20160268 Ver 1_PCN-Form-Signed_20160318

-<-)-A 0F \NArE',� �01,
. r
❑Nii�-1�1
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version
Pre -Construction Notification (PCN) Form
A.
Applicant Information
1.
Processing
1a.
Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1b.
Specify Nationwide Permit (NWP) number: 27 or General Permit (GP) number:
1c.
Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1d.
Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1e.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
For the record only for Corps Permit:
❑ Yes ® No
1f.
Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
❑ Yes
® No
1g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below.
❑ Yes
E No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
No
2.
Project Information
2a.
Name of project:
Poplar Cove Creek (Corpening) Stream Restoration Project
2b.
County:
Macon
2c.
Nearest municipality / town:
Franklin, NC
2d.
Subdivision name:
N/A
2e.
NCDOT only, T.I.P. or state
project no:
N/A
3.
Owner Information
3a.
Name(s) on Recorded Deed:
1) Kevin Corpening 2) Nancy Stiwinter 3) Peggy Huscusson
4) Kenneth Manus
3b.
Deed Book and Page No.
1) A-32/1121 2) B-12/18 3) R-36/1558
4) W-17/348
3c.
Responsible Party (for LLC if
applicable):
N/A
3d. Street address:
486 Smith Hill Road
3e.
City, state, zip:
Franklin, NC 28734
3f.
Telephone no.:
3g.
Fax no.:
3h.
Email address:
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4.
Applicant Information (if different from owner)
4a.
Applicant is:
❑ Agent ® Other, specify: Project Sponsor
4b.
Name:
Charles Anderson
4c.
Business name
(if applicable):
Resource Institute, Inc.
4d.
Street address:
2714 Henning Dr.
4e.
City, state, zip:
Winston -Salem, NC 27106
4f.
Telephone no.:
[phone]
4g.
Fax no.:
[phone]
4h.
Email address:
[e-mail]
5.
Agent/Consultant Information (if applicable)
5a.
Name:
Christopher M. Engle, P.E.
5b.
Business name
(if applicable):
Wolf Creek Engineering, pllc
5c.
Street address:
12'/2 Wall St. Suite C
5d.
City, state, zip:
Asheville, NC 28801
5e.
Telephone no.:
[phone]
5f.
Fax no.:
5g.
Email address:
[e-mail]
Page 2 of 11

B.
Project Information and Prior Project History
1.
Property Identification
1a.
Property identification no. (tax PIN or parcel ID):
1) 6553542200 2) 6553449081
3)6553437882 4)6553532766
1 b.
Site coordinates (in decimal degrees):
Latitude: 35.133705 Longitude: - 83. 4994736
(DD.DDDDDD) (-DD.DDDDDD)
1 c.
Property size:
1) 5.82 acres 2) 0.30 acres 3) 1.95 acres 4) 4.10 acres
2.
Surface Waters
2a.
Name of nearest body of water (stream, river, etc.) to
Poplar Cove Creek
proposed project:
2b.
Water Quality Classification of nearest receiving water:
WS -III
2c.
River basin: map is available at
Little Tennessee
http://h2o.enr.state.nc.us/admin/maps/
3.
Project Description
3a.
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 proposed project is located on privately owned property, with the left side of the stream used as residence and hay
production, and the right side being heavily forested. Site stream exhibits excessive erosion and instabilities due to
impacts from historical flooding and land use practices.
3b.
List the total estimated acreage of all existing wetlands on the property:
0.00 acres
3c.
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
748 linear feet of existing stream
3d.
Explain the purpose of the proposed project:
The purpose of the project is to restore ecological function, natural stability and aquatic and terrestrial habitat to a riparian
system which has been negatively impacted by historical flooding and land use practices.
3e.
Describe the overall project in detail, including the type of equipment to be used:
The proposed activities are intended to restore degraded portions of Poplar Cove Creek located within the project limits.
Erosion control measures will be installed prior to any land disturbing activity to prevent erosion and retain sedimentation
onsite. Where the stream channel departs from morphologically stable conditions, it will be reconstructed with proper
dimension, pattern and profile. Restoration will include the excavation of a new floodplain at bankfull elevation and the
installation of in -stream structures to provide stream bed integrity and improved habitat for aquatic species. Native
vegetation will be planted to provide restoration of a natural forested buffer adjacent to the stream channels and habitat
for insect, terrestrial and avian species. Upon completion of the work, all access roads, staging areas, construction
entrances and silt fence will be removed and all disturbed soils will be stabilized with mulch and native seed to establish
permanent ground cover. Equipment anticipated for construction efforts include track -hoes, skid -steers, track -trucks and
off-road trucks.
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4.
Jurisdictional Determinations
4a.
Have jurisdictional wetland or stream determinations
by the Corps or State been requested or obtained for
this property / project (including all prior phases) in the
❑ Yes ® No ❑ Unknown
past?
Comments:
4b.
If the Corps made the jurisdictional determination,
El Preliminary El Final
what type of determination was made?
4c.
If yes, who delineated the jurisdictional areas?
Agency/Consultant Company:
Name (if known):
Other:
4d.
If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5.
Project History
5a.
Have permits or certifications been requested or
obtained for this project (including all prior phases) in
❑ Yes ® No ❑ Unknown
the past?
5b.
If yes, explain in detail according to "help file" instructions.
6.
Future Project Plans
6a.
Is this a phased project?
❑ Yes ® No
6b.
If yes, explain.
Page 4 of 11

