20220378 Ver 1_401 Application_20220308

Staff Review Form
NORTH CAROLINA
Ertrlmnmertlrtl Quality
Updated September 4, 2020
Staff Review
Does this application have all the attachments needed to accept it into the review process?*
Yes No
ID# *
20220378
Version* 1
Is this project a public transportation project?*
Reviewer List:*
Select Reviewing Office: *
Submittal Type:*
Yes
No
Colleen Cohn:eads\cmcohn
Raleigh Regional Office - [phone]
401 Application
Does this project require a request for payment to be sent?*
Yes
No
How much is owed?* $240.00
$570.00

Project Submittal Form
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.
Project Type: *
For the Record Only (Courtesy Copy)
New Project
Modification/New Project with Existing ID
More Information Response
Other Agency Comments
Pre -Application Submittal
Re-Issuance\Renewal Request
Stream or Buffer Appeal
Project Contact Information
Name: James Michael Stocks
Who is submitting the information?
Email Address: [e-mail]
Project Information
Project Name:
Flowers Plantation SW Quad Dam Repair
Is this a public transportation project?
Yes
No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
Yes No Unknown
County (ies)
Johnston
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
Flowers SW Buffalo and NC-42 Dam Photos.pdf
Flowers Plantation Dam - SW Buffalo and NC42
Letter 10-13-20.pdf
Figure 4.pdf
Dam Repair area - New Pond Elevation 272-11 10-
22-21 REV 11-8-21.pdf
DWQ buffer Ietter03057_031003.pdf
Flowers Plantation JD_200320493.pdf
PCN FillableForm v4-2 01312022 Protected -
Submitted 3-8-22.pdf
Mike - AGENT AUTHORIZATION FORM.pdf
Only pdf or kmz files are accepted.
1.02MB
4.31MB
249.44KB
1.18MB
1.46MB
3.04MB
157.71KB
37.67KB

Describe the attachments or
comments:
Title of attachments were intended to be self-explanatory.
Sign and Submit
By checking the box and signing box below, I certify that:
• I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the
best of my knowledge and belief.
• I, 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 agree that submission of this online 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 online form.
Signature:
Submittal Date: Is filled in automatically.

NORTH CAROLINA
Environmental Quality
Water Resources
Office Use Only
Corps Action ID no. [Click to enter.] Date received: [Click to enter.]
DWR project no. [Click enter.] Date received: [Click to enter.]
Site Coordinates:
Latitude (DD.DDDDDD): 35.650878
Longitude (DD.DDDDDD): 78.348183
Form Version 4.2, January 31, 2022
Pre -Construction Notification (PCN) Form
(Ver. 4.2, January 31, 2022))
For Nationwide Permits and Regional General Permits and corresponding Water Quality Certifications
Please note: fields marked with a red asterisk * are required. The form is not considered complete until all
mandatory questions are answered.
The online help file may be found at this link:
https://edocs.deq.nc.gov/WaterResources/0/edoc/624704/PCN %20Help%20File%202018-1-30.pdf
The help document may be found at this link:
http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Permits/2017-Nationwide-
Permits/Pre-construction-Notification/
A. Processing Information
County (counties) where project is located: *
Johnston Additional (if needed).
Is this a NCDMS project? *
(Click yes only if NCDMS is the applicant or co-
applicant)
❑ Yes ❑x No
Is this a public transportation project? *
(Publicly funded municipal, state, or federal road, rail,
or airport project)
❑ Yes ❑x No
Is this a NCDOT project? *
❑ Yes ❑x No
If yes, NCDOT TIP or state project number:
Click to enter.
If yes, NCDOT WBS number: *
Click to enter.
Page 1 of 23 PCN Form -Version 4.2, January31, 2022

