20231185 Ver 1_20231185 Ver 1_20231185_Stream Det_Request_Millicent Hardison Property_20230828_20230828

ROY COOPER
0ovemar
ELIZABETH S. B1SER
Secretary
RICHARD E. ROGERS, JR,
Director
NORTH CAROLINA
Environmental Quality
Date Received 08-28-2023 DWR Use Only: Project # 20231185
Buffer Determination Request Form
Property Owner Information
1. Owner Information
1 a. Name(s) on Recorded Deed
Millicent D Hardison
I b. Responsible Party (for LLC)
I c. Mailing Address
961 NC H WY 581 N Goldsboro NC 27530
1 d. Telephone Number
919-738-2539
1 e. Email Address
Address of Property: 115 Daw Pate Road
Goldsboro NC 27534
Project Description (attach plan if available): We are wanting to sell these road front lots and would need to cover or relocate this ditch
around the small field where the lots would go. I have attached a drawing of the proposed lots
Consultant/Agent Information
4. Agent/Consultant Information
4a. Name, Company
Troy Daw ( nephew ) please call me with questions and to meet you when you come, Thanks
4b. Mailing address
152 Creek Run Drive Goldsboro NC 27534
4c. Telephone no.
919-920-1606
4d. Email address
[e-mail]
5. Project and Site Information
5a. Name of project
5b. County
Wayne
5c. Nearest Named Stream
Stoney Creek
5d. River Basin
Neuse
6. Has anyone from DWR visited the site?
I Y / No
Stat-f Name
Date of Visit?
Attach a map of the site indicating project boundaries on the USGS 1:24,000 "Topo and/or MRCS Soil Survey.
Please return form Joe Myers
to: 1628 Mail Service Center
Raleigh, NC 27699-1628
Email:
DEQ. [e-mail]
Notlli Carolma Delwnntem of linvvoniwital Ouality I IbviMon of Water Raomm"es
S 12 North Saliubury Strew 1 1617 Mail Service Cenler 1 Ralefult, North Carolina 2709-1617
919-707,900 )

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