20100367 Ver 1_Initial Interest_20100513

Gilleski, Lia
From: Scott Mitchell [[e-mail]]
Sent: Thursday, May 13, 2010 6:48 AM
To: Gilleski, Lia
Subject: Stream Origin Determination - T-Mobile Rand Meadows
Attachments: InitialinterestForm no scanned maps 051310.pdf
Lia,
The completed Express Review Program initial interest form for the T-Mobile Rand Meadows site is attached. I will bring
paper copies of the USGS map and Wake County Soil Survey map with me to our meeting tomorrow morning at 8:30.
Scanned copies are too large for my e-mail server. I will also bring a $200 check to our meeting. Please let me know if
you need anything else, and thank you for meeting with me on such short notice! Please call my mobile number (below)
with any questions.
Thanks,
Scott Mitchell, PE, LSS
Mitchell Environmental, P.A.
P.O. Box 341
Fuquay-Varina, North Carolina 27526
Scott(&MitchellEn vironmental. com
www.MitcheilEnvironmental.com
919-557-4682 Office
919-557-4683 Fax
919-669-0329 Mobile
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Expto - D3t.I
Form Version 6.2
June 29, 2009
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: 1 # Streams
? Non-404 Wetland Determination: # Wetlands
? Stormwater Management Plan Review (fee not additive if combined with 401):
# of Drainage Areas/Project Site
2. Project Information
2a. Name of project: T-Mobile Rand Meadows Site
2b. County: Wake
2c. Latitude/Longitude: Lat: 35.63719 Long: -78.66990
2d. River Basin: Neuse
2e. Tax PIN or Parcel ID: PIN 0698876015
2f. Nearest Named Stream: Little Creek
2g. Water Quality Classification of Nearest Named Stream: C; NSW
2h. Total project acreage (Stream or wetland determinations may omit this item): (acres)
2i. Total Built Out Imperviousness (Stream or wetland determinations may omit this item): %
2j. Provide a brief description of this project (attach a site plan): T-Mobile plans to construct a new communication
tower at the project site. A piped crossing of the feature illustrated as a stream on the Wake County soil survey map is
required to access the site.
2k. Provide directions from the nearest named town, including street names and/or highway numbers: From HWY 401
and HWY 70 split in Garner, travel south on HWY 401 towards Fuquay-Varina. Approximately 7-8 miles south of the
401 / 70 split, turn left (east) onto Banks Road. Continue straight through Banks Road stop sign controlled intersection
with Fanny Brown Road. Continue east on Banks Road to its intersection with Old Stage Road. Turn left (north) onto
Old Stage Road. Site is approximately 200 feet north of intersection of Banks Road and Old Stage Road, east of Old
Stage Road in a grassed meadow area.
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: Mr. Samuel Nye, PE
3c. Business name (if applicable): Velocitel, Inc.
3d. Street address: 2000 Regency Parkway, Suite 135
3e. City, State, zip: Cary, NC 27518
3f. Telephone no.: 919-380-0062 Ext. 211 3g. Fax no.: 919-380-0036
3h. Email address: S.NveOvelocitel.net
4. Agent/Consultant Information (if applicable)
4a. Contact Name: Scott Mitchell
4b. Company Name: Mitchell Environmental, PA
4c. Street address: PO Box 341
4d. City, State, zip: Fuquay Varina, NC 27526
4e. Telephone no.: 919-669-0329 4f. Fax no.: 919 557 4683
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: (acres) 5b. Total non-404/401 wetland impacts: (acres)
5c. Total 404 stream impacts: Intermittent: (linear feet) Perennial: (linear feet)
5d. Total non-404 stream impacts: Intermittent: (linear feet) Perennial: (linear feet)
5e. Total riparian buffer impacts: Zone 1: (sq. feet) Zone 2: (sq. feet)
6. Project History and Additional Information
6a. Has any DWQ staff visited the site? ? Yes ® No
If yes, provide staff name: and date of visit:
6b. Does this project require a Stormwater Management Plan (SMP)? ? Yes ? No ® Unknown

6c. Who will be responsible for the review of the SMP? ? Certified Local Gov't:
? 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 ® 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 [e-mail]), 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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