20230950 Ver 1_ePCN Application_20230703

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:
5/14/2023
BIMS # Assigned
20230950
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Reviewing Office*
Raleigh Regional Office - [phone]
Information for Initial Review
1a. Name of project:
Lake Michael Dam Repair
1a. Who is the Primary Contact?*
Gerald Pottern
1b. Primary Contact Email: *
[e-mail]
Date Submitted
7/3/2023
Nearest Body of Water
Mill Creek, Lake Michael
Basin
Cape Fear
Water Classification
Class WS-II-HQW-NSW
Site Coordinates
Latitude:
36.1081
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Orange
Is this a NCDMS Project
Yes No
Longitude:
-79.2507
Version#*
1
What amout is owed?*
$240.00
$570.00
Select Project Reviewer*
Zachary Thomas:[e-mail]
1c. Primary Contact Phone: *
[phone]
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: 03 - Maintenance
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular 401 Water Quality Certification - Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
Individual 401 Water Quality Certification
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification: Yes No
For the record only for Corps Permit: Yes No
1f. Is this an after -the -fact permit application? *
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1h. Is the project located in any of NC's twenty coastal counties?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
1d. Who is applying forthe 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:
City of Mebane
2b. Deed book and page no.:
Deed Book 6670 / Page 77
2c. Contact Person:
Chris Rollins, city manager
2d.Address
Street Address
106 East Washington Street
Address Line 2
city State / Province / Region
Mebane NC
Postal / Zip Code Country
27302 us

2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Gerald Pottern
4b. Business Name:
Mogensen Mitigation, Inc
4c. Address
Street Address
104 East Chestnut Ave
Address Line 2
City
State / Province / Region
Wake Forest
NC
Postal / Zip Code
Country
27587
us
4d. Telephone Number: 4e. Fax Number:
[phone]
4f. Email Address:"`
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
Mebane
2. Project Identification
2a. Property Identification Number:
982 586 2705
2c. Project Address
Street Address
7300 Lebanon Rd
Address Line 2
city
Mebane
Postal / Zip Code
27302
3. Surface Waters
3a. Name of the nearest body of water to proposed project: "
Mill Creek, Lake Michael
3b. Water Resources Classification of nearest receiving water:
Class WS-II-HOW-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.
03030002-0407
4. Project Description and History
2b. Property size:
260
State / Province / Region
NC
Country
us
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: *
Lake Michael Dam was constructed in 1952 as a water supply impoundment on Mill Creek. The earthen embankment dam has a hydraulic height of 29 feet and a concrete ogee -crested
spillway on the left (west) abutment. The 75-acre lake is no longer used as a raw water intake site, but is now used as a City park, and is upstream of the newer and larger Quaker Creek
Reservoir located four miles to the west which now serves as the raw water supply for Mebane and other nearby communities. The ogee spillway, intake riser, and toe drain system are in
need of repair to meet NC Dam Safety guiodance. Land areas adjacent to Lake Michael Dam include the City park, forest land, and single-family and multi -family residential development.
Lake Michael Way is a paved street providing access to the dam and the park from Lebanon Rd.
L

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:
0.46 acre in JD review area. Total parcel wetland area unknown.
4g. List the total estimated linear feet of all existing streams on the property:
220 feet in JD review area
4h. Explain the purpose of the proposed project:*
The proposed work will rebuild the 70-year old cracked concrete spillway; repair and upgrade the toe drain system to maintain structural integrity of the dam embankment; replace the riser
drain gate, valve, and trash track; install a new liner inside the riser outlet pipe; and modify the two outlets below the ogee spillway and the riser to improve energy dissipation and protect
the receiving streams from erosion.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
See construction sequence description in the cover letter.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No
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): Gerald Pottern
Agency/Consultant Company: Mogensen Mitigatiopn Inc.
Other:
6. Future Project Plans
6a. Is this a phased project?*
O Unknown
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?
A greenway trail project on the western portion of the property is currently in the permitting phase. This is a park amenity and is independent of the dam repairs. DWR Project # 20230812
version 1, public notice issued June 10, 2023.
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries 0 Buffers
Open Waters Pond Construction
2. Wetland Impacts
Q
u
2a1 Reason (?)
2b. Impact type * (?)
2c. Type of W. *
2d. W. name
2e. Forested"
2f. Type of Jurisdicition *
2g• Impact
?)
area *
W-1
clear & grub
T
Bottomland Hardwood Forest
wetland GA+GB
Yes
Corps
0.114
(acres)
W-1
stabilize outlet
P
Bottomland Hardwood Forest
wetland GA+GB
Yes
Corps
0.017
(acres)
W-2
clear & grub
T
mland Hardwood Forest
ff
wetland GB
Yes
Corps
0.024
(acres)
W-2
dam toe drain
P
ffornland Hardwood Forest �we7
B
t-A
Corps
0.014
(acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.138 0.031
2g. Total Wetland Impact
0.169

