20201709 Ver 1_Modification Request_20211012

Staff Review
Does this application have all the attachments needed to accept it into the review process?*
r Yes r No
ID#* Version*
20201709
Is this project a public transportation project?* r Yes
r No
Reviewer List:* Alan Johnson:eads\adjohnson1
Select Reviewing Office:* Mooresville 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
Pre -Filing Meeting Information
Pre -Filing meeting request information is not needed for this project.
Project Contact Information
Name: Michael Burkhard
Who is subrritting the inforrration?
Email Address: [e-mail]
Project Information
Existing ID #: Existing Version:
20201709 1
20170001(no dashes) 1
Project Name: Adams Shoreline
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.
Gick the upload button or drag and drop files here to attach docurrent
DWR Pre -Filing Meeting Request Form approval.pdf 56.62KB
Only pdf or krre files are accepted.
Describe the attachments
or comments:

On my submittal package, I entered the project address incorrectly.
The address shown on my DWR Pre -Filing Request the address of 424 Oak Tree Rd was correct.
The address I entered on the Shoreline Stabilization Application was 242 Oak Tree Rd which is incorrect.
Please Change the project address too: 424 Oak Tree Rd.
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');
■ 1 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:
Ac el1i gbr-khorc)
Submittal Date: Is filled in autocratically.