20211364 Ver 1_Quick Sheet Supplemental Information Form_20211015

Quick Sheet Using Supplemental Information Form for Transportation Permitting Branch to
submit Modifications/Revisions
The following link will always have the most updated form(s)available for use:
https://edocs.deq.nc.gov/Forms/form/new/80
The following form is a screen shot of the current form as of June 22, 2020 and shows the Modification/New Project
with Existing ID Form located at the link above.
Items to be filled out are marked by red numbers and correspond to the list below.
For any questions regarding this process please contact Kristi Lynn Carpenter at 919.707.8785 or
[e-mail].
1. Choose the Modification/New Project with Existing ID option.
2. For Submittal Type Choose Modifications.
3. Fill in your name and email underthe Project Contact Information.
4. Fill in the existing Project ID#and current version number.
5. Fill in the project name with the actual descriptive name. Please do not use just a TIP or WBS Element number.
Choose yes that it is a Public Transportation Project.Choose the appropriate radio button for information on the
project being located within a NC DCM Area of Environmental Concern (AEC).
6. Choose the County. You can add additional counties if needed by clicking the Add another county option.
7. Upload any documents related to the modification/revision.
8. Use the Describe the attachments box to fill in any information you normally provide to describe the
modification. Please include the previous DWR Number when applicable.
9. Check the signature box and then Sign using the verification process.
10. Choose Submit to send immediately or Save as Draft to save a copy to amend before submitting.
Once you have submitted the form,it will be routed according to how you have completed the information. When using
the form perthe instructions above,the steps below will all be true statements.
A copy of the form always goes to the Central Transportation Permitting Office to be verified and then linked into the
proper project folder inside of Laserfiche. The link provided when the application was originally received and assigned
will still be functional and contain all original documents and revised document(s). Once the document(s)is uploaded it
will be placed in the reviewers'queue so they will be on a deadline to take appropriate actions to review the project and
issue letters regarding theirfindings.The deadline can be subjectto change from the original deadline depending on the
document(s)provided.
A copy of the form always goes to the Army Corps of Engineers concurrently.
A copy of the form will be sent to DCM if the Yes radio button has been chosen that the project is located within an AEC.
A copy of the form will be sent to the Wildlife Resources Commission if within a trout watershed based on county.

Project Submittal Interim Form
MORT-=Art9LNA
Fmkaanmwl eauYiy
Updaled Jude 20,2017
Please note:ffefds marked with a red aster7sk*below are required. You will not be able to submit the form until all
mandatory questions are answered.
• Project Type:* C New Project New Project with Existing ID
y-J' Pre-Application Submittal O More Information Response
Other Agency Comments O Stream or Buffer Appeal
0 For the Record Only{Courtesy Copy}
© Submittal Type:"
v
Value is required.
New Project-Please check the new project type if you are trying to submit a new project that needs an official approval
decision.
Pre-Application Submittal-Please check the pre-application submittal it you just want feedback on your submittal and
do not have the expectation that your submittal will be considered a complete application requiring a formal decision.
More Information Response-Please check this type if you are responding to a request for information from staff and you
have and ID#and version for this response.
Other Agency Comments- Please check this if you are submitting comments on an existing project.
IIProject Contact Information
Name:
Wm is submitting the i nrormaliion?
Email Address:*
Project information
4 ExisUng ID :'� Existing Version:*
24170001(no-dashes)

UProject Name:*
Is this a p u bl i s transportation project?*
0 Yes
O No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
O Yes 0 No 0 Unknown
County(ies)*
6
Add another county
Please upload all files that need to be submited.
C ck:be upload bu tenor d•ag and d•op flea here to attach document
Upload
On y pdf or[gra files are accepted.
Describe the attachments or add comments:
8
* 0 By checking the box and signing box below: I certify that
▪ have given true: accurate,and complete information on this form;
▪ agree that submission of this form is a"transaction: subject to Chapter 66,Artide 40 of the NC General Statutes(the
`Uniform Electronic Transactions Act')
▪ agree to conduct this transaction by electronic means pursuant to Chapter 66 Artide 40 of the NC General Statutes
(the`Uniform Electronic Transactions Act");
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature;AND
▪ intend to electronically sign and submit the online form."
9 Signature: ` Sign
Submittal Date:
la filled in automatically once submitted.
10 Submit Save as Draft