20140782 Ver 1_Stream Call Request_20140813

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NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
DWQ Use Only: Project #
Stream Origin /Buffer Applicability Determination
Required Information
1. Owner Information (corporationAndividual who is legally responsible for the property and its compliance)
Ia. Name(s) on Recorded Deed
David W. Branch, Jr.
1 b. Responsible Party (for L-C)
3280 Charles Blvd. Greenville, NC 27858
1c. Mailing Address
106 Slaney Loop Winterville, NC 28590
1d. Telephone Number
bryan0arkconsultinaarouo.com
1e. Email Address
5a. Name of project
2. Location of Project Site - please include the county, nearest named town and highway number:
Village of Simpson, Pitt County, NC 33 E and River Branch Road
3. Has anyone from DWQ visited the site?
Y / N
I Staff Name
Tar River
Date of Visit?
I Tar / Pamlico
Additional Requested Information
4. AgentfConsultant Information (if applicable)
4a. Name, Company
Bryan Fagundus, Ark Consulting Group, PLLC
4b. Mailing address
3280 Charles Blvd. Greenville, NC 27858
4c. Telephone no.
252.558.0888
4d. Email address
bryan0arkconsultinaarouo.com
5. Project and Site Information
5a. Name of project
River Branch Subdivision
5b. County
Pitt
5c. Nearest Named Stream
Tar River
5d. River Basin
I Tar / Pamlico
5e. Provide a brief description of this project (attach site plan if available): Single Family Residential Subdivision
Please attach a map of the site indicating project boundaries on the USGS 1:24,000 Topic, 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: Anthony Scerbraugh
943 Washington Square Mall
Washington, NC 27889 Note: Submittals on Friday after 12:00 pm
will be stamped as received on the
Fax: [phone] next business day.
Email: anthonv.scarbraughencdenr.gov
Please contact Anthony Scarbraugh at (252) 946 -6481 if you have any questions.
Division of Water Resources - Water Quality Regional Operations Section - Washington Regional Office
943 Washington Square Mall, Washington, NC 27889
Phone: 252 - 94684811 Fax: 252 - 975-37161 Internet: www.ncdenr.gov
An Equal OpporWniry 1 Atrim tive Action Empbyw— Made in part by recycled paper

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