Loading...
HomeMy WebLinkAbout20190593 Ver 6_401 Application_20220121 sy STAT Staff Review Form NORTH CAROLINA Envlronm¢ntcl Qvoray Updated September 4,2020 Staff Review Does this application have all the attachments needed to accept it into the review process?* Yes No ID#* Version* 6 20190593 Is this project a public transportation project?* Yes No Is this a DOT Yes No project?* Reviewer List:* Rob Ridings:eads\rgridings Select Reviewing Office:* Central Office-(919)707-9000 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: Gordon Cashin Who is submitting the information? Email Address: gcashin@ncdot.gov Project Information ...................................................................................................................................................................................................................................................................................................................................................................................................... Existing ID#: Existing Version: 20190593 4 20170001(no dashes) 1 Project Name: 1-40 from I-440/US 64(Exit 301)to just north of SR 1525(Cornwallis 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#: 1-5111 1-4739 42346.3.1 (Applies to DOT projects only) ............................................................................................................. County(ies) Johnston Wake Please upload all files that need to be submited. Click the upload button or drag and drop files here to attach document 1-5111 1-4739 Individual Modification Wake Johnston 14.38MB January 21 2022.pdf Only pdf or kmz files are accepted. Describe the attachments or comments: DA#SAW-2009-00556 Please find attached cover letter, DMS Acceptance letter, Revised Permit and Buffer Drawings 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: 104 C ltfreavbf. 1)f Submittal Date: 1/21/2022 Is filled in automatically.