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HomeMy WebLinkAbout20231250 Ver 1_Determination Request_20230914Please 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 Timber Mill Solar (Easement) Yes No Yes No Buffer Isolated Wetland Check all that apply. Name on the Recorded Deed: * Robert Foscue Responsible Party : Cypress Creek Renewables (for LLC, Corporations, businness, agency, etc.) Telephone Number: 828-606-9856 Email Address: * kjersti.mckee@ccrenew.com How would you like to received your determination?* Is there an agent or consultant responsible for the request?* Yes No Attach agent authorization letter: * Timber Mill_AA_Foscue_signed_5.7.23. pdf Timber M i I I_J D_Foscue_s ig ned_5.7.23. pdf PDF only Agent/Consultant Information How would you like to receive your USPS determination letter?* Email Name of Agent: * Rhiannon Graham Company Name:* Terracon Email Address: * rhiannon.graham@terracon.com n IP Stream Determination Stream 320.4KB 469.42KB Has anyone form DWR done a previous site visit?* Yes No Other Date of Visit: Site Information Nearest Highway/Street: * HWY 17 Nearest Town: * Pollocksville Nearest Named Stream:* Mill 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 topo,soils, wotus, table_Optimized.pdf 3.09MB 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 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: 34.96211 Longitude:-77.24090 Misc attachments: 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'); 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 CitlaAM' Date Submitted: 9/14/2023 Initial Review ID#* 20231250 Version * Do you want to send for review?* Yes No Select Reviewer: * Robert Tankard:robert.tankard Select Regional Office:* Washington Regional Office - (252) 946-6481