20201196 Ver 1_DWR Pre-Filing Meeting Request Form_20201028

DWR Pre-Fil ing Meeting Req u est Form
ID#*Ve rsion *
Re gional Office *
Re v ie we r List *
Contact Name *
Contact Email Addre ss *
Proje ct Name *
Proje ct Owne r *
Proje ct County *
Is this a transportation proje ct?*
Type (s) of approv al sought from the DWR:
Doe s this proje ct hav e an e xisting proje ct ID#?*
Do you know the name of the staff me mbe r you would like to re que st a me e ting with?
Ple ase giv e a brie f proje ct de scription be low.*
Please give a couple of dates you are available for a meeting.
Ple ase attach the docume ntation you would like to hav e the me e ting about.
20201196 1
Winston-Salem Regional Office - [phone]
Dave Wanucha
Pre-Filing Me eting Reque st submitte d 9/21/2020
Amy Euliss
[e-mail]
R-5737
NCDOT Division 9
Davidson
Yes No
401 Water Quality
Certification - Regular
401 Water Quality
Certification - Express
Individual Permit Modification
Shoreline Stabilization
Yes No
Dave Wanucha
Convert at Grade Intersection to an interchange. Old Greensboro
Road at US29/70.
9/22/2020
pdf only
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water
Act Section 401 Certification Rule the following statements:

· This form completes the requirement of the Pre-Filing Meeting Request in the Clean Water Act Section
Signature
Submittal Date
401 Certification Rule.
· I understand by signing this form that I cannot submit my application until 30 calendar days after this pre-
filing meeting request.
· I also understand that DWR is not required to respond or grant the meeting request.

Your project’s thirty-day clock started upon receipt of this application.  You will receive notification regarding
meeting location and time if a meeting is necessary.  You will receive notification when the thirty-day clock has
expired, and you can submit an application.
9/21/2020