20010072 Ver 2_Initial Interest_20090202

Form Version 6
January 28, 2009
INITIAL INTEREST IN PARTICIPATION IN THE EXPRESS REVIEW PROGRAM
WITHIN THE 401 OVERSITF/FXPRFSS PFRMITTING UNIT
A. Applicant Information
1. Processing -`
? 401 Water Quality Certification (List NW(s) or GP# verified by Corps: j
? Non-404 Jurisdictional Permit
? Riparian Buffer Authorization
1 a. Type(s) of actions ? Riparian Buffer Minor Variance
requested: ? Coastal General "Major" Variance
(Check all that apply) Stream Determination: 1 # Streams
? Non-404 Wetland Determination: # Wetlands
? Stormwater Management Plan Review (fee not additive if combined with 401):
# of Drainage Areas/Project Site
2. Project Information
2a. Name of project: Lot 22- Zebulon Industrial Park
2b. County: Wake
2c. Latitude/Longitude: Lat: 35 49'38.74" Long: 78 18'17.36"
2d. River Basin: Neuse River
2e. Tax PIN or parcel ID: 2705.11.66-2933
2e. Nearest Named Stream: Little Creek (from USGS Topographic Map)
2f. Water Quality Classification of Nearest Named Stream:
2g. Total project acreage: (acres) [Stream or Wetland determinations may omit this item]
2h. Total built out imperviousness: (%) (Stream or Wetland determinations may omit this item]
2i. Provide a brief description of this project (attach site plan):
See site plan (sketch)

2j. Provide directions from the nearest named town, including street names and/or or highway numbers:
From Zebulon on NC 97 East (Gannon Ave.) approximately 1/2 mile to intersection with Industrial Drive
Please attach a map of site location using USGS 1:24,000 topographic map and the latest bound and
published County soil survey with the projecttsite boundaries delineated. A site plan should also be
included for all projects other than stream and wetland determinations.
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3. Applicant Information
3a. Applicant is: ?X Owner Q Agent ? Other, specify:
3b. Name. ZIP Developers Inc
3c. Business name (if applicable):
3d. Street address: 306 Lakeside Circle
3e. City, state, zip: Zebulon, NC 27597
3f. Telephone no.: 919-269-7439 3g. Fax no.:
3h. Email address:
4. Agent/Consultant Information (if applicable)
4a. Contact Name: Danny Williams
4b.Company name:
4c. Street address:
4d. City, state, zip: Williams-Pearoe & Associates
1000 N. Arendell Ave, (P O Box 892)
Zebulon, NC 27597
4e. Telephone no.: 919-269-9605 4f. Fax no.: 919-2694354
49. Email address. [e-mail]
5. Proposed Impacts (include both temporary and permanent) [Determination requests may omit this section)
5a. Total 404/401 wetland impacts: (acres) 5b. Total non-404 wetland impacts: (acres)
5c. Total 404 stream impacts: Intermittent: (linear feet) Perennial: (linear fe- et)_
5d. Total non-404 stream impacts: Intermittent: (linear feet) Perennial: (linear feet)
5e. Total riparian buffer impacts: Zone 1: (square feet) Zone 2: (square feet)
6. Project History and Additional Information
6a. Has any DWQ staff visited the site? ? Yes ? No
If yes, provide staff name: and date of visit:
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61b . Does this project require a Stormwater Management Plan? ? Yes ? No ? Unknown
? Certified Local Government:
6c. Who will be responsible for the review of the
Stormwater Management Plan? E) DWQ Stormwater Program
? DWQ 401/Express Review Unit
6d. Does this project require approval under SEPA or NEPA? ? Yes ? No
6e. Is this project an after-the-fad application or has a DWQ notice of violation been issued? ? Yes ? No
6f. Does this project include buffer impacts that are `prohibited" in the DWQ 'Red Rule Book? ? Yes ? No
6g. If you are aware of any local controversy concerning this project, provide details in a cover letter. Describe the
-11 - -y eiw airy niaasuiea uiar nave Deen taKen wim respect to public involvement.
This form must be submitted via email c/o 401express(7ncmail net, faxed (919-733-6893), or hand-delivered to: 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 email or fax. Successful applicants will then be instructed regarding detailed
procedures for full application (/Dote: Submittals of the review packages on Friday after 12:00 pm will be stamped as
received on the next business day).
Please contact Lia Myott Gilleski or Joseph Gyamfi at 919-733-1786 if you have any questions regarding this form.
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