20180725 Ver 1_More Information Received_20180613

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 6/13/2018 11:16:18 AM (Message Start Event)
Accept by Carpenter,Kristi 6/13/2018 2:56:41 PM (DOT - E�asting Project)
. The task was assigned to Carpenter,Kristi. The due date is: June 18, 2018 5:00 PM
6/13/2018 11:16 AM

Staff Review
i�#*
20180725
Version* �
Is this project a public transportation project? *
Is this a DOT F Yes f No
project?*
Reviewer List:*
Select Reviewing Office:*
Submittal Type:*
401 Application
C•' Yes
�' No
Joanne Steenhuis:eads\jhsteenhuis
Wilmington Regional Office - [phone]
Does this project require a request for payment to be sent? *
r
Yes
r•
No
Water Resources
ENVIRONMENTAL �UPLITV

Project Submittal Dated 6/13/2018
*
Please note: fields marked with a red asterisk beloware required. You will not be able to submit the form until all
mandatory questions are ans�red.
Project Type:* �' New Project
�' Pre-Application Submittal
C•' More Information Response
r Other Agency Comments
l' 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 e�ectation 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 ebsting project.
Project Contact Information
Name:
Email Address:*
Project Information
Existing ID#:*
20180725
20170001(no dashes)
Project Name:*
James J. Rerko, PWS
Who is subrritting the irrforrration?
[e-mail]
Existing Version:*
1
17BP.6. R.92/B-4479
Is this a public transportation project? *
C•' Yes
C' No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
C' Ye�' No l' Unknown
TI P#:
B-4479
County (ies) *
Columbus
WBS#:
17 BP.6. R.92
(Applies to DOT projects only)
Please upload all files that need to be submited.
C7ick the upload button or drag and drop files here to attach docurrent
B4479 Permit Package.pdf 5.19MB
Only pdf or Ivrz files are accepted.
Describe the attachments:

I had the consultant revise the permit drawings to include the areas for the rip-rap pads at the pipe outlets
and the few areas where the fill extended into areas shown as Hand Clearing. The impacts were minor but,
the drawings are now correct.
* �J 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 AcY')
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 online form."
Signature:
� :fir.r�� � � �:%rr j!-r�, � `./�jifA �,
Submittal Date: