20201664 Ver 1_Determination Request_20201103

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:*
Is this a transportation project?*
What type of request is this?*
Owner Information
Name on the Recorded Deed:*
Bells Bridge Nutrient Mitigation Site
r Yes r No
17 Buffer
r Isolated Wetland
Check all that apply.
White
r% IP Stream Determination
17 Stream
Responsible Party: Janet White Leggett and Mary Pat White Brady
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: 5122300424
How would you like to received your determination?*
r USPS W Email
Email Address:* [e-mail]
Is there an agent or consultant responsible for the request?*
r Yes
r No
Attach agent authorization letter:* White Bells Bridge Complete Landowner
74.67KB
Authorization Form.pdf
PDF only
Agent/Consultant Information
How would you like to receive your f USPS
determination letter?* r Email
Name of Agent:* Barrett Jenkins
Company Name:* Restoration Systems
Email Address:* [e-mail]
Project Information
Has anyone form DWR done a previous site visit?*
r Yes
r No
r Other

Date of Visit:
I
Nearest Highway/Street:* Bells Bridges Road
Nearest Town:* Roseneath
Nearest Named Stream:* Deep Creek
River Basin:* Tar -Pamlico
County:*
Halifax
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 documnt
White Farm Bells Bridge USGS TOP
4.12M6
WHOLE PAGE.pdf
Fat 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.
nick the upload button or drag and drop files here to attach document
White Farm Bells Bridge 2006 NRCS Soil
968.8KB
Map Overview.pdf
Rir 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 f Address Lookup
provide this information. r Manually
Latitude: 36.070266
Longitude:-77.456105
Misc attachments: Bells Bridge Nutrient Mitigation Site.kmz 5.3KB
Bells Bridge Nutrient Mitigation Site -
VIABILITY -ASSESSMENT -REQUEST- 13.81 MB
FORM_.pdf
pdt or krrz 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: 11/3/2020
Initial Review RRO
D# * 20201664
Version*
Do you want to send this for review? r Yes r No
Select Reviewer:* Rick Trone:eads\rvtrone
Select Regional Office:* Central Office - [phone]

BUFFER MITIGATI UTRIENT OFFSET
RCY COOPER
Governor SITE VIABILTV ENT REQUEST
MICHAEL S. REGAN `', •�'
Secretory
(Form must be complete and all ents included to process request)
LINDA CULPEPPER NORTH CAROUNA
Director Envlronmen taf Qualfry
❑ BUFFER MITIGATION ❑X NUTRIENT OFFSET ❑ BOTH
Name
Barrett Jenkins
Company
Restoration Systems, LLC
Address
1101 Haynes Street, Suite 211, Raleigh, NC 27604
Phone
[phone]
Email
[e-mail]
Do you have the right to access the property? Attachment 1
❑ YES ❑ NO
PARCEL/SITE DETAILS
Proposed Site Name
Bells Bridge
Address
Bells Bridge Road
City: Scotland Neck
Site Coordinates
36.070288,-77.452140
County: Halifax
River Basin
Tar -Pam
8-Digit HUC: 03020102
Sub -watershed (if in
Jordan Lake or Falls)
Will this be part of a stream or wetland project/bank?
❑ YES ® NO
Has anyone from DWR or the USACE visited the site in the past 12 months? ❑ YES ❑X NO
Has a riparian buffer or stream call been performed by Division of Water Resources staff on the
subject site? ❑ YES ❑X NO
Is the project receiving any state or federal grant money? ❑ YES ❑X NO
Are there any State, Local or Federal Permits associated with the subject site? ❑ YES ❑X NO
PARCEL/SITE ATTACHMENTS (provide items 1-4 as a separate attachment, not to exceed 10 pages)
1. Detailed description of the site including existing site conditions and Aerial Site Map;
2. Include a timeline of land uses and land use changes from 1990-Present;
3. Most recent 1:24,000 scale USGS Topo Map showing the site; AND
4. Most recent published NRCS county soil survey showing site;
SEND COMPLETE REQUEST TO:
NCDWR - 401 & Buffer Permitting Branch
Attn: Katie Merritt
1617 Mail Service Center
Raleigh, NC 27699-1617
orbs email to [e-mail]

