20090766 Ver 2_Initial Interest_20100514

Gilleski, Lia Ey-p OR - 0710 lp V Z
From: Debbie Edwards [[e-mail]]
Sent: Friday, May 14, 2010 3:00 PM
To: Gilleski, Lia
Subject: Agape Fellowship Church
Attachments: Initial Interest Package_051410.pdf
Lia,
Attached is an Initial Interest Package for a project that would like to go through the Express Review Program. Please
review and let me know if the project can be accepted into the program. Also, if we could go ahead and schedule a pre-
application meeting that would be helpful. If you believe the project will be accepted into the program, please send me
your next available dates and I will coordinate with the project engineer and applicant.
Thanks,
Debbie
Debbie Edwards
Soil & Environmental Consultants, PA
11010 Raven Ridge Road, Raleigh, NC 27614
office: 919-846-5900
fax: [phone]
mobile: [phone]
email: [e-mail]
bA, Think before you print.
This electronic communication, including all attachments, is intended only for the named addressee (s) and may contain confidential information. This electronic communication
may not have passed through our standard review/quality control process. Design data and recommendations included herein are provided as a matter of convenience and should
not be used for final design. Rely only on final, hardcopy materials bearing the consultant's original signature and seal. If you are not the named addressee (s), any use,
dissemination, distribution or copying of this communication is prohibited. if you have received this electronic communication in error, please notify, the sender by return e-mail
and delete the original communication from your system. Thank you-
?pOg"Dn(ot.U2
Form Version 6.2
..?? June 29, 2009
CCDENR
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
1a. 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):
# of Drainage Areas/Project Site
2. Project Information
2a. Name of project: Agape Fellowship Church
2b. County: Wake
2c. Latitude/Longitude: Lat: 35.7554 Long: - 78.5627
2d. River Basin: Neuse 03-04-02; Cataloging Unit 03020201
2e. Tax PIN or Parcel ID: 1723907334
2f. Nearest Named Stream: UT to Walnut Creek 27-34-(4)
2g. Water Quality Classification of Nearest Named Stream: C; NSW
2h. Total project acreage (Stream or wetland determinations may omit this item): 3.32 (acres)
2i. Total Built Out Imperviousness (Stream or wetland determinations may omit this item): 19.7 %
2j. Provide a brief description of this project (attach a site plan):
This project will be the construction of an aerial sanitary sewer connection for a church. Additionally, it is important to
note that this project was previously submitted to the NCDWQ for review and approval. The NCDWQ issued a Request
for More Information letter dated August 13, 2009; DWQ Project #2009-0766. The project could not move forward
because of financial reasons and therefore the application was returned. This new submittal has not changed from the
previous, all proposed impacts remain the same.
2k. Provide directions from the nearest named town, including street names and/or highway numbers:
From Crabtree Blvd: Take 440 east (inner beltline) towards Rocky Mt. , take Poole Road exit (Exit 15), turn left at Poole
Road, take 3rd right onto South New Hope Road, site approximately 1 mile on right.
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: Owner is Applicant. However all correspondence for
the project should be mailed to Applicant and Agent.
3b. Name: Jerry M. Williams
3c. Business name (if applicable): Agape Word Fellowship, Inc.
3d. Street address: 9100 Rhinebeck Ct.
3e. City, State, zip: Raleigh, NC 27613
3f. Telephone no.: 919-855-8001 3g. Fax no.: N/A
3h. Email address: N/A
4. Agent/Consultant Information (if applicable)
4a. Contact Name: Debbie Edwards
4b. Company Name: Soil & Environmental Consultants, PA
4c. Street address: 11010 Raven Ridge Road
4d. City, State, zip: Raleigh, NC 27614
4e. Telephone no.: 919-846-5900 4f. Fax no.: 919-846-9467
4g. Email address: [e-mail]
5. Proposed Impacts (include both temporary and permanent) [Determination requests may omit this item]
5a. Total 4041401 wetland impacts: 0 (acres) 5b. Total non-404/401 wetland impacts: 0 (acres)
5c. Total 404 stream impacts: Intermittent: 0 (linear feet) Perennial: 0 (linear ft)
5d. Total non-404 stream impacts: Intermittent: 0 (linear feet) Perennial: 0 (linear feet)
5e. Total riparian buffer impacts: Zone 1:1695 (sq. feet) Zone 2: 1622 (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 Lia.M.GilleskiA_ncdenr.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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Project No. 2
11268.P I Wake County Soll Survey
Project Mgr.` Agape Fellow5hlp Church Soil & Environmental Consultants, PA
DE Wake County, NC 11010 Raven Ridge Rd.e Raleigh, NC 27614
[phone] a [phone]
Scale: Web Page: www.SandEC.com
1" = 1 ,320'
Pages 60 and 70
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Project No. FIGjure I - 1:24K USGS
112G8.P I Topographic Quadrangle
Project Mgr.: Agape Fellow5hlp Church Soil & Environmental Consultants, PA
DE 11010 Raven Ridge Rd.• Raleigh, NC 27614
Wake County, NC [phone] • [phone]
Scale: Web Page: www SandEC.com
I " = 2,000' Raleigh East
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