20200710 Ver 1_Determination Request_20200526

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:* Brian and Cara Kuszyk Residence - 1646 Woodfield Circle
Is this a transportation project?* f Yes r No
What type of request is this?* P7 Buffer r IP Stream Determination
r Isolated Wetland r Stream
Check all that apply.
Owner Information
Name on the Recorded Deed:*
Responsible Party:
Brian and Cara Kuszyk
Brian Kuszyk
(far LLC, Corporations, businness, agency, etc.)
Telephone Number:
How would you like to received your determination?*
F 141
Email Address:* [e-mail]
Is there an agent or consultant responsible for the request?*
Yes
c'
Attach agent authorization letter:* Agent Authorization. pdf
FDF only
Agent/Consultant Information
How would you like to receive your r IJSPS
determination letter?* r Email
Name of Agent:* Billy Warren
Company Name:* Cscapes, LLC
Email Address:* [e-mail]
Project Information
Has anyone form DWR done a previous site visit?*
r
r
r
184.88KB
Date of Visit:

Site Information
Nearest Highway/Street:* Woodfield Circle
Nearest Town:* Greenville
Nearest Named Stream:* Tar
River Basin:* Tar -Pamlico
County:*
Please attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo.
aick the upload button or drag and drop files here to attach document
Topographic Map.pdf 2.39MB
Fttf 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.
oickthe upload button or drag and drop files here to attach document
Soil Survey Map.pdf 4.37MB
Fttf 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.
r Address Lookup
f Manually
Project Look Up Address
Street Address
1646 Woodfield Circle
Address Line 2
City
Greenville
Fbstal / Zip Code
27834-9372
Latitude: 35.64899349999999
Longitude:-77.4517766
State / Rovince / Fbgion
NC
Country
us
Misc attachments: Google Earth Imagery.pdf 13.39MB
pdF or kne 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:
Initial Review
ID#*
Version*
Do you want to send for review?*
Select Reviewer:*
Select Regional Office:*
n't,t
5/26/2020
20200710
1
r Yes r No
Robert Tankard:eads\rbtankard
Washington Regional Office - [phone]

From:Pullinger, Robert C
To:Scarbraugh, Anthony
Subject:FW: [External] Fwd: Ditch permit application
Date:Friday, May 29, 2020 9:04:02 AM

Chris Pullinger
Environmental Specialist II
Division of Water Resources – Water Quality Regional Operations
North Carolina Department of Environmental Quality
943 Washington Square Mall
Washington, NC 27889
252 948 3918 office
[e-mail]

From: Cscapes Office <[e-mail]>
Sent: Thursday, April 30, 2020 5:44 PM
To: Pullinger, Robert C <[e-mail]>
Subject: [External] Fwd: Ditch permit application

CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an
attachment to [e-mail]

Permission
Cscapes, LLC
BILLY WARREN
Begin forwarded message:
From: Cara Kuszyk <[e-mail]>
Date: April 29, 2020 at 10:54:15 AM EDT
To: Billy Warren <[e-mail]>
Subject: Re: Ditch permit application
Billy,
Yes we give you permission.
House Parcel # 46294
Lot of river parcel # 46295
Thanks,
Cara Kuszyk
Sent from my iPhone
On Apr 28, 2020, at 2:20 PM, Billy Warren <[e-mail]>
wrote:

Brian and Cara,
I need a reply back to this email of your consent to allow Billy Warren
submit your permit to review the drainage ravine on your property for the
construction of a potentially water control structure.

Also please provide your parcel # from Pitt County Opis (Tax parcel)

Thank you

Billy Warren

Brian an d Cara Ku szyk Resi den ce
2019 USGS Topographic Map Scale 1:24K for Greenville NW, North Carolina
Legend
Pitt County Tax Parc els
Project Loc ation
700 ft
N➤➤N
Brian an d Cara Ku szyk Resi den ce
Google Earth Im agery from 2020
Legend
Pitt County Tax Parc els
Project Loc ation
1000 ft
N➤➤N
Brian an d Cara Ku szyk Resi den ce
1974 NRCS Soil Survey of Pitt County, NC Sheet Num ber(s ) 25 and 33
Legend
Pitt County Tax Parc els
Project Loc ation
1000 ft
N➤➤N
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