20090591 Ver 1_Initial Interest_20090527

May 27 09 11:55a Benton Dewar 919-557-2255 P.1
FEB-16-2" 12.50 FROM:DWQ-WETLA11OS 9197336893 70:96357897 P:1/3
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Forth Carolina Department of Environment and Nararal Resources
Division of Water Quaity
Sevedy Eaves Pardue Coimn H. Sullins Dee Fmernan
Governor Mector secrOary
Dividon of Water Quality
Department of Environmental and Natural. Resources
401 Oversight/Express Review, Program Development and
Transportation Permitting Units
Street Address: 2321 Crabtree Blvd. Suite 250, Raleigh, NC 27604-22S4
Mailing Address: 1650-Ma0 Service Center Rale%b, NC 27699-1650
Contact Information: Phone: [phone]
Wx.x#: 919-73344
Fax To: 6A lid' ri i [a Y"O- ate..
Fax s: - 3 1- 70 `I
Company:
From: Lt?a rl '
Date: 5 2Gl61
Phone 7 %1 3 -9 S-D* Z-
Number of pages including cover sheet:
Notes or special instructions:
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FEB-17-2000 THU 14:41 TEL:[phone] NAME:DWQ-WETLANDS P. 1
May 27 09 11:55a Benton Dewar 919-557-2255 p.2
T0;96397097 P:2/3
FEB-16-2000 12-50 FROM:DW(a-WETLANDS 9197336893
(] Form Version 6.1
ARA. A ?Y Qq .. ?,S FebNary 18, 2009
i1NITfAf_ INTEREST
THE4g) QVERSIGHT1EXPREW PERMITTING UNIT
A. Applicant Information
1. Processing
1a. Type(s) of actions
regaestad: ,
(Check all that apply)
2. "ect Information
28. Name of proa)let
2b. County.
2C. L%wde/Longitude:
2d. River Basin:
2e. Tax PIN or Pwcei lD:
2f. Nearest Named Stream:
? 401 Water Quality Certific8km (List NrV(s) or GP* verified by Corps:
? NonA04-Jurisdictional Permit
? Riparian Buffer Authorization
0 Riparian Burger MilwWriance
0 am t Geneal "Major` Variance
d?tr Detamrination: -J-- # Stm..w-s
Q Non.4pq Wstland Wesrn # Wetlands
? Stormwatler Management Plan Review (fee not addtive if oorforled with 401):
# of Drainage AMMMMject She
Lab: 3 5° 3 Z ?. l" Long:
-20
2g. Water Quality ClarssftaWn of Nearest Named Stream:
2h. Total project acreage (Stream or wetland detemunations may omit this item): (acres) WA-
2i. Total Suat Out IrnpeNousness (Stream or wetland determinations may omit this item): % I?
2j. Provdea brim description of this project (attach she plan): r
liP &AAA
2k. Provide directions from the nearest nairged town induding street names and to y um s- D AG
US 0G S le- 2 2. S I-TO 13 1 .O .`!1 t
Please attach a map of the sibs location using USES 1:24,000 topograMdc map and a copy of the latest bound
and pubUshad County sail surdey with fife projecttaiEe boundar{es delineated. A site plan should also be included
for all projects other than stream and wetland deteminations.
FEB-17-2000 THU 14:41 TEL:[phone] NAME:DWQ-WETLANDS P. 2
May 27 09 11:56a Benton Dewar
FEe-16-2000 12=51 FRMDWQ-WETLANDS 9197336693
3. Applicant Information
Owner ? Agent ? Other
3a. AppllCent is:
3b. Narne: C -C-
3c. Business name (if apPiicable):
3d. Street address. (30
3e. City, State. zip:.
3g. Fax
3f. Telephone no.: no.:
j $ - 72
3h- Email address:
4. AgenllConsuttant lnf rmation t>N aPP.lica6te) !? p
43. Contact Name: lE.til1+?
Few.. /dsC?
919-557-2255 p.3
T0: %397097 P:3/3
initial Interest Farm v6.1 Cont.
4b. Company Name: W
40. Street address:
4d. City. St2W. Zip: a 1 ?T G ?
4f, Fax na.: a?Q Jrs ' 2 ?j?
4e. Telephone Ac.: Ql? AgzmNlt?A
4g. Email address= b&A-10 AC??1rlJdt O 1 • LD
setd pe enq [Determination requests may omittlZis Item)
5. Proposal Impacts (include bath t>cmt>wra*7
5a. Total 4044401 wetland impacts: 5b. Total non-4041401 wetland inlmpaats: (acres)
aces
( ) near feet) .
lntermiffent (linear feet) Perennial: (li
SC.Total 404 strearrr impacts:
5d. Total non-,404 stream imPaM: Intermittent: (linear feet) Perennial: (linear feet)
5e. Toto riparian buffer impacts: Zone 1: (sq. feet) Zone 2: (Sq. feeq
S. Project History *and Additional hrformalion
se, Has any OWCf staff visited the site? C) Yes No
if yes. provide staff name: and date of visit
09-90-
6b. Does this project require a Strmwater Management an (SMP)? ? Yes ©Unknown
4ET-Cert fled local Govt IIrw 4M W71
ec. Who wilt be responsilAe for the Tcvievr of the SMP? ? DWQ Stwn*ater Program Unit
? D1RVQ 4010Express ew
8d. Does this project require approval under SEPA or NEW ? Y" ?o [] Unknown
fie. is this project an after-the^fart aPPICOM or has a DM notice of vl0W0n been issued? ? Yes No
15f Dori this project include: buffer impacts that are `prohibited in the DWQ'Red Rule Soak"? ? Yes
6g. if you are aware of any local controversy conoirning this project. provide details in a 900LICAff- Describe the
controversy and arty measures that have been taken with respect to public involvement. JJ1AJr
This form must be Submitted via areal (Cft 40111MM"a faxed (919-7334M3), or hand-ddiMeied to:
Parkview Building. 2321 Crabtree Blvd. suite 250, Raleigh. NC 27604: Applicants who are selected to parWpaW In the
de Wiled
Express Review program will be notified via erna# or fax. Successful apprrcards wig than be I "ditldQd raga g
procedures for full application (Mote: SubmiWa of the review packages on Friday after 12:00 prn vA be starryred as
re0eiv Vd on the next baroness da)).
Please contact U& Myott Gilleski or Joseph Gyamfl at 919-733-1786 if you have any questions regarding this form-
2
FEB-17-2800 THU 14:42 TEL:[phone] NAME:DWQ-WETLANDS P. 3
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Michelle Freeman Property
http://imap s. co.wake.nc. us/imapslprintmap. asp?pin=0674799009&pinext=000&minX=207... 5/27/2009
Copyright 2008. City of Raleigh, Wake County. 0 - 289 ft
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Image courtesy of the U.S. Geological Survey
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