20220438 Ver 2_Project Submittal Interim Form_20220330

Project Submittal Interim Form
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:*
Name:
Email Address:*
Project Name:*
Is this a public transportation project?*
Is this a DOT project?*
Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
TIP#:WBS#:
County (ies)*
For the Record Only (Courtesy Copy)
New Project
Modification/New Project with Existing ID
More Information Response
Other Agency Comments
Pre-Application Submittal
Re-Issuance\Renewal Request
Stream or Buffer Appeal
Project Contact Information
Steve Trowell
Who is submitting the information?
[e-mail]
Project Information
Pipe Replacement SR 1538 Manning Road Martin County
Yes
No
Yes
No
Yes No Unknown
1B.10281
(Applies to DOT projects only)
Martin
Please upload all files that need to be submited.
Describe the attachments or add comments:
*
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:*
Submittal Date:
Click the upload button or drag and drop files here to attach document
Topo Sr 1538 Manning Road Pipe Replacement
Martin Co..pdf 1.11MB
Only pdf or kmz files are accepted.
This is a courtesy notification that NCDOT will be replacing an existing culvert pipe in a jurisdictional area under
Nationwide Permit 3 conditions. Location is on a UT to Lanier Swamp, Stream Index 23-52-1-2 in the Roanoke
River Basin.
Existing 60" x 40' CMP to be replaced with a 72" x 40' CAP located at N 35.7804, W -76.9085.
By checking the box and signing box below, I certify that:
Is filled in automatically once submitted.