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HomeMy WebLinkAboutVer _Determination Request_20240910Please 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 10009 Boyce Rd. Boat Club Yes No Yes No Buffer Isolated Wetland Check all that apply. IP Stream Determination Stream Name on the Recorded Deed: * Marcia L. Lewis and Marcia Lewis Properties, LLC (Ohio) Responsible Party : Marcia L. Lewis (for LLC, Corporations, businness, agency, etc.) Telephone Number: 919-614-5726 Email Address: * oraldock@aol.com How would you like to received your determination?* Is there an agent or consultant responsible for the request?* Yes No Project Information Has anyone form DWR done a previous site visit?* Yes No Other Date of Visit: Site Information Nearest Highway/Street: * Boyce Road Nearest Town: * Creedmore Nearest Named Stream:* Little Ledge Creek 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 USGS.pdf 304.04KB 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 NRCS SOIL.pdf Pdf file type only 297.2KB 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. Latitude: 36.06109444 Longitude: 78.73310 Misc attachments: By digitally signing below, I certify that: Address Lookup Manually boyce-boat-club-postdev-9-9-24.pdf 7.68MB pdf or kmz file types only d 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 O/6'N1YR1JF Ate. l (/ tlwlr Date Submitted: 9/10/2024 Initial Review RRO Do you want to send this for review?