20201943 Ver 1_Determination Request_20201009

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:* Douglas Hill Farm Nutrient and Buffer Mitigation Site
Is this a transportation project?* f Yes r No
Is this request for a mitigation site? * r Yes r No
What type of request is this?* V Buffer V IF Stream Determination
r- Isolated Wetland V Stream
Check all that apply.
Owner Information
Name on the Recorded Deed:* Douglas Hill Farm, LLC
Responsible Party: Craig West (Manager of Douglas Hill Farm, LLC
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: 9192910311
How would you like to received your determination?*
I— V
Email Address:* [e-mail]
Is there an agent or consultant responsible for the request?*
c:
r
Attach agent authorization letter:* DHF Landowner Authorization Form.pdf 67.43KB
PDF only
Agent/Consultant Information
How would you like to receive your r uSPS
determination letter?* r Email
Name of Agent:* Barrett M Jenkins
Company Name:* Restoration Systems
Email Address:* [e-mail]
Has anyone form DWR done a previous site visit?*
Yes
No
Other

Date of Visit:
Site Information
Nearest Highway/Street:* Douglas Hill Farm Road
Nearest Town:* Roseneath
Nearest Named Stream:* Cow Haul Swamp
River Basin:* Tar -Pamlico
County:*
Halifax
Please attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo.
Gick the upload button or drag and drop files here to attach docurrent
Douglas Hill Farm USGS topo.pdf 3.39MB
Rif 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.
Gickthe upload button or drag and drop files here to attach document
Douglas Hill Farm NRCS Soil Map
1.92 MB
2006.pdf
Rif 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 t: Address Lookup
provide this information. f Manually
Project Look Up Address: Street Address
7401 Douglas Hill Farm Road
Address Line 2
city
Enfield
Fbstal / Zip Code
27823
Latitude: 36.092433
State / Frovince / Region
NC
Country
US
Longitude:-77.50875099999999
Misc attachments: Douglas Hill Farm LLC Parcel.kmz 10.66KB
Douglas Hill Farm -VIABILITY- 10.42MB
ASSESSMENT -REQUEST -FORM- pdf
pdf or krre 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: 10/9/2020
Initial Review RRO
D# * 20201943
Version* 1
Do you want to send this for review? r Yes r No
Select Reviewer:* Shelton Sulivan:eads\sosullivan
Select Regional Office:* Central Office - [phone]

LANDOWNER AUTHORIZATION FORM
PROPERTY LEGAL DESCRITION:
Deed Book: Page: CS-1i County: dad,
Parcel ID Number: [D S-1 a- Y
Street Address:
Property Owner (please print:
Property Owner (please print):
`V
iM
F
The undersigned, registered property owner(s) of the above property, do hereby authorize
' of &4 d �J
(Contractor/Agent/Project Manager)' (Name of Contractor/A nt Firm/Agency)Z
(I
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:
(if different from above)
3o'? ",,v jpQ,/ 6� M
Property Owner Telephone Number:
Property Owner Telephone Number:
g-aq/-0J//
We hereby certify the above information to be true and accurate to the best of our knowledge.
(Property Owner Aut
(Property
tore)
Signature)
(Date)
(Date)
Name of full delivery staff member (full -deliveries) or DMS project manager (design -bid -build).
'Name of company (full -deliveries) or DMS (design -bid -build).
�j

_______________________________________________________________________________________________________________________________________________________________
NCDWR - 401 & Buffer Permitting Branch
Attn: Katie Merritt
SEND COMPLETE REQUEST TO: 1617 Mail Service Center
Raleigh, NC 27699-1617
or by email to [e-mail]

BUFFER MITIGATION &/OR NUTRIENT OFFSET
SITE VIABILTY ASSESSMENT REQUEST
(Form must be complete and all attachments included to process request)
☐ BUFFER MITIGATION ☐ NUTRIENT OFFSET ☒ BOTH

