20161200 Ver 3_MillstoneCreekPCN_20230614

DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 11, 2020 Ver 3.1
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all mandatory questions are answered.
Also, if at any point you wish to print a copy of the E-PCN, all you need to do is right -click on the document and you can print a copy of the form.
Below is a link to the online help file.
https://edoes. deq. n e.gov/WaterResou rces/0/ed oc/624704/PCN % 20 Help / 20F i le / 202018-1-30. pdf
A. Processing Information (:)
County (or Counties) where the project is located:*
Randolph
Is this a NCDMS Project*
F Yes r No
Click Yes, only if NCDlvS is the applicant a co -applicant.
Is this project a public transportation project?
O Yes F No
This is arry publicly funded by rrunicipal,state a federal funds road, rail, airport transportatim project.
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)
1 b. What type(s) of permit(s) do you wish to seek authorization?
P Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
This form may be used to initiate the standard/individual permit process with the Corps. Please contact your Corps representative concerning submittals for standard permits. All required items that
are not provided in the E-PCN can be added to the miscellaneous upload area located at the bottom of this form.
1c. Has the NWP or GP number been verified by the Corps?*
Yes r No
Nationwide Permit (NWP) Number: 27 - Restoration
NWP Numbers (for multiple NWPS):
List all NJVnurbers ycw are applying fa not m the drop dawn list.
1d. Type(s) of approval sought from the DWR:*
check all that apply
W 401 Water Quality Certification - Regular ❑ 401 Water Quality Certification - Express
r Non-404 Jurisdictional General Permit ❑ Riparian Buffer Authorization
r Individual Permit
le. Is this notification solelyfor the record because written approval is not required?
.............................................. .................... ....................
*
For the record onlyfor DWR 401 Certification: 6 Yes 6 No
For the record onlyfor Corps Permit:
1f. Is this an after -the -fact permit application?*
r Yes F No
6 Yes 6 No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
If so, attach the acceptance letter from ratigafim bank a in -lieu fee program
r Yes E No
Acceptance Letter Attachment

Click the upload button a drag and drop files here to attach dccunent
eApproval Letter_ Millstone Creek_SAW-2019-01363.pdf 212.01 KB
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1 h. Is the project located in any of NC's twe nty coastal counties?*
r Yes (-- No
1j. Is the project located in a designated trout watershed?*
r Yes r No
Link to trout information: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Progra"Agency-Coordination/Trout.aspx
B. Applicant Information
la. Who is the Primary Contact?*
Lin Xu
1c. Primary Contact Phone:*
1b. Pri mary Contact Email:*
(xxx)xxx-xxxx
[e-mail]
[phone]
1d. Who is applying for the permit?
r- Owner
rJ Applicant (other than owner)
(Check all that apply)
le. Is there an Agent/Consultant for this project?*
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:*
Joe Dean Cox and Wife Billie W. Cox
2b. Deed book and page no.:
Book 1228 and Page 1304
2c. Responsible party:
(for Corporations)
2d. Address*
Street Address
5567 Joe Dean Trail
Address Line 2
Qty
State / Aovince / Pegicn
Ramseur
NC
Fbstal / Zp Code
Country
27316
Randolph
2e. Telephone Number:*
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:*
3b. Business Name:
(d applicable)
3c. Address*
Street Address
217 W Jones St.
Address Line 2
Qty
State / Aovince / Pegicn
Raleigh
NC
Fbstal / Zp Code
Country
27603
Wake

