20110319 Ver 1_Initial Interest_20110405

© n Form Version 6.3
31 CI February 9, 2011
NCDENR I `t
INITIAL INTEREST IN PARTICIPATION IN THE EXPRESS REVIEW PROGRAM
WITHIN THE WETLANDS, BUFFERS, STORMWATER, COMPLIANCE AND 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: 2 Streams
? Non-404 Wetland Determination: # Wetlands
? Stormwater Management Plan Review (fee not a0ditive if combined with 401):
# of Drainage Areas/Project Site
2. Project Information
2a. Name of project: Stagville Road
2b. County: Durham
2c. Latitude/Longitude: Lat: 36 8' 15"N Long: 78 50'55"W
2d. River Basin: Neuse River
2e. Tax PIN or Parcel ID: 0846-04-47-8845
2f. Nearest Named Stream: Little River
2g. Water Quality Classification of Nearest Named Stream:
2h. Total project acreage (Stream or wetland determinations may omit this item): 341 (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):
This property is going to be divided into large residential lots. All lots will be over 10 acres
2k. Provide directions from the nearest named town, including street names and/or highway numbers:
This property is located near the intersection of Orange Factory Road (SR 1628) and Stagville Road (SR1615). See
attached Plat. The Plat is recorded at Plat Book 187, Page 271
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 v6.3 Cont.
3. Applicant Information
3a. Applicant is: ® Owner ? Agent ? Other:
3b. Name: Terry Sanford, Jr.
3c. Business name (if applicable): Treyburn Corporate Park
3d. Street address: 2020 W Main Street, Suite 300
3e. City, State, zip: Durham, NC 27705
3f. Telephone no.: 919-286-3321 3g. Fax no.:
3h. Email address: [e-mail]
4. Agent/Consultant Information (if applicable)
4a. Contact Name: Edmund W. Purcell
4b. Company Name: Summit Consulting
4c. Street address: 504 Meadowland Drive
4d. City, State, zip: Hillsborough, NC 27278
4e. Telephone no.: 919-732-3883 4f. Fax no.: 919-732-6676
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)
T
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 Lia.M.Gilleski(cD_ncdenr.gov and/or Joseph.Gyamfi(d-)_ncdenr.gov), faxed (919-
807-6494), or hand-delivered to: 512 N. Salisbury St (Archdale Bldg), 9,' Floor, Raleigh, North Carolina 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 (919-807-6446) or Joseph Gyamfi (919-807-6426) if you have any questions regarding
this form.
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