PARCEL/SITE DETAILS

Has anyone from DWR or the USACE visited the site in the past 12 months? ☐ YES ☒ NO
Has a riparian buffer or stream call been performed by Division of Water Resources staff on the
subject site? ☐ YES ☒ NO
Is the project receiving any state or federal grant money? ☐ YES ☒ NO
Are there any State, Local or Federal Permits associated with the subject site? ☐ YES ☒ 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;

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
Proposed Site Name Douglas Hill Farm
Address 7401 Douglas Hill Farm Road City: Scotland Neck
Site Coordinates 36.085, -77.513 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

RS – Site Viability Request, Douglas Hill Farm Nutrient Offset Site
Page 1

Restoration Systems’ (RS) requests a viability assessment for a single parcel encompassing
1,030 acres, in Halifax County, NC, for the development of a nutrient offset bank parcel. The
parcel is located 10 miles southwest of Scotland Neck, 3 miles off highway 258 from the town of
Roseneath. A landowner authorization letter is attached along with the following detailed
description of the parcel, including a historical land use analysis.

Site Description
The parcel includes 1,030 acres include approximately 450 acres utilized for row crop and/or
hay production with the remainder in forest. The site is located 10 miles southwest of Scotland
Neck, NC. A review of Google Earth aerial imagery beginning in 1994 reveal land use on the
tract has remained in similar condition. Several features existing on site including mapped and
unmapped channels. Landowners use a water control structure on a primary feature to flood
portions of the field for wildlife.

Watershed
The site is located within the Tar-Pamlico River Basin 14-digit USGS Cataloguing Units
03020102-050040 of the South Atlantic/Gulf Region. Mapped and unmapped features drain
into Cow Haul Swamp and Beech Swamp, a tributary to Fishing Creek. Both Cow Haul Swamp
and Beech Swamp are rated C, SW, NSW and fully supporting intended uses. Streams with a
best usage designation of C are suitable for aquatic life propagation and survival, fishing,
wildlife, secondary recreation, and agriculture. The supplemental classification of NSW
(Nutrient Sensitive Waters) is intended for waters needing additional nutrient management due
to their being subject to excessive growth of microscopic or macroscopic vegetation.

List of Attached Figures
Figure 1 – Site Location/Overview Map
Figure 2 – 2019 USGS Quad (Draughn)
Figure 3 – 2006 NRCS Soil Survey
Figure 4 – Google Earth 2016 USGS Topo
Figure 5 – 1994 Google Earth Aerial
Figure 6 – 1998 Google Earth Aerial
Figure 7 – 2008 Google Earth Imagery
Figure 8 – 2017 Google Earth Imagery
Figure 9 – 2018 Google Earth Imagery

References
NRCS. 2006 Soil Survey of Halifax County, North Carolina. United States Department of
Agriculture.
https://www.nrcs.usda.gov/Internet/FSE_MANUSCRIPTS/north_carolina/NC083/0/Halifax.pdf

Source: Esri, DigitalGlobe, GeoEye, Earthstar Geographics, CNES/Airbus DS, USDA, USGS, AeroGRID,IGN, and the GIS User Community
Douglas H ill Farm Halifax County, NCAerial Overview 0 650 1,300 1,950 2,600325Feet ¯
Sources: Esri, HERE, DeLorme, USGS, Intermap,INCREMENT P, NRC an, Esri Japan, METI, Esri China (HongKong), Esri Korea, Esri (Thailand), MapmyIndia, NGCC, ©OpenStreetMap contributors, and the GIS User Community
NCCGIA
Douglas Hill Farm Halifax County, N CUSGS TOPO 2019Draughn 1:24,000
0 600 1,200 1,800 2,400300Feet ¯
NCCGIA
Douglas Hill Farm Halifax County, N CNRCS Soil Map 2006
0 650 1,300 1,950 2,600325Feet ¯
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NCCGIA
Douglas Hill Farm Halifax County, N CUSGS TOPO 2019Draughn 1:24,000
0 600 1,200 1,800 2,400300Feet ¯
NCCGIA
Douglas Hill Farm Halifax County, N CNRCS Soil Map 2006
0 650 1,300 1,950 2,600325Feet ¯