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HomeMy WebLinkAbout20210812 Ver 1_401 Application_20210419 STATE Staff Review Form NORTH CAROLINA £nWrcnmenrcl Qua fay 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 20210812 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-(252)946-6481 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 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 Project Contact Information Name: Paul Williams Who is submitting the inforrration? Email Address: pcwilliams2©ncdot.gov Project Information Project Name: Northampton Bridge 13 Replacement Project Is this a public transportation project? r Yes ✓ No Is the project located within a NC DCM Area of Environmental Concern (AEC)? ✓ Yes r No r Unknown TIP#: WBS#: 17BP.1.R.92 (Applies to DOT projects only) County(ies) Northampton Please upload all files that need to be submited. Click the upload button or drag and drop files here to attach document 17BP.1.R.92_Permit Drawings_08.21.19.pdf 738.19KB SAW-2016-01758 NCDOT B-5502 Branches Bridge 259.22KB Road PJD.pdf SAW-2016-01758 NCDOT B-5502 Branches Bridge 222.02KB Road signed PJD.pdf Section 10 Email.pdf 115.15KB 17BP.1.R.92_Preliminary_JD_010719.pdf 23.52MB NH 13 Topo.pdf 528.7KB Only pdf or krre files are accepted. Describe the attachments or comments: Bridge 13(155'long)in Northampton County will be replaced on the existing alignment with a 168' long bridge over the Meherrin River.The existing bridge was built in 1976 as is Structural Deficient.The project will result in no jurisdictional wetland impacts and no jurisdictional stream impacts.The Meherrin River is not listed as Section 10 waters at this location.The bridge will not have deck drains. Storm water will be conveyed through 2 DI's on the west end of the bridge and discharged into vegetated areas near the west bank of the river.All as shown in the attached permit drawings. Sign and Submit ....................................................................................................................................................................................................................................................................................................................................................................................................... 117 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: c rru/C r//rr Ill/44/mt. Submittal Date: Is filled in autorretically.