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Home My WebLink About20211364 Ver 1_401 Application_20211108 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 20211364 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 Project Contact Information ............................................................................................................................................................................................................................................................................................................................................................ Name: Nancy Oberle Who is submitting the information? Email Address: nancy.oberle@threeoaksengineering.com Project Information ...................................................................................................................................................................................................................................................................................................................................................................................................... Existing ID M Existing Version: 20211364 1 20170001(no dashes) 1 Project Name: Replacement of Bridge No.530068 on SR 1515(Aldridge Store Rd)over Groundnut Creek 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#: 17BP.2.R90 38413.1.2 (Applies to DOT projects only) County(ies) Lenoir Please upload all files that need to be submited. Click the upload button or drag and drop files here to attach document Pre-Construction Notification(PCN)Form_10-14- 427.57KB 21.pdf Only pdf or kmz files are accepted. Describe the attachments or comments: The attached PCN form was previously submitted prior to the document being complete.We are submitting it now as a complete application. The project has been assigned Action ID SAW-2021-02323. T&E aquatic species surveys have not been done at this time,but are scheduled to be completed before the project is Let.Appropriate consultation will be completed prior to Let. It is anticipated,if the Biological Conclusion for Carolina madtom or Neuse River waterdog is MANLAA or MALAA,the appropriate payment will be made for each species per the existing PCO. 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: Is filled in automatically.