20180156 Ver 1_PCN Form Submission_20180201

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 1/31/2018 3:54:47 PM (Start Event)
Accept by Carpenter,Kristi 2/1/2018 11:45:54 AM (DOT Initial Review)
• The task was assigned to Carpenter,Kristi . The due date is: February 5, 2018 5:00 PM
1 /31 /2018 3:55 PM

E-PCN Submittal
���
�lulslaa af Water Resources
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
January 31, 2018 Ver 2.3
*
Please note: fields marked with a red asterisk below are required. You will not be ab/e to submit the form until all mandatory questions are ans�red.
Also, if at any point you wish to print a copy of the E-PCN, all you need to do is right-click on the document and you can print a copy of the form.
Below is a link to the online help file.
https://edocs. deq. nc.gov/WaterResources/0/edoc/624704/PCN%20Help%20File%202018-1-30. pdf
A. Processing Information
County(or Counties) where the project is located:*
Dare
Is this project a public transportation project? *(')
C�' Yes C' No
Is this a NCDOT Project?*
r Yes C' No
(NCDOT only) T.I.P. or state project number:
R-5738
WBS #
50196.3.1
(for NCDOT use only)
1a. Type(s) of approval sought from the Corps:*
rJ Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?*
fJ Nationwide Permit (NWP)
r Regional General Permit (RGP)
Nationwide Permit (NWP) Number: 14 - Linear transportation
Nationwide Permit (NWP) Number: 12 - Utility Lines
NWP Number Other:
List all MNnurrbers you are applying for not on the drop down list.
1c. Type(s) of approval sought from the DWR:*

check all that apply
ri 401 Water Quality Certification - Regular r 401 Water Quality Certification - E�ress
r Non-404 Jurisdictional General Permit r Riparian Buffer Authorization
*
1d. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification: �' Yes C•' No
For the record only for Corps Permit: �' Yes C�' No
1e. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
If so, attach the acceptance letter from rritigation bank or in-lieu fee program
C' Yes �' No
1f. Is the project located in anyof NC's twentycoastal counties?*
C� Yes �' No
1g. Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
C•' Yes C' No C' Unknown
1h. Is the project located in a designated trout watershed?*
C' Yes �' No
Link to trout information: http://�wwv.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Clay Willis
1b. Primary Contact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
fJ Owner r Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
NCDOT ROW on SR 1208 (Kitty Haw1c Rd)
2b. Deed book and page no.:
NCDOT ROW
2c. Responsible party:
(for Corporations)
i NCDOT Division One
2d.Address

Street Address
113 Airport Drive Suite 100
Address Line 2
Qty
Edenton
Fbstal / Zip Code
27932
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
[phone]
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
State / R-ovince / I�gion
NC
Country
USA
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
R-5738 Kitty Hawk Road Improvements / Bridge Replacement # 40
1b. Subdivision name:
(if appropriate)
wa
1c. Nearest municipality/town:*
Kitty Hawk
1d. Driving directions*
If it is a new project and can not easily be found in a G� rrapping system Rease provide directions.
Drive North on US 158 through Nags Head, then turn left at a stop light on SR 1206 (Kitty Haw1c Road). The project begins at the intersection
of SR 1210 (Bob Perry Rd) and ends at the end of SR 1206, were the asphalt surface stops. Project Location Map is attached.
2. Project Identification
2a. Property Identification Number:
(tax RNor parcel ID)
NCDOT - ROW SR 1206
2b. Propertysize:
(in acres)
8 acres
2c. Project Address
Street Address
SR 1206 Kitty Hawic Rd. (from intersection with SR 1210 Bob Perry Rd. to the end of SR 1206 were the asphalt surface ends)
Address Line 2
��
Kitty Hawk
Fbstal / Zip Code
27949
2d. Site coordinates in decimal degrees
State / Rovince / I�gion
NC
Country
USA

Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey-grade GPS device) after the decimal place as
appropriate, based on howthe location was determined. (For e>cample, most mobile phones with GPS provide locational precision in decimal degrees to
map coordinates to 5 or 6 digits after the decimal place.)
� Latitude:* Longitude:*
36.0726 -75.7294
ex:34.208504 -77.796371
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Jean Guite Creek
3b. Water Resources Classification of nearest receiving water:*
Class "SC"
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Pasquotank
River Basin Lookup
4. Project Description
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
The e�asting conditions consist of a two-lane secondary road (SR 1205), with ewsting 8-10' wide travel lanes and
narrowshoulders varying in width. There is also an e�asting wooden bridge structure measuring 53' X21', crossing
of Jean Guite Creek. There is a pedestrian pathway that parallels the road on the west side, from the intersection
SR 1207 (Twiford St.) to SR 1209 (Rogers St.). This pathway is a asphalt surface approximately 6' in width. The
project area is a characterized by predominate residential usage by single family home sites. There is a graveyard
at the end of the project area, which will not be impacted by the proposed road improvements.
4b. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for
DWR)
aick the upload button or drag and drop files here to attach docurrent
LocationMapTopo.pdf
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1.18M6
4c. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site.
(for DWR)
C7ick the upload button or drag and drop files here to attach docurrent
I KittyHawkRd_Soil_Map.pdf
Fle type rrust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
2 acres
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
200
4f. Explain the purpose of the proposed project:*
570.07KB

