20240138 Ver 1_Determination Request_20240111

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
Bridgers Family Farm
Yes No
Yes No
Buffer
Isolated Wetland
Check all that apply.
Name on the Recorded Deed: * Bridgers Family Farms, LLC
Responsible Party : John D. Lewis, Jr.
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: 9197351237
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: * 240108-Bridgers-signed-agent-
authorization.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: * [e-mail]
n
IF Stream Determination
Stream
471.34KB

Has anyone form DWR done a previous site visit?*
Yes
No
Other
Date of Visit:
Site Information
Nearest Highway/Street: * Pikeville -Princeton Road
Nearest Town: * Nahunta
Nearest Named Stream:* Little River
River Basin: * Neuse
County: *
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 - Delmus Bridgers Family Farms -
1.24M6
USGS Topography v2.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 - Delmus Bridgers Family Farms -
2.13M6
Soil Survey v2.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: 35.491167
Longitude:-78.083694
Misc attachments: NU01 - Delmus Bridgers Family Farms -
2.15M6
LiDAR.pdf
NU01 - Delmus Bridgers Family Farms -
2.16M6
Aerial Map v2.pdf
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
0 0tI�R.Y,6!l tAW
Date Submitted: 1/11/2024
Initial muview
ID#* 20240138
Version * 1
Do you want to send for review?* Yes No
Select Reviewer: * Blake Hartshorn: blake.hartshorn
Select Regional Office:* Central Office - [phone]