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NORTH CARO.INA
Staff Review Form
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Updated September2020
Staff Review
Does this application have all the attachments needed to accept it into the review process?*
Yes No
ID#* Version* 1
20201589
Is this project a public transportation project?* Yes
No
Is this a DOT Yes No
project?*
Reviewer List:* Donna Hood:eads\drhood
Select Reviewing Office:* Mooresville Regional Office-(704)663-1699
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
Is this supplemental information that needs to be sent to the Corps?*
Yes No
Please choose the commenting agency.*
DCM Comments DCM Permit
DFM Comments USFWS Comments
WRC Comments Other
Project Contact Information
...................................................................................................................................
Name: Dave McHenry
Who is submitting the information?
Email Address: david.mchenry@ncwildlife.org
Project Information
..................................................................................................
Existing ID#: Existing Version:
20201589 1
20170001(no dashes) 1
Project Name: B-5845 Cleveland County Bridge 25 Replacement
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#:
B-5845 (Applies to DOT projects only)
County(ies)
Cleveland
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
B-5845 Cleveland 25 IP Comments NCWRC
282.15KB
Comments.pdf
Only pdf or kmz files are accepted.
Describe the attachments or
comments:
WRC comments on IP
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.