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HomeMy WebLinkAboutVer _Determination Request_20230830Please 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:* Is this a transportation project?* Is this request for a mitigation site? What type of request is this?* Owner Information THE BEAUTIFUL COMMUNITY Yes No Yes No Buffer Isolated Wetland Check all that apply. Name on the Recorded Deed: * BUILDER BEE PROJECTS, LLC Responsible Party : CHARLES SANTOS (for LLC, Corporations, businness, agency, etc.) Telephone Number: 919-987-5068 Email Address: * charles@builderbeeprojects.com How would you like to received your determination?* Is there an agent or consultant responsible for the request?* Yes No Attach agent authorization letter: * 517 BUCK JONES ROAD AGENT AUTHORIZATION. pdf PDF only Agent/Consultant Information How would you like to receive your USPS determination letter?* Email Name of Agent: * RANDALL MILLER Company Name:* THOMPSON AND ASSOCIATES Email Address: * millerpel9793@gmail.com n IF Stream Determination Stream 45.37KB 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: Wake 517 BUCK JONES/5323 BARCLAY DR RALEIGH WALNUT CREEK 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 517 BUCK JONES ROAD USGS 1.84MB TOPO.pdf Pdf file type only 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 517 BUCK JONES SOIL MAP.pdf 1.48MB Pdf file type only 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 Address Lookup provide this information. Manually Project Look Up Address Street Address 517 Buck Jones Road Address Line 2 City Raleigh Postal / Zip Code 27606-2201 State / Province / Region NC Country US Latitude: 35.7750886 Longitude:-78.73156279999999 Misc attachments: 517 BUCK JONES ROAD VICINITY MAP 1.04MB (2).pdf pdf or knnz file types only By digitally signing below, I certify that: 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: 8/30/2023 Initial Review RRO Do you want to send this for review? Yes No SAMPLE AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: c -t 7 39 ? `F L4 7 o LOT NO. PLAN NO. _ PARCEL ID: O -173q 1 C1 37 1 STREET ADDRESS: 5 L I i3U C-V- TdaES Ro n-�D j2,p L" 14 4 c- Z,7(ooro 53 �3 t3a�2Lt.� prz�v� �1"-►c,�4 �..[;c Z7 CMG Please print: Property Owner: LD g� E P Property Owner: The undersigned, registered property owners of the above noted property, do hereby authorize i t . L _ 1-'C L.t..t-'� r of - l ►,c �� .�: - SScX= l-P-'z' €� (Contractor / Agent) (Name of consulting firm) to act on my behalf and take all actions necessary for the processing, issuance and acceptance of this permit or certification and any and all standard and special conditions attached. Property Owner's Address (if different than property above): k f 51 X Fo -�V-5R�D 5 R-A CZ-tC i IC_ Telephone: q I - Cl S 'SO e-8 We hereby certify the above information submitted in this application is true and accurate to the best of our knowledge. horized 6gnrature Authorized Signature Date: f Date: 704890 35° 46' 42" N 35° 46 21" N 704970 705M 705130 705210 3 it Q Map Sole: 1:3,130 if printed on A porb-at (8.5' x 11'� sheet. Meters N N 0 45 90 18D Z70 Feet A 0 150 300 600 900 Map projection: Web Merotor Comermordinates: WGS84 Edge bm: UTM Zone 17N WGS84 USDA Natural Resources Web Soil Survey Conservation Service National Cooperative Soil Survey Soil Map —Wake County, North Carolina (517 BUCK JONES ROAD-RALEIGH,NC) 704970 705M 705130 M5210 3 705370 35' 46 42" N 35° 4621" N 705370 3 v 8/30/2023 Page 1 of 3 Z m c Z CD N V c e+ (c ®® )p 0 X JK o C. n ® y 01 M of � � A to (n (n (n N (n O° O (o) n W co to (n n m.N. o°a o m om m m o 0- 0-< o m 0.0 mm mx Cl. < N < mD o O n n D m �m Ga . 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