20240669 Ver 1_ePCN Application_20240507

i 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.
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# *
20240669
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*
Raleigh Regional Office - [phone]
Zachary Thomas:zachary.thomas
Information for Initial Review
la. Name of project:
Will Brown Rd Driveway Access
1a. Who is the Primary Contact? *
Martin Richmond
1b. Primary Contact Email: * 1c. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
5/7/2024
Nearest Body of Water
UT to Terrells Creek
Basin
Cape Fear
Water Classification
WS-IV: NSW
Site Coordinates
Latitude: Longitude:
35.803825-79.372282
A. Processing Information O
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Chatham
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:
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
14 - Linear transportation
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
401 Water Quality Certification - Express
Riparian Buffer Authorization
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:
Hickory Mt Rifle & Pistol Club, Inc.
2b. Deed book and page no.:
Bk 2007 Pg 0674
2c. Contact Person:
Clifford Tilley
2d.Address
Street Address
560 Eden Hills Rd
Address Line 2
City State / Province / Region
Star City NC
Postal / Zip Code Country
27344 USA
Yes No
Yes No

2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Martin Richmond
4b. Business Name:
Lakenheath, Inc.
4c.Address
Street Address
2204 Lakenheath Ct
Address Line 2
City
Raleigh
Postal / Zip Code
27614
4d. Telephone 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:
Siler City
2. Project Identification
2a. Property Identification Number:
8784-00-97-6609
2c. Project Address
Street Address
302 Will Brown Rd
Address Line 2
City
Siler City
Postal / Zip Code
27344
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
UT to Terrells Creek
3b. Water Resources Classification of nearest receiving water:
WS-IV; NSW
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.
0303000205
4. Project Description and History
2f. Fax Number:
State / Province / Region
NC
Country
USA
4e. Fax Number:
2b. Property size:
12
State / Province / Region
NC
Country
USA
a

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 owned by the Hickory Mt Rifle & Pistol Club and currently used as club facility and target shooting range.
The property is approximately 12 acres, located on Will Brown Rd in Chatham County, NC. The main body of the parcel - approximately 11 acres - is accessed from Will Brown Rd by way
of a 40 ft-wide driveway easement, extending approximately 1200 ft north from the roadway, parallel to the adjacent property lines.
The easement has been cleared since 2018, when the east adjacent property was timbered. The easement was created from adjacent property after the 2018 timbering, and has served
as an unimproved access to the property since that time.
The main body of the property is partially wooded with the club facility located in the center of the tract. The surrounding properties are wooded, with a cleared agriculture field adjacent to
the east. There is one permanent pole barn structure on the site and multiple metal storage shipping containers.
There is one intermittent stream coursing perpendicular through the driveway easement. This permitting request is for permanent impacts to the intermittent stream necessary for the
construction of a permanent access drive.
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:
0.0
4g. List the total estimated linear feet of all existing streams on the property:
57
4h. Explain the purpose of the proposed project:
To improve an existing temporary driveway into a permanent access drive into the facility.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
The crossing of the intermittent stream with the access driveway will be constructed as a simple ford, which will meet the needs of the Club.
Rip Rap stone will be used to create the ford. The stone will be keyed into the channel at the approximate existing channel depth, allowing for adequate flow during wet times. The rip rap
driveway will extend outward from the stream channel, allowing for stabilization of roadway and the channel.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No O 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): Martin Richmond
Agency/Consultant Company: Lakenheath, Inc.
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?
None
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
❑
3a. Reason for impact (?)
3b.lmpact type "
3c. Type of impact*
3d. S. name *
3e. Stream Type*
(?)
3f. Type of
Jurisdiction*
3g. S. width
3h. Impact
length*
S1
Driveway
Permanent
Rip Rap Fill
Stream 1 ::1Intermittent::]
Both
Averege (feet)
�
27
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0

3i. Total permanent stream impacts:
27
3i. Total temporary stream impacts:
0
3i. Total stream and ditch impacts:
27
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:
For several years, the Club has used a neighboring offsite farm road for access to the facility. In 2023, the Club decided to move forward with
construction of their own access road on the 40It easement created from the neighboring parcel.
Due the presence of the intermittent stream perpendicular throughout the easement, a crossing could not be avoided.
The ford design is the minimal impact possible, allowing for both stream function and stabilization post -installation.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Erosion & Sediment Control measures will be implemented with County review/oversight.
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:
Less than 150 If and/or 0.10 acre threshold.
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
What type of SCM are you providing?
Level Spreader
Vegetated Conveyance (lower SHWT)
Wetland Swale (higher SHWT)
Other SCM that removes minimum 30 % nitrogen
Proposed project will not create concentrated stormwater flow through the buffer
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)
O
O
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.
One-time improvement of an existing driveway. No additional site development is involved.
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
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?
USFWS IPAC Report
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?
No EFH in Chatham Co
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?
NC SHPO
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?
Chatham Co GIS & Chatham Co Stormwater Dept
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
Will Brown Rd Chatham Co _ JD Request Packet 050724.pdf 6.51 MB
Will Brown Rd _ Impact Plans.pdf 4.31 MB
File must be PDF or KMZ
Comments
Buffer impacts are allowable through Chatham County.
Signature

p 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:
Martin Richmond
Signature
Date
5/7/2024