20061798 Ver 2_Initial Interest_20070103

Jan 03 07 10:41 p Barrett Kays
P.O. Box 30009, Raleigh, NC 27E22-0069
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9197879355
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^ Urgent ^ For Review ^ Please Comment ^ Please Reply ^ Please Recycle
• Comments:
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9197879355 p.2
INITIAL INTEREST IV PARTICIPATIOl\T IN THE EXPRESS REVIEW PROGRAM
'WITHIN THE 401 OVERSITE/E~s:PRESS PERMITTING LTTIT
October 1, 2006
Version 4
Applicant Name:
Applicant Address:
Applicant's phone number: -~ Fax number:~J,~~ ~2l ~ Q
Applicant's email address:
Consultant Name (if applicable):
Consultant address (if applicable):
C.e~l 9~9 ~9'~-
Consultant's phone number:
Consultant's email address: !;
Fax number: 9~9=~~~ ~' 93~7J~`
Type of action requested under the Express Re~Rew Program (check all that apply):
^ 401 Water Quality Certification Stream Origin Determination
^ Isolated Wetland Permit ~# of Determinations Requested
^ Riparian Buffer Approval ~ Intermittent/Perennial Determination
^ Riparian Buffer Minor Variance ~# of Determinations Requested
^ Coastal General "Major" Variance ^ Isolated Wetland Determination
linear feet or acres
^ Stormwater IVlanagement Plan (this fee is not additive when approval is combined with 401 Cert.)
# of Drainage Areas/Project Site ~,_
Name of Project: ~ ~ ~ County:
Total project acreage: ~~~~~~(acres} Total built out impervious area: (acres) ~ 3D/ y
Nearest
this project (attach site plan if

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Jan 03 07 10:41 p Barrett Kays 9197879355
lease attach a map of site location using USCi3 1:24,000 map and county soil surrey.
p.3
T nnnYinn of r~rniPCt cite -please incln~e reference to the county. nearest name town and hiehwav number:
~~~
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Acres of isolated ~vetlands
Linear feet of streams ~ja~y/!"/17/
Linear feet of isolated` streams
Square feet of protected stream buffers
Has consultant ar pplicant attended any DWQ-sponsored training sessions in the past two years % If so, please list
which ones. ~~
Has any DWQ staff visited the site?~Q, if yes, please provide DWQ staff name,
date of visit:
and
Which other environmental permits from other agencies will be needed for this project? Please list the permits and
iss ing agen ies below: .. r
.r ~
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r
oes t ~s project require approv under the State Environmental Policy Actor National En~~ironmental Policy Act?
Isis thct an .after-the-fact application or has this project received a previous Notice of Violation from DWQ?
Does this project require approval of a Variance from the l~rC Environmental Iaianagement Commission?
Are you aware of any Iocal controversy concerning this project? If so, please describe the controversy and any
mea~sur/es that have been taken with respect to public involvement.
~ V~
This form must be submitted via email (clo 401express(a),ncmail.net), faxed (919-733-6893) or hand-delivered to the
Parkview Buildinb, 2321 Crabtree Blvd. Suite 250, Raleigh, NC 27604. Applicants who are selected to participate in
the $xpress 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 revie•~v packages on F'ridap after 12:00 per.
will be stamped as received on the next business dayj.
Please contact Cynthia Van Der Wiele at 919715-3473 if you have any questions regarding this form.
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JAN-3-2007 WED 22:25 TEL: [phone] NAME:DWQ-WETLANDS P. 3
Proposed impacts: ~(~~ Acres of 404/401 wetlands

Jan 03 07 10:41 p Barrett Kays

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9197879355 p.4
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JAN-3-2007 WED 22:25 TEL:[phone] NAME:DWQ-WETLANDS P. 4