20170001 Ver 1_Mortimer 207 Waddell Rd Mooresville 28117_20210810

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Staff Review
Does this application have all the attachments needed to accept it into the review process?*
r Yes r No
ID#* Version*
20170001
Is this project a public transportation project?* r Yes
r No
Reviewer List:* Chris Pullinger:eads\rcpullinger
Select Reviewing Office:* Washington Regional Office - [phone]
Does this project require a request for payment to be sent?*
r
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
r
More Information Response
r
Other Agency Comments
r
Pre -Application Submittal
r
Re-Issuance\Renewal Request
r
Stream or Buffer Appeal
Is this supplemental information that needs to be sent to the Corps?*
r Yes r No
Project Contact Information
Name: Kim Jordan
who is subrritting the inforrration?
Email Address: [e-mail]
Project Information
Existing ID #: Existing Version:
20170001 1
20170001(no dashes) 1
Project Name: Mortimer Shoreline Project
Is this a public transportation project?
r Yes
r No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
r Yes r No r Unknown
County (ies)
Iredell
Please upload all files that need to be submited.
aick the upload button or drag and drop files here to attach document
Mortimer 207 Waddell Rd Mooresville 28117.pdf 10.97MB
Only pdf or lm7 files are accepted.
Describe the attachments
or comments:
2 Trees for removal.
NOT SURE if the Project ID is correct as I just submitted this application today. 207 Waddell Rd Mooresville,
NC 28117
Sign and Submit

W 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:
Submittal Date: Is filled in autorratically.