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HomeMy WebLinkAbout20211802 Ver 2_Re-Issuance_Renewal Request_20220525 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* 2 20211802 Is this project a public transportation project?* Yes No Is this a DOT Yes No project?* Reviewer List:* Hannah Sprinkle:eads\hhsprinkle Select Reviewing Office:* Wilmington Regional Office-(910)796-7215 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 Pre-Filing Meeting Date Request was submitted on: 12/13/2021 Project Contact Information Name: Mason Herndon Who is submitting the information? Email Address: tmherndon@ncdot.gov Project Information Existing ID#: Existing Version: 20211802 1 20170001(no dashes) 1 Project Name: Commerce Drive Extension 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-5878 44694.1.1 (Applies to DOT projects only) County(ies) Onslow Please upload all files that need to be submited. Click the upload button or drag and drop files here to attach document U-5878 404_401 Reissuance Request_20220525.pdf 185.49KB Only pdf or kmz files are accepted. Describe the attachments or comments: Reissuance request letter 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.