20200002 Ver 1_ePCN Application_20240418

DW R
Dlvlslon 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.
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 Version# *
20200002 1
Is a payment required for this project?*
No payment required
What amount is owed?*
Fee received
$240.00 $570.00
Fee needed - send electronic notification
$323.00 $767.00
Reviewing Office*
Select Project Reviewer*
Central Office - [phone]
Maria Polizzi:Maria. Polizzi
Information for Initial Review
1a. Name of project:
Three Creeks
1a. Who is the Primary Contact?*
Adam McIntyre
1b. Primary Contact Email:* 1c. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
4/18/2024
Nearest Body of Water
Little Brushy Fork
Basin
Yadkin-PeeDee
Water Classification
WS-III
Site Coordinates
Latitude: Longitude:
35.970173-80.197086
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Davidson
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 401 Water Quality Certification - Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
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: Yes No
For the record only for Corps Permit: Yes No
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)
le. Is there an Agent/Consultant for this project?
Yes No
2. Owner Information
2a. Nani on recorded deed:
Three Creeks Farm, LLC
2b. Deed book and page no.:
01213 and 0018/0019
2c. Contact Person:
Elizabeth Shoaf
2d.Address
Street Address
1151 Norman Shoaf Road
Address Line 2
City
State / Province / Region
Winston-Salem
NC
Postal / Zip Code
Country
27107
USA

2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address:'
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Adam McIntyre
3b. Business Name:
Three Creeks Mitigation, LLC
3c.Address
Street Address
111 Main Avenue
Address Line 2
City
State / Province / Region
Brookings
SD
Postal / Zip Code
Country
27549
USA
3d. Telephone Number: 3e. Fax Number:
[phone]
3f. Email Address:
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Heather Smith
4b. Business Name:
VHB
4c.Address
Street Address
940 Main Campus Dr
Address Line 2
Suite 500
City
State / Province / Region
Raleigh
NC
Postal / Zip Code
Country
27606
USA
4d. Telephone Number: 4e. Fax Number:
[phone]
4f. Email Address:
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
Midway
2. Project Identification
2a. Property Identification Number: 2b. Property size:
13-015-0-000-0001 43
Q

2c. Project Address
Street Address
1151 Norman Shoaf Rd
Address Line 2
city
Wintson-Salem
Postal / Zip Code
27107
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Little Brushy Fork
3b. Water Resources Classification of nearest receiving water:
WS-III
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.
030401030201
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 conservation easement on the Three Creeks Farm, LLC parcels is currently used for cattle grazing and is planted in pasture grasses. There are four unnamed tributaries to Little
Brushy Fork and Little Brushy Fork, and three areas of jurisdictional wetlands. Wetland 1 is dominated by herbaceous vegetation, Wetland 2 is partially covered by successional growth
vegetation and Wetland 3 is forested. Cattle have access to all three wetlands. The project is partially within the 100-year floodplain of Little Brushy Fork. The unnamed tributaries to Little
Brushy Fork don't have independent hydraulic models.
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:
4.11
4g. List the total estimated linear feet of all existing streams on the property:
8,275
4h. Explain the purpose of the proposed project:
The project will restore and enhance Little Brushy Fork and four unnamed tributaries to Little Brushy Fork. The project will restore appropriate channel dimensions, bedform diversity, and
riparian corridors to the degraded streams. It will restore three wetland areas through re-establishment and rehabilitation, and enhance two wetland areas. The wetlands will have wetland
hydrology, and wetland vegetation restored to three areas and increase wetland hydrology and restore wetland vegetation to two additional areas. The project will help offset unavoidable
impacts to jurisdictional resources in the Yadkin -Pee Dee 03040103 8-digit HUC.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
All stream reaches will be planted with appropriate riparian woody vegetation to a minimum of 50-foot from top of bank. Cattle will be removed permanently from the conservation
easement.
There are three reaches on Little Brushy Fork (LBF) with a total proposed restoration length of 3,400 If. All three reaches will have appropriate pattern, profile, and dimension restored to
them. LBF will have rock j-hooks, constructed riffles, brush toe stabilization, rock crossvanes, and log vane j-hooks used during the restoration.
There are three reaches of UT1 with a total proposed restoration length of 3,571 If. All three reaches will have appropriate pattern, profile, and dimension restored to them. UT1 will have
rock j-hooks, constructed riffles, log vane, brush toe stabilization, and log vane j-hooks installed during the restoration.
There is one reach on UT2 with a total proposed restoration length of 295 If. It will have appropriate pattern, profile, and dimension restored using double log drops, rock step pools, and a
head cut repair at the upstream end.
There are four reaches of UT3 with a total proposed enhanced length of 729 If. Reaches 1 and 2 will be enhanced with planting and removal of cattle. Reach 3 will be enhanced using
head cut repair structures. Reach 4 has a proposed restoration length of 92 If. UT3 Reach 4 will have appropriate pattern, profile, and dimension restored. Riffles will be installed as the
reach flows into UT4.
There are two reaches on UT4 with a total proposed restoration length of 1,475 If. Both reaches will have appropriate pattern, profile, and dimension restored to them and rockj-hooks,
constructed riffles, log vane, brush toe stabilization, and log vane j-hooks will be installed.
UT5 is currently piped directly into LBF. The proposed restoration length is 106 If. The pipe will be removed and double log drops, and riffles will be installed.
Wetland 1 will have a small Swale fille to enhance existing wetland hydrology, planted with appropriate wetland tree species, and cattle removal.
Wetland 2 will have two treatments; the pasture portion will be planted with appropriate wetland tree species and the successional portion will have cattle removed and placed under a
conservation easement.
Wetland 3 will be enhanced through reconnection to the LBF floodplain and cattle removal.
Wetlands 4 and 5 will have small ditches filled and planted with appropriate wetland tree species and cattle removal.
Typical construction equipment will be used, bulldozers, dumptrucks, cranes, and backhoes (etc.)
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:
SAW-2019-02341
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Heather Smith
Agency/Consultant Company: VHB
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
2/25/2021 Bryan Roden -Reynolds
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 D Buffers
Open Waters Pond Construction
2. Wetland Impacts
W1
Reason (?)
Fill to Grade
2b. Impact type*(?)
T
2c. Type of W.
Bottomland Hardwood Forest
2d. W. name
Wetland 1
2e. Forested*
No
2f. Type of Jurisdicition *
?)
th
fo
2g. Impact
area
0.180
(acres)
W2
Grading
T
Headwater Forest -]
Wetland 2
Yes
Both 2�=_
2g. Total Temporary Wetland Impact
0.280
2g. Total Wetland Impact
0.280
21. Comments:
3. Stream Impacts
2g. Total Permanent Wetland Impact
0.000
3a. Reason for impact (?)
3b.lmpact type*
3c. Type of impact*
Stream Type*
3f. Type of
3g. S. width
3h. Impact
❑
:]3�name*
�3e.
Jurisdiction *
length
S1
Restoration
Permanent
Fill
Little Brushy Fork
Perennial
Both
12
2,983
Averege (feet)
(linear feet)
g2
Restoration
Permanent
Fill
UT1
Perennial
Both
12
2,887
Averege (feet)
(linear feet)
S3
Restoration
Permanent
Fill
TribA
Perennial
Both
10
71
Average (feet)
(linear feet)
gq
Restoration
Permanent
Fill
UT2
Intermittent
Both
325
Average (feet)
(linear feet)
S5
Crossing
Permanent
Fill
UT1
Perennial::]
Both
12
20
Averege (feet)
(linear feet)

