20230847 Ver 1_ePCN Application_20230613

DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Initial Review
Has this project met the requirements for acceptance in to the review process?
Yes
No
Is this project a public transportation project?*
Yes No
Change only If needed.
Pre -Filing Meeting Date Request was submitted on:
2/17/2023
SIMS # Assigned
20230847
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Reviewing Office*
Mooresville Regional Office - [phone]
Information for Initial Review
la. Name of project:
Dogwood Park Dam Repair
1a. Who is the Primary Contact?*
Amy Black
1b. Primary Contact Email: *
[e-mail]
Date Submitted
6/13/2023
Nearest Body of Water
West Fork Twelvemile Creek
Basin
Catawba
Water Classification
C
Site Coordinates
Latitude:
34.999370
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Union
Is this a NCDMS Project
Yes No
Longitude:
-80.707870
Version#*
1
What amout is owed?*
$240.00
$570.00
Select Project Reviewer*
Andrew Pitner:[e-mail]
1c. Primary Contact Phone: *
[phone]
a
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 permits) 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: 03 - Maintenance
Nationwide Permit (NWP) Number: 18 - Minor Discharges
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
1f. Is this an after -the -fact permit application? *
Yes No
fig. 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:
Village of Wesley Chapel
2b. Deed book and page no.:
401 Water Quality Certification - Express
Riparian Buffer Authorization
2c. Contact Person:
Amanda Fuller
2d. Address
Street Address
6490 Weddington Road
Address Line 2
City
State / Province / Region
Wesley Chapel
NC
Postal / Zip Code
Country
28104
us
Yes No
Yes No

2e. Telephone Number:
[phone]
2g. Email Address:'
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Amy Black
4b. Business Name:
LJB Engineering PC
4c.Address
Street Address
311-A South Main Street
Address Line 2
City
Kernersville
Postal / Zip Code
27284
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:
Village of Wesley Chapel
2. Project Identification
2a. Property Identification Number:
06072005
2c. Project Address
Street Address
119 Lester Davis Road
Address Line 2
City
Wesley Chapel
Postal / Zip Code
28104
3. Surface Waters
3a. Name of the nearest body of water to proposed project: "
West Fork Twelvemile Creek
3b. Water Resources Classification of nearest receiving water:
C
3c. What river basin(s) is your project located in?*
Catawba
3d. Please provide the 12-digit HUC in which the project is located.
030501030201
4. Project Description and History
2f. Fax Number:
State / Province / Region
NC
Country
us
4e. Fax Number:
2b. Property size:
15.97
State / Province / Region
NC
Country
us
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 project area is located inside Dogwood Park. The project limits encompass approximately .89 acre. Flow enters the pond from overland flow from a 166-acre watershed. Flow
discharges from an existing 24" CMP riser/barrel and grassed emergency spillway. Flow discharges to an unnamed tributary that flows to West Fork Twelvemile Creek. The undersized
riser/barrel is frequently clogged with debris and there is a scour hole and stream erosion just downstream of the discharge location. There is significant erosion of the channel downstream
of the emergency spillway and the Village staff have attempted to repair the erosion, reroute the flow, and armor the channel. The crest of the embankment serves as part of the park trail
system and has an asphalt trail on the full length of the dam. There is a fence along the top of the downstream slope to keep park visitors from falling on the slope of the embankment and
a pedestrian over the emergency spillway. There is also approximately 0.1 acre of delineated wetlands downstream of the riser/barrel outlet.
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:
0.1
4g. List the total estimated linear feet of all existing streams on the property:
Approximately 2020 (intermittent)
4h. Explain the purpose of the proposed project: *
The Village of Wesley Chapel Dam (UNION-128) is a small, earthen, high hazard dam located within Dogwood Park in Wesley Chapel, North Carolina. The dam is owned by the Village of
Wesley Chapel and has deficiencies in the structure that jeopardize the safety of the dam. The dam has been classified as high hazard, and additional outlet capacity is needed to be able
to pass the appropriate design storm. This project will provide additional outlet capacity and bring the structure into compliance with current regulations.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
This project will replace the existing riser/barrel with a 16-foot by 8-foot concrete riser and two 60" RCP barrels. The emergency spillway will be graded to provide a 25-foot spillway at a
consistent elevation. These outlet systems will provide outlet capacity to pass the 1/3 PMP design storm for the dam. The downstream slope will be extended to provide a 3 to 1 slope and
the barrels will be constructed with a concrete cradle and sand filter diaphragm. The downstream channel will be lined with riprap from the outlet discharge location to a point beyond the
discharge from the emergency spillway channel. Construction drawings have been prepared to provide these dam repairs.
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):
Agency/Consultant Company: Spangler Environmental, 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?
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
2. Wetland Impacts
V
2a1 Reason (?)
2b. Impact type* (?)
2c. Type of W.*
2d. W. name
2e. Forested*
2f. Type of Jurisdicition *
(?)
2g• Impact
area *
ff
Stream stabilization
P
Unknown
NA
�s_JBoth
0.020
(acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.020