3d. Telephone Number:*
[phone] 3e. Fax Number:
(xxx)xxx-xxxx (xxx)xxx-xxxx
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:*
N/A
4b. Business Name:
(d applicable)
4c. Address*
Street Address
N/A
Address Line 2
aty
State / Aovince / Regim
N/A
N/A
Postal / Zp Code
Country
N/A
N/A
4d. Telephone Number:*
[phone]
4e. Fax Number:
(xxx)xxx-xxxx
(xxx)xxx-xxxx
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
Rease provide the Agent Aulhorizatm Letter if you are subrrittng the dmurrent.
Millstone Parcel.pdf
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C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Millstone Creek Mitigation Site Mitigation Project
1b. Subdivision name:
(d appropriate)
1c. Nearest municipality / town:
*
Ramseur
2. Project Identification
2a. Property Identification Number:
2b. Property size:
(tax RN a parcel ID)
(in acres)
8710492424
17.96
2c. Project Address
Street Address
5567 Joe Dean Trail
Address Line 2
aty
State / Aovince / Regim
Ramseur
NC
Postal / Zp Code
Country
27316
Randolph
458.04KB
2d. Site coordinates in decimal degrees
Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey -grade GPS device) after the decimal place as appropriate, based on howthe location was
determined. (For example, most mobile phones with GPS provide locational precision in decimal degrees to map coordinates to 5 or 6 digits after the decimal place.)
Latitude:* Longitude:*
35.696683-79.623956
ex: 34.208504-77.796371
3. Surface Waters

3a. Name of the nearest body of water to proposed project:*
Millstone Creek
3b. Water Resources Classification of nearest receiving water:*
C
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Cape Fear
3d. Please provide the 12-digit HUC in which the project is located.*
030300030200
River Basin Lookup
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 project site and contributing watersheds are located with the Carolina Slate Belt. For the last 25 years, land use characteristics for the project site has been relatively constant with
the majority of land being managed as pasture or hay production. The watershed for Millstone Creek is approximately 35 % in forest and rest of it is in pasture. Land use for the
tributaries is over 95 % in pasture and rest of it is in forest. Over 50 % of the stream length in the project area is incised.
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)
Oickthe upload button a drag and drop files here to attach docurrent
MillstoneTopoMap.pdf 708.18KB
File type crust be pdr
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)
Oickthe upload button a drag and drop files here to attach docurrent
MillstoneSoilMap.pdf 945.19KB
File type crust be pdr
4f. List the total estimated acreage of all existing wetlands on the property:
1.323
4g. List the total estimated linear feet of all existing streams on the property:
(intermittent and pffenrral)
3555
4h. Explain the purpose of the proposed project:*
The purpose of the proposed project is to provide stream and wetland mitigation credit in the Cape Fear 03030003 service area. Mitigation practices will include stream restoration,
enhancement and wetland enhancement.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Stream restoration will involve excavation of a new channel that is designed to be functional and stable. Stream dimension, pattern, and profile have been designed to provide a cross
sectional area sized for frequent overbank flows, a stable bed with variable bed forms using in -stream structures, well vegetated bank slopes, a well connected floodplain, and
improvements to aquatic habitat. The project area will be placed in a conservation easement to protect the project in perpetuity. The easement will be fenced to exclude livestock where
necessary. Native riparian vegetation will be planted on the streambanks andfloodplains. Excavators and bulldozers will be used for channel filling/excavation and floodplain grading.
Off -road dump trucks will be used for hauling soil.
4j. Please upload project drawings for the proposed project.
Oickthe upload button a drag and drop files here to attach docurrent
Millstone PCN Impacts Map.pdf 2.83MB
Millstone PCN Impacts Table_Stream.pdf 412.09KB
Millstone PCN Impacts Table_Wetland.pdf 404.13KB
File type crust be pdr
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
(-- Yes C No O Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
(- Preliminary c Approved (- Not Verified r Unknown r N/A
Corps AID Number:
Exarrple: SAW-2017-99999
SAW-2019-01363
5c. If 5a is yes, who delineated the jurisdictional areas?

