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Home My WebLink About20210926 Ver 1_401 Application_20211105 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 20210926 Is this project a public transportation project?* Yes No Is this a DOT Yes No project?* Reviewer List:* Rob Rid ings:eads\rgridings Select Reviewing Office:* Central Office-(919)707-9000 Submittal Type:* 401 Application 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 Project Contact Information ............................................................................................................................................................................................................................................................................................................................................................ Name: NCDOT Who is submitting the information? Email Address: jldilday@ncdot.gov Project Information ...................................................................................................................................................................................................................................................................................................................................................................................................... Project Name: US 401 at SR 2044(Ligon Mill Road)/SR 2224(Mitchell Mill Road) Is this a public transportation project? Yes No Is the project located within a NC DCM Area of Environmental Concern(AEC)? Yes No Unknown TIP#: WBS#: U-5748 50168.1.1 (Applies to DOT projects only) ......................................................................................................................................................................................................................................................................................................................................................... County(ies) Wake Please upload all files that need to be submited. Click the upload button or drag and drop files here to attach document U-5748 signed PJD.pdf 24.57MB U5748_PERMIT DRAWINGS_2021.11.02.pdf 28.31MB U5748 PERMIT 9.1 MB DRAWINGS_BUFFER_2021.11.02.pdf U5748 PERMIT 2.89MB DRAWINGS_BUFFER_UTILITIES_2021.11.01.pdf NOAA.pdf 174.35KB U-5748 Combined Mitigation.pdf 632.71 KB U-5748 EPCN Printed.pdf 2.02MB Only pdf or kmz files are accepted. Describe the attachments or comments: Due to technical issues with the ECPN form, please find the pdf of the form, permit drawings, buffer drawings, utility buffer drawings,Section 7 documentation,and compensatory mitigation information. 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: 11/5/2021 Is filled in automatically.