SW7110608_HISTORICAL FILE_20110615

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
DOC TYPE
❑ CURRENT PERMIT
❑ APPROVED PLANS
HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE�i��
YYYYMMDD

For DENR Use ONLY
Reviewer:
© ORMA North Carolina Department of Environment and Submit: � � i 1�
L Natural Resources
NCDENR Request for Express Permit Review Tim:
Confirm:
FILL-IN all the information below and CHECK the Permit(s) you are requesting for express review. FAX or Email the completed form to Express
Coordinator along with a completed DETAILED narrative, site plan (POF file) and vicinity map (same items expected in the application package
of the project location. Please include this form in the application package.
• Asheville Region -Alison Davidson 828-296.4698;alison.davidson(ancdonr.gov
• Fayetteville or Raleigh Region -David Lee 919-791-4203; david.lee(ancdenr.gov
• Mooresville & -Patrick Grogan 704-663-3772 or patrick.grogan(a.nccienr.gov
• Washington Region -Lyn Hardison 252-946-9215 or lyn.hardison(ancdenr.goV
• Wilmington Region -Janet Russell910-350-2004 or Lanet.russell(d)ncdenr.gov
NOTE.' Project application received after 12 noon will be stamped in the following work day.
Permits of request
SW
SW
SW
SW
SW
Project Name: DPD CONCRETE -HAVELOCK INDUSTRIAL PARK LOT 12 County: CRAVEN EXPRESS
Applicant: DEREK DUNN Company: DPD PROPERTIES II, LLC
Address: PO BOX 1639 City: WINTERVILLE, State: NC Zip: 28590-_ JUN ] 5 r101
Phone: [phone], Fax: [phone], Email: _(,
Physical Location:FROM THE INTERSECTION OF HWY 101 AND NCSR 1834, GO SOUTH ON NCSR 1834 APPg .SOLE E IS ON THE EAST SIDE OF
NCSR 1834
Project Drains into SHOP BRANCH waters — Water classification SC SW NSW (for classification see-http://h2o.enr.state.nc.us/bims/reports/repoHsWB.htmi)
Project Located in NEUSE River Basin. Is project draining to class ORW waters? Y/N , within''/: mile and draining to class SA waters Y/N or within 1 mile
and draining to class HQW waters? YIN
Engineer/Consultant: DERRICK SMITH Company: EAST CAROLINA CONSULTING, PLLC
Address: PO BOX 20714 City: GREENVILLE, Stale: NC Zip: 27858-_ S —7 (f 41 E,Lri�
Phone: [phone], Fax: [phone], Email: dsmith@eccollccom
SECTION ONE: REQUESTING A SCOPING MEETING ONLY
❑ Scoping Meeting ONLY ❑ DWQ, ❑ DCM, ❑ DLR, ❑ OTHER: _
SECTION TWO: CHECK ONLY THE PROGRAM (S) YOU ARE REQUESTING FOR EXPRESS PERMITTING
❑ 401 Unit ❑ Stream Origin Determination: _ # of stream calls — Please attach TOPO map marking the areas in questions
❑ Intermittent/Perennial Determination: _ # of stream calls — Please attach TOPO map marking the areas in questions
❑ 401 Water Quality Certification ❑ Isolated Wetland ( linear ft o r acres)
❑ Riparian Buffer Authorization ❑ Minor Variance ❑ Major General Variance
® State Stormwater ❑ General ❑ SFR, ❑ SFR < 1 ac. ❑Bkhd & Bt Rmp, ❑ Clear & Grub, ❑ Utility ❑ Other
❑ Low Density ❑ Low Density -Curb & Gutter _ # Curb Outlet Swales ❑ Off -site [SW _ (Provide permit #)j
❑ High Density -Detention Pond _#Treatment Systems ® High Density -Infiltration _#Treatment Systems
❑ High Density -Bio-Retention _ # Treatment Systems ❑ High Density -SW Wetlands _ # Treatment Systems
❑ High Density -Other _ # Treatment Systems / ❑ MOD:❑ Major ❑ Minor ❑ Plan Revision ❑ Redev. Exclusion SW (Provide permit#)
❑ Coastal Management ❑ Excavation & Fill ❑ Bridges & Culverts ❑ Structures Information
❑ Upland Development ❑ Marina Development ❑ Urban Waterfront
® Land Quality ❑ Erosion and Sedimentation Control Plan with 2.7 acres to be disturbed.(CK # (for DENR use)) fp 141,5
SECTION THREE - PLEASE CHECK ALL THAT IS APPLICABLE TO YOUR PROJECT (for both scoping and express meeting request)
Wetlands on Site ❑ Yes ❑ No
Wetlands Delineation has been completed: ❑ Yes ❑ No
US ACOE Approval of Delineation completed: ❑ Yes ❑ No
Received from US ACOE ❑ Yes ❑ No
Buffer Impacts: ❑ No ❑ YES: ac re(s)
Isolated wetland on Property ❑ Yes ❑ No
404 Application in Process w/ US ACOE: ❑ Yes ❑ No Permit
DENK use
Fee Split formultiDie permits: (Check #63t24 1 Total
Fee Amount E
SUBMITTAL DATES
Fee
SUBMITTAL DATES
Fee
LAMA
$
Variance (❑ Maj; ❑ Min)
$
SW (❑ HD, ❑ LD, ❑ Gen)
$ 3"»0
401:
$
LQS
$ <��
Stream Deter,_
$
NCDENR EXPRESS March 2009