20240031 Ver 1_Determination Request_20240103

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:*
Is this a transportation project?*
Is this request for a mitigation site?
What type of request is this?*
Owner Information
Wendell Falls Parkway / Eagle Rock Road
Yes No
Yes No
Buffer
Isolated Wetland
Check all that apply.
Name on the Recorded Deed: * Bryan Coates
Responsible Party : Town Of Wendell
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: 919-365-4448
Email Address: * [e-mail]
How would you like to received your determination?*
Is there an agent or consultant responsible for the request?*
Yes
No
Attach agent authorization letter: * Landonwer Letter.pdf
PDF only
Agent/Consultant Information
How would you like to receive your USPS
determination letter?* Email
Name of Agent:* Heather Smith
Company Name:* VHB
Email Address: * [e-mail]
Project Information
Has anyone form DWR done a previous site visit?*
Yes
No
Other
IP Stream Determination
Stream
123.92KB

Date of Visit:
Nearest Highway/Street: *
Nearest Town: *
Nearest Named Stream:*
River Basin: *
County: *
Wendell Falls Pkwy. / Eagle Rock
Rd.
Wendell
Buffalo Creek
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
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: 35.774616
Longitude:-78.400066
Misc attachments:
By digitally signing below, I certify that:
Wendel IFallsPkwy_EagleRockRd_SOB... 7.27MB
pdf or kmz file types only
• 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
r/4,-Alew 7Vmm-
Date Submitted: 1/3/2024
Initial Review
.................................................
ID#* 20240031
Version *
Do you want to send for review?* Yes No
Select Reviewer: * Rob Ridings:rob.ridings
Select Regional Office: * Central Office - [phone]