20180755 Ver 1_More Information Received_20200403

Staff Review
Does this application have all the attachments needed to accept it into the review process?
r Yes r No
ID#* Version* 1
20180755
Is this project a public transportation project?* r Yes
r No
Is this a DOT r Yes r No
project?*
Reviewer List:* Garcy Ward:eads\gpward
Select Reviewing Office:* Washington Regional Office - [phone]
Does this project require a request for payment to be sent?*
r
Yes
r
No

Project Submittal Form
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 Type: r
New Project
r
New Project w Existing ID
r
Pre -Application Submittal
r
More Information Response
r
Other Agency Comments
r
For the Record Only (Courtesy Copy)
r
Stream or Buffer Appeal
New Project - Please check the new project type if you are trying to submit a new project that needs an official approval
decision.
Pre -Application Submittal - Please check the pre -application submittal if you just want feedback on your submittal and
do not have the expectation that your submittal will be considered a complete application requiring a formal decision.
More Information Response - Please check this type if you are responding to a request for information from staff and
you have and ID# and version for this response.
Other Agency Comments - Please check this if you are submitting comments on an existing project.
Is this supplemental information that needs to be sent to the Corps?*
r Yes r No
Project Contact Information
Name: Paul Williams
VUio is subaitting the inforrration?
Email Address: [e-mail]
Project Information
Existing ID #: Existing Version:
20180755 1
20170001(no dashes)
Project Name: Bridge # 11 on SR 1333 Wynne Fork Road
Is this a public transportation project?
r Yes
r No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
r Yes r No r Unknown
TIP#: WBS#:
B-5606 45561.3.1
(Applies to DOT projects only)
County (ies)
Perquimans
Please upload all files that need to be submited.

click the upload button or drag and drop files here to attach document
Cable TV Relocation Final_Permit_Drawings_2018-
599.81 KB
05-23.pdf
Only pdf or lqm files are accepted.
Describe the attachments:
In addition to the previously permitted utility relocations, the Cable TV line on the project will need to be
relocated. A directional bore will be used to relocate the Cable TV line in a 2 in. conduit approximately 744
linear feet. The bore will be a minimum of 10' belowthe streambed of Raccoon Creek. The bore pits will be
placed on uplands, resulting in no additional impacts to jurisdictional wetlands or streams. All depicted in the
attached revised permit drawings.
Sign and Submit
P By checking the box and signing box 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
o I intend to electronically sign and submit the online form."
Signature:
c r?1111lC� 1111le r1 r%a...
Submittal Date: 04/03/2020
Is filled in automatically.