20191760 Ver 2_401 Application_20210927

Staff Review Form •
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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* 2
20191760
Is this project a public transportation project?* (' Yes
r No
Is this a DOT ( Yes C No
project?*
Reviewer List:* Donna Hood:eads\drhood
Select Reviewing Office:* Mooresville 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
r Modification/New Project with Existing ID
✓ More Information Response
✓ Other Agency Comments
✓ Pre-Application Submittal
✓ Re-Issuance\Renewal Request
✓ Stream or Buffer Appeal
Pre-Filing Meeting Information
Before submitting this form please ensure you have submitted the Pre-Filing Meeting Request Form as we will not
be able to accept your application without this important first step.The Pre-Filing Meeting Request Form is used in
accordance with 40 C.F.R. Section 121.4(a)"At least 30 days prior to submitting a certification request,the project
proponent shall request a pre-filing meeting with the certifying agency"and in accordance with 40 C.F.R. Section
121.5(b)(7),and (c)(5)all certification requests shall include documentation that a pre-filing meeting request was
submitted to the certifying authority at least 30 days prior to submitting the certification request.Click here to read
more information on when this form is needed prior to application submission or here to view the form.
Attach documentation of Pre-Filing Meeting Request here:
DWR Pre-Filing Meeting Request Form.pdf 56.42KB
Date for Meeting Request 10/6/2021
ID# 20191760 Version
Project Contact Information
Name: Joel M. Howard, NCDOT
who is submitting the inforrration?
Email Address: [e-mail]
Project Information
Existing ID#: Existing Version:
20191760/SAW No. 2018-01958
20170001(no dashes)
Project Name: C-5621
Is this a public transportation project?
Yes
C No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
c Yes c; No r Unknown

TIP#: WBS#:
C-5621 50146.3.1
(Applies to DOT projects only)
County(ies)
Mecklenburg
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
C-5621_Permit Drawings_20210913 Finalized.pdf 3.2MB
PJD.pdf 13.14MB
Only pdf or kaz files are accepted.
Describe the attachments
or comments:
C-5621 is an NCDOT Transportation Project that will consist of road improvements and the construction of
two roundabouts in the town of Cornelius, Mecklenburg County.The two roundabouts will be constructed
along US 21,one south of Catawba Ave and one north of Catawba Ave.This project can not be built without
impacts to streams and a wetland.The 404/401 permits for this project were originally applied for through the
online PCN process on 12/30/2019.An interim"More Information Response"was submitted on 4/20/2020 to
address Ms. Nicholle Braspennickx(USACE) request for additional information.
This project interim form is for the modification and request for additional information by Ms. Crystal
Amschler's(USACE)email dated 1/11/2021. Ms.Amschler requested that the plans show proper stream
alignment at the inlet of site 2A and also clarify the location of the outlet at site 2B. Site 2A after being
surveyed is now shown to correctly align at the pipe inlet. Site 2B is shown on plan sheet 6(inset)to match at
station 16+40 at the southern end of the project.
Ms.Amschler also request that a new PJD be submitted to note the newly identified wetland (Permit Site 4).
You will find that I have attached new plan sheets that include reduced impact totals.Also attached is a new
PJD that includes a wetland data form for permit site 4.
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:
)( itigiinefl
Submittal Date: 9/27/2021
Is filled in automatically.