20200929 Ver 1_Modification Request_20210226

Staff Review Form •
NORFH CA.,i0:INA
En vironmenfrr!QvoGry
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* 1
20200929
Is this project a public transportation project?* (' Yes
r No
Is this a DOT ( Yes C No
project?*
Reviewer List:* Garcy Ward:eads\gpward
Select Reviewing Office:* Washington 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:* r For the Record Only(Courtesy Copy)
r New Project
✓ Modification/New Project with Existing ID
✓ More Information Response
✓ Other Agency Comments
✓ Pre-Application Submittal
✓ Re-Issuance\Renewal Request
r Stream or Buffer Appeal
Pre-Filing Meeting Information
Pre-Filing meeting request information is not needed for this project.
Project Contact Information
.......................................................................................................................................................................................................................................................................................................................................................................................................
Name: Steve Trowell
Who is submitting the information?
Email Address: [e-mail]
Project Information
............................................................................................................................................................................................................................................................................................................
Existing ID#: Existing Version:
2020929 1
20170001(no dashes) 1
Project Name: Courtesey Notification-Tyrrell County SR 1321 South Gum Neck Road Pipe
Replacement
Is this a public transportation project?
a Yes
✓ No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
✓ Yes r No a Unknown
TIP#: WBS#:
1 B.208911
(Applies to DOT projects only)
County(ies)
Tyrrell
Please upload all files that need to be submited.

Click the upload button or drag and drop files here to attach document
Project Submittal Interim Form double pipe.pdf 51.46KB
Decision for 20200929 Ver 1 Courtesy Notification-
Tyrrell County SR 1321 South Gum Neck Road 100.95KB
Second Pipe.pdf
V2 Topo SR 1321 South Gum Neck Road near
1.09MB
Cherry Ridge Landing.pdf
only pdf or kaz files are accepted.
Describe the attachments
or comments:
This is a courtesy notification that NCDOT plans to modify DWR project no.2020929 v1.The reported
existing length of the double pipes was originally reported to be 75' long.This pipe length was taken from a
NCDOT pipe inventory.An actual physical measurement taken onsite indicates that the actual existing pipe
length is 80'. Based upon this new information NCDOT is modifying the original courtesy notification to
updated the proposed pipe size from an existing 72"x 80'CMP to a 84"x 88'CAPA.The increase in pipe
length will allow for more stable slopes.This pipe replacement will result in 412 ft2 of open water impact.
Sign and Submit
IW 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:
�JCaX.
Submittal Date: Is filled in automatically.