HomeMy WebLinkAboutSWA000082_Supplemental Info Review_20201218Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 12/18/2020 9:41:07 AM (Supplemental Submittal)
Submit by McCoy, Suzanne 12/18/2020 12:23:10 PM (Supplemental Info Submittal)
• The task was assigned to McCoy, Suzanne 12/18/2020 9:41 AM
Submittal Dated: 12/18/2020
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# * Perait N irrber
SWA000082
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* The Cottages at Hayes Mill
County: Henderson
Name: W. Jesse Hanlin
Vft is subrritting the inforrretion?
Email Address:* jesse@ridge.blue
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach docurrent
Revised Fast Track Form SIGNED and SEALED.pdf 553.12KB
North Carolina Secretary of State Search
42.89KB
Results.pdf
20009 DOCUSIGN Rev 4 Complete Set_2020-12-
17.57MB
18.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 inforrretion cannot be claimed as confidential: the narre and address of any permt applicant or
peraittee, pernit applications, permits, effluent data, information required by NRJES application forms provided by
the Director inclusive of all forrrs and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
Revised Fast Track Form, SOS Documentation, Revised Plans
* 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
I intend to electronically sign and submit the Supplemental Information form."
Full Name:* William Jesse Hanlin
Signature:
Date Submitted: 12/18/2020
Initial Review
Updated ID#: WFORfANT. REV1RAERSH0LLDVMFY and revise here if necessary.
SWA000082
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Jim Farkas - eads\jjfarkas
Review Date * 12/18/2020