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Home My WebLink About20211579 Ver 1_New Project Form_20211102 o 0 vim. NORTH CARO.INA Staff Review Form Envlmnm¢ntrtl Qvofiry Updated September2020 Staff Review Does this application have all the attachments needed to accept it into the review process?* Yes No ID#* Version* 1 20211579 Is this project a public transportation project?* Yes No Is this a DOT Yes No project?* Reviewer List:* Garcy Ward:eads\gpward Select Reviewing Office:* Washington Regional Office-(252)946-6481 Does this project require a request for payment to be sent?* Yes 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:* For the Record Only(Courtesy Copy) New Project 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: Site Visit.pdf 100.32KB Date for Meeting Request 10/11/2021 ID# Version Project Contact Information Name: Paul Williams Who is submitting the information? Email Address: pcwilliams2@ncdot.gov Project Information Existing ID#: Existing Version: 20211579 1 20170001(no dashes) 1 Project Name: Hertford Bridge 97 Replacement Project Is this a public transportation project? Yes No Is the project located within a NC DCM Area of Environmental Concern (AEC)? Yes No Unknown TIPM WBS#: 17BP.1.R.98 (Applies to DOT projects only) ........................................................................................................................................................................................................................................................................................................................................... County(ies) Hertford Please upload all files that need to be submited. Click the upload button or drag and drop files here to attach document Topo.pdf 1.2MB Soil_Map.pdf 661.89KB NCWRC Email.pdf 291.53KB 450097_Permit Drawings_20211012.pdf 1.71 MB Hertford Bridge 97-Tribal Coordination Letter 124.07KB Meherrin.pdf Hertford Bridge 97-Tribal Coordination Letter 124.07KB Tuscarora.pdf Hertford Bridge 97-Tribal Coordination Letter 124.07KB Catawba.pdf SAW-2019-00783 NCDOT Hertford Bridge 9.83MB 97_PJ D.pdf SAW-2019-00783 NCDOT Hertford Bridge 97.pdf 251.44KB PA 19-01-0018 No Archaeological Survey Required 1.31 MB Str No 97 on SR 1311 Hertford.pdf 19-01-0018NoSurvey.pdf 3.1 MB Pre-Construction Notification(PCN)Form.pdf 395.72KB Only pdf or kmz files are accepted. Describe the attachments or comments: Resubmittal of PCN and Documents. Sign and Submit ...................................................................................................................................................................................................................................................................................................................................................................................................... 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: 11/2/2021 Is filled in automatically.