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DWR Pre-Filing Meeting Request Form
NORTH CAROLINA
Environmental Quafuy
ID#* 20200233 Version* 2
Regional Office* Winston-Salem Regional Office-(336)776-9800
Reviewer List* Dave Wanucha
Pre-Filing Meeting Request submitted 2/25/2021
........................................................................................................................................................................................................................................................................................................................................................................................................................................................
Contact Name* Amy Euliss
Contact Email Address* aeuliss@ncodt.gov
Project Name* 17BP.9.R.98
Project Owner* NCDOT
Project County* Stokes
Owner Address: Street Address
375 Silas Creek Parkway
Address Line 2
City State/Bovine/Region
Wintson 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.*
20200233
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.*
This preapplication form is being submitted in case a permit
modification is needed during construction.A preapplication meeting
is not needed at this time.
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 2/25/2021