Ver _Determination Request (9)_20241003

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
134 ROBBINS ROAD
Yes No
Yes No
Buffer
Isolated Wetland
Check all that apply.
Name on the Recorded Deed: * X FORM LLC
Responsible Party : SHIV S. NUNNA
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: 919-824-0252
Email Address: * [e-mail]
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
IF Stream Determination
Stream
Nearest Highway/Street: *
ROBBINS ROAD
Nearest Town: *
DURHAM
Nearest Named Stream:*
LITTLE LICK CREEK
River Basin: *
Neuse

County: *
Durham
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
134 ROBBINS ROAD USGS TOPO.pdf 1.23MB
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
134 ROBBINS RD NRCS SOIL MAP.pdf 928.65KB
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 Address Lookup
provide this information. Manually
Project Look Up Address: Street Address
134 Robbins Road
Address Line 2
City State / Province / Region
Durham NC
Postal / Zip Code Country
27703 US
Latitude: 35.97646199999999
Longitude:-78.8056299
Misc attachments: 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
Date Submitted: 10/3/2024
Initial Review RRO

Do you want to send this for review? Yes No