20201088 Ver 1_401 Application_20200827

Staff Review Form
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En vironmenfrr!QvoGry
Updated August 24,2020
Staff Review
Does this application have all the attachments needed to accept it into the review process?*
6* Yes r No
ID#* Version* 1
20201088
Is this project a public transportation project?* (' Yes
r No
Is this a DOT ( Yes C No
project?*
Reviewer List:* Joanne Steenhuis:eads\jhsteenhuis
Select Reviewing Office:* Wilmington Regional Office-[phone]
Does this project require a request for payment to be sent?*
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:* C New Project ( New Project w Existing ID
C' Pre-Application Submittal C More Information Response
C Other Agency Comments r Stream or Buffer Appeal
c Re-issuance\Renewal Request 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.
Re-issuance\Renewal Request—Please check this if you are submitting for a re-issuance\renewal prior to expiration
date for the corresponding 401/404. If submitting after the expiration date or if modification needed use New Project with
Existing ID option.
Project Contact Information
Name: NCDOT Division 6
Who is submitting the inforrration?
Email Address: [e-mail]
Project Information
Project Name: Bridge No.250368 Hurricane Dorian Scour Repair on SR 1503 over Porter Swamp
Is this a public transportation project?
6' Yes
No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
c Yes 6- No c Unknown
TIP#: WBS#:
DF15406.024536
(Applies to DOT projects only)
County(ies)
Columbus
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
230368_SMU_GD_CrutchRepair_PreliminaryPlans... 258.95KB
Scour Bent Profile.pdf 41.96KB
Scour Plan View.pdf 40.69KB
Only pa or krrz files are accepted.

Describe the attachments
or comments:
Division 6 Bridge Maintenance must stabilize Bridge 250368 along SR 1503 over Porter Swamp in Columbus
County due to excessive scour during Hurricane Dorian. In order to stabilize the Bridge, NCDOT proposes to
install a crutch bent and then place Class A rip-rap stone to fill the void.A turbidity curtain will be placed at
the downstream side of the bridge.The area of fill amount to 3000 sf which will require 870 tons of Class A
rip-rap stone.
In looking at the Scour Plan View,the elevations are based on measuring down from the barrier rail to the
stream invert.
Lat/Long Coordinates:34.360397,-78.962264
Sign and Submit
.......................................................................................................................................................................................................................................................................................................................................................................................................
fJ By checking the box and signing box below, I certify that:
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 Act")
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 Act");
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 online form."
Signature:
Submittal Date: Is filled in autorratically.