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HomeMy WebLinkAbout20220664 Ver 1_Determination Request_20220512Stream 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: * Casey Creek Is this a transportation project?* Yes • No Is this request for a mitigation site?* • Yes No What type of request is this?* Buffer Isolated Wetland Check all that apply. Owner Information Name on the Recorded Deed: * Responsible Party : Martha Korngay Wildlands Engineering, Inc. (for LLC, Corporations, businness, agency, etc.) Telephone Number: 757.288.4880 How would you like to received your determination?* USPS Email Mailing Address: * Street Address 4200 Country Club Circle Address Line 2 City State / Province / Region Virginia Beach VA Postal / Zip Code Country 23455-4414 USA Name on the Recorded Deed: * Johnnie Mangrum Brock Responsible Party : Wildlands Engineering (for LLC, Corporations, businness, agency, etc.) Telephone Number: 919.705.3277 How would you like to received your determination?* USPS Email Email Address:* bedrockconst43@gmail.com Is there an agent or consultant responsible for the request?* Yes No IP Stream Determination Stream Attach agent authorization letter:* Agent/Consultant Information Martha Kornegay executed LOA.pdf Brock_LOA.pdf PDF only How would you like to receive your USPS determination letter?* 4 Email Name of Agent: * Company Name:* Email Address:* Project Information Chris Roessler Wildlands Engineering coessler@wildlandseng.com Has anyone form DWR done a previous site visit?* Yes • No Other Date of Visit: Site Information Nearest Highway/Street: * Nearest Town:* Nearest Named Stream: * River Basin:* County: * Wayne 3890 US Highway 13 Grantham, NC Casey Creek Neuse 27.32KB 361.99KB 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 Fig3USGS.pdf Pdf file type only 960.93KB 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 document Fig6bNRCSSoils.pdf Pdf file type only 1.04MB 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 Project Look Up Address: Latitude: Longitude: Misc attachments: Street Address 3890 US Highway 13 South Address Line 2 City State / Province / Region Goldsboro NC Postal / Zip Code Country 27530 US 35.2934495 -78.1854881 By digitally signing below, I certify that: Fig7Concept.pdf pdf or kmz file types only 4.72MB a I have given true, accurate, and complete information on this form; a 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") a 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"); a I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND a I intend to electronically sign and submit the "Determination Request' form." Signature Date Submitted: Initial Review ...................................................... ID#* 20220664 Version* 1 Do you want to send for review? * • Yes No Select Reviewer: * Shelton Sullivan:eads\sosullivan Select Regional Office: * Central Office - (919) 707-9000 5/12/2022 LANDOWNER AUTHORIZATION FORM PROPERTY LEGAL DESCRITION: Deed Book: 1823 Page: 155 County: Wayne Parcel ID Numbers: 2546314958, 2546229607 and 2546335459 Street Address: 3890 S US 13 Hwy, Goldsboro, NC 27530 Property Owner: Martha C. Kornegay, Trustee, or her successors in Trust, under the Martha C. Kornegay Declaration of Trust, dated November 21, 2000 The undersigned, registered property owner of the above property, does hereby authorize Wildlands Engineering, Inc. 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 US Army Corps of Engineers, to visit the property as part of these environmental reviews. Property Owner's Address: 4200 Country Club Circle, Virginia Beach, VA 23455-4414 Property Owner Telephone Number: 757-363-7040 I hereby certify the above information to be true and accurate to the best of my knowledge. -64 C. Kornegay, (Date) TP 9.15.21 LANDOWNER AUTHORIZATION FORM PROPERTY LEGAL DESCRITION: Deed Book: 916 Page: 852 County: Wayne Parcel ID Number: 2546248066 Street Address: Paul Hare Road, Goldsboro, NC 27530 Property Owner (please print): Johnnie Mangrum Brock The undersigned, registered property owner of the above property, does hereby authorize Wildlands Engineering, Inc. 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 US Army Corps of Engineers, to visit the property as part of these environmental reviews. Property Owner's Address: 536 Paul Hare Road, Goldsboro, NC 27530 (if different from above) Property Owner Telephone Number: 2 o j %,4) I hereby certify the above information to be true and accurate to the best of my knowledge. Owner Authorized SWature) (Date) 10.1.21 TP/MTC i Grantham USGS 7.5 Minute Topographic Quadrangle ■ ■ � 1 5 I' 1 I'IJORI a. i _- Aft -.-- Proposed Conservation Easement r is Figure 3 USGS Topographic Map �"'� W I L D L A N D S 0 250 500 Feet Casey Creek Mitigation Site ENGINEERING I I I I I Neuse River Basin (03020201) Wayne County, NC Figure 7 Concept Map W I L D L A N D S Casey Creek Mitigation Site ENGINEERING 0 150 300 Feet Neuse River Basin (03020201) I I I I I Wayne County, NC $� ,, ir' rrL, .. .�f..r... v. .;�. 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