20080026 Ver 1_Initial Interest_20071218

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INITIAL INTEREST IN PARTICIPATION IN THE EXPRESS REVIEW PROGRAM
WITHIN THE 401 OVERSITE/EXPRESS PERMITTING UNIT
October 1, 2006
Version 4
Applicant Name: Sylvia Coleman
Applicant Address: 1820 Martin Luther King Jr. Pk, Wilson, NC 27893
Applicant's phone number: [phone] Fax number: 252-234-0146
Applicant's email address: N/A
Consultant Name (if applicable): Bartlett En ing Bering and Surve i~ng, PC
Consultant address (if applicable): 1906 Nash St. North
Wilson NC 27893-1726
Consultant's phone number: 252-399-0704 Fax number: 252-399-0804
Consultant's email address: 'on bartletten .com
Type of action requested under the Express Review Program (check all that apply):
^ 401 Water Quality Certification
^ Isolated Wetland Permit
^ Riparian Buffer Approval
^ Riparian Buffer Minor Variance
^ Coastal General "Major" Variance
^ Stream Origin Determination
# of Determinations Requested
Intermittent/Perennial Determination
1 # of Determinations Requested
^ Isolated Wetland Determination
linear feet or acres
^ Stormwater Management Plan (this fee is not additive when approval is combined with 401 Cert.)
# of Drainage Areas/Project Site
Name of Project: Hwy 301/Lipscomb Rd County: Wilson
Total project acreage: 107.7 (acres) Total built out impervious area: ? {acres)
Nearest Named stream + River Basin (from USGS topo map): Toisnot Swamp, Neuse River Basin
Please provide a brief description of this project (attach site plan if available):
Not sure at this time.
1

Please attach a map of site location using USGS 1:24,000 map and county soil survey.
Location of project site -please include reference to the county, nearest name town and highway number:
Take Hwy 264 to Wilson. Turn North onto Hwv 301. Property will be on the right just past Lipscomb Rd
intersection behind old Cox Dodee.
Proposed impacts: NONE Acres of 404/401 wetlands
NONE Acres of isolated wetlands
NONE Linear feet of streams
NONE Lineaz feet of isolated streams
NONE Square feet of protected stream buffers
Has consultant or applicant attended any DWQ-sponsored training sessions in the past two years? If so, please list
which ones. NO
Has any DWQ staff visited the site? Not Sure if yes, please provide DWQ staff name,
and date of visit:
Which other environmental permits from other agencies will be needed for this project? Please list the permits and
issuing agencies below:
Erosion Control with NCDENR
Does this project require approval under the State Environmental Policy Act or National Environmental Policy Act?
NO
Is this project anAfter-the-fact application or has this project received a previous Notice of Violation from DWQ?
NO
Does this project require approval of a Variance from the NC Environmental Management Commission? NO
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 to public involvement.
This form must be submitted via email (c/o 401expressna,ncmail.net), faxed (919-733-6893) or hand-delivered to the
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 fax within 2 days. 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 Cynthia Van Der Wiele at 919-715-3473 if you have any questions regarding this form.
2

SHEET NUMBER 5
WILSON COUNTY, NORTH CAROLINA
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Projection is UTM Zone 18 NAD83 Datum G=-1.686
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