20190201 Ver 1_Determination Request_20190213

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
U-5747 - SR 1635 (McCrimmon Parkway) Grade Separation
r Yes C' No
rJ Buffer r IP Stream Determination
r Isolated Wetland rJ Stream
Check all that apply.
Name on the Recorded Deed:* NCDOT Right-of-Way
Responsible Party : NCDOT Division 5, ATTN: Chris Murray, Project Engineer
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: 919220-4633
(xxx)xxx-xxxx
How would you like to received your determination?*
� USPS N7 Email
Email Address:* [e-mail]
Is there an agent or consultant responsible for the request?*
C' Yes
r No
Project Information
Has anyone form DWR done a previous site visit? *
�' Yes
C' No
�' Other corridor is within NC54 Bypass
20�
Date of Visit: 9/10/2014
Site Information
Nearest Highway/Street:* McCrimmon Parkway & NC 54
Nearest Town:* Morrisville
Nearest Named Stream:* Crabtree Creek and Kit Creek
River Basin:* Neuse

County:*
Wake
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
U5747 USGS Topo Map.pdf 461.79KB
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
U-5747 NRCS Map.pdf 2.15MB
Wf 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 provide this information.
C' Address Lookup
C•' Manually
Latitude
Longitude
Misc attachments:
U5747 Vicinity Map.pdf
U5747 Stream Data Forms.pdf
U5747 JD Features Map.pdf
pdF or larn file types only
Bydigitallysigning below, I certifythat:
294.46KB
41.43KB
501.61 KB
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?*
35.840756
-78.845790
Sign
2/ 13/2019
20190201
1
C� Yes f No

Select Reviewer:* Rob Ridings:eads\rgridings
Select Regional Office:* Central Office -[phone]