20231360 Ver 1_ePCN Application_20230929

DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
October 2, 2023 Ver 4.3
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.
Pre -Filing Meeting Date Request was submitted on:
5/8/2023
Does this project involve maintenance dredging funded by the Shallow Draft Navigation Channel Dredging and Aquatic Weed Fund or involve the distribution or transmission of energy or
fuel, including natural gas, diesel, petroleum, or electricity?
Yes No
BIMS # Assigned
20231360
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
la. Name of project:
SCC Watershed Site 2 - Camp Creek Golf Course Stream Restoration
1a. Who is the Primary Contact?*
Jennings Environmental, PLLC, David Brown
1b. Primary Contact Email:
[e-mail]
Date Submitted
9/29/2023
Nearest Body of Water
Camp Creek and UT Camp Creek
Basin
Yadkin-PeeDee
Water Classification
C
Site Coordinates
Latitude: Longitude:
36.30916-80.85675
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Surry
Version#*
1
What amount is owed?*
$240.00
$323.00
Select Project Reviewer*
Rebecca Chandler:rebecca.chandler
1c. Primary Contact Phone:*
[phone]
$570.00
$767.00
a

Is this a NCDMS Project
Yes No
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)
Has this PCN previously been submitted?*
Yes
No
1b. 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: 27 - Restoration
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
1h. 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)
1e. Is there an Agent/Consultant for this project?'�
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
Cedarbrook Country Club Inc.
2b. Deed book and page no.:
2c. Contact Person:
Jeff Lawrence
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No
O

2d. Address
Street Address
225 Country Club Drive
Address Line 2
City
State Road
Postal / Zip Code
28676-8908
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Chris Knopf, County Manager
3b. Business Name:
Surry County
3c.Address
Street Address
P.O. Box 1467
Address Line 2
city
Dobson
Postal / Zip Code
27017
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
David Brown, PG
4b. Business Name:
Jennings Environmental, PLLC
4c.Address
Street Address
7 Samuel Ashe Drive
Address Line 2
City
Asheville
Postal / Zip Code
28805
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Cedarbrook Country Club
1c. Nearest municipality / town:
State Road
State / Province / Region
NC
Country
USA
2f. Fax Number:
State / Province / Region
NC
Country
USA
3e. Fax Number:
State / Province / Region
NC
Country
USA
4e. Fax Number:
O
2. Project Identification

2a. Property Identification Number:
Parcel ID 495303337074
2b. Property size:
1.39 ac portion of larger 219 ac tract
2c. Project Address
Street Address
225 Country Club Drive
Address Line 2
city
State Road
Postal / Zip Code
28676-8908
3. Surface Waters
3a. Name of the nearest body of water to proposed project: "
Camp Creek and UT Camp Creek
3b. Water Resources Classification of nearest receiving water:'
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.
Upper Yadkin 03040101
4. Project Description and History
State / Province / Region
NC
Country
USA
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 property is an existing golf course known as Cedarbrook Country Club. The land use in the vicinity of the property is rural residential, commercial, agricultural, and undeveloped
forested tracts. The project site consists of an approximate 1.39-acre riparian corridor along Camp Creek and a UT of Camp Creek in the west central part of the golf course. Both streams
have been impacted by past golf course practices at the property. The existing stream banks at the project site are incised and eroding. The drainage area at the project site is
approximately 0.36 square miles. See attached existing conditions photographs and USGS StreamStats report.
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:
None in project area
4g. List the total estimated linear feet of all existing streams on the property:
1,228 in project area
4h. Explain the purpose of the proposed project:
The objectives of the restoration activities is to stabilize the stream bank and bed, establish a native riparian buffer, construct flood benches, and to prevent additional soil loss to
downstream surface waters. The proposed stream restoration project will restore 1,047 If of Camp Creek and 72 If of the UT. This will improve the natural ecology of the stream and buffer.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
Camp Creek and the UT Camp Creek will be restored using natural channel and bank design techniques. The work will provide a more sustainable riparian ecosystem with natural buffers.
Channel dimension, pattern, and profile will be constructed to a tolerable morphology and held in place with multiple in -stream and bank structures. The channel will be stabilized with
constructed riffles, boulder steps, boulder vanes. The historical adjacent floodplain areas along Camp Creek will be improved and restored by constructing low benches.
A minimum 15-ft native herbaceous buffer will be planted in the riparian area to promote long-term stability, soil strength, and water quality benefits. Mature native trees along the
streambank will be preserved. Disturbed and restored areas of the stream buffer will be replanted using a combination of a native grass seed mix and native grass plugs. The riparian
buffer is part of the golf course play area and the planted native grass buffer is to be maintained to a height that will allow for course play. Work will be completed using tracked excavators
and dump trucks by a qualified stream restoration contractor. Equipment will be well maintained, cleaned prior to mobilization, and checked daily for leaks of petroleum products. Fueling
operations shall be performed in an area away from all surface waters. See attached plan sheets for additional details.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes
No
Comments:
A field survey of the project area was conducted to locate streams and wetlands. The purpose of the
survey was to make an effective analysis of the presence of waters and wetlands within the project
area in order determine proposed impacts to these aquatic features. Jennings Environmental is not
requesting the Corps make a jurisdiction determination of the aquatic features in the project area.
There are no wetlands at the project site and the location of Camp Creek and UT Camp are shown on
the plan sheets.
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
O Unknown
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
V
F]
S1
3a. Reason for impact (?)
Stream Restoration
3b.lmpact type"
Permanent
3c. Type of impact*
Other
3d. S. name*
Camp Creek
3e. Stream Type*
?)
Perennial
3f. Type ofwidth
Jurisdiction*
Both
Average (feet)
3h. Impact
length*
1,047
(linear feet)
g2
Stream Restoration
Permanent
Other
UT Camp Creek
Perennial
Both
35
Average (faeQ
72
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts:
1,119
3i. Total stream and ditch impacts:
73
31. Total temporary stream impacts:
0
3j. Comments:
The stream restoration work is to include removing an existing piped stream crossing and replacing it a bridge which will span Camp Creek. Also, 2
existing pedestrian bridges will be removed and replaced. No impacts to waters will be associated with pedestrian bridge tasks.
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:
As this project is an aquatic restoration project, it is impossible to completely avoid impacts to waters. However, considerations were made to minimize
disturbance to the extent necessary to provide appropriate functional uplift to aquatic resources.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Appropriately sized equipment will be utilized to minimize soil compaction and access grading. Scheduling and staging of equipment and materials will
be timed to minimize time spent working in the active stream channel. Ground/soil disturbance will be minimized to the extent possible.
The work will be conducted in sections of existing channel and will utilize a pump or pipe around system in order divert flows away from active work
areas. Also, construction impacts will be minimized by limiting in -channel work to low -flow conditions and working from the stream banks where possible
Graded stream banks will be stabilized by using a native grass seed mix, straw mulch, and biodegradable erosion control matting. Areas will be
stabilized within 3 working days of bank grading completion. Following construction activities, the site will be planted with native grasses to establish a
stream buffer. Erosion control matting that incorporates plastic mesh and/or plastic twine will not be used within stream channel(s) or along stream
banks.
Any discharge associated with the proposed impacts would consist of suitable clean fill material (no trash, asphalt, etc.). The fill material would also be
free of pollutants in toxic amounts. Proper sediment and erosion control devices would be installed prior to and during construction. Downstream turbidity
levels will likely increase during construction but would subside upon completion of in -stream work. An erosion and sediment control plan will be
submitted to NC DEMLR and/or Surry County for review and approval prior to construction. Erosion and sediment control details are included on the
project plans.
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?
0
Yes No

