DWR Exp StreamBuffer Request_WaRO_20240129pdf

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
NORTH CAROLINA
Environmental Quality
Buffer Applicability/ Stream Origin Determination Express Request
Property Owner Information
1. Owner Information (corporation/individual who is legally responsible for the property and its compliance)
1a. Name(s) on Recorded Deed
Kristo her and Hannah Katira
1b. Responsible Party (for LLC)
1c. Mailing Address
305 Boyne Way Winterville NC 28590 United States
1d. Telephone Number
3378496233
1 1e. Email address
[e-mail]
2. Address of Property or Location of Project Site (including county, nearest named town, and highway or road name/ number):
2399 waterview rd, greenville nc 27858
Lot 13
Parcel number 48404
3. Agent / Consultant Information
3a. Agent/ Consultant Name
Amy whitehurst
3b. Company
3c. Mailing address
226 St Greenville nc 27E
3d. Telephone no.
252-531-2234
3e. Email address
[e-mail]
4. Project / Site Information
4a. Name of project
4d. River Basin
4b. County
Pitt 4e. Lat/Long
4c. Nearest Named Stream
4F. Number Stream
Calls
5. Project Description (attach plan if available)
6. Has anyone from DWQ visited the site?
Y
N
Staff Name:
Date of Visit:
7. Does DWR staff have permission to
access this property?
Y
X
N
8. 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 DWR Washington Regional Office for assistance.
DWR Use Only: Is this determination for the purpose of Buffer mitigation? Nutrient offset credit?
9. Please return form to: Allen Stewart Note: Submittals on Friday after 12:00 pm
943 Washington Square Mall
Washington, NC 27889 Will be stamped as received on the
Email: [e-mail] Next business day
Please contact Allen Stewart at the Washington Regional Office at [phone] if you have any questions.
D_E Q�� North Carolina Department of Environmental Quality I Division of Water Resources
Washington Regional Office 1 943 Washington Square Mall 1 Washington, North Carolina 27889
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DWR Exp Stream/Buffer Request_WaRO_20240129

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID:
STREET ADDRESS:
Please print:
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize.
of
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance, and acceptance of
this permit or certification and all standard and special conditions attached.
Property Owner's Address (if different than property above):
Telephone:
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Print Name Authorized Signature
Date:
Date:
D E Q�� North Carolina Department of Environmental Quality I Division of Water Resources
Washington Regional Office 1 943 Washington Square Mall I Washington, North Carolina 27889
NORTH CAfiOLINA _
oapar-oiem�ranmemaiaaar� r 252.946.6481