20220540 Ver 1_Determination Request_20220322

Stream Origin/Buffer Applicability Determination
Please note: fields marked with a red asterisk * below are required. You will not be able to submit the form until all
mandatory questions are answered.
Project Name: * Bayswater Site
Is this a transportation project?* Yes • No
Is this request for a mitigation site?* Yes • No
What type of request is this?* Buffer
Isolated Wetland
Check all that apply.
Owner Information
Name on the Recorded Deed: *
Responsible Party :
Pobo, LLC
Kotarides Developers
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: 919-719-3466
How would you like to received your determination?*
USPS Email
Email Address:*
[e-mail]
Is there an agent or consultant responsible for the request?*
Yes
No
IP Stream Determination
Stream
Attach agent authorization letter:* Bayswater Terracon executed 3-21-22.pdf 362.15KB
PDF only
Agent/Consultant Information
How would you like to receive your
determination letter?*
Name of Agent: *
Company Name:*
Email Address:*
Project Information
USPS
Email
Rhiannon Graham
Terracon
[e-mail]
Has anyone form DWR done a previous site visit?*
Yes
• No
Other

Date of Visit:
Site Information
Nearest Highway/Street: *
Nearest Town: *
Nearest Named Stream: *
River Basin: *
County: *
Pitt
Baywater Road
Winterville
Fork Swamp
Neuse
Please attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo.
Click the upload button or drag and drop files here to attach document
Topo.pdf
Pdf file type only
1.6MB
TOPO map look up: https://viewer.nationalmap.gov/basic/
Please attach a map of the site indicating project boundaries on the NRCS Soil Survey.
Click the upload button or drag and drop files here to attach document
Soilsl .pdf
Pdf file type only
1.76MB
Soil Survey Link: https://www.nres.usda.gov/wps/portal/nres/surveylist/soils/survey/state/?stateld=NC
Latitude and Longitude
Please provide the Latitude and Longitude for physical location for the determination that. If you have a physical
address you can look up the Latitude and Longitude by typing in an address or filling out the information
manually.
Choose below how you would like to provide this information.
Address Lookup
• Manually
Latitude:
Longitude:
Misc attachments:
35.55188
-77.37025
By digitally signing below, I certify that:
Aerial.pdf
pdf or kmz file types only
2.23MB
o I have given true, accurate, and complete information on this form;
o I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the
"Uniform Electronic Transactions Act")
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act");
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the "Determination Request' form."

Signature
Date Submitted: 3/22/2022
Initial Review
ID# *
Version *
Do you want to send for review? *
Select Reviewer: *
Select Regional Office: *
20220540
1
Yes No
Robert Tankard:eads\rbtankard
Washington Regional Office - [phone]

1 erracon
USACE/NCDWR Agent Authorization Form
Property/Site: Bayswater Site
Address of Site: Bayswater Road
Winterville, NC 28590
Parcel Identification Number (PIN): 08092, 74327
Owner Information: /)
Name: po v, L/(
Address: 7 U
(e /6
Telephone Number: (Z-22.- 7/ /
E-mail Address:
Property Owner Certification:
I, the undersigned, a duly authorized owner of record of the property/properties identified herein,
do authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps)
and/ or the North Carolina Division of Water Resources (NCDWR) to enter upon the property
herein described for the purpose of conducting on-site investigations and issuing a determination
associated with Waters of the U.S (WOTUS) subject to Federal/State jurisdiction under Section
404 and 401 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899.
Terracon, as designated by the current property owner, is the authorized consultant to coordinate,
schedule, and provide supplemental ' f ation to both agencies in support of this verification
and/or permit application.
Property Owner Signature:
Date: y/2-*-s
Terracon Consultants Inc. 2401 Brentwood Road,Suite 107, Raleigh, NC 28208-3608
P:919-873-2211 F:919-873-9555 terracon.com
Environmental • Facilities Geotechnical Materials

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PM: Project No. EXHIBIT m
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Approved By: Date: 2401 Brentwood Road,Suite 107 Raleigh,NC 27604 North Carolina
JH March 2022 Phone:[phone] Fax:[phone]

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PM: Project No. Potential Wetlands and Waters EXHIBIT ml
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PM: Project No. EXHIBIT m
RT 70227120 NRCS Soils o
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Approved By: Date: North Carolina in
2401 Brentwood Road,Suite 107 Raleigh,NC 27604
JH March 2022 Phone:[phone] F. [phone]
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