1 a. Type(s) of approval sought from the Corps: *
❑x Section 404 Permit (wetlands, streams, waters,
Clean Water Act)
❑ Section 10 Permit (navigable waters, tidal
waters, Rivers and Harbors Act)
Has this PCN previously been submitted? *
❑ Yes ❑x No
Please provide the date of the previous submission. *
Click to enter a date.
1 b. What type(s) of permit(s) do you wish to seek
authorization?
❑x Nationwide Permit (NWP)
❑Regional General Permit (RGP)
❑ Standard (IP)
This form may be used to initiate the standard/ individual permit process with the USACE. Please contact your Corps
representative concerning submittals for standard permits. All required items can be included as attachments and
submitted with this form.
1 c. Has the NWP or GP number been verified by the Corps? *
0 Yes ❑ No
NWP number(s) (list all numbers ):
3
RGP number(s) (list all numbers ):
Click to enter.
Are you a federal applicant?
❑ Yes ❑x No
If yes, please provide a statement concerning compliance with the Coastal Zone Management Act *
Click to enter text.
1 d. Type(s) of approval sought from DWR (check all that apply): *
❑x 401 Water Quality Certification — Regular ❑ 401 Water Quality Certification— Express
❑ Non-404 Jurisdictional General Permit ❑ Riparian Buffer Authorization
❑ Individual 401 Water Quality Certification
Is this a courtesy copy notification
❑ Yes ❑x No
1 e. Is this notification solely for the record because written approval is not required? *
For the record only for DWR 401 Certification: *
❑ Yes ❑x No
For the record only for Corps Permit: *
❑ Yes ❑x No
1f. Is this an after -the -fact permit/certification application? *
❑ Yes ❑x No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts?
❑Yes ❑x No
If yes, attach the acceptance letter from mitigation bank or in -lieu fee program.
1 h. Is the project located in any of NC's twenty coastal counties? *
❑ Yes ❑x No
1 i. Is the project located within an NC DCM Area of Environmental
Concern (AEC)? *
❑Yes ❑x No ❑Unknown
1j. Is the project located in a designated trout watershed? *
❑ Yes ❑x No
If yes, you must attach a copy of the approval letter from the appropriate Wildlife Resource Commission Office.
Trout information may be found at this link: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Program/Agency-Coordination/Trout.aspx
Page 2 of 23 PCN Form - Version 4.2, January31, 2022

B. Applicant Information
la.
Who is the primary contact?
J. Michael Stocks
1 b.
Primary Contact Email:
[e-mail]
lc.
Primary Contact Phone: (###)###-####
252.903.6891
1 d.
Who is applying for the permit/certification?
all that apply)
(check
0 Owner ❑Applicant (other than owner)
1 e.
Is there an agent/consultant for this project?
0 Yes ❑ No
2. Landowner Information
2a. Name(s) on Recorded Deed: *
Flowers Crossroads Lake, LLC
2b. Deed Book and Page No.:
05794/0944
2c. Contact Person (for corporations):
Reid Stephenson
2d. Address *
Street Address:
4880 NC Highway 42 E
Address line 2:
Click to enter.
City:
Clayton
State/ Province/ Region:
NC
Postal/ Zip Code:
27527
Country:
USA
2e. Telephone Number: (###)###-####
919.369.8332
252.459.8197
2f. Fax Number: (I/II/f)###-####
2g. Email Address: i
[e-mail]
3.
Applicant Information (if different from owner)
3a.
Name:
Click to enter.
3b.
Business Name (if applicable):
Click to enter.
3c.
Address:
Street Address:
Click to enter.
Address line 2:
Click to enter.
City:
Click to enter.
State/ Province/ Region:
Click to enter.
Postal/ Zip Code:
Click to enter.
Country
Click to enter.
3d.
Telephone Number: (###)###-####
Click to enter.
3e
Click to enter.
Fax Number: (I/I/If)###-####
3f.
Email Address:
Click to enter.
Page 3 of 23
PCN Form -Version 4.2, January31, 2022

4. Agent/ Consultant (if applicable)
4a. Name: *
J. Michael Stocks
4b. Business Name:
Stocks Engineering, PA
4c. Address: *
Street Address:
801 E Washington Street
Address line 2:
PO Box 1108
City:
Nashville
State/ Province/ Region:
NC
Postal/ Zip Code:
27856
Country:
USA
*
252.903.6891
4d. Telephone Number: (44444)ftttt 4444444
252.459.8197
4e Fax Number: (44444)ftttt ###i#
4f. Email Address: *
[e-mail]
Agent Authorization Letter:*
Attach a completed/signed agent authorization form or letter. A sample form may be found at this link:
https://www.saw. usace.army. mi I/Missions/Redu latory-Permit-Program/Permits/2017-Nationwide-Permits/Pre-
construction-Notification/
Page 4 of 23 PCN Form - Version 4.2, January31, 2022

