HomeMy WebLinkAbout20161226 Ver 1_Buffer and/or Stream Determination_20161213Water Resources
ENVIRONMENTAL QUALITY
PMEIVEDMCDENR/DWR
DEC 13 2016
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
S. JAY ZIMMERMAN
DWR Use Only: Project #:
Date Received:
Buffer Applicability / Stream Origin Determination Request
3.
Property Owner Information
1. Owner Information (corporation/individual who is legally responsible for the property and its compliance)
1a. Name(s) on Recorded Deed
1 p�
1b. Responsible Party (for LLC)
3c. Mailing address
1c. Mailing Addressq
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1d. Telephone Number
_QS 1e. Email address
2. Address of Property or Location of ProjeSite
(i luding county, nearest named town, and highway or road name/ number):
R�
3.
Agent / Co ultant Information
3a. Agent/ Consultant Name
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3b. Company
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3c. Mailing address
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3d. Telephone no.
s?� C r�- e. Email address
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4. Project/ Site Information
4a. Name of project
4c. Nearest Named Stream
4b. County
4d. River Basin
5. Project Description (attach plan if available)
6. Has anyone from DWQ visited the site? I Y /f I Staff Name: Date of Visit:
7. 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 DWR Washington Regional Office for assistance.
DWR Use Only: Is this determination for the purpose of Buffer mitigation? Nutrient offset credit?
8. Please return form to:
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Anthony Scarbraugh
943 Washington Square Mall Note: Submittals on Friday after 12:00 pm
Washington, NC 27889 Will be stamped as received on the
Email: Anthonv.Scarbraugh@ncdenr.gov Next business day
Please contact Anthony Scarbraugh at the Washington Regional Office at (252) 948-3924 if you have any
questions.
State of North Carolina I Environmental Quality I Water Resources
Washington Regional Office 1 943 Washington Square Mall I Washington, North Carolina 27889
252 946 6481
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
Water Resources
ENVIRONMENTAL QUALITY S. JAY ZIMMERMAN
DWR Use Only: Project #:
Date Received:
Buffer Applicability / Stream Origin Determination Request
Property Owner Information
1. Owner Information (corporation/individual who is legally responsible for the property and its compliance)
1a. Name(s) on Recorded Deed
1b. Responsible Party (for LLC)
1c. Mailing Address
1d. Telephone Number 1e. Email address
2. Address of Property or Location of Project Site (including county, nearest named town, and highway or road name/ number):
3. Agent / Consultant Information I
3a. Agent/ Consultant Name
3b. Company
3c. Mailing address
3d. Telephone no. 3e. Email address
4. Project/ Site Information
4a. Name of project
d� 4c. Nearest Named Stream
4b. County
4d. River Basin
5. Project Description (attach plan if available)
6. Has anyone from DWQ visited the site? I Y / N I Staff Name: Date of Visit:
7. 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 DWR Washington Regional Office for assistance.
LDWR Use Only: Is this determination for the purpose of Buffer mitigation? Nutrient offset credit?
8. Please return form to: Anthony Scarbraugh
943 Washington Square Mall Note: Submittals on Friday after 12:00 pm
Washington, NC 27889 Will be stamped as received on the
Email: AnthonV.Scarbraugh@ncdenr.gov Next business day
Please contact Anthony Scarbraugh at the Washington Regional Office at (252) 948-3924 if you have any
questions.
State of North Carolina I Environmental Quality I Water Resources
Washington Regional Office 1 943 Washington Square Mall I Washington, North Carolina 27889
252 946 6481
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GPIN: 6694-11-5276 PROP_DESC : LOT 21 AUGUSTUS MBL : 66940087
GPINLONG : 6694-11-5276 WINDLEY PIN—I : 15014575
Disclamer: NAMEI : THOMPSON PEARLIE M LAND_VAL : 12650 DATE: 17.8.1979
Beaufort County online map access is provided as a public service, as is, as BLDG VAI, : 0 DB PG: 0783/00580
available and without warranties, expressed or implied. Content published on
this website is for informational purposes only and is not intended to constitute a NAME2 : TOT_VAL : 12650 STAMPS: 0
legal record nor should it be substituted for the advice or services of industry ADDRI : 842 FLEMING STREET DEFR VAL : 0 SALE PRICE: 0
professionals. The County of Beaufort and the Website Provider disclaim all
responsibility and legal liability for the content published em this website. The TAXABLE_VA : 12650
user agrees that Beaufort County and its Assigns shall be held harmless from all CITY: WASHINGTON PREV ASSES: 12650
actions, claims, damages orjudgments arising out of the use of County data.
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GPIN: 6694-11-6264 PROP_DESC : LOT 22 AUGUSTUS MBL : 66940087
GPINLONG : 6694-11-6264 WINDLEY PIN—1 :15014576
Disclamer• NAMEI : THOMPSON PEARLIE M LAND VAL : 11500 DATE: 17.8.1979
Beaufort County online map access is provided as a public service, as is, as BLDG VAL : 0 DB PG : 0783/00580
available and without warranties, expressed or implied. Content published on
this website is for informational purposes only and is not intended to constitute a NAME2 : TOT VAL : 11500 STAMPS: 0
legal record nor should it be substituted for the advice or services of industry ADDRI : 842 FLEMING STREET DEFR VAL : 0 SALE PRICE: 0
professionals. The County of Beaufort and the Website Provider disclaim all
responsibility and legal liability for the content published on this website. The TAXA13LE_VA: 11500
user agrees that Beaufort County and its Assigns shall be held harmless from all CITY: WASHINGTON PREV ASSES: 11500
actions, claims, damages or judgments arising out of the use of County data.
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