No
Both
0.015
(acres)
W-M
stream restoration
T
Bottomland Hardwood Forest
W-M
No
Both
0.026
(acres)
W-N
stream restoration
T
Bottomland Hardwood Forest
W-N
No
Both
0.010
(acres)
W-O
stream restoration
T
Bottomland Hardwood Forest
W-O
No
Both
0.005
(acres)
W-P
stream restoration
T
Bottomland Hardwood Forest
W-P
No
Both
0.011
(acres)

W-Q
stream restoration
P
Bottomland Hardwood Forest
W-Q
No
Both
0.009
(acres)
W-Q
stream restoration
T
Bottomland Hardwood Forest
W-Q
No
Both
0.104
(acres)
W-R
stream restoration
P
Bottomland Hardwood Forest
W-R
No
Both
0.016
(acres)
W-R
stream restoration
T
Bottomland Hardwood Forest
W-R
No
Both
0.157
(acres)
2g. Total Temporary Wetland Impact
1.811
2g. Total Wetland Impact
2.001
2g. Total Permanent Wetland Impact
0.190
2i. Comments:
The temporary impacts to the wetlands will consist of vehicle use over wetlands during the adjacent stream restoration work. The unavoidable
permanent impacts are from the realignment of the existing stream channels into a natural, stable pattern. The new channel alignments intersect the
adjacent wetlands in several locations.
3. Stream Impacts
3a. Reason for impact (?)
3b.Impact type*
3c. Type of impact*
3d. S. name*
3e. Stream Type*
(?)
3f. Type of
Jurisdiction*
3g. S. width
3h. Impact
length*
Si
Stream Restoration
Permanent
Relocation
UT1
Perennial
Both
10
Average (feet)
2,277
(linear feet)
S2
Stream Restoration
Permanent
Relocation
UT2
Intermittent
Both
6
Average (feet)
527
(linear feet)
S3
Stream Relocation
Permanent
Bank Stabilization
UT3
Intermittent
Both
5
Average (feet)
23
(linear feet)
S4
Stream Restoration
Permanent
Relocation
UT4
Intermittent
Both
6
Average (feet)
284
(linear feet)
S5
Stream Restoration
Permanent
Bank Stabilization
UT5
Intermittent
Both
5
Average (feet)
22
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
3,133
3i. Total stream and ditch impacts:
858
3i. Total temporary stream impacts:
0
3j. Comments:
Stream restoration utilizing Priority II methods will be conducted along the main channel (UT1) and its two larger tributaries (UT2 and UT4), while stream
enhancement methods to stabilize slopes and improve stream beds will be conducted along its smaller tributaries (UT3 and UT5).
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Stream restoration and bank stabilization methods and techniques will follow natural channel design principles. Native materials and vegetation will be
used for construction.
lb. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Placement of in -stream structures will be done from the streambanks.
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:
Compensatory mitigation is not required for stream restoration projects.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan

la. 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:
Surry County is not located in an area where NC Riparian Buffer Rules are in effect.
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:
N/A
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
1 b. 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)?*
Yes No
Comments: *
All applicable databases were searched and any results have been included here.
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.
No new infrastructure will be built as part of this project; therefore no additional development is anticipated after construction is completed. The project
will result in improved nearby downstream water quality.
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
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?*
Yes
5e. Is this a DOT project located within Division's 1-8?
Yes No
No Unknown
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
5h. Does this project involve the construction/installation of a wind turbine(s)?*
Yes No

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?
USFWS IPaC report and agency coordination (see attached agency response and report)
NCWRC agency coordination (see attached response)
NCNHP project report (attached)
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? *
NOAA Essential Fish Habitat Mapper website program (see attached)
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?*
NCSHPO agency coordination, and HPOweb tool and map search (see attached)
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8c. What source(s) did you use to make the floodplain determination?*
National Flood Hazard Layer (both FIRM maps and FEMA web tool - see attached figure)
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
UT_Cooks_PCN_Application_Attachments_COMBI N ED. pdf
UT_Cooks_Plan_Sheets_20221101.pdf
File must be PDF or KMZ
16.37MB
21.3MB
Comments
Please contact me at [e-mail] or 919-219-6339 with any questions regarding this submission. Please note that the landowners have no email address so I used mine for line 2g.
I can relay anything you want to give them or you may call them directly. Thank you!
-Scott King, PWS
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:
Scott Edwin King
Signature
Date
11/4/2022