C. Project Information and Prior Project History
1.
Project Information
1a.
Name of project: *
Flowers Plantation SW Quad Dam Repair
1 b.
Subdivision name (if appropriate):
Flowers Plantation
1 c.
Nearest municipality/town: *
Clayton
2.
Project Identification
2a.
Property identification number (tax PIN or parcel ID):
169900-32-8644
2b.
Property size (in acres):
17.00
2c.
Project Address:
Street Address:
4880 NC Highway 42 E
Address line 2:
City:
Clayton
State/ Province/ Region:
NC
Postal/ Zip Code:
27827
Country:
USA
2d.
Site coordinates in decimal degrees (using 4-6 digits
after the decimal point): *
Latitude (DD.DDDDDD): * 35.650878
Longitude (-DD.DDDDDD): *-78.348183
3.
Surface Waters
3a.
Name of nearest body of water to proposed project: *
Unamed Tributary to the Neuse River
3b.
Water Resources Classification of nearest receiving
water: *
27-(38.5)
The Surface Water Classification map may be found at this link:
https://ncdenr. maps. arcgis. com/apps/webappviewer/index. html?id=6e 125ad7628f494694e259c80dd64265
3c.
In what river basin(s) is your project located? *
Neuse
Choose additional (if needed)
3d.
Please provide the 12-digit HUC in which the project is
located: *
030202011104
The Find Your HUC map may be found at this link:
https://ncdenr. maps.arcgis.com/apps/Public) nformation/index. html?appid=ad3a85a0c6d644a0b97cd069db238ac3
Page 5 of 23 PCN Form - Version 4.2, January31, 2022

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 site is a +/-10.66 ac pond dam that was constructed over 50 years ago. The generally land use is residential
and commercial. All adjacent land is within the Flowers Plantation PUD.
4b. Have Corps permits or DWR certifications been obtained for this
project (including all prior phases) in the past?
❑Yes ❑x No ❑Unknown
If yes, please give the DWR Certification number and/or Corps
Action ID (ex. SAW-0000-00000):
[Click to enter.]
[Click to enter.]
Attach any pertinent project history documentation
4b2. Is any portion of the work already complete? *
❑ Yes ❑x No
If yes, describe the completed work.
Click to enter text.
4c. List of other certifications or approvals/denials received from other federal, state or local agencies for work
described in this application not related to the 404 or 401.
Notification to Johnston County.
4d. Attach an 81/2 x 11" excerpt from the most recent version of the USGS topographic map indicating the location of
the project site.
4e. Attach an 81/2 x 11" excerpt from the most recent version of the published County NRCS Soil Survey map
depicting the project site.
4f. List the total estimated acreage of all existing wetlands on the
property:
0.1 acres
4g. List the total estimated linear feet of all existing streams (intermittent
and perennial) on the property:
0.00 linear feet
4g1. List the total estimated acreage of all existing open waters on the
property:
10.67 acres
4h. Explain the purpose of the proposed project: *
To repair erosion of an existing dam
4i. Describe the overall project in detail, including the type of equipment to be used: *
Dewatering pump with silt bag, excavator, compactor, dump truck, miscellaneous hand tools.
4j. Attach project drawings/site diagrams/depictions of impact areas for the proposed project.
4k. Will this activity involve dredging in wetlands or waters? *
❑ Yes ❑x No
If yes, describe the type of dredging, the composition of the dredged material, and the locations of disposal area.
Click to enter text.
Page 6 of 23 PCN Form - Version 4.2, January31, 2022

5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or in
proposed impact areas? *
0 Yes ❑ No ❑Unknown
Comments:
Click to enter text.
5b. If the Corps made a jurisdictional determination,
what type of determination was made? *
❑ Preliminary ❑x Approved ❑ Emailed concurrence
❑ Not Verified ❑ Unknown ❑ n/a
Corps AID number (ex. SAW-0000-00000):
200320493
5c. If 5a is yes, who delineated the jurisdictional
areas?
Name (if known): Sean Clark and Kevin Martin
Agency/Consultant Company: S&EC
Other: Click to enter.
5d. List the dates of the Corps jurisdictional determination or State determination if a determination was made by
either agency.
USACE - Amanda Jones, August 13, 2003: NCDWR — Deborah Edwards, August 7 2002
5d1. Attach jurisdictional determinations.
6.
Future Project Plans
6a.
Is this a phased project?
❑ Yes ❑x No
6b.
If yes, explain.
Click to enter.
Are any other NWP(s), regional general permit(s), or individual permit(s) used, or intended to be used, to
authorize any part of the proposed project or related activity? This includes other separate and distant crossings
for linear projects that require Department of the Army authorization but don't require pre -construction
notification.
None
7. Addresses of adjoining property owners, lessees, etc. whose property adjoins the waterbody (if more than can be
entered here, please attach a supplemental list)
Southwest Crossroads Holding, LLC and Southwest Flowers Crossroads Association, Inc. at 4880 NC Highway
42 E, Clayton, NC 27527 and Ardmore at Flowers 1, LLC at 1400 W Northwood Street, Greensboro, NC 27408
8. Scheduling of activity:
To complete the repair as soon as possible.
Page 7 of 23 PCN Form - Version 4.2, January31, 2022

