20181249 Ver 1_IP Notice Submital_20180913

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 9/13/2018 11:56:11 AM (Message Start Event)
Accept by Carpenter,Kristi 9/13/2018 11:57:23 AM (DOT project)
. The task was assigned to Carpenter,Kristi. The due date is: September 18, 2018 5:00 PM
9/13/2018 11:56 AM

Water Resources
ENVIRONMENTAL �UPLITV
Staff Review
Does this application have all the attachments needed to accept it into the review process?
C' Yes C' No
ID#*
20181249
Version* �
Is this project a public transportation project? *
Is this a DOT C•' Yes l' No
project?*
Reviewer List:*
Select Reviewing Office:*
r Yes
l' No
Rob Ridings:eads\rgridings
Central Office - [phone]
Does this project require a request for payment to be sent? *
r
Yes
r•
No

Project Submittal Dated 9/13/2018
*
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
C' 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: Kristi Lynn Carpenter for Chris Rivenbark
Who is subrritting the irrforrration?
Email Address: [e-mail]
Project Information
Project Name: NC 540 Triangle Expressway Southeast Extension I-540 (R-2721, R-2828, R-2829)
Is this a public transportation project?
�' Yes
�' No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
C' Ye�" No �' Unknown
TI P#: WBS#:
R-2721 R-2828 R-2829 37673.1.TA2
(Applies to DOT projects only)
County (ies)
Wake
Please upload all files that need to be submited.
aick the upload button or drag and drop files here to attach docurrent
Only pdf or krre files are accepted.
Describe the attachments:
Originally sent via email. Files too large for form and have manually been placed inside Laserfiche.
rJ 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')

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
o I intend to electronically sign and submit the online form."
Signature:
f�rJrr �j�s'N [ }R��f-r�9Y11%t�
Submittal Date: