Project Submittal Interim 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:
12/6/2022
Project Contact Information
Name: Ashley Bentz
Who is submitting the information?
Email Address: * [e-mail]
Project Information
Existing ID #:
20230545
20170001(no dashes)
Project Name:* Saunders and Hinton Sidewalk Project
Is this a public transportation project?*
Yes
No
Is this a DOT project?*
Yes
No
Existing Version:*
2
1
Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
Yes No Unknown
Is this project connected with ARPA funding?*
Yes No
County (ies) *

Wake
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
Version 2 Saunders and Hinton Sidewalk
5.99MB
Project.pdf
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: