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Home My WebLink About20220618 Ver 1_Individual_20220428 o 0 vim. NORTH CARO.INA Staff Review Form Envlmnm¢ntrtl Qvofiry Updated September2020 Staff Review Does this application have all the attachments needed to accept it into the review process?* Yes No ID#* Version* 1 20220618 Is this project a public transportation project?* Yes No Is this a DOT Yes No project?* Reviewer List:* Rob Rid ings:eads\rgridings Select Reviewing Office:* Central Office-(919)707-9000 Submittal Type:* Individual 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: 8/26/2021 Project Contact Information ............................................................................................................................................................................................................... Name: Christopher A.Murray Who is submitting the information? Email Address: camurray@ncdot.gov Project Information ........................................ .................................................. Project Name: Airport Boulevard Extension-Phase I and Phase II,Wake County 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#: H L-0033 36249.4033 (Applies to DOT projects only) County(ies) Wake Please upload all files that need to be submited. Click the upload button or drag and drop files here to attach document HL-0033 suporting IP info Airport Boulevard 71.73MB Extension Phase I and Phase Il.pdf HL-0033 PCN FillableForm for ABE PI and PII 454KB 04282022.pdf HL-0033Eng_Form_4345_for ABE PI and PII 111.45KB 04282022.pdf Only pdf or kmz files are accepted. Describe the attachments or comments: 1. HL-0033 supporting IP info Airport Boulevard Extension Phase I and Phase II 2. HL-0033 PNC_FillableForm for ABE PI and PH 04282022 3. HL-0033Eng_Form_4345 for ABE PI and PH 04282022 Excel spreadsheets that provide parcel/property owner information that have direct connection or adjacent connection with a jurisdictional feature will be sent separately by email to Andy Williams, USACE. 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: C-�-17d h9�-A 41u 4Y Submittal Date: Is filled in automatically.