20211344 Ver 1_Pre-Filing Meeting Information_20210909

919/21, 9 '52 AM
Submission Completed
DWR Pre -Filing Meeting Request Form
Contact Name*
Contact Email Address*
Project Owner*
Project Name*
Project County*
Owner Address:
Is this a transportation project?*
Gene Young
[e-mail]
t4
a `S
n
NtlRr H CAROLINA
Ce.Ye.rrnd QueG,
Chris Plaford - Southeast Partners VIE, LLC
Lot 3 Hackney Dlvlsion
Pander
Street Address
1121 Military Cutoff RD, suite C 336
Address Line 2
City
wilmington
Postal / zip Code
28405
Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Individual Permit
Shoreline Stabilization
Does this project have an existing project ID#7
Yes No
Yes No
State 1 Province 1 Region
NC
Cbuni;y
USA
401 Water Quality Certification - Express
Modification
Do you know the name of the staff member you would like to request a meeting with?
No
Please give a brief project description below and include location Information.
Small fill Impact In order to construct home at Lot 3 Hackney Division_
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.
https:11edocs.deq.nc.gov/Forms/FomVSubmk 112

919/21. 9:52 AM
Submission Completed
• 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*
�eAe VOGhy, DENS
Submittal Date 9/9/2021
htipslledocs.deq.nc.govlFormslFom-dSubmk 212