20171100 Ver 2_More Info Received_20181212

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit
Accept
by Anonymous User 12/12/2018 7:57:21 AM (Message Start Event)
by Carpenter,Kristi 12/12/2018 3:10:38 PM (DOT - Existing Project)
• The task was assigned to Carpenter,Kristi. The due date is: December 17, 2018 5:00 PM
12/12/2018 7:57 AM

Staff Review For
Updated April 10, 2018
Water Resources
ENVIRONMENTAL QUALITY
Staff Review
Does this application have all the attachments needed to accept it into the review process?
R Yes r Nc
ID#*
20171100
Version*
Is this project a public transportation project?*
Is this a DOT
project? *
Reviewer List:*
( Yes r No
Select Reviewing Office:*
Submittal Type:*
r Yes
r No
Garcy Ward:eads\gpward
Washington Regional Office - [phone]
Does this project require a request for payment to be sent?*
Yes
r•
No

Project Submittal Form
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:
✓ New Project
✓ Pre -Application Submittal
F More Information Response
✓ Other Agency Comments
✓ 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: Paul Williams
Who is submitting the inforrration?
Email Address: [e-mail]
Project Information
Existing ID #:
20171100
20170001 (no dashes)
Existing Version:
1
Project Name: SR 1209 Culvert Replacement
Is this a public transportation project?
C' Yes
r No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
C' YesC No r Unknown
TIP#: WBS#:
44436
(Applies to DOT projects only)
County (ies)
Tyrrell
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach docurrent
Tyrrell County SR1209_Revised Permit Drawings
833.18KB
(RIP RAP).pdf
Only pdf or Ivre files are accepted.
Describe the attachments:

Rivers & Associates has requested a permit modification to the pipe replacement project in Columbia. They
plan to place rip rap on each corner of the canal, as shown in the attached permit drawings, to stabilize the
banks at each site. This was not depicted on the last set of permit drawings.
17 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 Act");
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:
[aT}rse�sl[1is�/isa.^ %/ Y/ram.;. (-X
Submittal Date: