20191466 Ver 2_401 Application_20221113

Staff Review
Does this application have all the attachments needed to accept it into the review process?*
Yes No
ID#* Version* 2
20191466
Is this project a public transportation project?* Yes
No
Is this a DOT Yes No
project?*
Reviewer List: * Ryan Conchilla:eads\rjconchilla
Select Reviewing Office:* Central Office - [phone]
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:
4/29/2022
Project Contact Information
Name: Jeffrey Hemphill NCDOT - ECAP
Who is submitting the information?
Email Address: [e-mail]
Project Information
Existing ID #: Existing Version:
201801859 1
20170001(no dashes) 1
Project Name: The Replacement of Bridge 780168 on NC 14/87 over the Smith River
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 R-0044 67044.1.1
(Applies to DOT projects only)
County (ies)
Rockingham
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
BR-0044 Reverification Request November 2022.pdf 18.16MB
Only pdf or kmz files are accepted.

Describe the attachments or
comments:
NCDOT requests the renewal of the 404 and 401 permits issued November 19, 2019 and November 20, 2019,
respectively for BR-0044 in Rockingham County. There have been no design changes to the project and the
original permit drawings from the October 30, 2019 Permit Application submittal are still valid.
Informal Concurrence for Roanoke logperch (MANLTAA) issued October 31, 2019 is still valid (James River
spinymussel has been dropped from the project area - IPAC November 8, 2022).
'The project is currently 5% complete. The original Let was delayed due to funding.
Due to a funding change, the WBS Element changed from 67044.1.1 to 49077.1.1
Tribal coordination with Catawba and Monacan (included) occurred on November 25 and December 16 2019,
respectively.
NCDOT requests a RGP 50 for this renewal.
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: 11/13/2022
Is filled in automatically.