D. Proposed Impacts Inventory
1. Impacts Summary
1 a. Where are the impacts associated with your project
(check all that apply):
❑ Wetlands
❑ Buffers
❑ Pond Construction
❑ Streams - tributaries
❑x Open Waters
2. Wetland Impacts
If there are wetland impacts proposed on the site, complete this table for each wetland area impacted.
2a.
Site #*
2a1.
Impact
Reason/Type*
2b.
Impact
Duration*
2c.
Wetland Type*
2d.
Wetland Name*
2e.
Forested
?*
2f.
Jurisdiction
Type*
2g.
Impact Area
(ac)
W1
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W2
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W3
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W4
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W5
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W6
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W7
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W8
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W9
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W10
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W11
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W12
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W13
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W14
Choose one
Temp/ Perrr
Choose one
Click to enter
Y/N
Choose one
Click to enter
W15
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
2g1. Total temporary wetland impacts
0.00 ac
2g2. Total permanent wetland impacts
0.00 ac
2g3. Total wetland impacts
0.00 ac
2h. Type(s) of material being discharged and the amount of each type in cubic yards:
N/A
2i. Comments:
This project is a dam repair project.
Page 8 of 23 PCN Form - Version 4.2, January31, 2022

3. Stream Impacts
If there are perennial or intermittent stream/ tributary impacts (including temporary impacts) proposed on the site,
complete this table for all stream/ tributary sites impacted.
** All Perennial or Intermittent streams must be verified by DWR or delegated local government
Site #*
3a
Impact
Reason*
3b.
Impact
Duration
3c.
Impact Type
3d.
Stream Name
3e.
Stream
Type
3f.
Jurisdiction
Type
3g.
Stream Width
(avg ft)
3h.
Impact length
(linear ft) *
S1
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S2
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S3
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S4
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S5
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S6
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S7
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S8
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S9
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S10
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S11
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S12
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S13
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S14
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S15
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S16
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S17
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S18
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S19
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S20
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
3i1. Total jurisdictional ditch
impact:
0.00 linear ft
3i2. Total permanent stream
impacts:
0.00 linear ft
3i3. Total temporary stream
impacts:
0.00 linear ft
3i4. Total stream and ditch
impacts:
0.00 linear ft
3j. Comments:
This project is a dam repair project.
Page 9 of 23 PCN Form - Version 4.2, January31, 2022

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., individually list all open water impacts in the table below.
4a.
Site #*
4a1.
Impact Reason
4b.
Impact
Duration*
4c.
Waterbody Name*
4d.
Activity Type*
4e.
Waterbody
Type*
4f.
Impact area
(ac)*
01
Dam Repair
Permanent
Unamed Trib to Neuse
Bank
Stabilization/ Fill
(Incl. Riprap)
Pond
0.15 Ac
02
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
03
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
04
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
05
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
4g. Total temporary open water impacts
0.15 ac
4g. Total permanent open water impacts
0.00 ac
4g. Total open water impacts
0.15 ac
4h. Comments:
We are proposing to place 6,702 SF of new fill material in order to repair the existing dam. The proposed water
surface will be raised 0.13' (1 9/16") higher. The net increase of the water surface will be 171 SF (0.0039256 Ac)
5. Pond or Lake Construction
If pond or lake construction is proposed, complete the table below. (*This does NOT include offline stormwater
management ponds.)
5a.
Pond ID
#
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (ac)
5d.
Stream Impacts (ft)
5e.
Upland
Impacts (ac)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
P2
Choose one
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
P3
Choose one
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
5f. Total
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
Click to
enter.
5g. Comments:
This project is a dam repair project.
5h. Is a dam high hazard permit required?
❑ Yes ❑ No
If yes, permit ID no.:
Click to enter.
5i. Expected pond surface area (acres):
Click to enter.
5j. Size of pond watershed (acres):
Click to enter.
5k. Method of construction:
Click to enter.
Page 10 of 23
PCN Form -Version 4.2, January31, 2022

