20201723 Ver 2_Pre-Filing Attachment_20210301

DWR Pre-Filing Meeting Request Form
NORTH CAROLINA
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ID#* 20201723 Version* 2
Regional Office* Winston-Salem Regional Office-[phone]
Reviewer List* Dave Wanucha
Pre-Filing Meeting Request submitted 2/25/2021
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Contact Name* Amy Euliss
Contact Email Address* [e-mail]
Project Name* 17BP.9.R.72
Project Owner* NCDOT Division 9
Project County* Stokes
Owner Address: Street Address
375 Silas Creek Parkway
Address Line 2
City State/Rovince/Region
Winston Salem NC
Fbstal/Zip Code Country
27106 USA
Is this a transportation project?* r Yes r No
Type(s)of approval sought from the DWR:
r- 401 Water Quality Certification- I— 401 Water Quality Certification-
Regular Express
I— Individual Permit rJ Modification
r- Shoreline Stabilization
Does this project have an existing project ID#?*
(' Yes r No
Please list all existing project ID's associated with this projects.*
20201723
Do you know the name of the staff member you would like to request a meeting with?
Dave Wanucha
Please give a brief project description below.*
We are submitting this request in case the permit needs to modified
during construction,and do not need a meeting at this time.

Please give a couple of dates you are available for a meeting.
Please attach the documentation you would like to have the meeting about.
pdf only
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:
• This form completes the requirement of the Pre-Filing Meeting Request in the Clean Water Act Section 401 Certification
Rule.
• I understand by signing this form that I cannot submit my application until 30 calendar days after this pre-filing
meeting request.
• I also understand that DWR is not required to respond or grant the meeting request.
Your project's thirty-day clock started upon receipt of this application. You will receive notification regarding meeting location
and time if a meeting is necessary. You will receive notification when the thirty-day clock has expired,and you can submit an
application.
Signature
Submittal Date 2/25/2021