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HomeMy WebLinkAbout49 Ver 1_Determination Request_20220927Please 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 ISAAC BRANCH SUBDIVISION Yes No Yes No Buffer Isolated Wetland Check all that apply. Name on the Recorded Deed: * BEAVER CREEK INVESTORS INC. Responsible Party : BETTY BULLOCK (for LLC, Corporations, businness, agency, etc.) Telephone Number: 910-346-9800 Email Address: * brianj@jlpnc.com How would you like to received your determination?* Is there an agent or consultant responsible for the request?* Yes No Project Information Has anyone form DWR done a previous site visit?* Yes No Other Date of Visit: Site Information IF Stream Determination Stream Nearest Highway/Street: * NCSR 1324 RAMSEY ROAD Nearest Town: * JACKSONVILLE Nearest Named Stream:* HALF MOON CREEK River Basin: * White Oak County: * Onslow 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 NC Jacksonville North 20190725 TM... 69.29MB (1).pdf 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 20220927_09531609635_4_Soil_Map.pdf 436.31 KB 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: 34.828875 Longitude:-77.449174 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'); 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: 9/27/2022 Initial Review ID#* 49 Version * 1 Do you want to send for review?* Yes No