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Home My WebLink About20080201 Ver 1_Initial Interest_20080129~xp rD$•O~ol INITIAL INTEREST IN PARTICIPATION IN THE EXPRESS REVIEW PROGRAM WITHIN THE 401 OVERSITE/EXPRESS PERMITTING UNIT October 1, 2006 Version 4 Applicant Name: Kyle McDermott -Johnston Memorial Hospital Applicant Address: _509 N. Bright Leaf Boulevard, Smithfield, NC, 27577 Applicant's phone number: _919-938-7115 Fax number: 919-989-7297 Applicant's email address: kmcdermott(a~johnstomnemorial.org Consultant Name (if applicable): -Matt Tays -Ingram Civil Engineering Group Consultant address (if applicable): _116 Wilson Pike Circle Brentwood, TN 37027 Consultant's phone number: _615-370-7964 x 107 Fax number: _615-370-1273 Consultant's email address: mtays c ,ingramcivil.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 _1_# of Determinations Requested ^ Intermittent/Perennial Determination # 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: _Clayton Outpatient Facility and Medical Office Building- County: -Johnston Total project acreage: _23.7 (acres) Total built out impervious area: _8.4 (acres) Nearest Named stream + River Basin (from USGS topo map): White Oak Creek Please provide a brief description of this project (attach site plan if available): The proposed scope of work includes the construction of a new outpatient facility and medical office building in Clayton, NC. The outpatient facility is 55,000 square feet and the medical office building is a three story 60,000 square foot building with related pedestrian ways, utility services, and appurtances. 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: _The site is 76 acres in Johnston County along NC Highway 42 West, approximately 2.3 miles west of the Highway 42 and Highway 70 intersection. Proposed impacts: Acres of 404/401 wetlands Acres of isolated wetlands Linear feet of streams Linear feet of isolated streams 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. NA Has any DWQ staff visited the site?_No_, 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: NCDENR Land Section approval and NCDENR Public Water Supply Division Does this project require approval under the State Environmental Policy Act or National Environmental Policy Act? No Is this project an After-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. No This form must be submitted via email (c/o 401express(a,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 Clayton Outpatient Facility Subject: Clayton Outpatient Facility From: "Matt Tays" <mtays@ingramcivil.com> Date: Tue, 29 Jan 2008 08:59:31 -0600 To: <401 express@ncmail.net> Lia, Attached are the initial interest letter, quad map for the area (Garner quad map), and Johnsont County GIS showing the pond and surrounding property. I also included information from NRCS Web Soil Survey website just for reference. I will follow up with the soils map as soon as we recieve it. Scott Williams at Johnston Memorial Hospital (919-938-7570) will be the representative that will need to meet you on site. I will contact him to let him know that he will need to be available sometime this week once we get this premliminary work finished and the check sent. Thanks for your help and call if you need anything. Matt Matt Tays, P.E. Project Manager INGRAM CIVIL ENGINEERING GROUP 116 Wilson Pike Circle, Suite 100 Brentwood, TN 37027 Office - 615.370.7964 x.107 Fax - 615.370.1273 mtays(a,in~ramcivil.com www. ingramcivi 1. com Content-Description: Clayton Soil 2.pdf '' Clayton Soil 2.pdf Content-Type: application/octet-stream Content-Encoding: base64 ', Content-Description: Clayton Soil.pdf Clayton Soil.pdf ~' Content-Type: application/octet-stream ~, Content-Encoding: base64 'I Content-Description: Clayton OF Boundary.pdf Clayton OF Boundary.pdfl, Content-Type: application/octet-stream I, Content-Encoding: base64 ~I IntialInterestForm IntialInterestForm Stream Determination 1-25-08.rtf (Content-Description: Stream Determination 1-25-08.rtf 1 of 2 1 /29/2008 9:59 AM • ~~- ~,~ C-~' -J ~ ~ /~-_ - ~ ~ `. 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