20150876 Ver 1_Buffer Determination Request_20150828

MA
NCDENR
North CarjMg\QppWkMWFFnvironment and Natural Resources
Pat McCrory
Governor AUG 28 2015
Water Quality Regional
operations Section
Washington Regional Office
Donald R. van der Vaart
Secretary
DWQ Use Only Project`# n ,I
Stream Origin /Buffer Applicability Determination
Required Information
1. Owner Information (corporation /individual who is legally responsible for the property and its compliance)
1a. Name(s) on Recorded Deed William E Clark
1 b. Responsible Party (for LLC)
1c. MailingAddress 336 Tradewinds Way, Grimesland, NC 27837
1d. Telephone Number (252)814 -7303 1e. Email Address I Bclark336 @gmail.com
2. Location of Project Site - please include the county, nearest named town and highway number:
336 Tradewinds Way, Grimesland, NC. Between Tucker Road and Hwy 33 east of Greenville, NC and North of Simpson, NC
3. Has anyone from DWQ visited the site? I N I Staff Name I
Additional Requested Information
4. Agent/Consultant Information (if applicable)
I 4a. Name, Company Same as above
I 4b. Mailingaddress
4c. Telephone no. 4d. Email address
5. Project and Site Information
Date of Visit?
5a. Name of project Stream erosion 5b. County Pitt
5c. Nearest Nam I unknown 5d. River Basin I Tar
5e. Provide a brief description of this project (attach site plan if available):
Stream has eroded bank on property line causing cave in on back of property. Would like to bulkhead stream to stop erosion
and restore area damaged by erosion.
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.
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DIN Use Only Is this stream calCfor the purpose of = buffermltlgatiom_nutrlent offset credit
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Please return form to: Anthony Scarbraugh
943 Washington Square Mall Note: Submittals on Friday after 12:00 pm willbe
Washington, NC 27889 stamped as received on the
Fax: [phone] nextbusinessday.
Email: anthonv.scarbrauehOncdenr.aov,
Please contact Anthony Scarbraughat (252) 946 -6481 if you have any questions.

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