20221515 Ver 1_Buffer and/or Stream Determination Request_20221012

ROY COOPER
Governor
MICHAEL S. REGAN
Secretory
LINDA CULPEPPER
Director
NORTH CAROLINA
Environmentof Quality
Buffer Applicability / Stream Origin Determination
Express Request
Property Owner Information
1. Owner Information (corporation/individual who is legally responsible for the property and its compliance)
la. Name(s) on Recorded Deed
Brown, Margaree H & Phyllis
lb. Responsible Party (for LLC)
lc. Mailing Address
24 Ormondsville Rd, Hookerton, NC 28538
id. Telephone Number
le. Email address
2. Address of Property or Location of Project Site (including county, nearest named town, and highway or road name/ number):
Across from 805 True Vine Rd, Pikeville, NC Wayne County
3. Agent / Consultant Information
3a. Agent/ Consultant Name
Bryan K Jones, PE
3b. Company
Bryan K Jones Consulting Engineers, PA
3c. Mailing address
PO Box 10882, Goldsboro, NC 27532
3d. Telephone no.
919-221-5222
3e. Email address
[e-mail]
4. Project / Site Information
4a. Name of project
True Vine
4d. River Basin
Neuse
4b. County
Wayne
4e. Lat/Long
35.460466 /-77.831035
4c. Nearest Named Stream
Button Branch
4F. Number Stream
Calls
1
5. Project Description (attach plan if available)
Subdivision
6. Has anyone from DWQ visited the site?
Y
No
Staff Name:
Date of Visit:
7. Does DWR staff have permission to
access this property?
Yes
N
Attached Agent Authorization
8. 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 DWR Washington Regional Office for assistance.
DWR Use Only: Is this determination for the purpose of Buffer mitigation? Nutrient offset credit?
9. Please return form to:
Lyn Biles
943 Washington Square Mall
Washington, NC 27889
Email: [e-mail]
Please contact Anthony Scarbraugh at the Washington Regional Office at [phone] if you have any
questions.
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Note: Submittals on Friday after 12:00 pm
Will be stomped as received on the
Next business day
North Carolina Department of Em ironmental Quality (Division of Water Resources - Washington Regional Office
943 Washington Square Mall. Washington, North Carolina 77889
52-946-64tl 1

ROY COOPER
Governor
MICHAEL S. REGAN
SIXTC l(!1'P
LINDA CULPEPPER
Director
PROPERTY LEGAL DESCRIPTION:
LOT NO.
NORTH CAROL INA
Environmental Quality
SAMPLE AGENT AUTHORIZATION FORM
PLAN NO. PARCEL ID: 3642845687
STREET ADDRESS: Opposite — 805 True Vine Rd, Pikeville, NC
Please print
Property Owner:
Property Owner:
?k. j/is Br6wn
Wavtda ., ,h rn so n
The undersigned, registered property owners of the above noted property, do hereby authorize
Bryan KJones, PE , of Bryan K Jones Consulting Engineers, PA
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
13Q.d dar d Reny-) Tki x d &lbw 1411 .0 • g S 8 a
Telephone:
45 a - LL - 1 LoD'
We hereby certify the above information submitted in this application is true and accurate to the
b t of our kawledg.g. Wa'd,, q .
Li 1) i S t rb cz n 4" - `i}"'1 jai
Authoried Print Name Authorize ignature
Date: 9-- 0 ' / —01, O�o�
Date: q- v '7, a 0 a a.J
�DEQV)
North Caro]ina Department of Enx iromnental Quality Division of Water Resources- Washington Regional Office
943 Washington Square Mall, Washington. North Carolina 27889
252-946-6481

