20231189 Ver 1_Determination Request_20230809

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:* Speedman Mitigation Bank
Is this a transportation project?* Yes No
Is this request for a mitigation site? * Yes No
What type of request is this?* Buffer IF Stream Determination
Isolated Wetland Stream
Check all that apply.
Owner Information
Name on the Recorded Deed: * Edith S. Smith
Responsible Party : Water & Land Solutions LLC
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: 571-643-3165
Email Address: * [e-mail]
How would you like to received your determination?*
Name on the Recorded Deed: * Ford Michelle Baker
Responsible Party :
Water & Land Solutions LLC
(for LLC, Corporations, businness, agency, etc.)
Telephone Number:
571-643-3165
Email Address:*
[e-mail]
How would you like to received your determination?
USPS Email
Is there an agent or consultant responsible for the request?*
Has anyone form DWR done a previous site visit?*
Yes
No
Other
Date of Visit:

Site Information
Nearest Highway/Street: * Thunder Swamp Rd
Nearest Town: * Dudley
Nearest Named Stream:* Brooks Swamp
River Basin: * Neuse
County: *
Wayne
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
Speedman - USGS Topo.pdf 699.57KB
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
Speedman - NRCS Soils.pdf 337.2KB
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: 35.250960
Longitude:-78.092484
Misc attachments: Speedman - Existing Aquatic Resources
849.44KB
Map.pdf
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: 8/9/2023
Initial Review
ID#* 20231189
Version *
Do you want to send for review?* Yes No
Select Reviewer: * Shelton Sullivan:Shelton.Sullivan
Select Regional Office: * Central Office - [phone]