WSMU_EASB_WSWP Submittal Review_20210412

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 4/8/2021 11:03:35 AM (Supplemental Submittal)
Approve by Clark, Paul 4/12/2021 8:27:03 AM (WSW Program Info Submittal Review)
p Thank you very much for the response. 1 will contact you with any questions, updates, etc. thx again.
paul
• The task was assigned to Clark, Paul. The due date is: April 22, 2021 5:00 PM 4/8/2021 11:03 AM

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NORTH CAROLINA
Ernvlronmental qualily
Submittal Dated: 4/8/2021
Water Supply Watershed Protection Program Info
Rease supply the information below
County:* Yadkin
What Type of IT Municipality
Program?* f County
Municipality:* East Bend
Choose additional counties if applicable:
Additional County:
WSW Program WSMU_EASB
Identifier:* Auto -populated from choices above
Name of Submitter:* Vickie Matthews
Vft is subrritting this information?
Title:* Other
Email: * [e-mail]
Telephone:* 3366998560
Map: Click the upload button or drag and drop files here.
Only pdf files are accepted.
The current version Click the upload button or drag and drop files here.
of your WSWP Only pdf files are accepted.
ordinance(s):
Other information: aick the upload button or drag and drop files here.
Only pdf files are accepted.
Describe the
attachments:
17 By checking the box and signing box below, I certify that:
have given true, accurate, and complete information on this form;
agree that submission of this 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 this form."
Full Name:* Vickie Matthews
Signature
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Date Submitted 4/8/2021
Submittal Date 20210408
Formatted

Review
Program Entity: East Bend
Edit if necessary
Verify Primary Yadkin
County * Update county if needed.
Verify WSW ID* East Bend (WSMU_EASB)
Update ID if needed.
Review Date 04/12/2021