HomeMy WebLinkAbout20070029 Ver 1_Initial Interest_20070105Q~~~oe~~
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SAN ~T~1~ INTEREST IN PARTICIPATION IN THE EXPRESS REVIEW PROGRAM
WITHIN THE 401 OVERSTTE/EXPR)FSS PF,RMiTTING UNIT
DENR -WATER QUALITY
WETLANDS AND STORMWATER BRANCH
October 1, 2006
Version 4
Applicant Name: r;
Applicant Address:
Applicant's phone number: X34 -~'$ ~ 3445 Fax number: 43q- 348' 328 2
Applicant's email address:
Consultant Name (if applicable):: T„nw~oNS C.~'.n~n ~o ~r~ah (_..r~~-c~.~'~l
Consultant address (if applicable): _ _ ~ZGO Goss ~ n ~p Q ~u Su. ~e
~r i h« Ci eC~'A/ . Vfi 23g ~s
Consultant's phone number: S0~- 541- GG (1 Fax number: $pq -7 S(-07 98
Consultant's email address: ~?riar~ cr~~h~:cf~C~-~:wtw-anc. Corn
Type of action requested under the Express Review Program (check all that apply):
^ 401 Water Quality Certification
^ Isolated Wetland Permit
^ Riparian Buffer Approval
^ Riparian Buffer Minor Variance
^ Coastal General "Major" Variance
L~J Stream Origin Determination
_~# of Determinations Requested
^ Intermittent/Perennial Determination
# of Determinations Requested
^ Isolated Wetland Determination
linear feet or acres
^ Stormwater Management Plan (this fee is not additive when approval is combined with 401 Cert.)
# of Drainage Areas/Project Site {~
Name of Project: ~~d'te ~ Sndi ~ o County: C ~ ~ 1/u.~Gw~
Total project acreage: g.S(, (acres) Total built out impervious area: . 4 (acres)
Nearest Named stream + River Basin (from USGS topo map):
1
Please provide a brief description of this project (attach site plan if available):
r ~ "'
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SAN 0 5 %OC7
l~rygs.,o~~ap of site location using USGS 1:24,000 map and county soil survey.
y~T1.ANOS AND STp(ZMyVATER BRANCH
Location of proj ect site -please include reference to the county, nearest name town and highway number:
Proposed impacts: -p • Acres of 404/401 wetlands
-O- Acres of isolated wetlands
O - Linear feet of streams
` O - Linear feet of isolated streams
' D ~ 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. j ~o
Has any DWQ staff visited the site?~, if yes, please provide DWQ staff name,
date of visit:
and
Which other environmental permits from other agencies will be needed for this project? Please list the permits and
issuing agencies below:
~(o we
Does this project require approval under the State Environmental Policy Act or National Environmental Policy Act?
Is tlu~s project an After-the-fact application or has this project received a previous Notice of Violation from DWQ?
0
Dces 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.
__ done
This form must be submitted via email (c% 401express .ncmail.net), faxed (919-733-6893) or hand-delivered to the
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 fax within 2 days. 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 Cynthia Van Der Wiele at 919-715-3473 if you have any questions regarding this form.
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DENS- WATER QUALITY
yyETLANDS AND S
SOIL SURVEY OF DURHAM COUNTY
Soil Survey of Durham County, North Carolina
Portion of Page 36
JAN ~ 5 i~~~7
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