Page 11 of 23 PCN Form - Version 4.2, January31, 2022

6. Buffer Impacts (DWR requirement)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts.
6a. Project is in which protected basin(s)?
(Check all that apply.)
❑ Neuse ❑ Tar -Pamlico ❑ Catawba
❑ Jordan ❑ Goose Creek ❑ Randleman
❑ Other:.:Aick to enter.
Site #*
6b.
Impact Type*
6c.
Impact Duration*
6d.
Stream Name*
6e.
Buffer
Mitigation
Required?*
6f.
Zone 1 Impact*
(sq ft)
6g.
Zone 2 Impact*
(sq ft)
B1
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B2
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B3
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B4
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B5
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B6
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B7
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B8
Choose one
Temp/ Perm
Click to enter.
'(IN
Click to enter
Click to enter.
B9
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B10
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B11
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B12
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B13
Choose one
Temp/ Perm
Click to enter.
YIN
Click to enter
Click to enter.
B14
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B15
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B16
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to ente
Click to enter.
B17
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B18
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B19
Choose one
Temp/ Perm
Click to enter.
ON
Click to enter
Click to enter.
B20
Choose one
Temp/ Perm
Click to enter.
'(IN
Click to enter.
Click to enter.
6h. Total temporary impacts:
Zone 1: 0 sq ft
Zone 2: 0 sq ft
6h. Total permanent impacts:
Zone 1: 6702 sq ft
Zone 2: Click to enter. sq ft
6h. Total combined buffer impacts:
Zone 1: 6702 sq ft
Zone 2: 0 sq ft
6i. Comments:
This is dam repair project. No permanent impact to buffer zone 1 or zone 2.
Please attach supporting documentation (impact maps, plan sheets, etc.) for the proposed project.
Page 12 of 23 PCN Form - Version 4.2, January31, 2022

E. Impact Justification and Mitigation
1.
Avoidance and Minimization
la.
Specifically describe measures taken to avoid or minimize the proposed impacts through project design: *
This is a dam repair project. Only working in area to repair the existing dam. Johnston County Erosion Control
Measures will be designed to protect sediment runoff and downstream waters.
1 b.
Specifically describe measures taken to avoid or minimize proposed impacts through construction techniques: *
This is a dam repair project. Only working in the area to repair the existing dam. Johnston County Erosion
Control Measures will be implemented to protect sediment runoff and downstream waters.
2. Compensatory Mitigation for Impacts to Waters of the U.S., Waters of the State, or Riparian Buffers
2a. If compensatory mitigation is required, by whom is it required? *
(check all that apply)
❑ DWR ❑ Corps
2b. If yes, which mitigation option(s) will be used for this
project? * (check all that apply)
❑ Mitigation Bank
❑ In Lieu Fee Program
❑ Permittee Responsible Mitigation
3. Complete if using a Mitigation Bank (Must satisfy NC General Statute143-214.11 (d1).)
3a. Name of mitigation bank:
Click to enter.
3b. Credits purchased/requested:
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Attach receipt and/or approval letter.
3c. Comments:
Click to enter.
4. Complete if Using an In Lieu Fee Program
4a. Attach approval letter from in lieu fee program.
4b. Stream mitigation requested:
Click to enter. linear feet
4c. If using stream mitigation, what is the stream temperature:
Choose one
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington
District's RIBITS website: (Please use the filter and select Wilmington district)
https://ribits.usace.army.mil/ribits apex/f?p=1 07:27:273470961 1497:: NO: RP:P27 BUTTON KEY:0
4d. Buffer mitigation requested (DWR only):
Click to enter. square feet
4e. Riparian wetland mitigation requested:
Click to enter. acres
4f. Non -riparian wetland mitigation requested:
Click to enter. acres
4g. Coastal (tidal) wetland mitigation requested:
Click to enter. acres
4h. Comments:
Click to enter.
Page 13 of 23
PCN Form - Version 4.2, January31, 2022

5. Complete if Providing a Permittee Responsible Mitigation Plan
5a. If proposing a permittee responsible mitigation plan, provide a description of the proposed mitigation plan,
including mitigation credits generated.
Click to enter.
5b. Attach mitigation plan/documentation.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — DWR requirement
6a. Will the project result in an impact within a protected riparian buffer
that requires buffer mitigation?
❑Yes ❑ No
If yes, please complete this entire section — please contact DWR for more information.
6b. If yes, identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required in the table below.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(square feet)
Zone 1
Click to enter.
Click to enter.
Choose one
Click to enter.
Zone 2
Click to enter.
Click to enter.
Choose one
Click to enter.
6f. Total buffer mitigation required
Click to enter.
6g. If buffer mitigation is required, is payment to a mitigation bank or
NC Division of Mitigation Services proposed?
❑ Yes ❑ No
6h. If yes, attach the acceptance letter from the mitigation bank or NC Division of Mitigation Services.
6i. Comments:
Click to enter.
Page 14 of 23 PCN Form - Version 4.2, January31, 2022

