19981398 Ver 2_Determination Request_20220912

Stream Origin/Buffer Applicability Determination
NORTH CAROLINA
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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: * Wayne DSS
Is this a transportation project?* u Yes O No
Is this request fora mitigation site?* 0 Yes O No
What type of request is this?*
D Buffer
O Isolated Wetland
Check all that apply.
Owner/Applicant Information
Owner Information
Name on the Recorded Deed:*
Responsible Party :
Telephone Number:
County of Wayne
(for LLC, Corporations, businness, agency, etc.)
919-731-1446
How would you like to received your determination?*
USPS Email
Email Address:*
[e-mail]
Is there an agent or consultant responsible for the request?*
Yes
No
Attach agent authorization letter:*
IP Stream Determination
Stream
D0C051822-05182022154950.pdf 862.5KB
PDF only
Agent/Consultant Information
Agent/Consultant Information
How would you like to receive your
determination letter?*
USPS
Email

Name of Agent:*
Company Name: *
Email Address:*
Morgan Gilbert
Timmons Group
[e-mail]
Project and Site Information
Project Information
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
Clingman Street
Goldsboro
Big Ditch
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
Figure 1-VIC.pdf
Pdf file type only
1.35MB
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
Figure 5- NRCS.pdf
Pdf file type only
734.38KB
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:
Longitude:
Misc attachments:
35.396609
-77.977238
Sign and Submit
pdf or kmz file types only
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*

Path: Y:\805\49607 - Wayne DSS\GIS\49607-JD-VIC.mxd
Site Limits
1st ST. -_
A7`4 iCAVE
Goldsboro HS
•
Wayne Sch Of
Engineering At
:G,IJcLor. H5
Site limits are approximate.
Topographic imagery from USGS.
1,000 2,000 3.000 4,000
Feet
Saint Mary
Catholic Sch
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WAYNE DSS
WAYNE COUNTY, NORTH CAROLINA
FIGURE 1: VICINITY MAP
TIMMONS GROUP JOB NUMBER:49607
PROJECT STUDY LIMITS: 23.1 ACRES
LATITUDE: 35.396609
LONGITUDE: -77.977238
TIMMONS GROUP
YOUR VISION ACHIEVED THROUGH OURS.
000
.$$
I
U.S.G.S. QUADRANGLE(S):NORTHEAST GOLDBORO
DATE(S):2019
WATERSHED(S):UPPER NEUSE (NEUSE RIVER BASIN)
HYDROLOGIC UNIT CODE(S):03020201
These plans and associated documents are the exclusive property of TIMMONS GROUP and may not be reproduced in whole or in part and shall not be used for any purpose whatsoever, inclusive, but not
limited to construction, bidding, and/or construction staking without the express written consent of TIMMONS GROUP.

Path: Y:\805\49607 - Wayne DSS\GIS\49607-JD-NRCS.mxd
•
---
•
• IQ
Site limits are approximate.
Soils from NRCS Web Soil Survey, Wayne County (1974).
WAYNE DSS
WAYNE COUNTY, NORTH CAROLINA
FIGURE 5: NRCS MAP
TIMMONS GROUP JOB NUMBER:49607
PROJECT STUDY LIMITS: 23.1 ACRES
LATITUDE: 35.396609
LONGITUDE: -77.977238
TIMMONS GROUP
YOUR VISION ACHIEVED THROUGH OURS.
ea 000
•
I
U.S.G.S. QUADRANGLE(S):NORTHEAST GOLDBORO
DATE(S):2019
WATERSHED(S):UPPER NEUSE (NEUSE RIVER BASIN)
HYDROLOGIC UNIT CODE(S):03020201
These plans and associated documents are the exclusive property of TIMMONS GROUP and may not be reproduced in w
limited to construction, bidding, and/or construction staking without the express written consent of TIMMONS GROUP.
hole or in part and shall not be used for any purpose whatsoever, inclusive, but not

TIMMONS GROUP
YOUR VISION ACHIEVED THROUGH OURS.
AGENT AUTHORIZATION and
PROPERTY OWNER CERTIFICATION FORM
All Blanks to be Filled in by Current Landowner
The Department of the Army
US Army Corps of Engineers
Wilmington District
PO Box 1890
Wilmington, NC 28402-1890
To Whom It May Concern:
NCDEQ — Division of Water Resources
401 & Buffer Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
I, the undersigned, current property owner designate, authorize representatives of Timmons
Group to act on my behalf as my agent in the processing of permit applications, to furnish upon
request supplemental information in support of applications, etc., from this day forward.
This the 18_ day of May , 2022_.
(number) (Month) (Year)
I, the undersigned, a duly authorized owner of record of the property/properties identified herein,
do authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps)
and NCDEQ Division of Water Resources (DWR) to enter upon the property herein described
for the purpose of conducting on -site investigations and issuing a determination associated with
Waters of the U.S. subject to Federal jurisdiction under Section 401 and 404 of the Clean Water
Act, and/or Section 10 of the Rivers and Harbors Act of 1899.
This notification supersedes any previous correspondence concerning the agent for this project.
Project Name: Wayne DSS
Parcel ID: 3600418229
Site Address: 800 Corporate Drive, Goldsboro, NC 27534
Property Owner's Name (Print): YNE, N
Property Owner's Signature
Property Owner's Mailing
Address:
C UNT F
PO BOX 22
RO NC 27530-0227
Property Owner's
Telephone:
919-731-1446
Fax
No.
Property Owner's
Email Address:
[e-mail]
FAX [phone]
TEL [phone]
*.timmons.com

•••..�
• •
TIMMONS GROUP
YOUR VISION ACHIEVED THROUGH OURS.
AGENT AUTHORIZATION and
PROPERTY OWNER CERTIFICATION FORM
All Blanks to be Filled in by Current Landowner
The Department of the Army
US Army Corps of Engineers
Wilmington District
PO Box 1890
Wilmington, NC 28402-1890
To Whom It May Concern:
NCDEQ — Division of Water Resources
401 & Buffer Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
I, the undersigned, current property owner designate, authorize representatives of Timmons
Group to act on my behalf as my agent in the processing of permit applications, to furnish upon
request supplemental information in support of applications, etc., from this day forward.
This the _18_ day of May , 20_22_.
(number) (Month) (Year)
I, the undersigned, a duly authorized owner of record of the property/properties identified herein,
do authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps)
and NCDEQ Division of Water Resources (DWR) to enter upon the property herein described
for the purpose of conducting on -site investigations and issuing a determination associated with
Waters of the U.S. subject to Federal jurisdiction under Section 401 and 404 of the Clean Water
Act, and/or Section 10 of the Rivers and Harbors Act of 1899.
This notification supersedes any previous correspondence concerning the agent for this project.
Project Name: Wayne DSS/HD
Parcel ID: 3600407478 and, 3600404583
Site Address: 1600 Clingman Street, Goldsboro, NC 27534
Property Owner's Name (Print):
Property Owner's Signature:
Property Owner's Mailing
Address:
Wayne Coy
PO Box 427,1Goldsboro. N
27533-0227
Property Owner's
Telephone:
919-731-1446
Fax
No.
Property Owner's
Email Address:
[e-mail]
FAX [phone]
TEL [phone]
*.timmons.com