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Home My WebLink About20210020 Ver 4_Determination Request_20220315Please 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: * Musselshell Nutrient Offset Bank Is this a transportation project?* Yes • No Is this request for a mitigation site?* • Yes No What type of request is this?* Buffer IP Stream Determination Isolated Wetland Stream Check all that apply. Owner Information Name on the Recorded Deed:* Betty Boyette Norris Responsible Party : (for LLC, Corporations, businness, agency, etc.) Telephone Number: N/A How would you like to received your determination?* USPS v Email Email Address:* bjenkins@restorationsystems.com Is there an agent or consultant responsible for the request?* Yes No Attach agent authorization letter: * Norris_LOA-signed.pdf 76.1 KB PDF only Agent/Consultant Information ......................................................................................................... How would you like to receive your USPS determination letter?* • Email Name of Agent:* Barrett Jenkins Company Name:* Restoration Systems Email Address:* bjenkins@restorationsystems.com Project Information .................................................................... Has anyone form DWR done a previous site visit?* • Yes No Other Staff Name: Katie Merritt Date of Visit: 3/8/2022 Site Information Nearest Highway/Street: * Kingsfield Road Nearest Town: * Trenton Nearest Named Stream: River Basin: * County: * Musselshell Creek Neuse 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 document B Norris Musselshell-2019-USGS- 519.86KB Topoquad.pdf Pdf file type only TOPO map look up: https:Hviewer.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 document B Norris Soil Map.pdf 989.26KB Pdf 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. Address Lookup Manually Latitude: 35.113663 Longitude: 77.336869 Misc attachments: Musselshell-ALL_1981 Soils_Map.pdf 1.92MB Musselshell-ALL_Field_Map.pdf 5.56MB Musselshell-ALL_USGS_Map.pdf 1.58MB pdf or kmz 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 o I intend to electronically sign and submit the "Determination Request' form." Signature Date Submitted: 3/15/2022 Initial Review ID# * 20210020 Version * Do you want to send for review?* • Yes No Select Reviewer: * Katie Merritt:eads\kymerritt Select Regional Office:* Central Office - (919) 707-9000 ¬«2 ¬«3 ¬«1 ¬«4 ¬«4 RESTORATION SYSTEMS, LLC 1101 HAYNES ST, SUITE 211RALEIGH, NC 27604 PHO NE : 919.755.9490FAX : 919.755.9492 This map and all data contained within are supplied as is with no warranty. Restoration Systems, LLC expressly denies responsibility for damages or liability from any claims that may arise out of the use or misuse of this map. It is the sole responsibility of the user to determine if the data on this map is compatible with the user’s needs. This map was not created as survey data, nor should it be used as such. It is the user’s responsibility to obtain proper survey data, prepared by a licensed surveyor, where required by law. Coordinate System: NAD _1983_SP_NC_FIPS_3200_Ft. SITE: Musselshell qFigure 1USGS 2 4 K t o p o q u a d (Tre n t o n , N C )M u s s e l s h e l l N u t r i e n t M i t i g a t i o n S i t e DATE: 9 - 2021 SCALE:1 in = 359 ft Imagery Source: USG S - 2019 Legend NOR RIS, BETTY BOYETTE NCCGIA, NC911 Board RESTORATION SYSTEMS, LLC 1101 HAYNES ST, SUITE 211RALEIGH, NC 27604 PHO NE : 919.755.9490FAX : 919.755.9492 This map and all data contained within are supplied as is with no warranty. Restoration Systems, LLC expressly denies responsibility for damages or liability from any claims that may arise out of the use or misuse of this map. It is the sole responsibility of the user to determine if the data on this map is compatible with the user’s needs. This map was not created as survey data, nor should it be used as such. It is the user’s responsibility to obtain proper survey data, prepared by a licensed surveyor, where required by law. Coordinate System: NAD _1983_SP_NC_FIPS_3200_Ft. SITE: Musselshell All 0 1,800900 Feet qFigure 3Neuse R i v e r B a s i nMusselshell N u t r i e n t M i t i g a t i o n S i t e DATE: 9 - 2021 SCALE:1 in = 542 ft Imagery Source: