20171307 Ver 1_Buffer and/or Stream Determination Request_20171016

N. ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
Water Resources S. JAY ZIMMERMAN
Environmental Quality Director
DWR Use Only: Project#:
Date Received:
Buffer Applicability / Stream Origin Determination Request
Property Owner Information
1. Owner Information (corporation/individual who is legally responsible for the property and its compliance)
la. Name(s) on Recorded Deed Vickie C. Dotson
Sb. Responsible Party (for LLC)
lc. Mailing Address 620 Duck Creek Road; Washington, NC 27889
Id. Telephone Number le. Email address
2. Address of Property or Location of Project Site (including county, nearest named town, and highway or road name/ number):
6411 US 17 HWY S; Chocowinity, NC (see attached map)
3•
Agent/ Consultant Information
3a. Agent/ Consultant Name
Kim Williams
31b. Company
Land Management Group, Inc.
3c. Mailing address
3805 Wrightsville Avenue; suite 15; Wilmington, NC 28403
3d. Telephone no.
910-452-0001 3e. Email address kwilliamsCollm¢rouo.net
6. Has anyone from DWQvisited the site? Y / N Staff Name: Date of Visit:
7. Attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo and/or NRCS Soil Survey
If you are unable to locate either of these maps, please contact the DWR Washington Regional Office for assistance.
4• Project /Site Information
4a. Name of project
Bay Branch Solar
4c. Nearest Named Stream
Bay Branch
4b. County
Beaufort
4d. River Basin
Tar -Pamlico
S. Project Description (attach plan if available)
Potential solar facility
6. Has anyone from DWQvisited the site? Y / N Staff Name: Date of Visit:
7. Attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo and/or NRCS Soil Survey
If you are unable to locate either of these maps, please contact the DWR Washington Regional Office for assistance.
DWR Use Only: Is this determination for the purpose of Buffer mitigation? Nutrient offset credit?
8. Please return form to: Anthony Scarbraugh
943 Washington Square Mall Note: Submittals on Friday after 12:00 pm
Washington, NC 27889 Will be stamped as received on the
Email: Anthonv.Scarbraueh@ncdenr eov Next business day
Please contact Anthony Scarbraugh at the Washington Regional Office at [phone] if you have any
questions. -5:>Nothing Compares:.-...
State of North Carolina I Environmental Quality I Water Resources -Water Quality Regional Operations Section -Washington Regional Office .
943 Washington Square Mall, Washington, North Carolina 27889
252-946-6481

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Scarbraugh, Anthony
From: Kim Williams <[e-mail]>
Sent: Monday, October 16, 2017 2:38 PM
To: Scarbraugh, Anthony
Cc: Christian Preziosi; Wes Fryar
Subject: [External] Bay Branch Solar; Beaufort County; Stream Determination Request
Attachments: Bay Branch Stream Determ Request Form.docx; Bay Branch Maps.pdf
CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you verify that the
attachment and content are safe. Send all suspicious email as an attachment to [e-mail].
Hi Anthony
Attached is a stream determination request for the Bay Branch Solar Site, which is located near Chocowinity (Beaufort
County). I have also attached a few site maps of the property.
Wes Fryar in our office is scheduled to meet Gary Beecher on site on October 24th to review the delineation. They are
meeting after the Sterling Pointe and Quail Ridge sites, so Gary is unable to attend the third site we discussed that is in
Kinston. I would still like to meet you at that Kinston site since the engineer already plans to be there.
Let me know when you are able to meet us at the Bay Branch site. Wes can meet you earlier on October 24", before our
other meetings, if that works for you. Or we can just meet another day that is convenient to you.
Thanks!
Kim
Kim Williams I Environmental Scientist
Land Management Group, Inc I Environmental Consultants
)irrU 4S' 000I x 1903 I Cvll 970.4/1 %0 3S I I ax 910.451.00(>0
3815 Wnghtrvillc Ave., Suit,, I5 I Wihr.ington. W 25403
.,I [e-mail] I �%, l�,.�,, www.lmgrouo.net

AGENT AUTHORIZATION FORM
TO WHOM IT MAY CONCERN:
I/we, the undersigned, hereby authorize Land Management Group, Inc. (LMG) to act as our
agent in the determination of jurisdictional wetland boundaries on the subject
property, Bay Branch Solar Tract By way of this form,
I/we additionally authorize access to the site by representatives of the US Army Corps of
Engineers (COE) and the NC Division of Coastal Management (NC DCM) for the purpose of
reviewing the flagged wetland boundary and providing a final jurisdictional determination.
Any questions regarding the jurisdictional determination should be directed to LMG.
Please provide the following information:
Property Address and Parcel ID Number: 6411 US HWY 17 S; 5663-12-4816
Current Property Owner Name: Vickie C. Dotsor,
Owner Address and Phone Number: 620 Duck Creek Road, Washington, NC 27889
Please answer the following ouestions (circle Yes or No):
1. Are you the current owner of the property? Yes oro
2. If you are not the current owner, do you have a option to purchase or a contrac to
purchase that allows for environmental due-diligence�"Iuding the determination of
wetlands? ( Yes ) or No
3. If you answered no to the questions above, do you have an existing easement?
Yes 0� A l No
.7
Name of Individual/Entity:j>� fJI�C�ytc(n 50foly'. �L
Signature of Authorized Representative:
c ` �y
Date: / /y 20/-7�
www.lmgroup.net • Phone: [phone] • Fax: [phone]
3805 Wrightsville Ave., Suite 15, Wilmington, NC 28403

Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION','
By signing below, i authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on-
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. 1, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
_O_ c _k -- -ID tD o t)" h------ --
Print Name
Capacity: 14 Owner ❑AuthorizedAgent5
q--9 7
Date
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid a 11 jurisdictional aquatic resources under Corps authority.
✓❑ 1 intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts tojurisdictional aquatic resources and as an initial step in a future permitting
process.
❑ 1 intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
❑ I intend to construct/develop a project or perform activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
HA Corps JD is required in order obtain my local/state authorization.
I intend to contest jurisdiction over a particular aquatic resource and request the Corps
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
❑ I believe that the site may be comprised entirely of dry land.
UOther:
' ror NCDOT'requests following the current NCDOT/USACE protocols, skip to Part E.
" If there are multiple parcels owned by different parties, please provide the following for each additional parcel on a
continuation sheet.
' Must provide agent authorization form/letter signed by owner(s).
Version: May 2017 Page 3