HomeMy WebLinkAbout20161256 Ver 1_Buffer and/or Stream Determination Request_20161215N'C.
Water Resources
ENVIRONMENTAL QUALITY
RECEIVED/NCDENR/DWR
DEC 15 2016
Water Quality Regional
Operations Section
Washington Regional Office
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secrerary
S. JAY ZIMMERMAN
DWR Use Only: Project #: 1 lc i..a'.
Date Received: 14.%/ �%lc
Buffer Applicability / Stream Origin Determination Request
Property Owner Information
1. Owner Information (corporation/individual who is legally responsible for the property and its compliance)
la. Name(s) on Recorded Deed Pitt County Government
1b. Responsible Party (for LLC)
1c. Mailing Address 1717 West Fifth St. Greenville, NC 27834
1d, Telephone Number 252-902-3170 1e. Email address Tim.Corley@pittcountync.gov
2. Address of Property or Location of Project Site (including county, nearest named town, and highway or road name/ number):
3.
Agent/ Consultant Information
3a. Agent/ Consultant Name
Tim Corley, PE
3b. Company
Pitt County
3c. Mailing address
1717 W. Fifth St. Greenville, NC 27834
3d. Telephone no.
252-902-3170 3e. Email address 77777TTim.corley@pittcountync.gov
4. Project/ Site Information
4a. Name of project
Animal Shelter
Expansion
4c Nearest Named Stream
Fork Swamp Canal
4b. County
Pitt
4d. River Basin
Neuse
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.
DWR Use Only: Is this determination for the purpose of Buffer mitigation? Nutrient offset credit?
8. Please return form to: Anthony Scarbraugh
943 Washington Square Mail Note: Submittals on Friday offer 12:00 pm
Washington, NC 27889 Will be stamped as received on the
Email: Anthony.Scarbraueh@ncdenr.eov 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 Mail I Washington, North Carolina 27889
252 946 6481
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