HomeMy WebLinkAbout20200533 Ver 2_More Information Received_20201113 _n
Staff Review Form
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Updated September 4,2020
Staff Review
Does this application have all the attachments needed to accept it into the review process?*
6* Yes r No
ID#* Version* 2
20200533
Is this project a public transportation project?* C Yes
r No
Reviewer List:* Sue Homewood:eads\slhomewood
Select Reviewing Office:* Winston-Salem Regional Office-(336)776-9800
Does this project require a request for payment to be sent?*
r
Yes
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 For the Record Only(Courtesy Copy)
r New Project
r Modification/New Project with Existing ID
✓ More Information Response
✓ Other Agency Comments
r Pre-Application Submittal
✓ Re-Issuance\Renewal Request
✓ Stream or Buffer Appeal
Is this supplemental information that needs to be sent to the Corps?*
Yes r No
Project Contact Information
Name: S&EC, PA-Bob Zarzecki
Who is submitting the inforrration?
Email Address: bzarzecki@sandec.com
Project Information
Existing ID#: Existing Version:
20200533 2
20170001(no dashes) 1
Project Name: Chatham Park North Village&Chatham Park Way North (NCDOT STIP#R-5930)
Is this a public transportation project?
(' Yes
✓ No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
✓ Yes r No r Unknown
TIP#: WBS#:
R-5930 (Applies to DOT projects only)
County(ies)
Chatham
Please upload all files that need to be submited.
Oick the upload button or drag and drop files here to attach docurrent
CP North Village-ADDITIONAL INFORMATION 11-
1.11MB
13-2020.pdf
Only pa or krrz files are accepted.
Describe the attachments
or comments:
Additional information in response to NCDWR Request for Additional Information letter dated October 21,
2020.
Sign and Submit
rJ By checking the box and signing box below, I certify that:
• I,the project proponent, hereby certifies that all information contained herein is true,accurate, and complete to
the best of my knowledge and belief.
• I,the project proponent, hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time.
• I agree that submission of this online 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: ♦z
Submittal Date: Is filled in automatically.