F. Stormwater Management and Diffuse Flow Plan (DWR requirement)
1.
Diffuse Flow Plan
1 a.
Does the project include or is it adjacent to protected riparian buffers
identified within one of the NC Riparian Buffer Protection Rules?
0 Yes ❑ No
1 b.
All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the
project is subject to a state implemented riparian buffer protection program, include a plan that fully documents
how diffuse/dispersed flow will be maintained.
All Stormwater Control Measures (SCM) must be designed in accordance with the NC Stormwater Design
Manual (https://deq.nc.dov/about/divisions/energy-mineral-land-resources/energy-mineral-land-permit-
guidance/stormwater-bmp-manual).
Associated supplement forms and other documentation must be provided.
What Type of SCM are you
providing?
(Check all that apply)
❑ Level Spreader
❑ Vegetated Conveyance (lower seasonal high water table- SHWT)
❑ Wetland Swale (higher SHWT)
❑ Other SCM that removes minimum 30% nitrogen
0 Proposed project will not create concentrated stormwater flow through the
buffer
For a list of options to meet the diffuse flow requirements, click here.
Attach diffuse flow documentation.
2.
Stormwater Management Plan
2a.
Is this an NCDOT project subject to compliance with NCDOT's
Individual NPDES permit NCS000250? *
❑ Yes 0 No
2b.
Does this project meet the requirements for low density projects as
defined in 15A NCAC 02H .1003(2)? *
0 Yes ❑ No
To look up low density requirements, click here:
http://reports.oah.state.nc. us/ncac/title%2015a%20-%20environmental%20quality/chapter%2002%20-
%20environmental%20management/subchapter%20h/15a%20ncac%2002h%20.1003. pdf
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
0 n/a — project disturbs < 1 acre
Note: Projects that have vested rights, exemptions, or grandfathering from state or locally implemented
stormwater programs or projects that satisfy state or locally -implemented stormwater programs through use of
community in -lieu programs should answer "no" to this question.
2d.
Which of the following stormwater management program(s) apply?
(Check all that apply.)*
0 Local Government
❑ State
If you have local government approval, please include the SMP on their overall impact map.
Local Government Stormwater Programs *
❑Phase II ❑ USMP
0 NSW ❑ Water Supply
Page 15 of 23
PCN Form - Version 4.2, January31, 2022

Please identify which local government stormwater program you are using. *
Johnson County. This is a dam repair project
State Stormwater Programs *
❑ Phase II ❑ HOW or ORW
❑ Coastal Counties ❑ Other
Comments:
Click to enter.
Page 16 of 23 PCN Form - Version 4.2, January31, 2022

G. Supplementary Information
1.
Environmental Documentation
1 a.
Does the project involve an expenditure of public (federal/state/local)
funds or the use of public (federal/state) land? *
❑ Yes
❑x 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
❑ No
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 letter.) *
❑ Yes
❑ No
Comments:
Click to enter.
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),
Federally Non -Jurisdictional Wetlands /Classified Surface Waters
(15A NCAC 2H. 1400) DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
❑ Yes
❑x No
2b.
If you answered "yes" to the above question, provide an explanation of the violation(s):
Click to enter.
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? *
❑ Yes ❑x No
3b.
If you answered "no", provide a short narrative description:
This is a dam repair project.
3c.
If yes, provide a qualitative or quantitative cumulative impact analysis in accordance with the most recent DWR
policy. (Attach .pdf)
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? *
❑ Yes ❑x No ❑ N/A
4b. If yes, describe in detail the treatment methods and dispositions (non -discharge or discharge) of wastewater
generated from the proposed project. If the wastewater will be treated at a treatment plant, list the capacity
available at that plant.
Click to enter.
Page 17 of 23
PCN Form - Version 4.2, January31, 2022

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? (IPAC weblink: https://www.fws.gov/ipac/ [fws.gov]) *
❑ Yes ❑x No
5b. Have you checked with the USFWS concerning Endangered Species
Act impacts? *
❑ Yes ❑x No
5c. If yes, indicate the USFWS Field Office you have contacted.
Choose one
5d. Is another federal agency involved? *
❑ Yes ❑x No ❑ Unknown
If yes, which federal agency?
Click to enter.
5e. Is this a DOT project located within Divisions 1-8? *
❑ Yes ❑x No
5f. Will you cut any trees in order to conduct the work in waters of the
U.S.?
0Yes ❑ No
5g. Does this project involve bridge maintenance or removal? *
❑ Yes ❑x No
5g1. If yes, have you inspected the bridge for signs of bat use such as
staining, guano, bats, etc.? Representative photos of signs of bat use
can be found in the NLEB SLOPES, Appendix F, pages 3-7.
❑ Yes ❑ No
Representative photos of signs of bat use can be found in the NLEB SLOPES, Appendix F, pages 3-7. Link to
NLEB SLOPES document: http://saw-red.usace.army.mil/NLEB/1-30-17-signed NLEB-SLOPES&apps.pdf
If you answered yes to 5g1, did you discover any signs of bat use? *
❑ Yes ❑ No ❑ Unknown
If yes, please show the location of the bridge on the permit drawings/ project plans
5h. Does this project involve the construction/ installation of a wind
turbine(s)? *
❑Yes ❑x No
If yes, please show the location of the wind turbine(s) on the permit drawings/ project plans (attach .pdf)
5i. Does this project involve blasting and /or other percussive activities
that will be conducted by machines, such as jackhammers,
mechanized pile drivers, etc.? *
❑ Yes ❑x No
If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this
activity on the property (attach .pdf)
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated
Critical Habitat? *
www.IPAC.gov. The species listed do NOT have a 'pond habitat' and would typically not be impacted by the
proposed dam repair work.
Attach consultation documentation.
6.
Essential Fish Habitat (Corps Requirement)
6a.
Will this project occur in or near an area designated as
an Essential Fish Habitat? *
❑ Yes
❑x No
Is there submerged aquatic vegetation (SAV) around
the project vicinity? *
❑ Yes
❑ No
❑x Unknown
Page 18 of 23
PCN Form - Version 4.2, January31, 2022

Will this project affect submerged aquatic vegetation? *
❑ Yes
❑ No ❑x Unknown
Explain: This is dam repair project
6b. What data source(s) did you use to determine whether your site would impact Essential Fish Habitat? *
www.IPAC.gov. The species listed do NOT have a 'pond habitat' and would typically not be impacted by the
proposed dam repair work. on
7.
Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data):
http://dis.ncdcr.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 history and archaeology)? *
❑Yes ❑x No
7b.
What data source(s) did you use to determine whether your site would impact historic or archeological
resources? *
The fact that previous ACOE and DWR permits have been issued on sites near by.
7c.
Attach historic or prehistoric documentation.
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain? *
❑ Yes
❑x No
8b. If yes, explain how the project meets FEMA requirements.
Click to enter.
8c. What source(s) did you use to make the floodplain determination?
County GIS mapping
Page 19 of 23 PCN Form - Version 4.2, January31, 2022

H. Miscellaneous
Page 20 of 23 PCN Form - Version 4.2, January31, 2022

Comments:
The SW Quad Pond at Flowers Plantation is in need of some major repair and rehabilitation. Per meeting on -
site with the ACOE and you, we are thinking Nationwide Permit Number 3. The is for maintenance, repair
and rehabilitation of an existing dam. There is no net loss of wetlands or surface waters. Normal
downstream flows will be maintained. No Flooding should take place. No dredging will be performed for
navigation. This is an inland pond and not beach restoration. No new stream channelization or stream
relocation will be needed.
Site Observations:
The existing dam embankment is approximately 426 feet long. The majority of the crest of the dam is brush
and grass with some trees along the edge near the water, and is approximately 8 to 12 feet in width and
approximately 2.3 feet in height above the normal pool elevations. The downstream slop varies from 5 to 20
feet in height. The downstream slope is steep (greater than 2H:1V in most areas based on estimated visual
observation) and heavily vegetated with brush and trees. These were NO working outlets observed, however
the dam along the southwestern edge has eroded (washed-out) and water is flowing out of the pond in the
south/southwest direction. See Flowers SW Buffalo and NC-42 Dam Photos.
Downstream Slope Observations:
No unstable areas or shallow sloughing was observed on the downstream slope of the pond, however as
previously noted it does appear to be 2H:1V or steeper in most locations. Slopes steeper than 2.5H:1V
typically have a higher potential for experiencing shallow sloughing, especially during the water times of the
year. Shallow sloughing does not typically result in immediate safety risk or dam failure, but it does require
maintenance and repair to avoid an increase in the advancement of distress and damage to the embankment
over time. In addition, there are large trees that over time my fall creating voids in the near surface of the
slope. Similar to sloughing this is more of a maintenance and repair issue.
Reconstruction Considerations:
As an alternative to complete removal and reconstruction we suggest consideration be given to construction
of a new embankment adjacent to the upstream side of the existing dam. As previously noted, the existing
embankment does not meet the required factor of safety for downstream slop stability, and the downstream
slope is steep and heavily overgrown. As such we recommend that a new dam be constructed in front of the
existing dam. The new dam can be connected to the existing embankment and not be negatively affected by
any potential future distress in the existing embankment. The existing downstream slope could remain
undisturbed since the previously mentioned sloughing and distress related to fallen trees would not
negatively affect the proper function of the new embankment. See the attached figure 4.
Design Considerations:
It is our understanding that the dam does NOT fall under review of the North Carolina Dam Safety Program.
It is a single private ownership that provides protection only to land or other property under the same
ownership and that does not pose a threat to human life or property below the dam. And it is less than 25
feet in height or that has an impoundment capacity of less than 50 acre-feet or water. Design and
construction requirements typically do not change based on classification, but the timing and complications
of plan preparation, submittal and construction is greatly reduced by not having to go through the full review
process. It is our understanding the Johnston County will issues Erosion and Sedimentation Control (land
disturbance permit), if disturbance is greater than one -acre and the US CORPS will need notification of
Nationwide Permit #3 to allow for the repair and rehabilitation work to be completed.
Construction Considerations:
Construction of the new embankment will require lowering the water level sufficient to install a coffer dam.
A pump system may be needed to create the required space for construction. Once the area has been
Page 21 of 23
PCN Form - Version 4.2, January31, 2022

