20190540 Ver 1_Determination Request_20190425

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:*
Curtis E. Lupton Drainage Maintenance
Is this a transportation project?* r Yes r No
What type of request is this?*
Owner Information
Name on the Recorded Deed:*
Responsible Party:
Telephone Number:
V Buffer
r- Isolated Wetland
Check all that apply.
Lupton, Curtis E. & May Y.
r IP Stream Determination
17 Stream
Curtis E. Lupton Jr
(for LLC, Corporations, businness, agency, etc.)
252-636-0591
How would you like to received your determination?*
V USPS r Email
Mailing Address:* Street Address
200 Sim Dawson Road
Address Line 2
C1ty
State / Province / Pegion
New Bern
NC
Fbstal / Zip Code
Country
28562-6937
US
Is there an agent or consultant responsible for the request?*
r Yes
r No
Project Information
Has anyone form DWR done a previous site visit?*
r Yes
r No
r Other 1990's but no paperwork received from visit
Date of Visit:
Site Information
Nearest Highway/Street:* Spring Garden Road
Nearest Town:* Jasper

Nearest Named Stream:* Mill Run
River Basin:* Neuse
County:*
Craven
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 docurrent
Curtis E. Lupton Topo.pdf 3.35MB
Rif 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 docurrent
Curtis E. Lupton Jr - Soil Map (Sheet
473.02KB
8).pdf
Rif file type only
Soil Survey Link: https://vmw.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.
r Address Lookup
r Manually
Latitude: 35.2139
Longitude: -77.1989
M isc attachments: pdf or lom 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 Sign
Date Submitted: 4/25/2019
Initial Review
D# * 20190540

Version *
Do you want to send for review?* r Yes t: No

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