SW4191001_Supplemental Info Review_10/29/2019

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/29/2019 3:55:15 PM (Supplemental Submittal)
Submit by Strickland, Shane 10/31/2019 10:53:46 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 10/29/2019 3:56 PM

Submittal Dated: 10/29/2019
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 supply the permt nunber for this project.
................................................................................................................................................................................................
D# * FL-rnit Narrber
SW4191001
Examples: SWxxxxxxx, NOGKxxxxx, or NCSxxxxxx
Facility Name:* Winding Creek Subdivision
County: Alamance
Name: Shawn C. Sidener
Who is subnitting the infornation?
Email Address:* [e-mail]
Please upload all files that need to be submited.
nick the upload button or drag and drop files here to attach docurrent
17-002 Rev04 2019-10-16 Full.pdf
15.2MB
SWM Permit Application signed.pdf
6.11 MB
Deed Restriction Lots 1-32.pdf
777.03KB
Deed Restriction Lot 33.pdf
797.61 KB
Calcs - Storm 2019-10-17.pdf
60.63MB
D_F i n a I+Images_Record_3239_32390957.tif_doc...
144.83 KB
D_F i n a I+Images_Record_2487_24870215.tif_doc...
82.6 KB
D_F i n a I+Images_Record_2823_28230093.tif_doc...
97.9 KB
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 * N07E The following information cannot be clairred as confidential: the narre and address of any pernit applicant or
pernittee, pernit applications, pernits, effluent data, infornation required by NTES application forms provided by
the ❑rector inclusive of all forms and attachrrents [Ibf. 40 CFR 122.7(b) and (c)].
Describe the attachments:
Attached are a set of plans, the stormwater calcualtions (containing USGS Map and narratice), copies of the recend
deeds and copies of the signed deed restrictions.
* V By checking the box and signing box below, I certify that:

o 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)
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 Supplemental Information form."
Full Name:* Shawn Christopher Sidener
Signature:
Date Submitted: 10/29/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW4191001
Who needs a V Central Office
copy?* F Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Select Reviewing Office*
Winston-Salem Regional Office — 336-776-
9800
Select RO Reviewer:*
[e-mail]