20140892 Ver 1_Stream Call Request_20140818

� RECEIVED
NCDENR ��� �� Zola
North Carolina Department of Environment and Natural Re rc
Pat McCrory NQ MSF� af�, II
Governor D'A e Air
DWQ Use Only: Project #
Stream Origin /Buffer Applicability Determination
Required Information
1. Owner Information (corporationlndividual who is legally responsible the property and its compliance) el
1 a. Name(s) on Recorded Deed
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1b. Responsible Parry (for LLC)
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1c. Mailing Address
4b. Mailing address
1d. Telephone Number
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le. Email Address
77
2. Location of Project Site - please include the county, nearest named town and
ighway numb r:
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sorb led as
3. Has anyone from DWQ visited the site?
Y (V Staff Name
5a. Name of project
Date of Visit?
5b.
Additional Requested Information
4. Agent/Consultant Information (if applicable)
4a. Name, Company
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4b. Mailing address
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4c. Telephone no.
77
4d. EmaiTladdress AWO 10 7 Z GM Q<L ,
5. Project and Site Information
5a. Name of project
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5b.
County
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5c. Nearest Named Stream
7
5d.
River Basin
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5e. Provide a brief description of this project (attach site plan if available):
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Please attach a map of the site indicating project boundaries on the USGS 1: 4,000 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: Anthony Scarbraugh
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: anthony.scarbrauch Wricdenr.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 - 946-64811 Fax: 252 - 975 -37161 Internet: www.ncdenr.gov
An Equal Opportunity 1 Afirmabve Action Employer -Made in part by recycled paper
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WI f-
,;...;Pitt County Government
Greenville. North Carolina
F►0�' www.pittcountync.gov
Disclaimer This tax record is prepared for the inventory of real property within Pdt
County and is compiled from recorded deeds, plats, tax maps, surveys, and other
public records. Users of this data are hereby notified that the aforementioned pudic
primary information sources should be consulted for venfication. Pitt County assumes
no legal responsibility for the information contained herein.
Copyright ® 2010, Pitt County, North Carolina.
'S , Gil, / / /,ors
PLEASE NOTE:
Parcel ownership information updated nightly.
Map printed 8/16/2014.

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