20171630 Ver 1_More Information Received_20180530

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 5/30/2018 2:44:23 PM (Message Start Event)
Accept by Montalvo, Sheri A 5/30/2018 2:46:22 PM (NON -DOT - Existing Project)
• The task was assigned to Montalvo, Sheri A. The due date is: June 4, 2018 5:00 PM
5/30/2018 2:44 PM

Staff Review
ID#* Version* 1
20171630
Is this project a public transportation project?* r Yes
r No
Reviewer List:* Sue Homewood:eads\slhomewood
Select Reviewing Office:* Winston-Salem Regional Office - [phone]
Submittal Type:*
401 Application
Does this project require a request for payment to be sent?*
r
Yes
r
No

Project Submittal Dated 5/30/2018
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:* r New Project
r Pre -Application Submittal
F More Information Response
r Other Agency Comments
r For the Record Only (Courtesy Copy)
New Project - Please check the new project type if you are trying to submit a new project that needs an official approval
decision.
Pre -Application Submittal - Please check the pre -application submittal if you just want feedback on your submittal and
do not have the expectation that your submittal will be considered a complete application requiring a formal decision.
More Information Response - Please check this type if you are responding to a request for information from staff and
you have and ID# and version for this response.
Other Agency Comments - Please check this if you are submitting comments on an existing project.
Project Contact Information
Name: Chris Hopper
Who is subrritting the information?
Email Address:* [e-mail]
Project Information
Existing ID #:* Existing Version:*
20171630 1
20170001 (no dashes)
Project Name:* North Wilkesboro Sewer Improvements
Is this a public transportation project?
r Yes
r No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
r Yes' No r Unknown
County (ies) *
Wilkes
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach docurrent
Revised_PCN_Wilkesboro_053018.pdf 56.2MB
Only pdf or k rm files are accepted.
Describe the attachments:
Updates requested during application review (revised cover letter, PCN form, and figures).
Full -Size plan sheets (PDF)
* V 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")
• 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
o I intend to electronically sign and submit the online form."
Signature:
rwItI-Y11d���. t
Submittal Date: