20230422 Ver 1_04_R5808_CE_20230321

Appendix 4
Section G (1 and 7)
TIP R-5808 Categorical Exclusion (CE) (09/29/2021)

DocuSign Envelope ID:56D375A6-3D13-4688-80E3-50349DC57C58
I. Categorical Exclusion Approval:
STIP Project No. R-5808
WBS Element 46972.1.1
Federal Project No. NHP-0158(076)
Prepared By:
=4'78..
9/29/2021
Date Colin Frosch, PE
Kimley-Horn
Prepared For: NCDOT Division 1
Reviewed By: DocuSigned by:
9/29/2021 ""`
7C7960D2941F47E...
Date Paul Williams, Jr.
Highway Division 1 Environmental Officer
North Carolina Department of Transportation
❑ Approved
[� Certified If classified as Type III Categorical Exclusion.
DocuSigned by:
9/29/2021 � . 5"
OC7D14031128433...
Date for Sterling Baker, P.E., Highway Division 1 Engineer
Ryan Shook, Highway Division 1 Project Engineer
North Carolina Department of Transportation
FHWA Approved: For Projects Certified by NCDOT (above), FHWA signature required.
DocuSigned by:
9/29/2021 Wl
59967A500F8714F0.
Date for John F. Sullivan, III, PE, Division Administrator
Federal Highway Administration
Note: Prior to ROW or Construction authorization, a consultation maybe required(please see
Section Vll of the NCDOT-FHWA CE Programmatic Agreement for more details).
v2019.1 R-5808 Type /// CE Page 11