Name (if known): Melonie Allen
Agency/Consultant Company: NC DIMS
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made bythe Corps or DWR.
UCACE Determination by Samantha Dailey on March 11, 2020
5d1l. Jurisdictional determination upload
Oickthe upload button a drag and drop files here to attach docurrent
Millstone JD.pdf 2.72MB
File type rust be FLF
6. Future Project Plans
6a. Is this a phased project?*
r Yes E 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? This
includes other separate and distant crossing for linear projects that require Department of the Army authorization but don't require pre -construction notification.
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
rJ Wetlands r Streams -tributaries C Buffers
r Open Waters 7' Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
"W." will be used in the table below tore present the word "wetland".
2al Reason*(?)
2b. Impact type*(?)
2c. Type of W.
2d. W. name*
2e. Forested*
2f. Type of
2g. Impact
Jurisdicition*(?)
area*
W1
Relocation
P
Non -Tidal Freshwater Marsh
Wetland 1
No
Corps
0.003
(acres)
W2
Stream Bankvrork
T
Non -Tidal Freshwater Marsh
Wetland 1
No
Corps
0.079
(acres)
W3
Stream Bankvmrk
L
Non -Tidal Freshwater Marsh
Wetland 1
No
Corps
0.024
(acres)
2g. Total Temporary Wetland Impact
0.103
2g. Total Permanent Wetland Impact
0.003
2g. Total Wetland Impact
0.106
2h. Comments:
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.
"S." will be used in the table below to represent the word "stream".
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
M
Jurisdiction*
length*
S1
Stream
Tem orar
P Y
Stabilization
MC R1
Perennial
DWR
38
1,462
Restoration/Enhancement
Avaage (feet)
(linear feet)
S2
Stream
Tem orar
P Y
Other
MC R1
Perennial
DWR
38
30
Restoration/Enhancement
Average (feet)
(linear feet)
S3
Stream
Tem orar
P Y
Stabilization
MC R2
Perennial
DWR
31
54
Restoration/Enhancement
Average (feet)
(linear feet)
S4
Stream
Tem orar
P Y
Relocation
MC R2
Perennial
DWR
31
339
Restoration/Enhancement
Average (feet)
(linear feet)

S5
Stream
Tem orar
P Y
Stabilization
MC R2
Perennial
DWR
31
160
Restoration/Enhancement
Average (feet)
(linear feet)
S6
Stream
Tem orar
P Y
Stabilization
NT R1
Perennial
DWR
6
303
Restoration/Enhancement
Average (feet)
(linear feet)
S7
Stream
Tem orar
P Y
Stabilization
NT R2
Perennial
DWR
5
103
Restoration/Enhancement
Average (feet)
(linear feet)
SS
Stream
Tem orar
P Y
Stabilization
ffR1
Perennial
DWR
12
505
Restoration/Enhancement
Average (feet)
(linear feet)
S9
Stream
Tem orar
P Y
Stabilization
UTA R2
Perennial
DWR
15
100
Restoration/Enhancement
Average (feet)
(linear feet)
S10
Stream
Tem orar
P Y
Stabilization
UTB
Perennial
DWR
5
529
Restoration/Enhancement
Average (feet)
(linear feet)
**All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square feet:
3i. Total permanent stream impacts:
3i. Total temporary stream impacts:
3,585
3i. Total stream and ditch impacts:
2124
3j. Comments:
E. Impact Justification and Mitigation V
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
Stream restoration activities will introduce fill to existing stream channel but are designed to have an overall positive impact. Stream impacts will be
avoided and minimized to project reaches that exhibit less instability and incision. Stream alignments for restoration reaches were designed to
avoid existing wetland as much as possible and avoid grading impacts. Unavoidable impacts to wetlands are due to floodplain grading or conversion of
wetland to stream channel.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Restoration will involve construction of offline channel sections which will minimize sedimentation to aquatic systems during construction. Newly
constructed channel banks will be stabilized using biodegradable coir fiber matting and seeded and planted with native riparian vegetation. Temporary
construction crossing will be minimized. Construction practices will follow guidelines from the NC Erosion and Sediment Control Planning and Design
Manual.
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?
C Yes E No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
NWP 27 is exempt from compensatory mitigation.
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS website.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
*** Recent changes to the stormwater rules have required updates to this section .***
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?
C Yes F No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
The project will follow approved sedimentation and erosion control plan.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*

