20180755 Ver 2_More Information Received_20210712

Staff Review Form •
NORFH CA.,i0:INA
En vironmenfrr!QvoGry
Updated September 4,2020
Staff Review
Does this application have all the attachments needed to accept it into the review process?*
6* Yes r No
ID#* Version* 2
20180755
Is this project a public transportation project?* (' Yes
r No
Is this a DOT ( Yes C 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?*
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 For the Record Only(Courtesy Copy)
r New Project
r Modification/New Project with Existing ID
✓ More Information Response
✓ Other Agency Comments
r Pre-Application Submittal
✓ Re-Issuance\Renewal Request
✓ Stream or Buffer Appeal
Is this supplemental information that needs to be sent to the Corps?*
Yes r No
Project Contact Information
Name: Paul Williams
Who is submitting the inforrration?
Email Address: [e-mail]
Project Information
Existing ID#: Existing Version:
20180755 2
20170001(no dashes) 1
Project Name: Bridge#11 on SR 1333 Wynne Fork Road
Is this a public transportation project?
(' 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 docurrent
Additional Riprap Stabilization Permit Drawings
525.12KB
07.12.2021.pdf
Final_Wetland Impact Summary Sheet
61.09KB
07.12.2021.pdf
Only pdf or krrz files are accepted.

Describe the attachments
or comments:
Due to the impacts of a ruptured natural gas line,the shoreline at End Bent 1 will need additional riprap
stabilization resulting in additional open water impacts on the project.Approximately 460 sq.ft.of Class II
riprap will permanently impact open waters,as shown on the attached revised permit drawing.
Sign and Submit
.............................................................................................................................................................
w 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:
cTru/Cr//rr 1ll/44/mt.r'�v.
Submittal Date: Is filled in autorretically.