20081786 Ver 1_Initial Interest_20081208

INITIAL INTEREST IN PARTICIPATION IN THE EXPRESS REVIEW PROGRAM
WITHIN THE 401 OVERSITE/EXPRESS PERMITTING UNIT
February 8, 2008
Version 5
Applicant Name:PAUL B. FORREST
Applicant Address: 511 Dundalk Way, Cary, NC 27511
Applicant's phone number: [phone] Fax number: [phone]
Applicant's email address: [e-mail]
Consultant Name (if applicable):
Consultant address (if applicable):
PAI
Consultant's phone number:
Consultant's email address:
Fax number:
Type of action requested under the Express Review Program (check all that apply):
? 401 Water Quality Certification x® Stream Origin Determination
? Isolated Wetland Permit 2 # of Determinations Requested
? Riparian Buffer Approval ? Intermittent/Perennial Determination
? Riparian Buffer Minor Variance # of Determinations Requested
? Coastal General "Major" Variance ? Non-404 Wetland Determination
# of Wetlands
Stormwater Management Plan (this fee is not additive when approval is combined with 401 Cert.)
# of Drainage Areas/Project Site
Name of Project: 511 Dundalk Wa County: Wake
Site Location (DM.MM) - Latitude: 35.75356 Longitude: _-78.82119
Total project acreage: (acres)
Total built out impervious area: (acres)
Nearest Named stream + River Basin (from USGS topo map): _UT to swift Creek, Neuse River Basin
Please provide a brief description of this project (attach site plan if available):
_A 308 sq. ft. sunroom addition, Stick built on a brick
Please attach a map of site location using USGS 1:24,000 topographic map and County soil survey.
E)L9 o8- ?I$(o
1
Location of project site - please include reference to the county, nearest named town and street name or highway number:
-From US 1/64W take the Cary Parkway exit and go right on Cary Parkway. Continue on Cary Parkway through the
Lake Pine Dr. intersection. After passing the'Lake Pine Dr. intersection, take the 3`d left onto Dundalk Way. Go to the
end of Dundalk Way. It ends in a cul-de-sac. 511 Dundalk Way is on the left as yo enter the
circle.
Proposed impacts:
Acres of 404/401 wetlands
Acres of non-404 wetlands
Linear feet of streams
Linear feet of isolated streams
Square feet of protected stream buffers
Has consultant or applicant attended any DWQ-sponsored training sessions in the past two years? If so, please list which
ones.
Has any DWQ staff visited the site? , if yes, please provide DWQ staff name,
of visit:
and date
Which other environmental permits from other agencies will be needed for this project? Please list the permits and issuing
agencies below:
Is there local government implementation of a State-mandated stormwater control program on your site?
(If yes, please state local government and implemented program (ex. Town of Wake Forest, NPDES Phase 2):
Does this project require approval under the SEPA or NEPA?
Is this project an After-the-fact application or has this project received a previous Notice of Violation from DWQ?
Does this project require approval of a Variance from the NC Environmental Management Commission?
Are you aware of any local controversy concerning this project? If so, please describe the controversy and any measures
that have been taken with respect to public involvement.
This form must be submitted via email (c/o 401expressgncmail.net), 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 or Joseph Gyamfi at 919-733-1786 if you have any questions regarding this form.
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W K1611 f01*HE CITY OF PALQIGH
'arcel Number. 07532022 57000
REID: 0117598
FORREST, PAUL
OWNERI: BRADLEY & KATHLEEN K
ADDR1: 511 DUNDALK WAY
ADDR2: CARY INC 27511-5073
BOOK: 05421
PAGE: 0785
DATE: 1211/1992
ACRES: 0.46
VAL: 120031
) VAL: 58000
NG CLASS: INDIVIDUAL
:RIPTION: L021 KILARNEY WDS
SUB SE3 BM1981-201
NAME: 075317
JUM: 0753202257
:XT: 000
CAR
NSHIP. CARY
2 BUILT: 1983
:PRICE: 107000
:DATE: 12/1/1992
USE: Single Family
GIN STYLE: Conventional
S: 0
CLASS: RESIDENCE- 10
ACRES-HOME SITE
NG: R12
PARCEL NUMBER: 571-00000-0820
511
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Elevation
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2005 BAV
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? Wake County
Boundary
http://imaps.co.wake.nc.us/imapslprintmap.asp?pin=0753202257&pinext=000&minX=205... 12/4/2008
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