20091262 Ver 2_Initial Interest_20100217

LT Form Version 6.2
June 29, 2009
NCDENR
INITIAL INTEREST IN PARTICIPATION IN THE EXPRESS REVIEW PROGRAM
WITHIN THE 401 OVERSIGHT/EXPRESS PERMITTING UNIT
A. Applicant Information
1. Processing
? 401 Water Quality Certification (List NW(s) or GP# verified by Corps: )
? Non-404 Jurisdictional Permit
? Riparian Buffer Authorization
1 a. Type(s) of actions ? Riparian Buffer Minor Variance
requested: ? Coastal General "Major" Variance
(Check all that apply)
? Stream Determination: # Streams
? Non-404 Wetland Determination: # Wetlands
® Stormwater Management Plan Review (fee not additive if combined with 401):
3 # of Drainage Areas/Project Site
2. Project Information
2a. Name of project: Rocky Mount High School
2b. County: Nash
2c. Latitude/Longitude: Lat: 35.93927 Long: -77.83462
2d. River Basin: Tar-Pamlico
2e. Tax PIN or Parcel ID: 374906494130
2f. Nearest Named Stream: Tar River
2g. Water Quality Classification of Nearest Named Stream: WS-IV; NSW
2h. Total project acreage (Stream or wetland determinations may omit this item): 60.52 (acres)
2i. Total Built Out Imperviousness (Stream or wetland determinations may omit this item): 37.2 %
2j. Provide a brief description of this project (attach a site plan): The City of Rocky Mount is proposing to
construct a new high school facility, including a classroom building, athletic facilities, and parking lots, A new sewer line
will also be placed to connect the new facility to the existing City of Rocky Mount sewer system.
2k. Provide directions from the nearest named town, including street names and/or highway numbers: The
property is located adjacent to the north side of Bethlehem Road (SR 1714), west of its intersection with US 301 and
east of its intersection with Old Mill Road (SR 1713)
Please attach a map of the site location using USGS 1:24,000 topographic map and a copy of the latest bound
and published County soil survey with the project/site boundaries delineated. A site plan should also be included
for all projects other than stream and wetland determinations.
Initial Interest Form v6.2 Cont.
3. Applicant Information
3a. Applicant is: ® Owner ? Agent ? Other:
3b. Name: Mark Strickland
3c. Business name (if applicable): Nash - Rocky Mount Board of Education
3d. Street address: 930 Eastern Avenue
3e. City, State, zip: Nashville, NC 27856
3f. Telephone no.: 252-459-5220 3g. Fax no.: 252-459-6404
3h. Email address: mslrickl [e-mail]
4. Agent/Consultant Information (if applicable)
4a. Contact Name: J. Michael Stocks
4b. Company Name: Stocks Engineering, PA
4c. Street address: 1100 Eastern Avenue, P.O. Box 1108
4d. City:, State, zip: Nashville, NC 27856
4e. Telephone no.: 252-459-8196 4f. Fax no.. 252-459-8197
4g. Email address: [e-mail]
5. Proposed Impacts (include both temporary and permanent) [Determination requests may omit this item]
5a. Total 404/401 wetland impacts: 0.138 (acres) 5b. Total non 404/401 wetland impacts: 0 (acres)
5c. Total 404 stream impacts: Intermittent: 271 (linear feet) Perennial 10 (linear feet)
5d. Total non-404 stream impacts: Intermittent: (linear feet) Perennial: (linear feet)
5e. Total riparian buffer impacts: Zone 1: 600 (sq. feet) Zone 2: 400 (sq. feet)
6. Project History and Additional Information -
6a. Has any DWQ staff visited the site? ? Yes ?X No
If yes, provide staff name: and date of visit:
6b. Does this project require a Stormwater Management Plan (SMP)? ?X Yes ? No ? Unknown

6c. Who will be responsible for the review of the SMP? E Certified Local Gov't: City of Rocky Mount
? DWQ Stormwater Program
? DWQ 401/Express Review Unit
6d. Does this project require approval under SEPA or NEPA? ? Yes © No ? Unknown
6e. Is this project an after-the-fact application or has a DWQ notice of violation been issued? ? Yes_ ?X No
6f. Does this project include buffer impacts that are "prohibited" in the DWQ "Red Rule Book"? ? Yes ® No
6g. If you are aware of any local controversy concerning this project, provide details in a cover letter. Describe the
controversy and any measures that have been taken with respect to public involvement,
This form must be submitted via email (c/o Lia M.Gilleski0mcdenr.gov), faxed (919-733-6893), or hand-delivered to:
Parkview Building, 2321 Crabtree Blvd. Suite 250, Raleigh, NC 27604. Applicants who are selected to participate in the
Express Review Program will be notified via email or fax. Successful applicants will then be instructed regarding detailed
procedures for full application (Note: Submittals of the review packages on Friday after 12:00 pm will be stamped as
received on the next business day).
Please contact Lia Myott Gilleski or Joseph Gyamfi at 919-733-1786 if you have any questions regarding this form.
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