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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* 2
20190505
Is this project a public transportation project?* Yes
No
Is this a DOT Yes No
project?*
Reviewer List:* Amy Chapman:eads\aschapman
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
Pre-Filing Meeting Date Request was submitted on:
10/25/2021
Project Contact Information
...............................................................................................................................................................................................................
Name: Erin Cheely
Who is submitting the information?
Email Address: ekcheely@ncdot.gov
Project Information
_....... ...... ...........
Existing ID#: Existing Version:
2019505 1
20170001(no dashes) 1
Project Name: B-4571 -Bridge 7 over Indian Creek on NC 82 in Lincoln County
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-4571 38414.1.2
(Applies to DOT projects only)
County(ies)
Lincoln
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
B-4571 Lincoln Reverification October 2022.pdf 9.67MB
Only pdf or kmz files are accepted.
Describe the attachments or
comments:
Reverification of this project is requested as the previously issued Nationwide Permits will expire and
construction is not anticipated to be complete by the expiration.Construction has not yet begun as this project
is scheduled to let in December 2022.
The previously issued 404 and 401 Permits(Permit Package)and Application Package are attached.There
have been no changes to design or impacts since the previously issued permits and the plans submitted with
the original application package remain accurate and valid.
Protected species surveys for this project are up to date,with surveys for dwarf-flowered heartleaf and
Michaux's sumac last being conducted in 2021,with no individuals of either species found. Northern long-eared
bat is no longer listed within the project area.
There have been no changes to Archaeology and Historic Properties since the previously issued permits.The
original permit pre-dated current tribal coordination protocols. Please find attached tribal coordination for this
project.
NCDOT is hereby requesting reverification under RGP 50.
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:
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Submittal Date: Is filled in automatically.