Crosscreek Charter School - 11/20/2018 9:06:40 AM

Submittal Dated: 11/20/2018
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 perrrit nunber for this project.
D# * FL-rrrit Narrber
SW5181101
Exarrples: SWxxxxxxx, NOC;axxxx, or NCSxxxxxx
Facility Name:* Crosscreek Charter School
County: Franklin
Name: Dalton Engineering & Associates, PA
Who is submitting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
tick the upload button or drag and drop files here to attach document
NCDENR Stormwater Application 111418.pdf 3.27MB
Crosscreek Charter School Revised Plans
11.33MB
Stamped.pdf
Only pdf files are accepted.
Describe the attachments:
Transmittal to NCDENR for Crosscreek Charter School Attention Rick Riddle, Jr. Stormwater Application, Design
Calculations, Check $505.00, O&M Agreement & Soils Information, Stormwater Narrative, Deed, Secretary of State
Information and Grading, Utility, and Stormwater Management Plan
* W 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)
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');
• 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:* Jill Howard

Signature:
0�& 55`r`AW,tle
Date Submitted: 11/20/2018

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW5181101
Who needs a d Central Office
copy?* rJ Regional Office
Central Office Reviewer:
Rick Riddle - eads\rlriddle1
Select Reviewing Office*
Raleigh Regional Office — 919-791-4200
Select RO Reviewer:*
[e-mail]