20211212 Ver 1_Determination Request_20210806

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:* Allen Road, LLC
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?* F Buffer IP Stream Determination
F Isolated Wetland rJ Stream
Check all that apply.
Owner Information
Name on the Recorded Deed:*
Responsible Party:
Telephone Number:
Allen Road, LLC
Thomas J. Glennon
(for LLC, Corporations, businness, agency, etc.)
How would you like to received your determination?*
V USPS F cmail
Mailing Address:* Street Address
PO Box 30803
Address Line 2
city
State / Frovince / Region
Greenville
NC
Rbstal / Zip Code
Country
27833
USA
Is there an agent or consultant responsible for the request?*
r YP�
C
Attach agent authorization letter:* Allen Road LLC Agent Authorization. pdf 45.32KB
FDF only
Agent/Consultant Information
How would you like to receive your r USPS
determination letter?* r Email
Name of Agent:* J. Dantzler Withers, PE
Company Name: * Ark Consulting Group, PLLC
Email Address:* [e-mail]
m

Project Information
Has anyone form DWR done a previous site visit?*
r
r
r
Date of Visit:
Site Information
Nearest Highway/Street:* Allen Road
Nearest Town:* Greenville
Nearest Named Stream:* Greens Mill Run
River Basin:* Tar -Pamlico
County:*
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
NC —Greenville —SW 20190722_TM geo... 58.88MB
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.
Gick the upload button or drag and drop files here to attach docunent
20210806_14430902359_22_Soil_Repo...
498.66K6
9.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 provide this information.
f Address Lookup
r Manually
Latitude: 35.599846
Longitude:-77.421089
M isc attachments: pdf or lace file types only
By digitally signing below, I certify that:
o 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:*
8/6/2021
20211212
1
r Yes r No
Robert Tankard:eads\rbtankard
Washington Regional Office - [phone]

AGENT AUTHORIZATION
PROPERTY LEGAL DESCRIPTION:
Pitt County Parcel Number 12068 (Deed Book 1810, Page 781).
LOCATION:
On the east side of Allen Road, approximately 1,900 linear feet south of the intersection of Allen
Road (North Carolina State Road 1203) and Stantonsburg Road (North Carolina State Road 1467).
PROPERTY OWNER:
Allen Road, LLC
203 SW Greenville Blvd, Suite 140
Greenville, NC 27834
lj�vma-S J .(AM404 , Manager of Allen Road, LLC, owner of the property described above,
do hereby authorize J. Dantzler Withers, PE of Ark Consulting Group, PLLC to act on my behalf and take
all actions necessary to obtain a Buffer Authorization permit and permits under Section 404 and 401 of
the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899 to construct a single-family
and multi -family subdivision.
l " i"L G'c, `S' 'vim-,. ✓�►, r-1 �s f2 %� �,z �, }e. r-
Printed Name / Title
Signature
a Notary Public for the State of North Carolina, County of
do hereby certify that IC.. C tI} r_✓t 6A_ . personally appeared before me this �j — _
day of ��IFuS'� 2021, and acknowledged the due execution of the forgoing document.
Witness m�ol Qisfpcial seal.
F
NOTA
Jos
'ell C, �`� Seal
My Comm?Igumlpf '

Z Z
OOZZV6£ 009ZV6£ 009Zb6£ OOVZV6£ OOCZV6£ 007b6£ 0NZb6£ OOOZb6£
M „TS,bZ oLL •;;;SA ,� v M„TS.tZ oLL
N
CL
P
h g
1
[ r
�( N
N
L
7 Q
0 :o $$ 8
V/
o LL Qj Ln
L�
0 Vy oo
14
In
6i o
" 1 m m
N u O O 1
NOTM „8£ ,SZ oLL I I M „8£ ,SZ oLL
OOLZb6£ 009Zb6£ O09Zb6£ 00bZb6£ OO£ZV6£ 007b6£ ONZb6£ OOOZV6£
z z
En

MEMO11(C�r(� U.S. DEPARTMENT OF THE INTERIOR lu, GREENVILLE SW QUADRANGLE
`MO U.S. GEOLOGICAL SURVEY 4>• NMH—IOLINA -HTT CWNTY
�p US Topo TS-MNUTESE1I6
'is.mm Nnn ']4®"E 15 ]6 ]] 78 N 80 81 82 83 84 n.'i] 'iimm
i
1
`
B
Joe
1:
,
®
I
..
I
i"all
diI
�IW
�
RJR
ILE-MOM
Maim
Kim
,cee by the Unit1 S.y
I
u.
�
re
]]
w
^s
ssmu
]8 ]9 80
SCALE 1:24 01
x•a�rzxs �
81 82 83
rzowcusiFlcnnax
x.r
�„rcam xa,re �us xa,re Osv,.,m„�. Y
wws
rx,,,a< � x.a,�� mi
�'3 ��,,,,,,,o„oh.,,,.. o..x.�
em..,aa.,«., �,,.a a�,�oaa,aah..•mo„o.�•
� .�.,e,.,.� GREENVILLE SW, NC
.op.sawo,.�,e 2019 zz