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N ��SoaTF NCDOT TIA Scoping Checklist ���R.k <br /> :�1 <br /> " TIA Need ® i TIA <br /> Screening Submittal � <br /> Agreement by All Parties <br /> The undersigned agree to the contents and methodology described above for completing the required traffic <br /> impact analysis for the proposed development identified herein. Any changes to the above methodology <br /> contemplated by the Applicant or the TIA Consultant must be submitted to the District Engineer in writing. <br /> If approved by NCDOT,then such changes may be accepted for the TIA report. Subsequent revisions to the <br /> development plan(e.g.land use,density,site access,or schedule)may require additional Scoping and analysis, <br /> and may modify the TIA requirements. <br /> This agreement shall become effective on the date approved by NCDOT, and shall expire months after <br /> the effective date or upon significant changes to the roadway network and/or development assumptions, <br /> whichever occurs first. Once expired,renewal or re-scoping will be required for subsequent TIA submittals. <br /> APPLICANT <br /> Frank Csapo <br /> Signature Print Name Date <br /> TIA CONSULTANT <br /> Matt Peach,PE,PTOE 5/28/2020 <br /> Signature Print Name Date <br /> LOCAL GOVERNMENT REPRESENTATIVE (If Applicable) <br /> Signature Print Name Date <br /> Email concurrence may be used in lieu of the signature. <br /> NCDOT DISTRICT REPRESENTATIVE <br /> Reviewed and approved by the NCDOT Division 7 District 1 on <br /> Docu Signed by: <br /> G. N. f�warrjs Jr. , Pf <br /> C60668060F9M58... <br /> Signature Print Name <br /> Email concurrence may be used in lieu of the signature. <br /> Effective Date: 10/01/2017 (Version 17-721) Page 7 of 7 <br />