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HomeMy WebLinkAbout20220437 Ver 1_More Information Received_20220512 o
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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
20220437
Is this project a public transportation project?* Yes
No
Is this a DOT Yes No
project?*
Reviewer List:* Garcy Ward:eads\gpward
Select Reviewing Office:* Washington Regional Office-(252)946-6481
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:
4/29/2022
Is this supplemental information that needs to be sent to the Corps?*
Yes No
Project Contact Information
.....................................................................................................................................................................................................................................................................................................................................................................................................
Name: Paul Williams
Who is submitting the information?
Email Address: pcwilliams2@ncdot.gov
Project Information
................................................................................................
Existing ID#: Existing Version:
20220437 1
20170001(no dashes) 1
Project Name: W-5701 E NC 32/37 Intersection Improvement Project
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#:
W-5701 E 44847.1.5
(Applies to DOT projects only)
County(ies)
Chowan
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
W-5701 E permit drawings_05.11.2022.pdf 1.24MB
Only pdf or kmz files are accepted.
Describe the attachments or
comments:
Revised drawings attached as requested.
SAW-2019-00680
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: 05/12/2022
Is filled in automatically.