SW4200702_Supplemental Info Review_20200708

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/8/2020 9:06:10 AM (Supplemental Submittal)
Submit by Strickland, Shane 7/13/2020 11:12:13 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 7/8/2020 9:06 AM

Submittal Dated: 7/8/2020
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
SW4200702
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Lewisville Community Center
County: Forsyth
Name: Adam Carroll
Vft is subrritting the inforr ation?
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
Signed Low Density Permit.pdf
543.07KB
Signed Low Density Suppliment Form.pdf
327.92KB
Stormwater Narrative.pdf
92.19KB
Lewisville CC USGS Map 06.26.20.pdf
1.62MB
Lewisville CC Stormwater Calculations 06.26.20.pdf
3.88MB
Lewisville Community Center - Bid Documents
19.2MB
06.26.20.pdf
Deed.pdf
73.47KB
NRCS Soils Report.pdf
735.12KB
Lewisville_Community_Center_-
5.13MB
_Geotech_Report.pdf
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 infornation cannot be claimed as confidential: the nave and address of any perrrit applicant or
perrrittee, perrrit applications, perrrits, effluent data, information required by WCM application forms provided by
the Director inclusive of all forrrs and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:

Please find the attached:
- Signed low density permit
- Signed supplemental form
- Stormwater narrative
- USGS site map
- Sealed stormwater calculations
- Plan set
- Property deed
- Geotech report
- NRCS soils report
* 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:* Joseph Adam Carroll
Signature:
o'KzW e vkm, r err t tvvv
Date Submitted: 07/08/2020

Initial Review
Updated ID#: WFORfANT. REV1RAERSH0LLDVMFY and revise here if necessary.
SW4200702
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Jim Farkas - eads\jjfarkas
Review Date * 07/13/2020