20171434 Ver 1_US 74 & SR 1001 Interchange_20171127

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 11/27/2017 2:21:43 PM (Supplemental Submital)
Accept by Carpenter,Kristi 11/27/2017 2:32:10 PM (DOT - E�asting Project)
• The task was assigned to Carpenter,Kristi 11/27/2017 2:21 PM

Water Resources
ENVIRONMENTAL OUALITY
Staff Review:
Submittal Type: l" New Project
C' Pre-Application Submittal
C�' More Information Response
New Project - Please check the new project type if you are trying to submit a new project that needs an official approval
decision.
Pre-Application Submittal - Please check the pre-application submittal if you just want feedback on your submittal and do
not have the expectation that your submittal will be considered a complete application requiring a formal decision.
More Information Response - Please check this type if you are responding to a request for information from staff and
you have and ID# and version for this response.
ID#*
20171434
Version*
1
Is this project in a CAMAAEC area?* �' Yes
�' No
Reviewer List:*
Select Reviewing Office:*
Joanne Steenhuis:eads\jhsteenhuis
Wilmington Regional Office - [phone]
Project Submittal Interim Form
subrritted: 11/27/2017
Project Contact Information:
Name: James J. Rerko
Who is subrritting the inforrration?
Email Address: [e-mail]
Project Information:
Existing ID #:* Existing Version:*
20171434 1
Project Name: US 74 & SR 1001 Interchange
Is this a public transportation project?
l•' Yes
C' No
TIP#: R-5749
WBS#: 53086.1. FD1
(Applies to
DOT projects
only)

County (ies) *
Columbus
Describe the attachments:
Adding the additional open water impacts that I missed while completing the PCN.
Please upload all files that need to be submited.
R5749add itionalSWlmpacts. pdf
Only pdF files are accepted.
rJ By checking the box and signing box below, I certify that:
91.66KB
o I have given true, accurate, and complete information on this form;
o I agree that submission of this form is a"transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the
"Uniform Electronic Transactions AcY')
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions AcY');
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the form.
Signature:
� 8 ��