HomeMy WebLinkAboutR-2577ABC US 158 Improvements - 1/29/2023Please 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
Submittal Type:*
401 Application
Pre -Filing Meeting Date Request was submitted on:
4/29/2022
Project Contact Information
Name: Amy Euliss
Who is submitting the information?
Email Address:* aeuliss@ncdot.gov
Project Information
Project Name: * R-2577ABC US 158 Improvements
Is this a public transportation project?*
Yes
No
Is this a DOT project?*
Yes
No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
Yes No Unknown
TIP#: WBS#:
R-2577ABC 37405.1.1
(Applies to DOT projects only)
County (ies)*
Forsyth
Guilford
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
R2577ABC_IP_Package_01.27.2023.pdf 169.46MB
Only pdf or kmz files are accepted.
Describe the attachments or add comments:
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: 1/27/2023