20240678 Ver 1_Determination Request_20240423

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:* Clyde's Place
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: * Clydes Place LLC
Responsible Party : Chris Tommerdahl
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: 9199712196
Email Address: * [e-mail]
How would you like to received your determination?*
Is there an agent or consultant responsible for the request?*
Yes
No
Attach agent authorization letter: * Clydes Place signed AA.pdf
PDF only
Agent/Consultant Information
.......................................................................................
How would you like to receive your USPS
determination letter?* Email
Name of Agent:* Jordan Burbage
Company Name:* Eco Terra
Email Address: * [e-mail]
Project Information
Has anyone form DWR done a previous site visit?*
Yes
No
Other
IP Stream Determination
Stream
332KB

Date of Visit:
Site Information
Nearest Highway/Street: * 413 Bowden Rd
Nearest Town: * Chapel Hill
Nearest Named Stream:* Neville Creek
River Basin: * Cape Fear
County:
Orange
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
CF02 - Clydes Place LLC - USGS
1.2MB
Topography Figure 1.pdf
Pdf file type only
TOPO map look up: https://viewer.nationaImap.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
CF02 - Clydes Place LLC - Soils Survey
1.14M6
Figure 2.pdf
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
Project Look Up Address: street Address
413 Bowden Road
Address Line 2
City
State / Province / Region
Chapel Hill
NC
Postal / Zip Code
Country
27516
USA
Latitude: 35.890943
Longitude:-79.134027

Misc attachments: CF02 - Clydes Place LLC - Lidar Figure
2.68M6
3.pdf
CF02 - Clydes Place LLC - Aerial Figure
2.21 MB
4.pdf
pdf or kmz file types only
By digitally signing below, I certify that:
• I have given true, accurate, and complete information on this form;
• 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")
• 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');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
• I intend to electronically sign and submit the "Determination Request' form."
Signature
Date Submitted:
Initia. .� �..
ID#*
Version
Do you want to send for review?*
Select Reviewer: *
Select Regional Office:*
(40me,l-Y �<!tAw
4/23/2024
20240678
1
Yes No
Blake Hartshorn: blake.hartshorn
Central Office - [phone]