20071776 Ver 1_Initial Interest_20071019

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O.c~ 18 07 10:47p Neal C. Floyd ~ Rssoc. 676 8395~~`~~~~
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I1riITIAI.~ INTEREST IN PARTICII'ATIUN IN THE EXPRESS REVIEW PRUGRAM
WITHIN THE 4UI OVERSITE/EXPRESS PEKMITTING UNIT
Applicant Name: ~~~ -
October 1, ZU06
Version 4

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Applicant Address:~J E (nO .~' L~ _ __-- W._
Ga ~,r~r. -J G ~ ~ ~?g . __
Applii:ant's phone number: 1 13 _ ~ ~~~ ~ _ Fax number:
Applicant's email address:
Consultant Narne (if' applicable}; ~Q9~-- ~ ~ u
Consultant address rf a licable
r'.~'.P~%g ~ ~ G Z? co ~5 _.._
Consultant's phone number: ~"2-~-~~P7~"~J' Faxntulnber.:~- ~.y7~°-
Consultant's email address: N~~SSc~~1~-S ~ L~~ `~-~'^
Type of action requested under the Expt~ss Review Program (check all that apply):
^ 401 Water Quality Cerlitication
^ Isolated Wetland Permit
^ Riparian Buffer Approval
^ Riparian Buffer Minor Variance
^ Coastal General "Major" Variance
5
~( Stream Origin Determinatioq
# of Determinations Requested
^ Intermittent/Perennial Determination
# of Determinations Requested
^ Isolated Wetland Determination
linear feet or _ _ _ __ acres
^ Stormwaier ItiSanagement Plan (this fee is not additive when approval is combined with 40l Cert.)
_# of Drainage Areas/Project Site
Name of Project: ~. ~ ~USf 1 S~ ~~~--~ Caunty:.~~~-
Total project acreage: ~~ (acres) Total built out impervious area: ~ t3DfQ (acres)
:~;~~e~t Named stream + River Basin (from USGS topo map):
Plcase provide a brief description of this project (attach site plan if available):
C~,S ~ ~ a~ Su-)b C~iV ~ Si t11~ W +~ Ga1,~~ ~ ~~
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1
OCT-18-2©07 THU 20:45 TEL:[phone] NAME:DWQ-WETLANDS F. 1

O.c~ 18 07 10:47p Neal C. Floyd ~ Rssoc. 676 8395
soil survey.
please attach a map oi'site location using USGS 1:24,000 map and county
Location of project site -please include reference to the county, nearest name town and highway number: 2d
i ~ ~ hh ~ 1521 ~ ~~ ~"~ 1~~..
Proposed impacts: ~ ~
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Acres of 4041401 wetlands
~~ Acres of isolated wetlands
Linear feet of streams
Linear feet of isolated streams
~ ~ Square feet of protected stream buffers
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Has consultant or applicant attended any DWQ-stp,.o,.nsored training sessions in the past two years.? if so, please list
which ones. Q_ ~ H%1 ~ .° a' ~ '~"' Q~-~~q~
-~-- ? if es, please provide DW Q staff name, ------------ -and
Has any DVI'Q stair visited the site ~ y
date of visit: ______.l
Which other environmental permits from other agencies wilt be needed for this project? Please list the ~pe~rm,,it(s and
issuing agenci s below: ~ ~ ~R~... ~~~ C ~~ ~ ~•. ~~`
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5i„~.,MW ri (~ ~.~. ~ 1
S ~ ~ ~ ~ 17T ~oo_ s ~,.-apt ~ ~
oes this ro~ect require approval under the State Environmental Policy Act ar National Environmental Policy Act?
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-~~ After-the-fact application or has this project received a Previous Notice of Violation from DVJQ?
is this protect an
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Doe h SS 1 project require approval of a Variance from the NC Environmental Management Conun.ission? hL? -_
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 Ev public involvement.
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This form must be submitted via email (c/o 401ex ress n mai1276~ APp19ci nt 3Who are sel~,~ted to partiLapat ~in
Parkview Building, 2321 Crabtree Blvd. Suite 250, Raleigh,
the 1;xpress Review Prog'am will be notified via fax w'ttiltn ittals o the revierupackcxges on Frida`vla,}ter,l`t OcPm
regarding detailed procedures for full application (Note: Subm .f
will be stamped as received on the next business day).
i'lease contact Cynthia Van Der Wiele at 919-715-3473 if you have any questions regarding this form.:
. 2
OCT-18-2007 THU 20:46 TEL:[phone] NAME:DWQ-WETLANDS F• 2

O,ct 18 07 10:54p Neal C. Floyd & Rssoc. 676 8395 p•4
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OCT-18-2007 THU 20:53 TEL:[phone] NAME:DWQ-WETLANDS P. 4

Oc1t'18 07 10:48p Neal C. Floyd & Assoc. 676 8395
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Cu_T-18-~~~G~7 THU ;~Oc 46 TEL: 919 T 336893

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* * * DISCLAIMER
3ohnston County ass>.unes no legal responsibility for the information represented here.
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Scale 1 inch = 400 feet Date 18-Oct-07
(The scale is only accurate when printed landscape on a letter size sheet wi[h page scaling set [n none.)