20120789 Ver 3_Application_20130813

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory Thomas A. Reeder John E. Skvada, III
Governor Acting Director Secretary
DWQ Use Only: Project -1��
Stream Origin /Buffer Applicability Determination
Required Information
1. Owner Information (corporationhndividual who is legally responsible for the property an
$q compliance)
1a. Name(s) on Recorded Deed
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1b. Responsible Party (for LLC)
4b. Mailing Address
1c. Mailing Address
4c. Telephone no.
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1d. Telephone Number
5. Project and Site Information
1e. Email Address
2 oration of Pro Site pl a nclu e e serest o nd hi (h 4T num
3. Has anyone from DWQ visited the site?
Y!
Staff Name
REMMM
Additional Requested Information AUG 1 3 2013
4. Agent/Consultant Information (if applicable)
4a. Name, Company
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4b. Mailing Address
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4c. Telephone no.
4d. Email address
5. Project and Site Information
5a. Name of project
5b. County
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5c. Nearest Named Stream
5d. River Basin
5_e. Provi0a brief d, e�scn'pbt is p attach site plan if available):
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: _buffer mitigation_nutrient offset credit
Please return form to
Roberto Scheller
943 Washington Square Mall
Washington, NC 27889
Fax: [phone]
Email: roberto.scheller @ncdenr.gov
Note: Submittals on Friday after 12:00 pm will be
stamped as received on the next business
day.
Please contact Roberto Schaller (252) 948 -3940 if you have any questions.

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12 -0789 A
N 35 29.913'
W 76 51.062'
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12 -0789 E
N 35 29.887'
W 76 50.838'
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Name:BATH
Date: 8114/2013
Scale. 1 inch equals 1000 feet
12 -0789 D
N 35 29.893'
W 76 50.969'
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12 -0789 F
N 35 29.857'
W 76 50.647'
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Location: 035° 29' 42.8" N 076° 50'42.66" W
Caption: White Post Road Solar Site, Phase II
1998, Maptech, Inc.
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