This project proposes to make roadway improvements along a 1 mile stretch of Kitty Hawk Road by adding 2 feet
to the existing travel lanes, increase shoulder width to achieve a more uniform cross-section, and replace 2-
culverts. There will also be a bridge replacement associated with this project, which will replace an e�asting 53' X
21' wide wooden bridge with a 65' X40' precast concrete bridge structure. The road improvements will increase
safety along a narrow roadway that carries a significant number of vehicles traveling through the area. The bridge
replacement will insure a safe crossing over Jean Guite Creek and replace an aging wood bridge built in 1959.
The new bridge will also accommodate a pedestrian crossing and retain continuity along the pedestrian trail that
parallels Kitty Hawk Road.
4g. Describe the overall project in detail, including indirect imapacts and the type of equipment to be used:*
The project proposes to widen the ewsting travel lanes from 10' to 11' paved lanes and establish a uniform
shoulder section. This will involve some minor grading along the shoulder and extending the asphalt surface 1' on
either side of the roadway. There will also be 2 culvert replacements in association with the road improvements.
These are small culverts and will be replaced with larger diameter structures to accommodate burial under the
stream bed and increase hydraulic connectivity. There will also be the replacement of bridge # 40, wfiich crosses
over Jean Guite Creek. This is an aging v�rooden bridge that has deficiency rating, making it eligible for
replacement. The e�asting wooden bridge is 53 ' X 21' and will be replaced with a 65' X 40' precast concrete
structure. The wider bridge is designed to have a pedestrian walkway along the north side, which will retain
connectivity of the e�asting pedestrian path located to the east and west of Jean Guite Creek. The bridge
replacement will require the relocation of a waterline, telephone/fiber line and temporary relocation of a power line.
These utility relocations will be bored under Jean Guite Creek per the attached plans. Once the project is
complete, the power line will be placed back on the aerial telephone poles. The waterline and fiber optic phone line
will remain in the new locations.
4h. Please upload project drawings for the proposed project.
Qick the upload button or drag and drop files here to attach docurrent
R5738_PERMIT_20171212_Drawing.pdf 5.18MB
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5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
�' Yes �' No �' Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
C� Preliminary l" Approved C' Unknown l" N/A
Corps AID Number:
Exarrple: SAV�2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other
Clay Willis
NCDOT - Environmental Supervisor
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
The project was delineated by Clay Willis in May of 2016.
5d1. Jurisdictional determination upload
aick the upload button or drag and drop files here to attach docurrent
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6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*

