Buffer Determination Request - Goss yates Mill Store Assemblage

Division of Water Resources, Raleigh Regional Office, Water Quality Operations Section http://portal.ncdenr.org/web/wq/aps
1628 Mail Service Center, Raleigh, NC 27699-1628 Phone: [phone]
Location: 3800 Barrett Drive, Raleigh, NC 27609 Fax: [phone]
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Interim Director

Date Received_______________ DWR Use Only: Project # _________________

Buffer Determination Request Form
Property Owner Information
1. Owner Information
1a. Name(s) on Recorded Deed Goss, Dennis Christopher & Wilbur Mearl Goss Jr.
1b. Responsible Party (for LLC)
1c. Mailing Address 910 Arrowhead Rd.
1d. Telephone Number 919.604.5604 1e. Email Address N/A
Address of Property: 1359, 1400, & 0 Yates Store Rd. Cary, NC Wake County (35.813884, -78.920588)
Project Description (attach plan if available): Unknown

Consultant/Agent Information
4. Agent/Consultant Information
4a. Name, Company A.J. Kamal, Soil & Environmental Consultants, PA (S&EC)
4b. Mailing address 8412 Falls of Neuse Road, Suite 104, Raleigh, NC 27587
4c. Telephone no. 828.320.1959 4d. Email address [e-mail]
5. Project and Site Information
5a. Name of project Goss Yates Mill Store Assemblage 5b. County Wake
5c. Nearest Named Stream Indian Creek 5d. River Basin Cape Fear / 03030002
6. Has anyone from DWR visited the site? Y / N N Staff Name N/A Date of Visit? N/A
Attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo and/or NRCS Soil Survey.

Please return form
to:

Division of Water Resources, Raleigh Regional Office, Water Quality Operations Section
1628 Mail Service Center
Raleigh, NC 27699-1628
Email: [e-mail]

Please contact the Raleigh Regional Office at [phone] if you have any questions.

NC Center for Geographic Information & Analysis
Project Number:
SB
Project Manager:
1" = 1000'Scale:
7/13/22Date:
Map Title:
Source:
Figure 1 - USGS
Goss Yates Store Assemblage
Wake/Chatham County, NC
2019 USGS Green Level
Quad
¯0 1,000 2,000
Feet
15297.W1

YATES STORE RD
SEALINE DR
F
LY

B
R
I
D
G
E

D
R
SILVERTON CT
BROWARD LN
TRANSOM VIEW WAY
NC Center for Geographic Information & AnalysisProject Number:
SBProject Manager:
1" = 200'Scale:
06/08/2022Date:
Map Title:
Source:
Figure 3 - Aerial Map
Goss Yates Store AssemblageWake/Chatham County, NC
Aerials from NC OneMap
¯0 200 400
Feet
15297.W1