O Yes O No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)? *
O Yes F No
To look up lowdensity requirement click here 15A NCAC 02H .1003(2).
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater
program?
• Yes No
f•N/A - project disturbs < 1 acre
Hnt: projects that have vested rights, exerrlAors, a grandrathering from state a locally inplerrented stormater programs a projects that satisfy state a locally-inplerrentei stormater programs through use of ccrrnnity irrlieu programs should answer no
to this question.
3. Stormwater Requirements
3a. Select whether a completed stormwater management plan (SMP) is included for review and approval or if calculations are provided to document the project will not cause
degradation of downstream surface waters.*
6 Stormwater Management r Antidegradation
Plan Calculations
3b. Stormwater Management Plan: If submitting a SMP for review and approval, it shall complywith the high -density development requirements set forth in 15A NCAC 02H .1003.
Include all appropriate stormwater control measure supplemental forms and associated items.
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3c. Antidegradation Calculations: If submitting calculations to document the project will not cause degradation of downstream surface waters, the documentation shall include a
detailed analysis of the hydrological impacts from stormwater runoff when considering the volume and velocityof stormwater runoff from the project built upon area and the size
and existing condition of the receiving waterbody(ies).
Oickthe upload button a drag and drop files here to attach dccurrent
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Comments:
None
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
C1 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
C No
1c. If you answered "yes" to the above, has the document review been finalized bythe State Clearing House? (If so, attach a copyof the NEPAor SEPAfinal approval letter.)*
(-- Yes r No
NEPAor SEPAFinal Approval Letter
Oickthe upload button a drag and drop files here to attach dccurrent
Millstone CE.pdf 287.48KB
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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)? *
c- Yes
r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in additional development, which could impact nearby downstream water quality?*
r Yes
(-- No
3b. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWR Requirement)
4a.Issewage disposal required byDWRforthis project?*
f Yes f No f 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
r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
(-- Yes r No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
r Yes No
5e. Is this a DOT project located within Division's 1-8?*
Yes r No
5f. Will you cut anytrees 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?*
O Yes O No
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-1,0-17-signed_NLEB-SLOPESRapps.pdf
5h. Does this project involve the construction/installation of a wind turbine(s)?'*
r Yes r• No
r 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.? *
r Yes C No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
USFWS and NC Natural Heritage program databases were utilized. USFWS commented that "the proposed actions is not likely to adversely affect any
federally -listed endangered or threatened species, their formally designated critical habitat, or species currently proposed for listing under the Act."
ESA correspondence is included in the Categorical Exclusion.
Consultation Documentation Upload
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Millstone CE.pdf 287.48KB
File type crust be FLF
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?
r Yes f- No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
USFWS and NCWRC were contacted regarding fish and wildlife issues associated with the proposed project. No concerns were identified regarding
essential fish habitat. Correspondence is included in the Categorical Exclusion.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.neder.gov/hpoweb/
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 (e.g., National Historic
Trust designation or properties significant in North Carolina historyand archaeology)?*
r Yes (-- No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCSHPO was contacted regarding the presence of historical properties or cultural resources within the project area. SHPO commented that they were
aware of no historic or cultural resources that would be affected by the project. Correspondence is included in the Categorical E)clusion.
7c. Historic or Prehistoric Information Upload
Oickthe upload button a drag and drop files here to attach docurrent
File must be FLF
8. Flood Zone Designation (Corps Requirement)
Link to the FEMAFIoodplain Maps: https://rrse.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year flood plain? *
r Yes
0- No
8c. What source(s) did you use to make the floodplain determination?*
NC Floodmap
Miscellaneous
Comments

Final mitigation plan, cover letter and fee memo are uploaded here
Miscellaneous attachments not previously requested.
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MillstoneCreek401 FeeMemo.pdf
331.46KB
MillstoneCreek401 COffice.pdf
347.35KB
Mil Isto ne_Mit_Plan_5-1-20_fina I. pdf
62.69MB
Response to Comments Final.pdf
231.63KB
File mst be FLF a IQvZ
Signature U
0 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:*
Lin Xu
Signature
Le"
Full Name (Co -Signor)*
N/A
Co -Signor Signature*
Date
6/19/2020