20171594 Ver 1_Buffer and/or Stream Determination Request_20171213

Water Resources
Pnvironmenlal Quality
DEC 1 3 2011
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ROY COOPER
Governor
MICHAEL S. REGAN
secnrnry
S. JAY ZIMMERMAN
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DWR Use Only: Project N:
Date Received:
Express Buffer Applicability / Stream Origin Determination Request
Property Owner Information
1. Owner Information (corporation/individual who Is legally responsible for the property and Its compliance)
Ia. Name(s) on Recorded Deed Edwards Nora Lee Heirs c/o Raymond Cox, Jr.
lb. Responsible Party (for LLC) N/A
lc. Mailing Address 3921 E. 1011 Street, Greenville, NC 27858
Id. Telephone Number Not Available I 1e. Email address Not Available
2. Address of Property or Location of Project Site (Including county, nearest named town, and highway or road name/ number):
2300 LT Hardee Road
3.
Agent/ Consultant Information
3a. Agent/ Consultant Name
Richle Brown, PE
3b. Company
Stroud Engineering, PA
3c. Mailing address
1078 Commerce Street, Greenvllle,NC 27858
3d. Telephone no.
252-756-9352 3e. Email address [e-mail]
4. Project/ Site Information
4a. Name of project
PN 05052
4b. Nearest Named Stream Hardee Creek
4d. River Basin Tar
4c. County
Pitt
4e No, of Stream 1
Call/property
S. Project Description (attach plan If available): Vacant Farm property seeking stream call that may affect future uses.
6. Has anyone from
YE] / NO
Staff
N/A
Date of Visit:
N/A
DWQvisited the site?
Name:
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: Chris Pullinger
943 Washington Square Mall Note: Submittals on Friday after 12:00 pm
Washington, NC 27889 Will be stamped as received on the
Email: chrls.oullhuter0ocdenr.aov Next business day
Please contact Chris Pullinger at the Washington Regional Office at [phone] if you have any
questions.
"Nothing Compares".,
Slate of North Carolina I EnviromnentaI Quality I Water Resources -Water Quality Regional Operations Section -Washington Regional Office
943 Washington Square Mall, Washington, North Carolina 27889
252-946-6481

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