20220293 Ver 1_Buffer and/or Stream Determination Request_20220128

Stream Origin/Buffer Applicability Determination
Processing Information
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?*
Is this request for a mitigation site?*
What type of request is this?*
Owner/Applicant Information
Owner Information
Is there an agent or consultant responsible for the request?*
Attach agent authorization letter:*
Agent/Consultant Information
Britt & Hales Buffer Mitigation Site
Yes No
Yes No
Buffer IP Stream Determination
Isolated Wetland Stream
Check all that apply.
Name on the Recorded Deed:*
Responsible Party :
Telephone Number:
How would you like to received your determination?*
Email Address:*
Eddis Earl Britt, Linda Britt Hales
(for LLC, Corporations, businness, agency, etc.)
919-922-0070
USPS Email
[e-mail]
Yes
No
220128 - Britt & Hales - Agent
Authorization - PIN 2733.pdf 546.94KB
PDF only
Agent/Consultant Information
How would you like to receive your
determination letter?*
Name of Agent:*
Company Name:*
Email Address:*
Project and Site Information
Has anyone form DWR done a previous site visit?*
Date of Visit:
Nearest Highway/Street:*
Nearest Town:*
Nearest Named Stream:*
River Basin:*
County:*
Please attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo.
TOPO map look up: hps://viewer.naonalmap.gov/basic/
Please attach a map of the site indicating project boundaries on the NRCS Soil Survey.
Soil Survey Link: https://www.nrcs.usda.gov/wps/portal/nrcs/surveylist/soils/survey/state/?stateId=NC
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.
USPS
Email
Jamey O'Shaughnessey
Eco Terra, LLC
[e-mail]
Project Information
Yes
No
Other
Site Information
O'berry Rd
Mount Olive
Neuse River
Neuse
Wayne
Click the upload button or drag and drop files here to attach document
20220126 - Britt & Hales - TopoMap.pdf 2.94MB
Pdf file type only
Click the upload button or drag and drop files here to attach document
20220126 - Britt & Hales - Soil Survey.pdf 2.09MB
Pdf file type only
Latitude and Longitude
Choose below how you would like to
provide this information.
Latitude:
Longitude:
Misc attachments:
Sign and Submit
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 *
Address Lookup
Manually
35.254653
-78.164589
pdf or kmz file types only
Figure 2: NRCS Soil Survey
Britt & Hales Buffer Site
Neuse 03020201
35°15'16.75"N 78° 9'52.52"W
Wayne County, North Carolina
/
0 750 1,500375
Feet1974 USDA Soil Survey of Wayne County, North
Carolina Map Sheet #35
City of Goldsboro, Johnston County, State of North Carolina DOT, Esri,
HERE, Garmin, INCREMENT P, USGS, EPA, USDA
Legend
Proposed Conservation Easement
Figure 1: USGS Topographic Map
Britt & Hales Buffer Site
Neuse 03020201
35°15'16.75"N 78° 9'52.52"W
Wayne County, North Carolina
/
0 0.5 10.25
Miles
City of Goldsboro, Johnston County, State of North Carolina DOT, Esri,
HERE, Garmin, INCREMENT P, USGS, METI/NASA, EPA, USDA
2019 USGS Topographic Quadrangles: Grantham &
Dobbersville
Legend
Proposed Conservation Easement
ecoAterraa
Agent Authorization Form
Parcel ID: 2544982733
County: Wayne
Street Address: 35°15'9.90"N 78° 9'42.57"W (O'berry Rd.)
Property Owner(s): Eddis Earl Britt & Linda Britt Hales
The undersigned, registered property owners of the above noted
property, do hereby authorize employees of Eco Terra Partners LLC
(Contractor / Agent) to act as an agent on our behalf in the identification
and delineation of jurisdictional wetlands and streams located on the
above property.
We hereby authorize entry upon the property by authorized agents of the
United States Army Corps of Engineers, North Carolina Division of Water
Resources, and North Carolina Division of Mitigation Services to perform
duties in conjunction with the establishment of a mitigation or buffer bank.
The above information submitted in this form is true and accurate to the
best of our knowledge.
each eekti i-S2-e;0 Pan9
Owner 1 / Authorized Signature Date
3/ 2 let D9/',t YI
Property Owner's Address (if different than property above)
919: 689. c2,67‘ 9/9 9g- moo
Telephone
4,06. 14a)-g-, /- a - z 2
Owner 2 / Authorized Signature Date
175 ,Pd 4,kti(1
Property Owner's Address (if different than property above)
9 f7- “f 9- Z V 9't ?' 4A0, a a 8
Telephone
1328 Dekalb Ave NE, Atlanta, GA 30307 404.596.8004 EcoTerra.com
Printed on 100% post -consumer recycled paper