Restoration Systems' (RS) requests a viability assessment for a single tract, 358-acre parcel, in Halifax
County, NC, for the development of a nutrient offsite bank parcel. A landowner authorization letter is
attached along with the following detailed description of the parcel, including a historical land use
analysis. This property is near the White Farm 125 site recently submitted for review and owned by the
same family. The parcel has been in the family for approximately 5 generations.
Site Description
The parcel, a +/- 358-acre tract utilized for row crop production, is located in the Scotland Neck Township
5.25 miles north of Bath, NC between highways 258 and 125 on Bells Bridge Road. Via historical mapping,
LiDAR analysis, and in -field review, at appears historic site features have been modified to maximize row
crop production on the parcel. Agricultural use predates 1994 based on review of Google Earth aerial
photography. The property drains to Deep Creek.
Water Quality
The site is located within the Tar -Pamlico River Basin 14-digit USGS Cataloging Unit 03020102-070030.
Deep Creek is classified by NCDWR as C:NSW where class C is for uses such as secondary recreation
where human body contact with water takes place in an infrequent, unorganized, or incidental matter
and supplemental classification NSW represents Nutrient Sensitive Waters needing additional nutrient
management due to being subject to excessive growth of microscopic or macroscopic vegetation.
Physiography
The site is at the transition of the United States Geological Survey's (USGS) Level IV Ecoregion 65m,
Southeastern Plains Rolling Coastal Plain to 63e, Middle Atlantic coastal Plain, Mid -Atlantic Flatwoods of
North Carolina.
Land Use
The site has been cleared of native forest vegetation, streams have been relocated, ditched, and
straightened, and groundwater hydrology has been lowered due to the ditching of site streams. Corn,
peanuts, and cotton are typical agricultural crops.
List of Attached Figures
Figure 1—
Site Location Map
Figure 2 —
Feature Overview
Figure 3 —
2019 USGS Quad (Hobgood)
Figure 4 —
1995 NRCS Soil Survey
Figure 5 —
LIDAR Overview
Figure 7 —
1993 Google Earth Imagery
Figure 8 —
1998 NCDOT Historic Imagery
Figure 9 —
2011 Google Earth Imagery
Figure 10-2018
Google Earth Imagery
RS — Site Viability Request, Bells Bridge Nutrient Offset Site Page 1

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LANDOWNER AUTHORIZATION FORM
1)
PROPERTY LEGAL DESCRITION:
Deed Book: Page:
Parcel ID Number:
Street Address: h ftdu Cf l ). G - 4914XV6t
Property Owner (please print):Q
Property Owner (please printe7.
County: _f zt �_, I�
The undersigned, registered property owner(s) of the above property, do hereby authorize
Ct ".-
of
1,At" w,, ,
(Contractor/Agent/Project Manager)i (Name of Contractor/ ent Firm/Ageney)2
to take all actions necessary for the evaluation of the property as a potential stream, wetland and/or
riparian buffer mitigation project, including conducting stream and/or wetland determinations and
delineations, as well as issuance and acceptance of any required permit(s) or certification(s). I
agree to allow regulatory agencies, including the NC Division of Water Resources, to visit the
property as part of these environmental reviews.
Property Owners(s) Address: 61 r i 14 — F+ ` F, L�
(if different from above)
s -�,� Ct� �: ►. - lle. ILL ak5�?o
Property Owner Telephone Number:(d --
Property Owner Telephone Number �Z -
We hereby certify the above information to be true and accurate to the best of our knowledge.
(Property)OwnerAuthorized Signal
(Property by • Authorized Signature)
9 - 0) ^ aoz-,0
(Date)
(Date)
'Name of full delivery staff member (full -deliveries) or DMS project manager (design -bid -build).
2Name of company (frill -deliveries) or DMS (design -bid -build).