C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ® Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number—
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404, other)
(acres)
Temporary T
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland impacts
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.
3a.
3b.
3c.
3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ❑ P ®T
Restoration
Poplar Cove
Creek
® PER
❑ INT
® Corps
❑ DWQ
15.3
748
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
748
3i. Comments: Site stream exhibits instabilities in the form of actively eroding, vertical banks, which will be improved by the
implementation of restoration activities.
Page 5 of 11

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then indivi ually list all open water impacts below.
4a.
4b.
4c.
4d.
4e.
Open water
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑P❑T
02 ❑ PEI T
03 ❑ PEI T
04 ❑ PEI T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse ❑ Tar -Pamlico ❑ Other:
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number—
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
impact
re uired?
131 ❑P❑T
❑Yes
❑ No
B2 ❑PFIT
F-1 Yes
❑ No
B3 ❑P❑T
F-1 Yes
❑ No
6h. Total buffer impacts
6i. Comments:
Page 6 of 11

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Where mature vegetation exists on the stream banks it will be incorporated into the newly constructed stream bank.
b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Construction access will take the most direct route to minimize disturbance to existing vegetation and land in current
agricultural production.
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 yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
ElPayment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: N/A
3b. Credits Purchased (attach receipt and letter)
Type
Quantity
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
Page 7 of 11
PCN Form — Version 1.3 December 10, 2008 Version

5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? If yes, you will have to fill out this entire form — please
contact the State for more information.
❑ Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments:
Page 8 of 11

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1a.
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b.
If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
Comments:
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
<1 %
2b.
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why: This
project will not increase runoff.
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
❑ Certified Local Government
2e.
Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3.
Certified Local Government Stormwater Review
3a.
In which local government's jurisdiction is this project?
N/A
❑ Phase II
3b.
Which of the following locally -implemented stormwater management programs
❑ NSW
F1 USMP❑
apply (check all that apply):
Water Supply Watershed
❑ Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4.
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a.
Which of the following state -implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006-246
❑ Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ❑ No
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b.
Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 9 of 11
PCN Form — Version 1.3 December 10, 2008 Version

F.
Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
1 a.
Does the project involve an expenditure of public (federal/state/local) funds or the
® Yes
❑ No
use of public (federal/state) land?
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
❑ Yes
® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes
❑ No
letter.)
Comments:
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes
® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b.
Is this an after -the -fact permit application?
❑ Yes
® No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3.
Cumulative Impacts (DWQ Requirement)
3a.
Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes
® No
additional development, which could impact nearby downstream water quality?
3b.
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
This project is a stream restoration project. The site will include provision of a riparian buffer to protect the stream from
future anticipated impacts.
4.
Sewage Disposal (DWQ Requirement)
4a.
Clearly detail the ultimate treatment methods and disposition (non -discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
No wastewater will be generated by the proposed project.
Page 10 of 11
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑Yes No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
E] Raleigh
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NRCS internal process — Form CPA -52
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essentia�fish bitat?❑
Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NRCS internal process — Form CPA -52
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
Yes ®No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
NRCS internal process — Form CPA -52
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:
The project is within a FEMA Limited -detailed studied stream and the proposed activities will result in an improvement to
the stream channel and increased conveyance. A No -Rise Certification will be submitted to the local Floodplain
Administrator in accordance with FEMA requirements.
8c. What source(s) did you use to make the floodplain determination? NC Floodmaps
Christopher M. Engle, P.E.
/X,�,�
Applicant/Agent's Printed Name
Date
Applicant/ en s Signature
(Agent's signature is valid only if an authorization letter from the applicant
isprovided.)
Page 11 of 11