20181714_Determination Request_20190909

Stream Origin/Buffer Applicability Determination
Processing Information
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?*
What type of request is this?*
HF Lee Stormwater Pond - Stream
r Yes F No
FJ Buffer rJ IP Stream Determination
F- Isolated Wetland r` Stream
Check all that apply.
Owner/Applicant Information
Owner Information
Name on the Recorded Deed:*
Responsible Party:
Telephone Number:
Duke Energy -Progress
Steve Cahoon
(for LLC, Corporations, businness, agency, etc.)
919-546-7457
How would you like to received your determination?*
r USPS 9 Email
Email Address:* [e-mail]
Is there an agent or consultant responsible for the request?*
( Yes
C No
Agent/Consultant Information
Project and Site Information
Project Information
Has anyone form DWR done a previous site visit?*
d Yes
0 No
d Other
Date of Visit:

Site Information
Nearest Highway/Street:* Black Jack Church Road
Nearest Town:* Goldsboro
Nearest Named Stream:* Neuse River
River Basin:* Neuse
Cou nty: *
Wayne
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
Topo_Map.pdf 859.73KB
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.
Qick the upload button or drag and drop files here to attach docurrent
Soils_Map.pdf 1.21 MB
Rif 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 r Address Lookup
provide this information. r Manually
Latitude: 35.367528
Longitude: -78087794
M isc attachments: pdf or lore file types only
Sign and Submit
By digitally signing 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 Act")
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 Act');
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 Request' form."

Signature *

I e 0 0.475 0.95 I
Miles
NRCS Soils Map
H. F. Lee 7812180069 Project Area
Wayne County, NC
Legend
Project Area
Soils
DUKE
ENERGY,
wood.
Job No. 7812180069
Drawn Bw JAH
Reviewed Bv:
Date: 9/9/2019
The map shown here has been
created with all due and
reasonable care and is strictly for
use with Wood project number
7812180069. Wood assumes no
liability, direct or indirect,
whatsoever for any such third
party or unintended use.
4-00
M--—
y,
i
C
vw
0 250 500
Feet
1 inch h7 = 250 feet
W
o -
s 4
Y i
7.
kit

e 0 0A75 0.95
Miles
USGS Topographic Map
H. F. Lee 7812180069 Project Area
Wayne County, NC
Legend
Project Area
DUKE
ENERGY,
wood.
Job No. 7812180069
Drawn Bw JAH
Reviewed Bv:
Date: 9/9/2019
The map shown here has been
created with all due and
reasonable care and is strictly for
use with Wood project number
7812180069. Wood assumes no
liability, direct or indirect,
whatsoever for any such third
party or unintended use.
0 500 1,000
Feet
1 I inch = 500 feet