r Yes r No r Unknown
7. Future Project Plans
7a. Is this a phased project?*
C' Yes C•' No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the
proposed project or related activity? This includes other separate and distant crossing for linear projects that require Department of the
Army authorization but don't require pre-construction notification.
D. Proposed I m pacts I nventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
� Wetlands r% Streams-tributaries r Buffers
fJ Open Waters r Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. Site #- Reason for impact* 2b. Impact type * 2c. Type of wetland*
Site1 - shoulder Fill P
N�p label (e.g. I�ad Qossing 1- Qalvert, F�rrranent (P� or
dewatering, etc) Terrporary (�
Site1 - work area/hand T
IClearing F2rrranerd(P�or
fv�p label (e.g. Id�ad Qossing 1- CLlvert, Terrporary (�
dewatering, etc)
Site2 - shoulder Fill/retaining P
I wall F2rrranent (P� or
N�p label (e.g. Fd�ad Qossing 1- Qalvert, Terrporary (�
dewatering, etc)
Site2- work area/hand T
Iclearing F2rrranent(P�or
N�p label (e.g. I�ad Qossing 1- CLlvert, Terrporary (�
dewatering, etc)
Site 3 steel sheet retaining P
w811 F�rrranent (P� or
I N�p label (e.g. Fd�ad Q-ossing 1- Qalvert, Tenporary (�
dewatering, etc)
Site 3 hand clearing T
N�p label (e.g. Road Qossing 1- Qalvert, F2rrrnnent (P� or
dewatering, etc) Terrporary (�
Site 4 shoulder fill P
N�p label (e.g. f�ad Q'ossing 1- CLlvert, F2rrranent (� or
dewatering, etc) Terrporary (�
Site 4 hand clearing T
N�p label (e.g. F�ad Qassing 1- Qalvert, F�rrranerd (P� or
dewatering, etc) Terrporary (�
Site 5 shoulder fill P
N�p label (e.g. F�ad Qossing 1- Qalvert, F�rrranent (P� or
dewatering, etc) Terrporary (�
Site 5 hand clearing T
fv�ip label (e.g. I�ad CXossing 1- CLlvert, F2rrrenent (�j or
dewffiering, etc) Terrporary (�
Non-Riverine Swamp
Forest
Non-Riverine Swamp
Forest
2d. Wetland name *Ze. 2f. Type of 2g. Impact
Forested* Jurisdicition* area*
Site 1 Yes Both 0.005
(404, 10) or D�R(401, (acres)
other)
Site 1 Yes Both 0.015
(404, 10) or aNF2(401, (acres)
other)
Non-Riverine Swamp Site 2
Forest
Non-Riverine Swamp Site 2
Forest
Non-Riverine Swamp Site 3
Forest
Non-Riverine Swamp Site 3
Forest
Salt/Brackish Marsh Site 4
Salt/Brackish Marsh Site 4
Salt/Brackish Marsh Site 5
Salt/Brackish Marsh Site 5
No
Yes
Yes
Both 0.002
(404, 10) or L7�ft(401, (acres)
other)
Both 0.026
(404, 10) or C7�R(401, (acres)
other)
Both 0.002
(404, 10) or C7�NR(401, (acres)
other)
Yes Both 0.017
(404, 10) or CMR(401, (acres)
other)
No Both 0.020
(404, 10) or L7�ft(401, (acres)
other)
No Both 0.010
(404, 10) or CMR(401, (acres)
other)
No Both 0.006
(404, 10) or CMR(401, (acres)
other)
No Both 0.016
(404, 10) or C7�ft(401, (acres)
other)

2a. Site #- Reason for impact* 2b. Impact type * 2c. Type of wetland * 2d. Wetland name *Ze. 2f. Type of 2g. Impact
Forested* Jurisdicition* area*
Site 6 shoulder fill P Salt/Brackish Marsh Site 6
N�p label (e.g. Finad Qassing 1- Qalvert, F2rrrenent (P'j or
dewatering, etc) Terrporary (�
Site 7 shoulder fill/ culvert P Riverine Swamp Site 7
N�p label (e.g. Id�ad Q'ossing 1- Qilvert, F2rrranent (Pj or Fol'est
dewatering, etc) Terrporary (�
Site 8 shoulder fill P Non-Riverine Swamp Site 8
N�p label (e.g. f�ad Qossing 1- CUlvert, F�rrrenerd (P� or Forest
dewatering, etc) Terrporary (�
Site 8 hand clearing T Non-Riverine Swamp Site 8
N�p label (e.g. Road C7assing 1- Qalvert, F2rrranent (P'j or Forest
dewatering, etc) Terrporary (�
Site 9 shoulder fill P Non-Riverine Swamp Site 9
fv�p label (e.g. I�ad Q'ossing 1- CLlvert, F2rrrenent (Pj or Forest
dewatering, etc) Terrporary (�
Site 9 hand clearing T Non-Riverine Swamp Site 9
N�p label (e.g. f3�ad Qossing 1- Qalvert, FBrrrenerd (P� or Forest
dewatering, etc) Terrporary (�
2g. Total Temporary Wetland Impact
0.110
2g. Total Permanent Wetland Impact
0.047
2g. Total Wetland Impact
0.157
2h. Comments:
Temporary Hand cleared wetlands will be allowed to re-vegetate following project completion
No
No
Yes
Yes
Yes
Yes
Both 0.006
(404, 10) or D�NR(401, (acres)
other)
Both 0.004
(404, 10) or C7�NR(401, (acres)
other)
Both 0.001
(404, 10) or C7�NR(401, (acres)
other)
Both 0.017
(404,10) or �ft(401, (acres)
other)
Both 0.001
(404, 10) or C7�ft(401, (acres)
other)
Both 0.009
(404, 10) or C7�NR(401, (acres)
other)
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this question for all stream sites
impacted.
3a. Site #- Reason for 3b.lmpact
impact * type *
Site 2 culvert P
N�p label (e.g. F�ad Qassing 1) f�rrranent (Fj or
Terrporary (�
Site 7 culvert P
N�p label (e.g. Fd�ad Qassing 1) F2rrraner�t (P/ or
Terrporary (�
3c. Type of impact* 3d. Stream name *
Culvert
Culvert
unnamed
unnamed
3e. Stream
Type *
Perennial
F�rennial (F�2) or
interrrittent (IfVn
Perennial
F2rennial (F9�) or
irderrrittent (If�
"" All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
10
3i. Total temporary stream impacts:
0
3f. Type of
Jurisdiction *
Both
Both
3g. Stream 3h. Impact
width* length*
3 4
Average (feet) (linear feet)
5 6
Average (feet) (linear feet)

