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HomeMy WebLinkAbout20240413 Ver 1_Determination Request_20240313Please 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:* Grady G. Harris 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: * Grady G Harris Responsible Party : The Rich Company (for LLC, Corporations, businness, agency, etc.) Telephone Number: 2529448769 Email Address: * rosie@therichcompany.com How would you like to received your determination?* Is there an agent or consultant responsible for the request?* Yes No Project Information Has anyone form DWR done a previous site visit?* Yes No Other Date of Visit: Site Information IP Stream Determination Stream Nearest Highway/Street: * 15 th Street Nearest Town: * Washington Nearest Named Stream:* Tranter Crekk River Basin: * Tar -Pamlico County: * Beaufort 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 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 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 provide this information. Address Lookup Manually Latitude: Longitude: Misc attachments: pdf or kmz file types only By digitally signing below, I certify that: o I have given true, accurate, and complete information on this form; d 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'); d 1 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: 3/13/2024 Initial Review ID#* 20240413 Version * 1 Do you want to send for review?* Yes No Select Reviewer: * Robert Tankard:robert.tankard Select Regional Office: * Washington Regional Office - (252) 946-6481