20080267 Ver 1_Initial Interest_20080207

Jan. 9 '88 18:23 8880 JAMES R. MELUIN TEL [phone] P. 1
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INITIAL INTEH~:ST IN I'ARTICIFA'~'>ION 1N ~`H)K EXPIt.F.S~ RE W
WI.T1FiIN THE 401 UVtti;}i,~+ITF./F7iPRESS 1'tt;1ZM1.TTING UNiT
()ctnber 1, 2006
VcrRion 4
Applicant Nanae: Country Fun Land, Tnc .
Applicant Address: 1994 I~Ihite Lake Drive___,,,. ~,. ..._,.,_...._..._.
,,..,White Lake w, t~ ~ C . 2 8 3 3 7 _..---," _.,
Applicant's phone number: a ~ n R~ 2- 4 4 3 6 _ Fax number:
Applicant's emai l address: j me lv_~,~,6 ~ ec . r r . c om -.._ _ ................, ....__ _T__ ~ .
Consultant Name (if applicable): __ N/A
(",onsultani address (if applicable): _~~
(;onsultant's phone number:
1~ax number:
Lon.sultant's dtnail address:
1"ype of action requested under the Express Rcvic~~+ Program (check all that apply):
^ 4U1. Water Quality Certi~cation~
~~~~,.,
~ lsolatad Wetlau~d Permit. ' `'.. ~~
~] Riparia.n Buffer Approval
© Itiparia.n Buffer Minor Variance
^ C~oastat General "Major" Variance
^ Stream Origin Determination
# of Determinations Requested
^ lntermittent/Perennial Determination
# of Determinations Requested
^ Isolated Wetland Determinatipn
linear feet or acres
^ Stormwater Management Plan (this fee is not additive when approval is eombinocl wish 401 Cert.)
_ ._.# of Drainage Areas/Project Site
Name of Projeot: Pln,np „_,_,_,~.~~.~ Lounty: B].aden
Total project acreage: One (1) (acres} Total built nut impervious area: (acres)
Nearest Named sixearr- ~- River Basin (from USES taps map):
~.,^ a ,~.~.
1>lease provide a brief description of this project. (atiach site plan if available):
One-acre ex,~,ansion Qf existing__ parking lot _ _~~..,...R.,,~...
JAN-9-2888 WED 18:42 TEL:[phone] NAME:DWQ-WETLANDS P. 1

PI©ase attach a map of site lbcat.ibn using USGS I;24,0()0 map and county soil survey.
Location of prtijeet site -please include reference to the county, ne;iresl n'it're town and highway numtx~r:
downtown white Lake,_.Bladen..-_county, 100' off White Lake Drive
Proposed impacts: ~,,,, _.„n_ ..,_,,,a_ Acres of a0Q/401 wetlands
None
Acres cif isolated wetlands
Linear #eet of'streams
Lint;ar feet. of isolated streams
Square feet of protected stream buffers
Has consultant or applicant attended any DW(~_sponsored training sessions in the past t.VNb years'1 ]f so, please list
which ones. N~ ~- -- .~._._.._-------
Has any DWQ staff visited the site? yc;s, if yes, please provide DWQ stRff Hama, .Chad Turl ington and
date bf visit:: 11 2 7 0 7 ^
Which other environmental permits from other agencies will be rteedixi fur ibis prbjeci.7 Please lion the permits and
issuing agencies below:
Lfiknown -- USAGE Permit applied for (pending)
Does this project require approval under the Stall; F...nvironmenlal Pc.,licy Act nr National Environmental Policy Act''?

Is this project an After~the-fact application br has this project received a previous Notice bf Violation from DWQ7
Dees this project require approval of a Variance froth the NC Fnviroritnental Management Commission? Unknown
Are you aware of any local controversy concerning this project`? If so, please describe the controversy and any measures
that hgve been taken wish respoct to public involvement. No
'I'bis form must be submitted via email (c/o 40l ex~ress~ ncmail.netl. faxed (<I19-733-6803) or hand-detiverec! to the
Parkview Building, 2371 Crabtree $lvd. Suite 254, Raleigh, NC 271504. Applicants who are selected to pttrt.icipate in
Iku I7.uwwfraa pnvio~ar D~nnro~» ~vet~ ~ nnti~aw~ viv fov »ri!{~in '7 ~{atirc C~~nraaccf~tl anntiro.+lc wi~~ +{~sn 1.n i..o+.+~n4oa
JAN-9-2088 WED 18:42 TEL:[phone] NAME:DWQ-WETLANDS P. 1

wall he stWrnped cts received vn the nexl. business diiy~, _ v
Plea.~e contact. Cynthia Van Dex Wiele at 919-715-347:1 if you have as~y questior~s regarding this fornn.
2
JAN-9-2808 WED 18:42 TEL:[phone] NAME:DWQ-WETLANDS P. 1

Jan. 9 '88 18:24 0000 JAMES R. MELV]N TEL [phone] P. 2
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JAN-9-2008 WED 18:43 TEL:[phone]
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