20230105 Ver 1_Determination Request_20230121

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: * 972 Deamon Old Creek Snow Hill
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: *
Octavio Acevedo
Responsible Party : Octavio Acevedo
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: 252 320-4225
How would you like to received your determination?*
USPS Email
Email Address: *
franciscolimon 12@yahoo. com
Is there an agent or consultant responsible for the request?*
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:*
Deamon Old Creek Road
Snow Hill
Contentnia
Neuse
IP Stream Determination
Stream

County: *
Greene
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
972 Beaman Old Creek Rd Snow Hill.pdf
972 Beaman Old Creek Rd Snow
Hill_Aerial.pdf
Pdf file type only
78.29KB
134.04KB
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
972 Beaman Old Creek Rd Topo_Soil.pdf 135.48KB
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
Project Look Up Address: Street Address
972 Deamon Old Creek Re
Address Line 2
City State / Province / Region
Snow Hill NC
Postal / Zip Code Country
28580 US
Latitude: 35.475402
Longitude: 77.712239
Misc attachments:
By digitally signing below, I certify that:
pdf or kmz file types only
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: 1/21/2023
Initial Review
ID#*
Version *
Do you want to send for review? *
Select Reviewer: *
Select Regional Office: *
20230105
1
Yes No
Robert Tankard:eads\rbtankard
Washington Regional Office - [phone]

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