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DWR Pre-Filing Meeting Request Form
NORTH CAROLINA
Environmental Qunfuy
ID#* 20140090 Version* 8
Regional Office* Winston-Salem Regional Office-(336)776-9800
Reviewer List* Dave Wanucha
Pre-Filing Meeting Request submitted 1/28/2021
........................................................................................................................................................................................................................................................................................................................................................................................................................................................
Contact Name* Amy Euliss
Contact Email Address* aeuliss@ncdot.gov
Project Name* U-2579B(U-2579BA)
Project Owner* NCDOT Division 9
Project County* Forsyth
Owner Address: Street Address
375 Slias Creek Parkway
Address Line 2
aty State/Bovine/Region
Winston Salem NC
Fbstal/Zip Code Country
27106 USA
Is this a transportation project?* F Yes r No
Type(s)of approval sought from the DWR:
1 401 Water Quality Certification- I— 401 Water Quality Certification-
Regular Express
I— Individual Permit fJ Modification
1 Shoreline Stabilization
Does this project have an existing project ID#?*
(' Yes r No
Please list all existing project ID's associated with this projects.*
2014-0090 v.7
Do you know the name of the staff member you would like to request a meeting with?
Dave Wanucha
Please give a brief project description below.*
Please accept this preapplication request for any potential modifications
needed to the permit once the project is under construction.The LET
date for the project in April 2021.
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
Submittal Date 1/28/2021
Reviewer Meeting Request Decision
...............................................................................................................................................................................
Has a meeting been scheduled?* C Yes (' No