2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The project objective is to construct a more natural functioning stream reach to replace the degraded and unstable stream reach. The project will result in permanent impacts to waters, but
these impacts will not result in a permanent loss of waters that require compensatory mitigation.
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:
The project is located in the Yadkin Basin.
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:
Stream restoration project. No impervious area(s) are proposed as part of this project.
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?
Yes 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)?*
Yes No
Comments: *
Project is below thresholds for requiring an environmental document.
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.
Project will not result in change in adjacent land uses.
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
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
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
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?
Jennings Environmental reviewed the latest versions of NC Natural Heritage Program data on element occurrences for listed species and USFWS online
interactive mapping and species occurrence datasets (IPaC, county species lists, etc.) to determine the likelihood for the presence of federally listed
species and/or their critical in the project area. No listed federally endangered/threatened species were located in/near project site and no suitable
habitat exists based upon information submitted to date.
The project is not located near any known occurrences of hibernacula or maternity roost sites for listed bat species. Onsite evaluations conducted in
June 202 indicated there are no caves, no cave like features, no sizeable rock cervices, and no out -buildings within the project area which may provide
roosting habitat.
Consideration of potential effects to listed bats assumes the presence of the species, even though it is not known if the species actually occur in the
project area. The forested areas adjacent to the project site could be used for roosting and/or foraging by northern long-eared bat (Myotis
septentrionalis), gray bat (Myotis grisescens), and tricolored bat (Perimyotis subflavus). Bat species naturally avoid areas where habitat disturbance
activities (elevated noise, tree removal, etc.) are taking place. It is expected any bat species that may be present near site will migrate to forested areas
in the vicinity. No trees larger that 3-inch dbh will be cut as part of the project.
There will be a minor short term disturbance to the wildlife habitats within the project area. However, the project will not destroy or negatively modify the
roosting and foraging habitat of the listed bats species. Long term this habitat should be improved by the stream restoration actions. Thus, the proposed
project should benefit or aid in the recovery of listed species. This project is expected to result in indirect positive benefits to listed bat species. The direct
effects of this action to bat species are believed to be discountable and the long term and cumulative effects of this action will be beneficial.
Prior to the start of construction activities, bridges, culverts, and other unconventional roosting structures in the project area will be inspected to detect
evidence of bat use. Although use of heavy equipment will be required, no extreme percussive activities (blasting, pile -driving, etc.) will be conducted.
Other activities that produce noise or vibrations are expected to be short-term and would not exceed background conditions (e.g., thunderstorm and
daily human activity that bats are frequently exposed to when present on the landscape).
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 EFH 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?
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?"
Jennings Environmental has reviewed NCDCR maps and online data. There are no known historic resources identified in the project area.
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?"
NCFRIS
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
1115_SITE_2_CEDARBROOK_CC_CAM P_CREEK_PERM IT_DRAW I NG_25SEP2023. pdf
3.3M B
401 Pre -filing Request.pdf
1.01MB
IPaC_ Explore Location resources.pdf
693.15KB
Parcel 7074.pdf
562.77KB
Signed Agent Authorization. pdf
132.51 KB
Site Photos and Figures.pdf
4.17MB
Soil Map.pdf
777.08KB
StreamStats Camp Cr 0.4 sgmi.pdf
412.47KB
File must be PDF or KMZ
Comments
Supporting Attachments:
Agent Authorization Form
Permit Design Drawings/Plans
Site Photographs and Figures
USGS StreamStats
Soil Map
401 Pre -filing Meeting Request
Parcel Maps
USFWS IPaC
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:
David Brown
Signature
D,4viD�ow�I
Date
9/29/2023
L