dewatered it will need have to be excavated down to firm material prior to installation of the new outlet
structure and new embankment. There will likely be a significant amount of soft material that has been
deposited in this area that will be required to be removed. The loose wet material will also need to be
removed from the upstream slope.
Final Deposition of the Dam/Surface Area of the pond:
The current water surface elevation is 271.98 feet with a surface area of 464,480 SF. The proposed dam will
encroach into the existing surface water approximately 10- to 18-feet. The new embankment will place
approximately 3,000 CY of fill material in front of the existing embankment. The proposed new water surface
will be 272.11 feet. This is 0.13 feet higher than current. Due to raising the water surface 0.13 feet the new
water surface area will be 464,651 SF. This is the water surface area after deducting the newly place fill
material. The new water surface area will be 171 SF larger than the current. No wetlands will be impacted
on the downstream of the dam, as no construction activity will be done on the downstream side and not
wetlands on the upstream side will be flooded. It is our belief that the current pond is several inches below
the elevation of the pond when the wetlands surrounding the pond were evaluated. Therefore, raising the
water surface elevation of the pond 0.13 feet will be closer to the original pond elevation. The currently
existing dam height is +/-274.25. With the new water surface elevation at 272.11, there will be 2.14 feet of
dam height above the water surface elevation at normal pool.
From: Deborah Shirley <[e-mail]>
Sent: Tuesday, February 01, 2022 2:28 PM
To: Hopper, Christopher D CIV USARMY CESAW (USA) <[e-mail]>
Cc: Mike Stocks <[e-mail]>
Subject: RE: SW Quad Flowers Dam Maintenance
Question: NWP 3 includes removal of sediments in the immediate vicinity. Paragraph b. addresses removal of
accumulated sediments outside the immediate vicinity of the maintenance activity. I am under the
impression sediments accumulated against the existing dam would need to be removed. Would other areas
of the pond be excavated as well, or only those deposits abutting the repair project?
Response: No sediment within the surface waters of the pond will be removed EXCEPT in the vicinity of the
current dam. All existing wet material/sedimentation will be removed in order to construct the dam on/in
solid material in this area only. The area within about 15 to 20 feet immediately in front of and adjacent to
the existing dam will be excavated and this material removed. A keyway will be cut into the face of the dam
and then a low permeable material will be placed to construct a new dam in front of the existing. Figure 4
shows the 'new dam' to be constructed in front of the existing dam. No material will be remove from the
pond other than the material needed for construct the dam. Dam repair Area — New Pond Elevation 242-11
10-22-21 REV 11-8-21. Pdf shows a plan view of the area where the material will be removed and replaced. It
is only the area denoted as 'NEW FILL FOR DAM EMBANKMENT.'
From: Hopper, Christopher D CIV USARMY CESAW (USA) <[e-mail]>
Sent: Friday, February 18, 2022 8:10 AM
To: Deborah Shirley <[e-mail]>
Cc: Mike Stocks <[e-mail]>
Subject: RE: SW Quad Flowers Dam Maintenance
Good Morning;
A NWP 3 would cover this activity, and written verification should be secured.
Page 22 of 23
PCN Form - Version 4.2, January31, 2022

Thank you,
Christopher D. Hopper
Regulatory Specialist
Attach pertinent documentation or attachments not previously requested
I. Signature*
❑ By checking the box and signing below, I, as the project proponent, certify to the following:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete, to
the best of my knowledge and belief;
• 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;
• The project proponent hereby agrees 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");
• The project proponent hereby agrees to conduct this transaction by electronic means pursuant to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• The project proponent hereby understands that an electronic signature has the same legal effect and can be
enforced in the same way as a written signature; AND
• As the project proponent, I intend to electronically sign and submit the PCN/online form.
Full Name: * J. Michael Stocks
Signature: * Click to enter.
Date: * 2/28/2022
Page 23 of 23 PCN Form - Version 4.2, January31, 2022