20190179 Ver 1_Determination Request_20190211

Water Resources
*
Please note: fields marked with a red asterisk beloware required. You will not be able to submit the form until all
mandatory questions are ans�red.
Project Name:*
Is this a transportation project?*
What type of request is this?*
Owner I nformation
Name on the Recorded Deed:*
Responsible Party :
Telephone Number:
Old Airport Road Widening
r Yes C' No
rJ Buffer r IP Stream Determination
r Isolated Wetland rJ Stream
Check all that apply.
The City of New Bern
Jordan B. Hughes
(for LLC, Corporations, businness, agency, etc.)
(xxx)xxx-xxxx
How would you like to received your determination?*
N7 USPS � Email
Mailing Address:* StreetAddress
PO Box1129
Address Line 2
CSty State / R-ovince / Fdegion
New Bern NC
Fbstal / Zip Code Country
28562 USA
Is there an agent or consultant responsible for the request?*
�' Yes
l' No
Attach agent authorization letter:* 04_AgentAuthorization.pdf
F�F only
Agent/Consultant Information
How would you like to receive your C' USPS
determination letter?* C•' Email
Name of Agent:* William Sullivan
Company Name:* Kimley-Horn
Email Address:* [e-mail]
618.94KB
Project Information

Has anyone form DWR done a previous site visit? *
�' Yes
C•' No
C' Other
Date of Visit:
Site Information
Nearest Highway/Street:* Old Airport Road
NearestTown:* NewBern
Nearest Named Stream:* Brice Creek
River Basin:* Neuse
County:*
Craven
Please attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo.
Qick the upload button or drag and drop files here to attach docurrent
Fig 2_USGS.pdf 1.6MB
Wf 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.
Qick the upload button or drag and drop files here to attach docurrent
Fig 4_NRCS.pdf 1.57MB
Wf file type only
Soil Survey Link: https://vwwu.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.
C' Address Lookup
�' Manually
Latitude
Longitude:
Misc attachments:
35.017922
-77.022737
Fig 1_Vicinity.pdf
Fig 3.0_JDlndex Map.pdf
Fig 3.1-3.7_JurisdictionalFeatures.pdf
pdF or larn file types only
324.03KB
2.37MB
13.14MB
Bydigitallysigning below, I certifythat:
o I have given true, accurate, and complete information on this form;

o 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 AcY')
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions AcY');
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the "Determination RequesY' form."
Signature
Date Submitted:
Initial Review
ID#*
Version *
Do you want to send for review?*
Select Reviewer:*
Select Regional Office:*
Sign
2/11/2019
20190179
1
r Yes C' No
Garcy Ward:eads\gpward
Washington Regional Office - [phone]