20240204 Ver 1_Buffer and/or Stream Appeal Determination_20240129

1/29/24. 3:27 PM
Submission Completed
bre ar"n r)
u�r r e �f A P I L
I CAROL.INA
Pirocessing Information
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: * Seymour IFairms
Is this a transportation project?* Yes No
Is this request for a mitigation site?* Yes No
What type of request is this?* Buffer IP Stream Determination
Isolated Wetland Stream
Check all that apply.
Owineir/Applicaint Information
la it Information
Name on the Recorded Deed: *
Responsible Party:
Telephone Number:
CAIR O LlI INA A IRIIIBUSII IN IESS, ILILC IFIKA, HAIM STORAGE, ILILC
Bobby IHarn
(for LLC, Corporations, businness, agency, etc.)
Email Address: * [e-mail]
How would you like to received your determination?*
USPS Email
https://edocs.deq.nc.gov/Forms/Form/Submit 1/4

1 /29/24. 3:27 PM
Submission Completed
Is there an agent or consultant responsible for the request?*
Yes
No
Attach agent authorization letter:* Signed Agent ILetter. 1pd-f 130.251KIB
PDF only
Agent/Consul-taint Information
Agent/Consull-taint lifformation
How would you like to receive your USPS
determination letter?* Email
Name of Agent: * wyatt brown
Company Name: * Brown's nviironmenlall Group, iinc
Email Address: * [e-mail]
�Piroject andSite Information
Projectlifformation
Has anyone form DWR done a previous site visit?*
Yes
No
Other
Date of Visit:
Site Information
Nearest Highway/Street: * INC13
Nearest Town: * ;snow IHiillll
Nearest Named Stream: * Button Branch
https://edocs.deq.nc.gov/Forms/Form/Submit 2/4

1/29/24, 3:27 PIVI Submission Completed
River Basin: * INeuse
County: *
Greene
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
Quad. 1pd-f 326.81 IKIB
Pdf file type only
'TOIPO malp look ulp:: 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
Soil Survey IBuffeired Stireams.lpdf 14'7.191KIB
Pdf file type only
Soil Survey I-InIlk: https://www.nrcs.usda.gov/wps/portal/nrcs/surveylist/soils/survey/state/?stateld=NC
Latitude and Loinglitude
............... ...............
Please 1piroviide the ILatiitude and Longitude for 1plhysiicall location for the determination that., Iff you Ihave a
p1hysicall addiress you cain look up the ILatiitude and Longitude lby typing in ain addiress or filling out the
information imainualllly.
Choose below how you would like to Address Lookup
provide this information. Manually
Latitude: 35.439
Longitude: -77.821
Misc attachments:
Sigin and Submit
Aerial.1pd-l'
Aerial, owneirlpdf
pdf or kmz file types only
lBy digitally signing lbellow, 11 ceirtify t1hat:
W
https://edocs.deq.nc.gov/Forms/Form/Submit 3/4

1 /29/24. 3:27 PM
Submission Completed
II Knave given tirue, accurate, and c innlpllete iiirnfoirinnatl oirn oin this foirm;
II agiree that Submission of this foirm its a "tira irn ctii irn„ subject to Chapter 66, Article 40 of the INCeirneir ll Statutes
(the "U niifoirirnrn I IIecLiroirniic 'Tir irn cLii irn Ad)
II agiree to conduct this fira in sach o in Iby electiroirniic inneans puirsu irnt to Chapter 66, Article 40 of the INCeirneir ll Statutes
(the "U niifoirirnrn I IIecLiroirniic 'Tir irn cLii irn Ad);
II understand that ain electiroirniic Signature Knee the sainne Ile II effect and cairn Ibe eirnfoirced iiirn the sainne way as a written
Signature; AIN ID
II linteind to elediroirniic lllly siigin and sulbinnit the "IDeteirmiiirn tii irn Request" f irirnrn."
Signature *
e'W")r
https://edocs.deq.nc.gov/Forms/Form/Submit 4/4