20180086 Ver 1_Buffer and/or Stream Determination Request_20180115

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MICHAEL S. REGAN
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Water Resources a S. JAY ZIMMERMAN
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QWR 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 Weyerhaeuser
1b. Responsible Party (for LLC) Cliff Tyson
1c. Mailing Address 17858 Weyerhaeuser Road Vanceboro , NC 28586
1d. Telephone Number 252-229-8328 1 1e. Email address [e-mail]
2. Address of Property or Location of Project Site (including county, nearest named town, and highway or road name/ number):
Beaufort county off HWY 264 near the intersection of Hwy 92
3. Agent / Consultant Information
3a. Agent/ Consultant Name
3b. Company
3c. Mailing address
3d. Telephone no. 3e. Email address
4. Project / Site Information
4a. Name of project
300513-2018
4c. Nearest Named Stream
Goose Creek
4b. County
Beaufort
4d. River Basin
Tar Pam
5. Project Description (attach plan if available
Located at access 76.889 35.523 of hwy 264
76.89 35.524
6. Has anyone from DWQ visited the site? I Y / N I staff Name: I no pate 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? I
8. Please return form to: Anthony Scarbraugh
943 Washington Square Mall Note: Submittals on Friday after 12:00pm
Washington, NC 27889 Will be stamped as received on the
Email: [e-mail]
Next business day
Please contact Anthony Scarbraugh at the Washington Regional Office at [phone] if you have any
questions.
INWhing C:crmpare%
State of North Carolina I Environmental 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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