HomeMy WebLinkAbout20151319 Ver 1_Buffer Determination Request_20151222K,
Water Resources
ENVIRONMENTAL OUALITY
RECEIVED/NCDENR/DWR
DEC 2 2 2015
Water Quality Regional
Operations Section
Washington Regional Office
PAT MCCRORY
On,eZ,,
DONALD R. VAN DER VAART
Secretary.
S. JAY ZIMMERMAN
DWR Use Only: Project#
Stream Origin/Buffer Applicability Determination
Required Information
1. Owner Information (corporationfindividual who is legally responsible for the property and its compliance)
1 a. Name(s) on Recorded Deed
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1 b. Responsible Party (for LLC)
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1 c. Mailing Address
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1 d. Telephone Number
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6 3 te. E ail Address
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2. Location of Project Site - please include the county, nearest named town and highway number: It
3. Has anyone from DWR visited the site?
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Staff Name
�5 Provide a brief description of this prof�jct (attach site plan if available):
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Date of Visit?
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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.
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4d. Email address
5. Project and Site Information 07" R `C /W 1941'
5a. Name of project
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5b. County
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5c. Nearest Named Stream
5d. River Basin
�5 Provide a brief description of this prof�jct (attach site plan if available):
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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.
DWR Use Only: Is this stream call for the purpose of: buffer mitigation nutrient offset credit
Please return form to: Anthony Scarbreugh
943 Washington Square Mali
Washington, NC 27889 Note: Submittals on Friday after 12:00 pm
will be stamped as received on the
Fax: (252) 946-9215 next business day.
Email: anthonv.scarbraugh(a)ncdenr.gov
Please contact Anthony Scarbraugh at (252) 946-6481 if you have any questions.
2011'& of North Carolina I Environmental Quality WaterResnances —Water Quality Regional Operations—WashingtonRegionalOffice
LU 943 Washington Squate Mail, Washington, NC 27889
252-946-6481
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ConrectGIS Feature Report
OBJECTID
PIN
GPIN
4204
15010610
5667-37-6472
GPIN Lona
OWNER NAME
OWNER NAME2
5667-37-6472
WHICHARD BOBBY DEAN
MAILING ADDRESS
MAILING ADDRESS 2
CITY
4475 US HWY 264W
WASHINGTON
STATE
ZIP
PROPERTY ADDRESS
NC
27889
US 264
ACRES
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MAP SHEET
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85991
566700
NBR BLDG
DEED BOOK and PAGE
LAND VAL
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19281
BLDG VAL
DEFR VAL
TOT VAL
0
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19281
NBHD CDE
NBHD DESC
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SUB DESC
STAMPS
SALE PRICE
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LAND USE
DISTRICT
PROP DESC
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BUCKMAN
MBL
EXEMPT AMT
ROAD TYPE
566700128
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YR BUILT SQ FT NBR BED
EFF YR PREV ASSESS
19281
DATE ZONE
03/07/1996
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