20131168 Ver 1_Stream Call Request_20131105

DWQ Use Only: Project # 1 3 11 t" J
Express Stream Origin /Buffer Applicability Determination
Required Information
EXPRESS
1a. Name(s) on Recorded Deed
NOV
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05 2013
North Carolina Department of Environment and Natural Resourc C DENR
Division of Water Quality
1 d. Telephone Number
Pat McCrory Thomas A. Reeder
John E. Skvarla, III
Governor Acting Director
Secretary
DWQ Use Only: Project # 1 3 11 t" J
Express Stream Origin /Buffer 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
J &N Developers, LLC
1 b. Responsible Party (for LLC)
Stacy Johnson
1c. Mailing Address
588 Neuse River Rd., Clayton, NC 27527
1 d. Telephone Number
919.921.2642
1 e. Email Address
sjohnson042 @nc.rr.com
2. Location of Project Site - please include the county, nearest named town and highway number:
347 Charlie Braswell Road, Rosewood, NC — Wayne County
3. Has anyone from DWQ visited the site?
NO
I Staff Name
5d. River Basin
Date of Visit?
5e. Provide a brief description of this project (attach site plan if available):
Single Family Residential
Additional Requested Information
4. AgentlConsultant Information (if applicable)
4a. Name, Company
Bryan K Jones Consulting Engineers, PA
PO Box 10882, Goldsboro, NC 27532
4b. Mailing address
4c. Telephone no.
919.221.5222
4d. Email address
I bkjones @nc.rr.com
5. Project and Site Information
5a. Name of project
Ingram Fields Subd
5b. County
Wayne
5c. Nearest Named Stream
Charles Branch
5d. River Basin
Neuse
5e. Provide a brief description of this project (attach site plan if available):
Single Family Residential
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 Schaller or Lyn Hardison
943 Washington Square Mall
Washington, NC 27889 Note: Submittals on Friday after 12:00 pm
Fax: [phone] will be stamped as received on the
next business day.
Email: Roberto.5chellera(7ncdenr.gov,
Ivn. hardisonCdlncdenr.gov
Please contact Roberto Schaller at (252) 946 -6481 if you have any questions.

Personal Account Information Redacted
EXPRESS
NOV 05 2013
IBC DENR

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Date: 11/7/2013
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Location: 035° 25' 26.98" N 078'05'17.85" W
Caption: Ingram Fields Subdivision, Charlie Barswell Rd. (SR 1235)
Wayne Co.
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Location: 035° 25' 26.98" N 078'05'17.85" W
Caption: Ingram Fields Subdivision, Charlie Barswell Rd. (SR 1235)
Wayne Co.

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