20090119 Ver 2_Initial Interest_20090518

2 Form Version 6.1
Ok 'T
February 18, 2009
NCDENR
INITIAL INTEREST IN PARTICIPATION IN THE EXPRESS REVIEW PROGRAM
WITHIN THE 401 OVERSIGHT/EXPRESS PERMITTING UNIT
A. Applicant Information
1. Processing
? 401 Water Quality Certification (List NW(s) or GP# verified by Corps: )
? Non-404 Jurisdictional Permit
? Riparian Buffer Authorization
la. 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):
4 # of Drainage Areas/Project Site
2. Project Information
2a. Name of project: Jamestown Middle School
2b. County: Guilford
2c. Latitude/Longitude: Lat: 35°59'07"N Long: 79°54'44" W
2d. River Basin: Randleman Lake (Cape Fear Basin)
2e. Tax PIN or Parcel ID: 15-94-7039-0-0937-00-003 & 15-91-6805-0-0885-00-017
2f. Nearest Named Stream: Deep River
2g. Water Quality Classification of Nearest Named Stream: WS-IV; CA
2h. Total project acreage (Stream or wetland determinations may omit this item): 68.67 (acres)
2i. Total Built Out Imperviousness (Stream or wetland determinations may omit this item): 14.5 %
2j. Provide a brief description of this project (attach a site plan):
A new public school building and associated roads, parking lots and athletic fields is proposed. Safe access
to the site necessitates impacts to wetlands, streams and stream buffers.
The project has been submitted to DWQ for 401 General Water Quality Certification (Sue Homewood, Winston-
Salem Regional Office) and to USACoE. NC DWQ requires review and approval of a Stormwater Management
Plan.
2k. Provide directions from the nearest named town, including street names and/or highway numbers:
From Jamestown Town Hall (301 E. Main Street) travel east on E. Main St. (US-291US-70) approx. 0.8-miles; turn
right and travel southeast on Vickery Chapel Rd. for approx. 0.3 miles; turn right and travel south on Harvey
Rd. (NCSR-1355) for approx. 0.6 miles. Site is located on left (east) side of the road behind 4815 Harvey Road.
Please attach a map of the site location using USGS 1:24,000 topographic map and a copy of 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.
Initial Interest Form v6.1 Cont.
3. Applicant Information
3a. Applicant is: ® Owner ? Agent ? Other:
3b. Name: Guilford County Schools (att. Andrew LaRowe)
3c. Business name (if applicable):
3d. Street address: 617 West Market Street
3e. City, State, zip: Greensboro, NC 27401
3f. Telephone no.: 336-370-3500 3g. Fax no.: 336-370-3499
3h. Email address: larowea0acsnc.com
4. Agent/Consultant Information (if applicable)
4a. Contact Name: Steven Miller
4b. Company Name: CLH Design, PA
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: smillerOclhdesignpa.com
5. Proposed Impacts (include both temporary and permanent) [Determination requests may omit this item]
5a. Total 404/401 wetland impacts: 0.31 (acres) 5b. Total non-404/401 wetland impacts: 0 (acres)
5c. Total 404 stream impacts: Intermittent: 130 (linear feet) Perennial: 0 (linear feet)
5d. Total non-404 stream impacts: Intermittent: 0 (linear feet) Perennial: 0 (linear feet)
5e. Total riparian buffer impacts: Zone 1: 11,525 (sq. feet) Zone 2: 10,110 (sq. feet)
6. Project History and Additional Information
6a. Has any DWQ staff visited the site? ® Yes ? No
If yes, provide staff name: Sue Homewood and date of visit: March 2009
6b. Does this project require a Stormwater Management Plan (SMP)? ® Yes ? No ? Unknown

6c. Who will be responsible for the review of the SMP? ? Certified Local Gov't:
? DWQ Stormwater Program
® DWQ 401/Express Review Unit
6d. Does this project require approval under SEPA or NEPA? ? Yes ® No ? Unknown
6e. Is this project an after-the-fact 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
controversy and any measures that have been taken with respect to public involvement.
This form must be submitted via email (c/o 401 expressOncm ail. 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.
2
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JAMESTOWN MIDDLE SCHOOL CLH DESIGN P
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GUILFORD COUNTY PUBLIC SCHOOL SYSUM .
DATE SEPTEMBER, 2008
PROJECT NO` 1277 MacGregor Park
125 Edinburgh South
Suite 310

1AMESTOWN MIDDLE SCHOOL QUAD MAP Cary, North Carolina 27511
Phone: () 319-6716
Fax: [phone]

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JA40TOWN MIDDLE SCHOOL CLH DESIGN P.A.
GUILFORD COUNTY PUBLIC SCHOOL SYSTEM
DATE SEPT"ER, 2008 MacGregor Park
PROJECT NO. W 125 Edinburgh South
Suite 310
/? p /? SOILS c Cary, North Carolina 27511
GUILFORD CO N?/ I I SO W P Phone: [phone]
Fax: [phone]
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