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HomeMy WebLinkAbout20190230 Ver 7_More Information Received_20220228 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* 7 20190230 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 Is this supplemental information that needs to be sent to the Corps?* Yes No Project Contact Information ...................................................................................................................................................................................................................................................................................................................................................................................................... Name: Paul Williams Who is submitting the information? Email Address: pcwilliams2@ncdot.gov Project Information ............................................................................................................................................................................................................................................................................................................................................................ Existing ID#: Existing Version: 20190230 6 20170001(no dashes) 1 Project Name: NCDOT-US 158 Widening/Improvements(R-2582A) 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#: R-2582A 34472.3.2 (Applies to DOT projects only) .............................................................................................................................................................................................................................................................................................................................................. County(ies) Northampton Please upload all files that need to be submited. Click the upload button or drag and drop files here to attach document Site 5 East Front Face Revised.pdf 176.57KB R-2582A Wetland Impact Summary 118.7KB Sheet_2022.2.28.pdf Only pdf or kmz files are accepted. Describe the attachments or comments: To stabilize slope at site 5, NCDOT requests a conversion of 0.056 acre of previously authorized mech. clearing in wetlands to perm.fill in wetlands,as shown in attached drawing. 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: 02/28/2022 Is filled in automatically.