2g. Total Wetland Impact
0.020
2i. Comments:
Channel will be stabilized with riprap for erosion protection. Remaining wetlands in the area will be left undisturbed.
3. Stream Impacts
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*
g1
Stream stabilization
Permanent
Dam construction
Unnamed tributary
Intermittent
Both
15
Average (feet)
120
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
120
3i. Total stream and ditch impacts:
120
3j. Comments:
Channel will be stabilized with riprap for erosion protection.
4. Open Water Impacts
3i. Total temporary stream impacts:
0
4a. Site #
P1
4a1. Impact Reason
Riser/Barrel
Construction
4b. Impact type
T
4c. Name of waterbody
Dogwood Park Pond
4d. Activity type :114e.
Dewatering
Waterbody type
Pond
4f. Impact area
0.12
P2
Riser/Barrel
P
Dogwood Park Pond
Excavation
Pond
0.01
4g. Total temporary open water Impacts:
0.12
4g. Total open water impacts:
0.13
4g. Total permanent open water impacts:
0.01
4h. Comments:
The open water impacts are needed to construct a riser/barrel for additional outlet capacity to meet Dam Safety requirements.
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The proposed outlet is located in the same area as the existing outlet to avoid additional disturbance in removing the existing infrastructure. Access into
the lake bed will be from the northern bank - adjacent to the existing trail and less steep than the slope of the embankment. All impacts are directly
related to the dam repair and improvements.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
An Erosion & Sediment Control plan is included in the project documents.
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 project will provide erosion protection for the downstream outlet. There will be minimal loss of open water due to a larger riser outlet structure.
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:
This project will not add impervious area and does not require a diffuse flow plan.
2. Stormwater Management Plan
a
O

2a. Is this a NC DOT 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:
This project replaces existing infrastructure and does not add impervious area.
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
Yes No
1b. If you answered "yes" to the above, does the project require preparation of an environmental document pursuant to the requirements of the National or State (North Carolina)
Environmental Policy Act (NEPA/SEPA)?*
Yes No
Comments:*
This project will not add impervious area and does not impact a critical habatat.
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.
Repair of this existing dam will not result in additional development in the area.
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
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
5g(1). If yes, have you inspected the bridge for signs of bat use such as staining, guano, bats, etc.?
Yes No
If you answered "Yes" to 5g(1), did you discover any signs of bat use?
Yes No Unknown
5h. Does this project involve the construction/installation of a wind turbine(s)?*
Yes No
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?
IPaC Resource List for proposed area; https://ipac.ecosphere.fws.gov/
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?
IPaC Resource List for proposed area; https://ipac.ecosphere.fws.gov/
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?"
http://gis.ncdcr.gov/hpoweb/
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?"
fris.nc.gov
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
Dogwood Dam Repair PCN documents.pdf 16.45MB
File must be PDF or KMZ
Comments
The construction plans, Agent Authorization, Soils Map, USGS Map, and Species List from iPaC are included as attachments.
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:
Amy Black, PE
Signature
6;4,
Date
6/13/2023
U