20140666 Ver 1_Stream Call Request_20140701

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NorM Carolina Department of Environment and Natural Resources
JUL - 1 2014 Division of Water Quality
Pat McCrory Thomas A. Reeder John E. Skvarla, III
Gove6npr, Acting Director Secretary
DM Use Only Project S
Stream Origin /Buffer Applicability Determination
Required Information
1. Owner Information (corporationlindividual who is legally responsible for the property and its compliance)
1 a. Name(s) on Recorded Deed Weyerhaeuser Company
1b. Responsible Party (for LLC)
4a. Name, Company
1 c. Mailing Address
1785 Weyerhaeuser Road Vanceboro, NC 285856
1d. Telephone Number
252- 229.8328 1e. Email Address
weyerhaeuser.com
2. Location of Project Site - please include the county. nearest named town and highway number:
06F,5k,t k \ler F�. r Pw ci
3. Has anyone from DWO visited the site? N
Staff Name
Date of Visit?
Sc. Nearest Named Stream fit 0 nnp_ f Q r - — 5d. River Basin
Additional Requested Information
4, AgenUConsultant 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 ' 3 OZ St - ZOI ct 5b. County
Sc. Nearest Named Stream fit 0 nnp_ f Q r - — 5d. River Basin
New@
5e. Provide a brief description of this pr j (attach site^ plan if available)
Final Harvest
Access at } ?- O O 3 S3 3s- Z 4 j4 g
Call at
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.
of X tlttfwilil1f tan �ndwo? teto»1 111
Please return form to: Anthony Scarbrar.gh
943 Washington Square Mall Note. Submittals on Friday alter 1200 pm
Washington, NC 27889 will be stamped as received on the
Fax: [phone] next business day.
Email - "nonv scarbrauenLZIDncde -ir acv
Please contact Anthony Scarbrough at (252) 946 -6481 if you have any questions.

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