20070537 Ver 1_Initial Interest_20070326

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26/2007 14:16 3590 428 L~UKK LfilVt ~ ~u~ ~~
INITIAL iNT LEST IN PARTICIPATION IN THE EXPR$SS i~EV1EYV PROGRAM
IN THE 401 OVERSITEIEXPRESS PERMITTING UNIt

~ - D ~3i
September i, 20t>4 ~~\
Version 3
licant Name:
A ~ s +r ~ ~ V ~ a ~n ~ ~ a+n v~ ~ "~ 4+ f a ~+
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licant Address:
A ca ~~ 4 W ~~ ~`~
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hone number:
licant's
A '7'7 -
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Fax number. 1 ~ ' ~

iiCanYs email address:
A
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Consultant Name (if appl- I~): L
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Cansultant address (if appl~ ble): a-'~ 5 ~- M P ~ N S t -- -
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Consultant's phone numge ~.~ ~ t.h w L 4 - rl ~ `t

Fax number: ~ I ~f ?'~
S - O

Consultant's email address: ,y~
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Type of action requested u r the Express Review Program (check aA that apply):
~'] a0t Water Qualify
^ Isolated Weiland P ~tific~tton ~ Stveam Urigin DeterminakiOn
rnhit ~ ~ of Determinations Requested
^ Riparian Buf6er val ^ IntermittenUPerennisl Determination
^ Sbormwater Mane ment Plan * of Detem~inations Requested
^ Mitigation Plan
~] Slrapm ~ WFltlend ^ Buffers (shed: all appraprish)
Name of Project:
Total project acreage:
Nean3st named stream ( ~~~ "'~ County: _ ~,) o N w S ~' ~' "'
(acxes) Total built out impervbus arm: ~~>+!~ (acres)
USGS taps map)- ~~ ~rw•~GL,
Please provide a brief d 'ption of this project (attach site plan if available):

MAR-26-2007 MON 12:59 TEL:[phone] NRf'1t:UWl!-WtILHNUS r. 1

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2612007 14:16 3590 428 ~uKrc LF51Vt ~ ~~~ ~<
Please attach a map of site lion using U$GS 1:24,000 map and county soil survey.
Location of project situ - p
~w include reflerence to the county, nearest name fawn and highway number:
Ml7.~jN.~~c ~.~r - ra
V R /~. IktiiC IM 1 ~ n O ~ ~w.w~~~ ,

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Proposed impacts: ~/~A
Acres of 4 wetlands:
Ades of ' led wetlands: -
Linearfeet f streams:
Linear feet f isolated streams:
Square of protected stream buffers:
liar consultant or applicant ttleended any DW4sponsored training sessions in the past two years? If so, please list
u
whkh ones
.
was any Iowa t:taff visited a site? inJ , if yes, please provide DWa staff name, ~
date of visit:
Which other environmental rtrlits from other agencies wi11 be needed for this project? Please list the permits and
issuing agencies below,

Ctves this project require a royal under the State Envlronmerttal Policy Act or National Environmental Policy Act?
h~
Is this project an After-the- applicetlon or has this pn~ject received a previous Notice of Violation from DWa?
r~
Does this project regain; ap al of a Variance from the NC Environmental Management Commission? h d
Are you aware of any local troverSy concerning this project? If so, please describe the controversy and any
measures that have been kern with n~pect to public involvement.
at ~~ oNr ~6 ~.~c.

This forth must be sutxnilted via ertraN (do 401axpre8s~ncrnail.nstl. faxed (919-733893) or hand-ti~livbred to tt10 Palltvbw BuNdlnp,
Crabtree Blvd., Raleigh, NC 27 Applicants who are selected to participate in thr: Expn~se Review ~'aG''a"'' will bs nottlled vls small c
within 2 days. SuGCesaful appl wiN than bs inatmctsd r+sSardt-g detaNed Procedures for full ~pliation (Please Note: Submktala of the n
packapea on Friday after 12~pQ wNl be stamped as rocelved an the next business day).
Please contact Cynthia Yan t]er rsla at 919-716-3473 if you have any questions +vyardN+p thin torm.
1321
r fax
visor
MAR-26-2007 MON 12:59 TEL:[phone] NHI'1t:UWL!-WtILHNUS r• ~

MAR-26-2007 MON 13:00 TEL: 919 (..i.Sb~i9.i NHrit: uw~-w~ i ~ryrv~.~

X3/26/2007 14:16 3590428 LURK LANE PAGE 04
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0 0.09 0.18 0.27 0.36 0.43 Mt
3S° 34.36'N, 78° 34.QS'W (NAP83/WG584)
USGS Edmaadsan (NC) Qaadran~le hA=-8.856
Projection is UTM Zone 17 NAp83 patum G-1.416
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5.5266&lon=-78.56747&s=24&size=l&u=7&la... 3/26/2007
`1AR-26-2007 MON 13:01 TEL:[phone] NAME:DWQ-WETLANDS P. 4