20150160 Ver 3_More Information Received_20180220

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 2/20/2018 2:36:02 PM (Supplemental Submital)
Accept by Carpenter,Kristi 2/21/2018 3:37:02 PM (DOT - E�asting Project)
• The task was assigned to Carpenter,Kristi 2/20/2018 2:36 PM

Water Resources
ENVIRONMENTAL OUALITY
Staff Review:
i�#*
20150160
Reviewer List:*
Select Reviewing Office:*
Version *
3
Joanne Steenhuis:eads\jhsteenhuis
Wilmington Regional Office - [phone]
Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
C' Yes C•' No C' Unknown
Does this project C' Yes
require payment?* r No
Project Submittal Interim Form
subrritted: 2/20/2018
Submittal Type: C•' New Project
C' Pre-Application Submittal
C' More Information Response
Project Contact Information:
Name: Anneliese Westphal
Who is subrritting the inforrration?
Email Address: [e-mail]
Project Information:
Project Name: NC Highway 53 Improvements
Is this a public transportation project?
C' Yes
l' No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
l' Yes �' No �' Unknown
TIP#: R-5023B&C
WBS#: 41922.3.4
(Applies to DOT projects only)
County(ies)*
Onslow
Describe the attachments:

The attached is a pdf PCN package for the reissue of permits for the R-5023B&C project. The package
includes permit drawings which are the same as those submitted for the original permits in September 2015.
Please upload all files that need to be submited.
R5023BC_PCN package_reissue_electonic.pdf 11.43MB
Only pdF files are accepted.
r7 By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;
o I agree that submission of this form is a"transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the
"Uniform Electronic Transactions Act")
o 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');
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the form.
Signature:
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