2i. Comments:
Portion of wetland GB along toe of dam has shrub -scrub cover, not forest.
3. Stream Impacts
3a. Reason for impact (?)
3b.lmpact type"
3c. Type of impact*
3d. S. name*
3e. Stream Type*
3f. Type of
3g. S. width
3h. Impact
❑
(?)
Jurisdiction*
length*
g1
S-1
Temporary
Bank Stabilization J
Mill Creek
Perennial
Corps
12
89
Averege (feet)
(linear feet)
S2
S-1
Permanent
Dam construction J
Mill Creek
Perennial
Corps
12
Average (feet)
(linear feet)
S3
S-2
Temporary
Bank Stabilization J
UT Mill Creek
Perennial
Corps
33
Averege (feet)
(linear feet)
S4
S-2
Permanent
Rip Rap Fill
UT Mill Creek
Perennial
Corps
6
40
Averege (feet)
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
44
3i. Total stream and ditch impacts:
166
3j. Comments:
4. Open Water Impacts
3i. Total temporary stream impacts:
122
4a. Site #
4a1. Impact Reason
4b. Impact type
4c. Name of waterbody
4d. Activity type :114e.
Waterbody type
4f. Impact area
O-1
cofferdam
T
Lake Michael
Fill
_11
Lake
0.02
4g. Total temporary open water Impacts:
0.02
49. Total open water impacts:
0.02
4h. Comments:
Temporary cofferdam in lake bed upstream of spillway to divert Flow during construction.
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all that apply.
Neuse
Catawba
Goose Creek
Other
4g. Total permanent open water impacts:
0.00
Tar -Pamlico
Randleman
Jordan Lake
6b. Impact Type
6c. Per or Temp
6d. Stream name
6e. Buffer mitigation required?
6f. Zone 1 impact
6g. Zone 2 impact
clear forest vegetation, allowed
T
Mill Creek, west bank 11
No
1,365
0
clear herb -scrub veget, allowed
T
Mill Creek, west bank
No
2,260
1,925
clear forest vegetation, allowed
T
Mill Creek, east bank ii
No
2,420
0
clear herb -scrub veget, allowed
T
Mill Creek, east bank
No
1,125
1,710
clear forest vegetation, allowed
T
Lake Michael, west bank
No
3,480
0
clear herb -scrub veget, allowed
T
Lake Michael, west bank
No
1,660
3,705
clear forest vegetation, allowed
T
Lake Michael, east bank
No
1,120
830
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 13,430.00 8,170.00

Zone 1 Zone 2
Total Permanent impacts: 0.00 0.00
Zone 1 Zone 2
Total combined buffer impacts: 13,430.00 8,170.00
61. Comments:
Riparian buffer impacts for dam maintenance and repair are allowed. Buffers do not apply on the dam footprint, which must be maintained tree -free for
dam safety compliance.
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:
Existing access paths from Lake Michael Way and a dirt trail off Lebanon Road will be used to minimize forest clearing. The replacement spillway will be
on the footprint of the existing spillway. Additional riprap in the downstream channels is necessary for channel stability.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Erosion and sedimentation controls will be installed along the access road and staging area. The lake will be only partially drained to protect fish and
aquatic life, and a minimum release flow into Mill Creek will be maintained. Disturbed land areas will be promptly revegetated.
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:
Impacts are mostly temporary. The permanent impacts (44 ft of riprap in streams, 0.031 ac of wetland) are below mitigation thresholds.
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:
Not applicable; no new impervious area will be created.
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
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:*
Dam repair to maintain existing function and pool elevation does not trigger SEPA.
0
0
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.
The project will maintain existing dam functions and pool elevation only and is not likely to affect urban growth in the Mebane 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.
Raleigh
5d. Is another Federal agency involved?"
Yes No Unknown
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
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?
The FWS-IPaC search tool lists two rare species in the general vicinity of the project: the tricolored bat (proposed endangered) and monarch butterfly
(candidate). Neither species is presently listed as endangered or threatened. The NC Natural Heritage Program (NHP) database has two recent records
(2018 to 2021) of tricolored bat in the area: one north of Hillsborough (5 to 6 miles from Lake Michael) and the other near the Town of Haw River (6 to 7
miles from Lake Michael). Forests and large trees in the project area may be potential habitat for the tricolored bat, and cutting these trees could affect
the bats. The dam embankment and other scrub -dominated areas along forest edges and roadsides may be suitable habitat for the monarch butterfly.
There is no designated critical habitat in the project area.
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?
The NOAA National Marine Fisheries Service Essential Fish Habitat Mapping Tool shows no EFH in or near the project area.
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? *
The NC State Historic Preservation Office online database shows two existing historic structures along Saddle Club Rd within 0.5 mile of Lake Michael
Dam. Rice House II (OR0883) is approximately 600 feet north of the project area, and Rice House I (OR0882) is approximately 1100 feet north of the
project area. These two structures are identified as "surveyed only" and are not listed in the national Register of Historic Places. Neither will be affected
by the project, although Rice House 11 may be visible from the eastern access road and staging area.
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 will improve dam stability and prevent a potential dam failure that could result in damage downstream. It will not affect flood elevations.
8c. What source(s) did you use to make the floodplain determination?"
FEMA-FRIS Map # 3710981500K indicates a 100-year flood -hazard zone AE elevation of 610.2 feet in the stream at the toe of Lake Michael Dam 10
and 635.5 feet in the lake upstream of the dam.
Miscellaneous O
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
PJC-PCN Mebane Support Biinder1.pdf 5.69MB
File must be PDF or KMZ
Comments
Signature
By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief'; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Gerald Pottern
Signature
Date
7/3/2023