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HomeMy WebLinkAbout20231616 Ver 1_Determination Request_20231207Please 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:* Buckleberry Is this a transportation project?* Yes No Is this request for a mitigation site? * Yes No What type of request is this?* Buffer Isolated Wetland Check all that apply. Owner Information Name on the Recorded Deed: * D & P LAND LLC Responsible Party : Daniel Kornegay, Jr. (for LLC, Corporations, businness, agency, etc.) Telephone Number: 919-921-1617 Email Address: * jordan@ecoterra.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: * 231205 - D & P Land - Agent Authorization - SIGNED.pdf PDF only Agent/Consultant Information How would you like to receive your USPS determination letter?* Email Name of Agent: * Jordan Burbage Company Name:* Eco Terra Email Address: * jordan@ecoterra.com n IP Stream Determination Stream 435.88KB Has anyone form DWR done a previous site visit?* Yes No Other Date of Visit: Site Information Nearest Highway/Street: Nearest Town: * Nearest Named Stream:* River Basin: * County: * Johnston 1750 Buckleberry Rd Princeton Neuse River Neuse 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 NU01 - D & P Land LLC #2 - USGS 1.38MB Topography.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 NU01 - D & P Land LLC #2 - Soil 2.01 MB Survey.pdf 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: 35.354625 Longitude:-78.177003 Misc attachments: NU01 - D & P Land LLC #2 - Aerial.pdf 2.21 MB NU01 - D & P Land LLC #2 - LiDar.pdf 2.21 MB 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 c Iemekw ZlltAkl v Date Submitted: 12/7/2023 Initial Review ID#* 20231616 Version * 1 Do you want to send for review?* Yes No Select Reviewer: * Blake Hartshorn: blake.hartshorn Select Regional Office: * Central Office - (919) 707-9000