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HomeMy WebLinkAbout20231482 Ver 1_Determination Request_20231023Please 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 Hannaford Farms Development Yes No Yes No Buffer Isolated Wetland Check all that apply. Name on the Recorded Deed: * Hunter P. Hannaford Responsible Party : Brett Hannaford (for LLC, Corporations, businness, agency, etc.) Telephone Number: 7045342135 Email Address: * brett.hannaford@gmail.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 IP Stream Determination Stream Nearest Highway/Street: * Dickinson Avenue Ext. Nearest Town: * Greenville Nearest Named Stream:* Greens Mill Run River Basin: * Tar -Pamlico County: * Pitt 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 Hannaford Family Property (1).pdf 3.22MB 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 Project Look Up Address: Street Address 2971 Dickinson Avenue Address Line 2 City Greenville Postal / Zip Code 27834 Latitude: 35.587358 Longitude:-77.40583 Misc attachments: pdf or kmz file types only By digitally signing below, I certify that: State / Province / Region NC Country US o 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 �tdt'%�itw%ra�bt�( Date Submitted: 10/23/2023 Initial Review ID#* 20231482 Version * Do you want to send for review? * Yes No Select Reviewer: * Robert Tankard: robert.tan kard Select Regional Office:* Washington Regional Office - (252) 946-6481