S6
Crossing
Permanent
Fill
Little Brushy Fork
Perennial
Both -]
12
60
Average (feet)
(linear feet)
S7
Restoration
Permanent
Fill
UT3
Intermittent
Both
35
Average (feet)
(linear feet)
gg
Crossing
Permanent
Fill
UT3
Intermittent
Both
38
Averege (feet)
(linear feet)
S9
Enhancement
Temporary
Dewatering
UT3
Intermittent
Both
4
730
Average (feet)
(linear feet)
S10
Restoration
Permanent
Fill
F
Perennial
Both
1,101
Averege (feet)
(linear feet)
fl
Restoration
Permanent
Dewatering �ff7
Intermittent
Both
25
Average (feet)
(linear feet)
31. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
7,545
3i. Total stream and ditch impacts:
1309
3j. Comments:
3i. Total temporary stream impacts:
730
E. Impact Justification and Mitigation O
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The design will not utilize jurisdictional areas for staging. Wetland impacts were designed to be temporary in order to enhance wetland hydrology where
work is being completed.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The project will be constructed in the dry where feasible and water will be turned into the new stream channels once construction on those is complete.
This will maintain the function of the jurisdictional resources throughout the course of the construction.
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:
This is a restoration project.
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 not in a river basin with State regulated buffers.
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
1a. 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.
This project is designed to improve water quality on -site and downstream. This project will not result in future developments in the surrounding area. The
infrastructure of the area will remain the same.
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 No
What Federal Agency is involved?
FFMA
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
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?
There are currently 2 species listed for the project area, Perimyotis subflavus (Tricolored bat) and Helianthus schweinitzii (Schweinitz's sunflower)
according to the official IPaC species list dated 12/14/2023. A North Carolina Natural Heritage Program Data Explorer Report indicates there are no
known federally protected species within a mile of the project area. A plant -by -plant survey was conducted for Schweinitz's sunflower in September 2020
and September 2023 with no specimens were observed. There is no suitable habitat for the bald eagle on -site. The tricolored bat is proposed
endangered and there is marginally suitable habitat in the form of a single row of trees along Little Brushy Fork (LBF) and the forested areas around the
site. The only trees to be cut are the ones along LBF and a few required for structures. A biological conclusion is not required at this time but if the
species is listed prior to construction and tree clearing, the recommended biological conclusion is May Affect, Not Likely to Adversely Affect. A copy of
the 2021 submittal to the Asheville Regional Office of the USFWS is attached. No comment was received from the USFWS. This letter was for the listed
species at that time.
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?
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?
Yes No

7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
A letter from the State Historic Preservation Office was received on 6/19/2020 stating no historic resources. Letter is in the supporting documentation.
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:
A CLOMR was approved on 8/25/2022. It is in the supporting documentation.
8c. What source(s) did you use to make the floodplain determination?"
Flood Risk Information Systems DFIRM 3710684000J
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
SupportingDocumentation.pdf 50.36MB
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:
Heather Smith
Signature
Date
4/18/2024
L