19850177 Ver 3_WRC Comments_20180706

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/6/2018 10:40:57 AM (Message Start Event)
Accept by Montalvo, Sheri A 7/9/2018 8:03:02 AM (NON -DOT - E)asting Project)
The task was assigned to Montalvo, Sheri A. The due date is: July 11, 2018 5:00 PM
7/6/2018 10:41 AM

Staff Review
ID#* Version* 3
19850177
Is this project a public transportation project?* r Yes
r No
Reviewer List:* Anthony Scarbraugh:eads\adscarbraugh1
Select Reviewing Office:* Washington Regional Office - [phone]
Submittal Type:*
Application Attachments
Does this project require a request for payment to be sent?
r
Yes
r
No

Project Submittal Dated 7/6/2018
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: r New Project
r Pre -Application Submittal
r More Information Response
r Other Agency Comments
r For the Record Only (Courtesy Copy)
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.
Other Agency Comments - Please check this if you are submitting comments on an existing project.
Project Contact Information
Name: Maria Dunn
Who is subrritting the information?
Email Address: [e-mail]
Project Information
Existing ID #: Existing Version:
19850177 3
20170001 (no dashes)
Project Name: William Black
Is this a public transportation project?
r Yes
r No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
r Yesr No r Unknown
County (ies)
Chowan
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach docurrent
CMDF—William Black_NCWRC^ pdf 862.84KB
Only pdf or k rnz files are accepted.
Describe the attachments:
V By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;

• 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 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
o I intend to electronically sign and submit the online form."
Signature:
Submittal Date: