20131168 Ver 1_Stream Call Request_20140606

NCDENR
North Carolina Department of Environment and
Division of Water Quality
Pat
Governor McCrory EXPRESS
JUN 0 9 RECD
201+
NC DENR
Thomas A. Reeder
Acting Director
I" iz
JUN - 6 2014
Natural Resources
D1�� - ��ohnE$kva(la III
Secretary
DWQ Use Only: Project #
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
1 c. Mailing Address
588 Neuse River Rd., Clayton, NC 27527
1d. Telephone Number
919.921.2642
1e. 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?
YES
I Staff Name
I Roberto Scheller
I Date of Visit?
1 11/4/13
Additional Requested Information
4. Agent/Consultant Information (if applicable)
4a. Name, Company
Bryan K Jones Consulting Engineers, PA
4b. Mailing address
PO Box 10882, Goldsboro, NC 27532
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 a t 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.scheller(a )ncdenr.gov,
Iyn.hardisoniNncdenr.gov
Please contact Roberto Schaller at (252) 946 -6481 if you have any questions.

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