SW4200902_Supplemental Info Review_20201022

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/22/2020 3:48:47 PM (Supplemental Submittal)
Submit by McCoy, Suzanne 10/29/2020 1:13:22 PM (Supplemental Info Submittal)
• The task was assigned to McCoy, Suzanne 10/22/2020 3:48 PM

Submittal Dated: 10/22/2020
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.
Existing Project Information:
Rease suDDly the Derrrit nunber for this Drolect.
D# * Perrrit N irrber
SW4200902
Exarrples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Miller's Reserve
County: Forsyth
Name: Lee Bryant
Vft is subrritting the infornation?
Email Address:* [e-mail]
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach docurrent
Miller's Reserve Wet Detention Pond Plan 10-21-
15.04MB
20.pdf
Narrative.pdf 322.93KB
Phase 1 Construction plans 9-8-20.pdf 6.87MB
Stormwater Permit application.pdf 879.61 KB
Supplement EZ.pdf 551.55KB
Only pdf files are accepted.
Please alert us to any confidential information contained in the uploaded documents.
Uploads contain r NO
Confidential r YES
Information * NOTE The following inforrretion cannot be clairred as confidential: the narre and address of any perrrit applicant or
perrrittee, perrrit applications, pernits, effluent data, infornation required by MODES application forr s provided by
the Director inclusive of all forms and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
* V By checking the box and signing box below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this Supplemental Information form is a "transaction" subject to Chapter 66, Article 40 of the
NC General Statutes (the "Uniform Electronic Transactions Act")

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');
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 Supplemental Information form."
Full Name:* Lee Bryant
Signature:
O�r
Date Submitted: 10/22/2020

Initial Review
Updated ID#: WFORfANT. REV1RAERSH0LLDVMFY and revise here if necessary.
SW4200902
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Review Date * 10/29/2020