20211370 Ver 1_Determination Request_20210914

Stream Origin/Buffer Applicability Determination
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:*
Lot 1 - Northside Commercial
Is this a transportation project?* r Yes t: No
Is this request for a mitigation site?* f Yes No
What type of request is this?*
Owner Information
Name on the Recorded Deed:*
Responsible Party :
r Buffer
r Isolated Wetland
Check all that apply.
r IP Stream Determination
17 Stream
Thomas F Taft, Hoover E. Taft, III, Etal
Thomas F. Taft
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: 252-752-7101
How would you like to received your determination?*
Email Address:* [e-mail]
Is there an agent or consultant responsible for the request?*
(
Attach agent authorization letter:* Authorization Stream-Signed.pdf 172.63KB
FCF only
Agent/Consultant Information
How would you like to receive your r USPS
determination letter?* C' Email
Name of Agent:*
Company Name:*
Email Address:*
Scott Anderson, PE
Ark Consulting Group
[e-mail]
Has anyone form DWR done a previous site visit?*
C Yes
No
C Other

Date of Visit:
Site Information
Nearest Highway/Street:* US Hwy 264 E
Nearest Town:*
Nearest Named Stream:*
River Basin:
*
County: *
Pitt
Greenville
Tar River
Tar -Pamlico
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 docurrent
Exhibit - Quad.pdf
Rif file type only
611.45KB
TOPO map look up: https://viewer.nationalmap.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 docurrent
Pitt County Soil Survey - Sheet 35 A.pdf 495.04KB
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.
C' Address Lookup
f Manually
Project Look Up Address: Street Address
3700 U.S. 264 e
Address Line 2
Latitude:
Longitude:
Misc attachments:
City State / Ftovince / Region
Greenville NC
Rbstal / Zip axle Country
27834 US
35.6254395
-77.32516230000002
OPIS Print.pdf
pdf or krre file types only
702.97KB
By digitally signing below, I certify that:

o I have given true, accurate, and complete information on this form;
o 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")
o 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");
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the "Determination Request' form."
Signature
Date Submitted:
Initial Review
.......................................................
ID#* 20211370
Version* 1
Do you want to send for review?* C' Yes r No
Select Reviewer:* Robert Tankard:eads\rbtankard
Select Regional Office:* Washington Regional Office - [phone]
9/14/2021

USGS
science far a changing world
G
UTM GRID AND 2019 MAGNETIC NORTH
DECLINATIONAT "ENTER OF SHEET
U.S. DEPARTMENT OF THE INTERIOR
U.S. GEOLOGICAL SURVEY
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U.S. DEPARTMENT OF THE INTERIOR
U.S. GEOLOGICAL SURVEY
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Feet GREENVILLE SE, NC
1:12000.000
CONTOUR INTERVAL 5 FEET
NORTH AMERICAN VERTICAL DATUM OF 1988
2019
Project Mgr STA
Drawn By: KLG
Checked By: STA
Project No 21 XXX
Scale: AS SHOWN
Date: 9/10/2021
ARK
NC License: P-1199
CONSULTING
GROUP PLLC
Engineers & Planners
2755-B Charles Blvd. I Greenville, NC 27858
SITE LOCATION PLAN
LOT 1 - NORTHSIDE COMMERCIAL CENTER
USGS QUAD MAP
GREENVILLE, PITT COUNTY, NORTH CAROLINA
EXHIBIT
A-1

4 s7fr 4.Pitt County Government
Greenville, North Carolina
www.pittcountync.gov
64354
FiW'e 764
pftt(oir
US2 4_E
Disclaimer: This tax record is prepared for the inventory of real property within Pitt County
and is compiled from recorded deeds, plats, tax maps, surveys, and other public records.
Users of this data are hereby notified that the aforementioned public primary information
sources should be consulted for verification. Pitt County assumes no legal responsibility for
the information contained herein.
Copyright © 2017, Pitt County, North Carolina.
Parcel:
More Info:
Physical Address:
Owner Name:
OwnerAddressl:
OwnerAddress2:
OwnerAddress3:
City / State / Zip:
NC PIN:
Subdivision / Section /
Phase:
Prior Legal
Description:
Block / Lot:
Tract:
Building Number /
Unit:
Acres:
Current Owner
Deed/Document:
Map Book:
Deed / Document Date:
Deed / Document Sales
Price:
Building Type / Use:
Number of Buildings:
Year Built:
Total Living Area:
Building Value:
Extra Features Value:
Land Value:
Total Current Market
Value:
Total 2019 Market
Value:
Municipality:
Township:
Fire Service District:
Census Tract:
Neighborhood:
Elementary School:
Middle School:
High School:
16855
16855
0 US 264 E
TAFT THOMAS F
TAFT E HOOVER III
ETAL
PO BOX 566
GREENVILLE NC 27835
4698767204
NORTHSIDE COMMERCIAL
CENT
7.96
003077 00222
42-142
03/2013
$0
0
0
$0
$0
$216,711
$216,711
$173,369
PACTOLUS
STATON HOUSE FIRE SERVICE
DISTRICT
900
005533
Pactolus
Pactolus
J H Rose HS
PLEASE NOTE:
The parcel information is updated nightly
and reflects current property values.
Printed: 9/14/2021 7:08:43 PM

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ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Director
NORTH CAROLINA
Ertkfran ri ntrrl Qualify
AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION: Lot 1 - Northside Commercial
LOT NO. 1 PLAN NO. PARCEL ID: 16855
STREET ADDRESS: 3700 US 264 E
Greenville, NC 27834
Please print:
Property Owner: Thomas F. Taft
Property Owner: Hoover E. Taft, III Etal
The undersigned, registered property owners of the above noted property, do hereby authorize
Scott T. Anderson, PE , of Ark Consulting Group, PLLC
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
PO Box 566, Greenville, NC 27835
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Thomas F Taft
-7-Ze-krta.d- P-/a6-t-
Authorized Print Name Authorized Signature
Date: 9/14/2021
Date:
9/14/2021
Cr)
North Carolina Department of Environmental Quality Division of Water Resources - Washington Regional Office
943 Washington Square Mall, Washington, North Carolina 27889
252-946-6481