TMENT OF THE
USGS U.S. DU. S GEOLOGICCAL SURVEYERIOR
science for a changing world
77°52'3C
35°30'
240000mE
3932000mN
3931
3930
3929
3928
27' 30"
25'
3927
3926
3925
3924
3923
3922
3921
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FEET
3920
3919
35°22'30"
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40
241
2 340 000 FEET
Produced by the United States Geological Survey
North American Datum of 1983 (NAD83)
World Geodetic System of 1984 (WGS84). Projection and
1 000-meter grid: Universal Transverse Mercator, Zone 18S
10 000-foot ticks: North Carolina Coordinate System of 1983
Imagery NAIP, May 2012 - June 2012
Roads ©2006-2012 TomTom
Names GNIS, 2012
Hydrography National Hydrography Dataset, 2012
Contours National Elevation Dataset, 2008
Boundaries Census, IBWC, IBC, USGS, 1972 - 2012
41
50'
242
244
The National Map
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Grid Zone Designation
18S
50'
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This map was produced to conform with the
National Geospatial Program US Topo Product Standard, 2011.
A metadata file associated with this product is draft version 0.6.11
47'30"
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2013
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USGS
science for a changing world
78°00'
35°30'
3932000m N
3931
3930
3929
27' 30'
25'
39
3926
3925
392
3923
3922
600 000
FEET
3920
3919
35°22'30"
78°00'
U.S. DEPARTMENT OF THE INTERIOR
U.S. GEOLOGICAL SURVEY
229000m E
STONEY HILL RD
2 300 000 FEET
BOOKER ST
229
INDUSTRY CT
0
230
COMBS RD
#3
35.449618
-77.96291
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Produced by the United States Geological Survey
North American Datum of 1983 (NAD83)
World Geodetic System of 1984 (WGS84). Projection and
1 000-meter grid: Universal Transverse Mercator, Zone 18S
10 000-foot ticks: North Carolina Coordinate System of 1983
This map is not a legal document. Boundaries may be
generalized for this map scale. Private lands within government
reservations may not be shown. Obtain permission before
entering private lands.
Imagery NAIP, May 2014
Roads U.S. Census Bureau, 2015 - 2016
Names GNIS, 2016
Hydrography National Hydrography Dataset, 2014
Contours National Elevation Dataset, 2008
Boundaries Multiple sources; see metadata file 1972 - 2016
Wetlands FWS National Wetlands Inventory 1977 - 2014
ORO
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41,
231
S COTTONWOOD DR
9° 33"
170 MILS
1° 42'
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GN
30 MILS
UTM GRID AND 2016 MAGNETIC NORTH
DECLINATION AT CENTER OF SHEET
U.S. National Grid
100,000-m Square ID
TE
Grid Zone Designation
18S
57'30"
Wayne_
Executive
Jetport
PICKENS DR
111
CARDINAL DR
31 57'30"
232
The National Map
C US Topo
233
234
#2
35.414393
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#1
35.396642
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232
0.5
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1
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DAW PATE RD
Langton
233
SCALE 1:24 000
KILOMETERS 1
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70
235
2
0.5
0
1000 0 1000 2000 3000
METERS
0
1000
2000
MILES
4000 5000
FEET
6000 7000 8000 9000 10000
CONTOUR INTERVAL 5 FEET
NORTH AMERICAN VERTICAL DATUM OF 1988
This map was produced to conform with the
National Geospatial Program US Topo Product Standard, 2011.
A metadata file associated with this product is draft version 0.6.19
55'
55'
236
COLEY RD
E NEW HOPE RD
_7' NORTH CAROLINA•
QUADRANGLE LOCATION
2
3
4
5
6
7
8
ADJOINING QUADRANGLES
237
NORTHEAST GOLDSBORO QUADRANGLE
NORTH CAROLINA-WAYNE CO.
7.5-MINUTE SERIES
WOODS MILL RD
1 Kenly East
2 Fremont
3 Stantonsburg
4 Northwest Goldsboro
5 Jason
6 Southwest Goldsboro
7 Southeast Goldsboro
8 La Grange
BEAR
CREE
237
Expressway
Secondary Hwy
Ramp
2 330 000 FEET
ADDY'S RD 125
EXUM MILL LN
77°52'30"
35°30'
100 M�iltB
1l // INCH R
238 000m E
ROAD CLASSIFICATION
OODCROFT'DR
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New Hope
Local Connector
Local Road
4WD
3932
3931
3930
630 000
FEET
3929
"28
27'30"
927
3926
3925
3924
25'
922
921
920
919000.N
35°22'30"
77°52'30"
• Interstate Route US Route O State Route
NORTHEAST GOLDSBORO, NC
2016