3i. Total stream and tributary impacts:
10
3j. Comments:
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of the U.S. then individually list
all open water impacts below.
4a. Site # - Reason for
i impact*
Site 2 Cubert
N�p label (e.g. F�ad Qassing 1)
Site 7 Culvert
fv�p label (e.g. 13�ad Qossing 1)
4b. Impact type * 4c. Name of waterbody*
T unnamed
F2rrranent (Pj or (if applicable)
Terrporary (�
T unnamed
F2rrranent (P� or (if applicable)
Terrporary (�
4g. Total temporary open water Impacts:
0.02
4g. Total permanent open water impacts:
0.00
4g. Total open water impacts:
0.02
4h. Comments:
impacts are temporary from impervious dike for the 2 culvert installation
E. Impact Justification and Mitigation
1. Avoidance and Minimization
4d.Activitytype* 4e.Waterbodytype*4f.lmpact
area*
Dewatering Tributary
Dewatering Tributary
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
The design has minimized widening of the roadway and shoulders to the ma�mum extent practicable, while still
being able to retain project safety purpose. The alignment of the roadway was retained within the existing
impacted footprint. The bridge replacement design is using a single span, which will eliminate the existing 2 interior
bents in Jean Guite Creek. Stormwater has been routed of the bridge deck and through a vegetated conveyance.
0.01
(acres)
0.01
(acres)
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
The bridge will be built using staged construction and will not use an on-site v�rork bridge or temporary detour
bridge. The roadway lane widening and shoulder improvements will have the work areas contained by an
approved erosion and sediment control plan. This plan will be implemented and maintained during the life of the
project. Utility relocations are using a boring method under Jean Guite Creek, which is eliminating jurisdictional
impacts.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
i 2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
C' Yes
�' No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Wetland impacts have been avoided to the mabmum e�ent practicable and the result is a permanent impact of 0.047 acres of impact.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)

""* Recent changes to the stormwater rules have required updates to this section .*"�
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection
Rules?
C' Yes C•' No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
Located in the Pasquotank Basin
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
�' Yes C' No
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
C� Yes �' No
1b. If you answered "yes" to the above, does the project require preparation of an environmental document pursuant to the
requirements of the National or State (North Carolina) Environmental PolicyAct (NEPA/SEPA)?*
C' Yes C•' No
Comments:*
Qualifies under a minimum criteria checklist - SEPA document
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or
DWR Surface Water or Wetland Standards or Riparian Buffer Rules (15A NCAC 2B .0200)? *
C' Yes C•' No
2b. Is this an after-the-fact permit application?*
C' Yes C•' No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in additional development, which could impact
nearby downstream water quality?*
C' Yes C•' No
3b. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? *
C' Yes C' No C' f�/A

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
C' Yes �' No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
C•' Yes �' No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
C' Yes �' No
5e. Is this a DOT project located within Division's 1-8?*
C� Yes C' No
�' Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
T&E species list for Dare County - USFWS
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
C' Yes C•' No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NOAA - NMFS list
I 7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.ncdcr.gov/hpoweb/
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural
preservation status (e.g., National Historic Trust designation or properties significant in North Carolina historyand archaeology)?*
C' Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
SHPO review and survey
7c. Historic or Prehistoric Information Upload
C7ick the upload button or drag and drop files here to attach docurrent
16-06-0055NHPA_SHPO_noeffect.pdf 2.52M6
archaeology_report_nosurvey.pdf 8.35M6
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8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
C� Yes �' No
8b. If yes, explain how project meets FEMA requirements:
Project has been designed and reviev�d by professional civil and hydraulic engineers, with consideration of FEMA
requirements
8c. What source(s) did you use to make the floodplain determination?*
NC Floodplain FEMA maps

Miscellaneous
Miscellaneous attachments not previously requested.
Qick the upload button or drag and drop files here to attach docurrent
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Signature
rJ By checking the box and signing below, I certify that:
■ I have given true, accurate, and complete information on this form;
■ I agree that submission of this PCN form is a"transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic
Transactions AcY');
■ I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic
Transactions AcY');
■ 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 PCN form.
Full Name:*
Clay Willis
Signature
��/�.r� �T�r.�t�l
Date :

Initial Review
Is this project a public transportation project? *(?)
C� Yes C' No
Change only if needed.
Has this project met the requirements for acceptance in to the review process?*
C� Yes
C' No
BIMS # Assigned*
20180156
Version#*
1
Reviewing Office *
Washington Regional Office - [phone]
Select Project Reviewer*
Garcy Ward:eads\gpward
Is a payment required for this project?*
C' No payment required
�' Fee received
C' Fee needed - send electronic notification