20231081 Ver 1_Determination Request_20230807

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 Information
[e-mail]
Yes No
Yes No
Buffer
Isolated Wetland
Check all that apply.
IP Stream Determination
Stream
Name on the Recorded Deed: * Eastern North Carolina Food Commercialization Center
Responsible Party : Keith Purvis
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: 2527581700
Email Address: * [e-mail]
How would you like to received your determination?*
Is there an agent or consultant responsible for the request?*
Yes
No
Attach agent authorization letter: * BRNB4220074BCAC_001334.pdf
PDF only
Agent/Consultant Information
............................................................................................................
How would you like to receive your USPS
determination letter?* Email
Name of Agent:* Brian Edwards
Company Name:* Rivers and Assoicates
Email Address: * [e-mail]
m
Project Information
135.16KB

Has anyone form DWR done a previous site visit?*
Yes
No
Other
Date of Visit:
Site Information
Nearest Highway/Street: * Anderson Truss Rd
Nearest Town: * Ayden
Nearest Named Stream:* Swift Creek
River Basin: * Neuse
County: *
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
USGS Topo Map.pdf 5.87MB
Pdf file type only
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
USDA Soils Map.pdf 7.64MB
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.
Latitude: 35.449989
Longitude:-77.431810
Misc attachments: 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
I intend to electronically sign and submit the "Determination Request' form."
Signature
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Date Submitted: 8/7/2023
Initial Review
ID#* 20231081
Version *
Do you want to send for review?* Yes No
Select Reviewer: * Robert Tankard:robert.tankard
Select Regional Office:* Washington Regional Office - [phone]