20191252 Ver 1_More Information Received_20191113

Staff Review
Does this application have all the attachments needed to accept it into the review process?
r Yes r No
ID#* Version* 1
20191252
Is this project a public transportation project?* r Yes
r No
Is this a DOT r Yes r No
project?*
Reviewer List:*
Select Reviewing Office:*
Submittal Type:*
Application Attachments
Joanne Steen h u is:eads\jhsteen h u is
Wilmington Regional Office - [phone]
Does this project require a request for payment to be sent?*
r
Yes
r
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: r New Project
r Pre -Application Submittal
r More Information Response
r Other Agency Comments
r For the Record Only (Courtesy Copy)
r Stream or Buffer Appeal
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.
Is this supplemental information that needs to be sent to the Corps?*
r Yes r No
Project Contact Information
Name: NCDOT-Jason Dilday
ftio is subrritting the inforrration?
Email Address: [e-mail]
Project Information
Existing ID #: Existing Version:
20191252 1
20170001(no dashes)
Project Name: Bridge 9 over South River on US 13
Is this a public transportation project?
r Yes
r No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
r Yes r No r Unknown
TIP#:
B-4635
County (ies)
Sampson
WBS#:
38446.1.2
(Applies to DOT projects only)
Please upload all files that need to be submited.

Oickthe upload button or drag and drop files here to attach document
B-4635 Reforestation Plan Sheets.pdf
1.26MB
B-4635 Revised - RW - CIF 06.pdf
70.41 KB
final tearsheet B 4635 2015 1191 PJD.pdf
45.03KB
Impact tables.pdf
77.82KB
B4635utilities_combined.pdf
2.22MB
B4635_Permit Drawings20191104.pdf
12.95MB
additional information.pdf
207.64KB
Only pdt or Iv17 files are accepted.
Describe the attachments:
Please find the following attached supplemental information for the project.
-responses from 9/24/19 email
-PJD for project
-Reforestation plan sheets
-Revised DMS acceptance letter
-Impact tables (similar to ones in ePCN)
-Revised Permit Drawings and Utility Impact Drawings
V By checking the box and signing box below, I certify that:
• 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
• I intend to electronically sign and submit the online form."
Signature:
Submittal Date: 11/13/2019
Is filled in autorratically.