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Home My WebLink About20220552 Ver 1_Other Agency Documents_20220427 sy STAT Staff Review Form NORTH CAROLINA Envlronm¢ntcl Qvoray Updated September 4,2020 Staff Review Does this application have all the attachments needed to accept it into the review process?* Yes No ID#* Version* 1 20220552 Is this project a public transportation project?* Yes No Is this a DOT Yes No project?* Reviewer List:* Dave Wanucha:eads\djwanucha Select Reviewing Office:* Winston-Salem Regional Office-(336)776-9800 Does this project require a request for payment to be sent?* Yes 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:* 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 Pre-Filing Meeting Date Request was submitted on: Is this supplemental information that needs to be sent to the Corps?* Yes No Please choose the commenting agency.* DCM Comments DCM Permit DFM Comments USFWS Comments WRC Comments Other Project Contact Information ...................................................................................................................................................................................................................................................................................................................................................................................................... Name: Dave McHenry Who is submitting the information? Email Address: david.mchenry@ncwildlife.org Project Information Existing ID#: Existing Version: 20220552 1 20170001(no dashes) 1 Project Name: Replacement of Bridge 80 over UT North Deep Creek on SR 1512 Is this a public transportation project? Yes No Is the project located within a NC DCM Area of Environmental Concern (AEC)? Yes No Unknown TIP#: WBS#: BR-0109 67109.1.1 (Applies to DOT projects only) ..................................................................................................................................................................................................................................................................................................................... County(ies) Yadkin Please upload all files that need to be submited. Click the upload button or drag and drop files here to attach document BR-0109_DWR 20220552_Bridge 80_GP 216.7KB Application NCWRC Comments.pdf Only pdf or kmz files are accepted. Describe the attachments or comments: Please accept these comments from the NCWRC on the application. Thanks Sign and Submit ...................................................................................................................................................................................................................................................................................................................................................................................................... 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: Submittal Date: Is filled in automatically.