20160262 Ver 1_Buffer Determination Request_20160311

Water Resources
ENVIRONMENTAL QUALITY
RECEIVED/NCDENR/DWR
MAR 11 M6
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PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secrelary
S. JAY ZIMMERMAN
Water Quality Regional DWR Use Project
Operations Section Y J
Washington Regional Office
Stream Origin/Buffer Applicability Determination
Required Information
1. Owner Information (corporation/individual who is legally responsible for the property and its compliance)
la. Name(s) on Recorded Deed
Housing Authority of Goldsboro
1 b. Responsible Party (for LLC)
Rama Chittilla, Engineering Dept. City of Goldsboro
1 c. Mailing Address
200 N Center Street, Goldsoboro, NC 27530
1 d. Telephone Number
919 580 4328
1 e. Email Address
[e-mail]
2. Location of Project Site - please include the county, nearest named town and highway number:
Blue Line Ditch Regarding: Near Astor Court, near West Holly Street, US 117 South Bypass
3. Has anyone from DWR visited the site?
Y / ON
Staff Name
I N/A
Date of Visit?
N/A
Additional Requested Information
4. Agent/Consultant Information (if applicable)
4a. Name, Company
4b. Mailing address
4c. Telephone no.
4d. Email address
5. Project and Site Information
5a. Name of project
5b. County
5c. Nearest Named Stream
5d. River Basin
5e. Provide a brief description of this project (attach site plan if available):
Drainage problem in Astor court, existing blue line ditch needs to be regarded by City maintenance crew,
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 Usb Only: Is this stream call for the purpose of: — buffer mitigation nutrient offset credit
Please return form to: Anthony Scarbraugh
943 Washington Square Mall
Washington, NC 27889 Note: Submittals on Friday after 12:00 pm
will be stamped as received on the
Fax: [phone] next business day.
Email: anthonv.scarbraugh(a.ncdenr.gov
Please contact Anthony Scarbraugh at [phone] if you have any questions.
State of North Carolina I Environmental Quality l Water Resources—Water Quality Regional Operations—Washington Regional Office
943 Washington Square Mail, Washington, NC 27889
252-946-6481

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