20090312 Ver 2_Initial Interest_20090506

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Y- >7 (? - D a. U 9L Form Version 6
January 28, 2009
INITIAL INTEREST IN PARTICIPATION IN THE EXPRESS REVIEW PROGRAM
WITHIN THE 401 OVERSITE/EXPRESS PERMITTING UNIT
A. Applicant Information
1. Processing
? 401 Water Quality Certification (List NW(s) or GP# verified by Corps: )
? Non-404 Jurisdictional Permit
?X Riparian Buffer Authorization
1 a. Type(s) of actions ? Riparian Buffer Minor Variance
requested: ? Coastal General "Major" Variance
(Check all that apply) ? Stream Determination: # 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: Wake County Continuum of Care
2b. County: Wake
2c. Latitude/Longitude: Lat: 35.4715 Long: 78.3494
2d. River Basin: Neuse
2e. Tax PIN or parcel ID: 1724401187
2e. Nearest Named Stream: Crabtree Creek [from USGS Topographic Map]
2f. Water Quality Classification of Nearest Named Stream: C:NSW
2g. Total project acreage: 18.924 (acres) [Stream or Wetland determinations may omit this item]
2h. Total built out imperviousness: 20 (%) [Stream or Wetland determinations may omit this item]
2i. Provide a brief description of this project (attach site plan):
New commercial construction, associated parking, utilities, and roadway improvements to Sunnybrook and Merrell Drive
2j. Provide directions from the nearest named town, including street names and/or or highway numbers:
From Downtown Raleigh, Take New Bern Avenue East, towards Wake Med Hospital. Turn right onto Sunnybrook Road.
The site is located on your left directly across from the intersection with Falstaff Road.
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 project/site 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 ? Agent ? Other, specify:
3b. Name: County of Wake
3c. Business name (if applicable):
3d. Street address: 336 Fayetteville Street
3e. City, state, zip: Raleigh, NC 27602
3f. Telephone no.: 919-856-6357 3g. Fax no.: 919-856-5305
3h. Email address: [e-mail]
4. Agent/Consultant Information (if applicable)
4a. Contact Name: Jason Kennedy
4b.Company name: CLH Design, P.A.
4c. Street address: 400 Regency Forest Drive, Suite 120
4d. City, state, zip: Cary, NC 27518
4e. Telephone no.: 919-319-6716 4f. Fax no.: 919-319-7516
4g. 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 feet)
5d. Total non-404 stream impacts: Intermittent: (linear feet) Perennial: (linear feet)
5e. Total riparian buffer impacts: Zone 1: 400 (square feet) Zone 2: 600 (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:
6b. Does this project require a Stormwater Management Plan? ? Yes ?x No ? Unknown

6c. Who will be responsible for the review of the
Stormwater Management Plan? ? Certified Local Government:

?DWQ Stormwater Program
? DWQ 401/Express Review Unit
6d. Does this project require approval under SEPA or NEPA? ? Yes ?x No
6e. Is this project an after-the-fact application or has a DWQ notice of violation been issued? ? Yes ?x 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
controversy and any measures that have been taken with respect to public involvement.
This form must be submitted via email c/o 401 express(a)ncmail.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 (Note: 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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