20140473 Ver 1_Stream Call Request_20140512

REC "E ME
N NCDMR
MAY 1 2 pp)q o Carolina Department of Environment and Natural Resources
Division of Water Quality
Pet McCrory Thomas A. Reeder John E. Skvaria, III
1�mpr /I ! Acting Director Secretary
DWQ use Orl Pr"ects 14rt94T�-
Stream Origin /Buffer Applicability Determination
Required Information
1. Owner Information (corporation/individual who is legally responsible for the property and its compliance)
Ia. Name(s) on Recorded Deed
Weyerhaeuser Company
1 b. Responsible Party (for LLC)
1c. Mailing Address
1785 Weyerhaeuser Road Vanceboro, NC 285856
1d. Telephone Number
252- 229 -8328
1 le. Email Address
Cliff .tyson @weyerhaeuser.corn
2. Locationy�vrr Site - please include the county, nearest named town and highway number:
<< u �o c� Fr r-J i`/ 3 �-'
3. Has anyone from DWQ visited the site)
I N
Staff Name
5a. Name of project
Date of Visit?
5b. County
Additional Requested Information
4. Agent/Consultant Information (if applicable)
4a. Name, Company
4b. Mailing address
4c. Telephone no.
4d. Email address
5. Project and Site Information See attached maps
5a. Name of project
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5b. County
5c. Nearest Named Stream
5d. River Basin ldauee r
5e. Provide a brief description of this project (attach site plan if available). 7,j7, S r S q
Final Harvest
Access at Y� Z Z 3 /
call at
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Please attach a map of the site indicating project boundaries on the US GS 1:24,000 Topo and/or NRCS Soil Survey.
_ _Y... ,.s •heee ...e....,ieata cnnRegional tact the Re Office for assistance.
Please return form to: Anthony Scarbraugh
943 Washington Square Mall Note. Submittals on Friday alter 12:40 pm
Washington, NC 27889 will be stamped as received on the
Fax [phone] next business day.
Email: anthonv scarbrauahAncdenr.00v
Please contact Anthony Scarbraugh at (252) 946 -6481 if you have any questions.

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