20070156 Ver 1_401 Application_20070107

I'^~1~ID
2074156
Office Use Only' Form Version March OS
USACE Action ID No. DWQ No.
(li any particular item is not appucavie to uu~ ~r~~o~y ~„~ax ~,.~~, ~.~~ err==~~~-~ ~. -.,...,
I. Processing
1. Check all of the approval(s) requested for this project:
Q Section 404 Permit X^ Riparian or Watershed Buffer Rules
^ Section 10 Permit ^ Isolated Wetland Permit from DWQ
® 401 Water Quality Certification ^ Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested
NW 18
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ^
4. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ^
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here:
p ~~~' p
II. Applicant Information
JAN 2 6 2007
1. Owner/Applicant Information
F.H. SHACKELFORD, JR. DENR _ WATER cauaun
Name: ---_-.,.,~e r~rrM
Mailing Address: PO BOX 38 V1~U1NU~ti~ua~,.~,M.~
HOOKERTON, NC 28535
Telephone Number: 252-747-2642 Fax Number:
E-mail Address: [e-mail]
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Updated 11/1/2005
Page 5 of 12

10. Describe the overall project in detail, including the type of equipment to be used:
rnNSTRUCTION OF A DAM TO RETAIN AN APPROXIMATELY 7-ACRE LAKE.
11. Explain the purpose of the proposed work:
AGRICULTURAL WATER STORAGE AND RECREATION
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
SCOTT JONES OF USACE VISITED SITE AND DETERMINED WETLANDS WERE
WIDTH OF STREAM. DATE OF VISIT WAS FALL Zc~~i~.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
PRELIMINARY PLANNING FOR A FUTURE DEVELOPMENT IS UNDERWAY. DEVELOPMENT
PLANS ARE NOT DEFINITE AS TO WHEN OR IF DEVELOPMENT WILL BE UNDERTAKEN.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should be shown on a delineation map, whether or not impacts are proposed to these systems.
Wetland and stream evaluation and delineation forms should be included as appropriate.
Photographs may be included at the applicant's discretion. If this proposed impact is strictly for
wetland or stream mitigation, list and describe the impact in Section VIII below. If additional
space is needed for listing or description, please attach a separate sheet.
1. Provide a written description of the proposed impacts:
DIVERSION OF DRAINAGE FEATURE DURING DAM CONSTRUCTION, DAM CONSTRUCTION,
SPILLWAY CONSTRUCTION, AND POND IMPOUNDMENT.
Updated 11/1/2005
Page 7 of 12

2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
separately list impacts due to both structure and flooding.
Wetland Impact
Site Number

(indicate on map)
T e of Im act
yp p Type of Wetland

(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
100-year
Floodplain

es/no) Distance to
Nearest
Stream

(linear feet) Area of
Impact
(acres)
1 CLEAR & FILL FOREST Y p 0.01
2 IMPOUNDMENT FOREST Y 0 0.07

WETLAND AREA S WIDTH OF STREAM ASED ON DISCUSSIONS WITH SCOTT JO ES, USACE.
Total Wetland Impact (acres) 0.085
3. List the total acreage (estimated) of all existing wetlands on the property: UNKNOWN
4. Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
plans and profiles showing the linear footprint for both the original and relocated streams
must be included. To calculate acreage, multiply length X width, then divide by 43,560.
Stream Impact
Number
indicate on ma
Stream Name
Type of Impact
Perennial or
Intermittent? Average
Stream Width
Before Im act Impact
Length
(linear feet) Area of
Impact
(acres
1 NIA FILL I 1.77 FT 300 0.012
2 NIA IMPOUND I 1.77 FT 1800 0.073

N TE: THIS A EA IS COINCID NT WITH W TLAND A
Total Stream Impact (by length and acreage) 2100 0.085
5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.}. Open water impacts include, but are not limited to
fill, excavation, dredging, flooding, drainage, bulkheads, etc.
Open Water Impact
Site Number
indicate on ma Name of Waterbody
(if applicable)
Type of Impact Type of Waterbody
(lake, pond, estuary, sound, bay,
ocean, etc. Area of
Impact
acres

Total Open Water Impact (acres) 0
SEA
Updated 11/1/2005
Page 8 of 12

6
List the cumulative im act to all Waters of the U.S. resultin from the ro'ect:
Stream Im act acres
Wetland Im act acres
0 en Water Impact (acres): 0
Total Im act to Waters of the U.S. (acres 0
Total Stream Impact (linear feet): 2100
7. Isolated Waters
Do any isolated waters exist on the property? ^ Yes XD No
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.
8. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): X^ uplands ^ stream Q wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.): DAM EMBANKMENT
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): IRRIGATION STORAGE
Current land use in the vicinity of the pond: AGRICULTURAL
Size of watershed draining to pond: 243 AC. Expected pond surface area: 7 AC.
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
DAM ON DRAINAGE FEATURE NEEDED TO COLLECT SURFACE RUNOFF FOR IRRIGATION.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
Updated 11/1/2005
Page 9 of 12

USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on January 15, 2002, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCEEP concurrence shall be placed on hold as incomplete.
An applicant may also choose to review the current guidelines for stream restoration in DWQ's
Draft Technical Guide for Stream Work in North Carolina (see DWQ website for most current
version.).
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http~//www.nceep.net/~ages/inlieureplace.htm. If use of the NCEEP is proposed,
please check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Updated 11/1/2005
Page 10 of 12

IX. Environmental Documentation (required by DWQ)
1. Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federal/state) land? Yes ^ No X^
2. If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ^ No ^
If yes, has the document review been finalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes ^ No ^
X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify NEUSE )? Yes ^X No ^
2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffer multi tiers.
Zone* Impact
(s uare feet) Multiplier Required
Miti ation
1 3 (2 for Catawba)
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration /Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260.
THE PROPOSED ACTIVITY IS ALLOWABLE WITHOUT MITIGATION PROVIDED THAT A
50-FOOT BUFFER IS PROVIDED AROUND THE NEW POND. A 50-FOOT BUFFER
WILL BE PROVIDED.
Updated 11/1/2005
Page 11 of 12

XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
Stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level.
PROPOSED CONSTRUCTION IS AN EARTH DAM
DAM AND SPILLWAYS WILL SLOW
RUNOFF OF STORMWATER. NO SIGNIFICANT IMPERVIOUS SURFACES ARE BEING CONSTRUC
XII. Sewage Disposal (required by DWQ)
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.
N~LT /aPPLl1:~BLE
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ^ No
Is this an after-the-fact permit application? Yes ^ No
XIV. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ^ No
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
http://h2o.enr.state.nc.us/ncwetlands. If no, please provide a short narrative description:
XV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
i
~~ ~.
Applica /Agent'.
(Agent's signa re is valid
Updated 11/1/2005
ture
r~~ Q
Date
y if an authorization letter from the applicant is provided.)
Page 12 of 12

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Soil Survey of Greene cotmiy, North Carolina ~-~ IMAM AREA
Map Unit Legend Summary
Greene County, North Carolina
Map Unit Symbol Map Unit Name Acres in AOT Percent of AOI
AuB Autcy`cill~ fine sand, Q to b 1.1 0.4
percent slopes
BB Bibb Iuam, frequently flooded. 15:8 ~i.2
CoC2 Cowart sandy 1©arn, ~ to 12 3.6.E 14.4
percenC slopes, eroded
GoA Goldsboro loamy sand, 0 to 2 16:1 6.3
percent slopes
NoA I~Torfolk loatz>i~ sand;. U to 2 114.6 45.2`
perecnt'~lopes
NoB Norfolk loamy sand, 2 to 6 69.4 27.4
percent clope~,
Ra' .1t~trassanciy loam 0.0 11.0
USD~- Natv~lB~ourcec Web Sgil Survey 1.1 l/IR/2007
~ cbaxrraNaaSerdce National Cooperative Soil Survey Page 3 of3

F.H. SHACKELFORD DAM PROJECT
Stream Width every 50 feet
Elevation @ 64FT.
1 10 inches
2 35 inches
3 35 inches
4 23 inches
5 20 inches
6 16 inches
7 18 inches
8 24 inches
9 14 inches
10 11 inches
11 13 inches
12 20 inches
13 28 inches
14 32 inches
15 30 inches
16 31 inches
17 16 inches
18 41 inches
19 33 inches
20 36 inches
21 28 inches
22 18 inches
23 42 inches
24 32 inches
25 15 inches
26 22 inches
27 13 inches
28 11 inches
29 13 inches
30 15 inches
31 16 inches
32 15 inches
33 15 inches
34 10 inches
35 15 inches
36 11 inches
37 31 inches
38 11 inches
39 11 inches
21.3 INCHES AVE. WIDTH
1.77 FT AVE. WIDTH
1800 LF OF LAKE IMPOUNDMENT BY TOPO
300 LF OF FILL AT DAM
2100 LF TOTAL
0.073 ACRES LAKE IMPOUNDMENT
0.012 ACRES FILL
0.085 ACRES TOTAL IMPACT

F.H. SHACKELFORD DAM
GREENE COUNTY, NC
A NEUV PROPOSED DAM ON A TRIBUTARY TO RAINBODU
CREEK, NEUSE RIVER BASIN
FIGURES FOR USACE PRECONSTRUCTION NOTIFICATION
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