20201695 Ver 1_Pre-Filing Meeting Request_20201106

ID#* 20201695
Version* 1
Regional Office* Winston-Salem Regional Office - [phone]
Reviewer List* Sue Homewood
Pre -Filing Meeting Request submitted 11/6/2020
Contact Name *
Contact Email Address*
Project Name*
Project Owner*
Project County*
Owner Address:
Bradley S. Luckey
[e-mail]
Cottage Hill Subdivision
806 Gibb Street, LLC
Forsyth
Street Address
11 Brokestone Avenue
Address Line 2
aty
Winston-Salem
Rbstal / Zip Code
27101
Is this a transportation project?* r Yes r No
State / Frovince / Region
NC
Country
USA
Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - F- 401 Water Quality Certification -
Regular Express
r- Individual Permit r- Modification
r- Shoreline Stabilization
Does this project have an existing project ID#?*
r Yes r No
Do you know the name of the staff member you would like to request a meeting with?
Sue Homewood
Please give a brief project description below.
Applicant does not request a meeting. The applicant may submit a request
401 WQC.
Please give a couple of dates you are available for a meeting.

Please attach the documentation you would like to have the meeting about.
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 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.
Signature
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Submittal Date 11/6/2020