20181134 Ver 1_401 Application_20190114

Water Resources
ENVIRONMENTAL OUALITY
�'
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 ansv�red.
Project Type:* �' New Project
C' Pre-Application Submittal
C•' More Information Response
�' Other Agency Comments
C' 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 existing project.
Project Contact I nformation
Name
Email Address:*
Paul Williams
Who is subrritting the irrforrration?
[e-mail]
Project I nformation
Existing ID#:*
20181134
20170001(no dashes)
Existing Version:*
1
Project Name:* Courtesy Notification - Currituck SR 1148 North Gregory Road - Pipe Replacement
Is this a public transportation project?*
C' Yes
C' No
Is this a DOT project?*
C•' Yes
l' No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
C' Yes�' No f" lJnknown
TI P#: WBS#:
1 B.202711
(Applies to DOT projects only)

County(ies)*
Currituck
Please upload all files that need to be submited.
C]ickthe upload button or drag and drop files here to attach docurrent
North Gregory Rd (Currituck Co.) Topo.pdf 1.07MB
Only pdF or Ivre files are accepted.
Describe the attachments:
Proposed pipe sizes for Pipe 1 has been modified to (2) 66" X51" X40' CAPA's. The revised attached
document reflects the modification.
* �IJ 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 online form."
Signature:
*
'f %r�rt ! �rxr..• f'l,tr�rrr� . r sf .
Submittal Date:

Pipe Replacements on SR 1148
North Gregory Road
Currituck County Quad Name Lambs Corner
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Pipe 1
,• Existing 72" X 48" X 36' CMPA
Proposed (2) 66" X 51" X 40' CAPA's
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