20150369 Ver 1_Buffer Determination Request_20150416

NCDENR
North Carolina Department of Environment and
Division of Water Quality
Pat Thomas A. Reeder
Governor Director
APR 16 2015
Operatlorn seed%
`""n>Efrmrr Origin /Buffer
Natural Resources
John E. Skvarla, III
Secretary
DWQ Use Only: Project #
Applicability Determination
Required Information
1. Owner Information (corporation /individual who is legally responsible for the property and its compliance)
1a. Name(s) on Recorded Deed
Holly Hill Pentecostal Church
1 b. Responsible Party (for LLC)
N/A
1 c. Mailing Address
PO Box 636, Vanceboro NC 28586
1d. Telephone Number
252- 229 -4796
1 1e. Email Address
I pastormartywarren @yahoo.com
2. Location of Project Site - please include the county, nearest named town and highway number:
Craven County, Southwest of Vanceboro, Piney Neck Road -NCSR #1444, Craven County Parcel ID:1- 055 -19001
3. Has anyone from DWQ visited the site?
N
Staff Name
Swift Creek
Date of Visit?
I Neuse
Additional Requested Information
4. Agent/Consultant Information (if applicable)
4a. Name, Company
Gaskins Land Surveying, P.A.
4b. Mailing address
PO Box 354, Vanceboro NC 28586
4c. Telephone no.
252 - 714 -0983
4d. Email address
Pls3824 @embargmail.com
5. Project and Site Information
5a. Name of project
Holly Hill Pentecostal Church
5b. County
Craven
5c. Nearest Named Stream
Swift Creek
5d. River Basin
I Neuse
5e. Provide a brief description of this project (attach site plan if available):
The church is in the process of expanding and need to use the area located next to the blue line stream for their expansion.
Please attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo and/or NRCS Soil Survey.
If you are unable to locate either of these maps, please contact the Regional Office for assistance.
DWQ Use Only: Is this stream call for the purpose of: _X_ buffer mitigation nutrient offset credit
Please return form to: Anthony Scarbraugh
943 Washington Square Mall
Washington, NC 27889 Note: Submittals on Friday after 12:00 pm
will be stamped as received on the
Fax: [phone] next business day.
Email: anthonv.scarbrauoh(dncdenr.00v
Please contact Anthony Scarbraugh at (252) 946 -6481 if you have any questions.

,•;,, Craven County does NOT warrant the information shown on this map
and should be used ONLY for tax assessment purposes.
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