HomeMy WebLinkAbout20120673 Ver 3_More Info Received_20201213 :Toot,
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Project Submittal Interim Form
NORTH CAROLINA
Ertrlrcnmertrct Qcaffty
Updated September 4,2020
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 For the Record Only(Courtesy Copy)
✓ New Project
✓ Modification/New Project with Existing ID
✓ More Information Response
✓ Other Agency Comments
✓ Pre-Application Submittal
r Re-Issuance\Renewal Request
✓ Stream or Buffer Appeal
Pre-Filing Meeting Information
Before submitting this form please ensure you have submitted the Pre-Filing Meeting Request Form as we will not
be able to accept your application without this important first step.The Pre-Filing Meeting Request Form is used in
accordance with 40 C.F.R. Section 121.4(a)"At least 30 days prior to submitting a certification request,the project
proponent shall request a pre-filing meeting with the certifying agency"and in accordance with 40 C.F.R. Section
121.5(b)(7),and (c)(5)all certification requests shall include documentation that a pre-filing meeting request was
submitted to the certifying authority at least 30 days prior to submitting the certification request.Click here to read
more information on when this form is needed prior to application submission or here to view the form.
Attach documentation of Pre-Filing Meeting Request here:* R-2707
Phased
Renewal
359.7..
Cleveland
December
14 2020.pdf
Date for Meeting Request* 12/14/2020
ID# 20120673 Version
Project Contact Information
Name: Michael Turchy
an is subrritting the information?
Email Address:* maturchy@ncdot.gov
Project Information
Existing ID#:* Existing Version:*
20120673 3
20170001(no dashes) 1
Project Name:* R-2707 Shelby Bypass
Is this a public transportation project?*
r Yes
✓ No
Is this a DOT project?*
( Yes
✓ No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
✓ Yes r No r Unknown
TIP#: WBS#:
R-2707 34497.1.FS6
(Applies to DOT projects only)
County(ies)*
Cleveland
Please upload all files that need to be submited.
Dick the upload button or drag and drop files here to attach docurrent
R-2707 Phased Renewal Cleveland December 14
359.77KB
2020.pdf
Only pdf or krre files are accepted.
Describe the attachments or add comments:
Cover Letter.
No Pre-Filing Notification is being provided for this project,as it has(and continues to be)in the Merger
process.
* fJ By checking the box and signing box below, I certify that:
• I,the project proponent, hereby certifies that all information contained herein is true,accurate, and complete to
the best of my knowledge and belief.
• I,the project proponent, hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time.
• I agree that submission of this online 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 online form.
Signature:*
T
Submittal Date: Is filled in autorratically once submitted.