USG S - 2020 Legend Jones Co. Tax Parcels (2021) Musselshell_Proposed_CE ¬«41 KINGFIELD RD KINGFIELD RD NCCGIA, NC911 Board RESTORATION SYSTEMS, LLC 1101 HAYNES ST, SUITE 211RALEIGH, NC 27604 PHO NE : 919.755.9490FAX : 919.755.9492 This map and all data contained within are supplied as is with no warranty. Restoration Systems, LLC expressly denies responsibility for damages or liability from any claims that may arise out of the use or misuse of this map. It is the sole responsibility of the user to determine if the data on this map is compatible with the user’s needs. This map was not created as survey data, nor should it be used as such. It is the user’s responsibility to obtain proper survey data, prepared by a licensed surveyor, where required by law. Coordinate System: NAD _1983_SP_NC_FIPS_3200_Ft. SITE: Musselshell All 0 1,800900 Feet qFigure 1Neuse R i v e r B a s i nMusselshell N u t r i e n t M i t i g a t i o n S i t e DATE: 9 - 2021 SCALE:1 in = 542 ft Imagery Source: USG S - 2020 Legend Jones Co. Tax Parcels (2021) Musselshell_Ditches Musselshell_Blue_Line_Streams Musselshell_Proposed_CE ¬«41 KINGFIELD RD KINGFIELD RD NCCGIA, NC911 Board RESTORATION SYSTEMS, LLC 1101 HAYNES ST, SUITE 211RALEIGH, NC 27604 PHO NE : 919.755.9490FAX : 919.755.9492 This map and all data contained within are supplied as is with no warranty. Restoration Systems, LLC expressly denies responsibility for damages or liability from any claims that may arise out of the use or misuse of this map. It is the sole responsibility of the user to determine if the data on this map is compatible with the user’s needs. This map was not created as survey data, nor should it be used as such. It is the user’s responsibility to obtain proper survey data, prepared by a licensed surveyor, where required by law. Coordinate System: NAD _1983_SP_NC_FIPS_3200_Ft. SITE: Musselshell All 0 1,800900 Feet qFigure 2Neuse R i v e r B a s i nMusselshell N u t r i e n t M i t i g a t i o n S i t e DATE: 9 - 2021 SCALE:1 in = 542 ft Imagery Source: USG S - 2020 Legend Jones Co. Tax Parcels (2021) Musselshell_Ditches Musselshell_Blue_Line_Streams Musselshell_Proposed_CE ¬«41 KINGFIELD RD KINGFIELD RD NCCGIA, NC911 Board RESTORATION SYSTEMS, LLC 1101 HAYNES ST, SUITE 211RALEIGH, NC 27604 PHO NE : 919.755.9490FAX : 919.755.9492 This map and all data contained within are supplied as is with no warranty. Restoration Systems, LLC expressly denies responsibility for damages or liability from any claims that may arise out of the use or misuse of this map. It is the sole responsibility of the user to determine if the data on this map is compatible with the user’s needs. This map was not created as survey data, nor should it be used as such. It is the user’s responsibility to obtain proper survey data, prepared by a licensed surveyor, where required by law. Coordinate System: NAD _1983_SP_NC_FIPS_3200_Ft. SITE: Musselshell All qFigure 3Neuse R i v e r B a s i nMusselshell N u t r i e n t M i t i g a t i o n S i t e DATE: 9 - 2021 SCALE:1 in = 250 ft Imagery Source: USG S - 2020 Legend Musselshell_Proposed_CE OWNNAME NORRIS, BETTY BOYETTE (~55-ac) ¬«41 KINGFIELD RD KINGFIELD RD LANDOWNER AUTHORIZATION FORM PROPERTY LEGAL DESCRITION: �_ Deed Book: /O ^ Page: J County: SciA e S Parcel ID Number: �5� 7C/ 3 00 Street Address: Property Owner (please print: e-I-fy 130y Jl(l rN f 77 Property Owner (please print): The undersi ncd, registered property owner(s) of the above property, do hereby authorize 36\creTl .P�L.l,\S of e 1-0 eo-.4'I&A c, 54-e/10- ZZ.. C (Contractor/Agent/Project Manager)' (Name of Contractor/Agent Firn{/Agency)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. f% f Property Owners(s) Address: / 7 C� ,`— 1�n ~ �/ J) .24 • P tY () ]� (if different from above) )c2S Property Owner Telephone Number: 9"C.) 0 "3 2 5C9 Property Owner Telephone Number: We hereby certify the above information to be true and accurate to the best of our knowledge. -4C—C16— (Property de4T rized Signature) -2777.7-0 (Date) (Property Owner Authorized Signature) (Date) Name of full delivery staff member (full -deliveries) or DMS project manager (design -bid -build). 2Name of company (full -deliveries) or DMS (design -bid -build).