Cozart Subdivision - 2/6/2019 2:38:28 PM

Submittal Dated: 2/6/2019
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 perrrit nunber for this project.
D# * FL-rrrit Narrber
SW6190104
Exarrples: SWxxxxxxx, NOC;axxxx, or NCSxxxxxx
Facility Name:* Cozart Subdivision
County: Harnett
Name: Fleet Temple
Who is submitting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
Oick the upload button or drag and drop files here to attach document
LLC Documentation.pdf
Current Deed.pdf
USGS Map.pdf
Project Narrative.pdf
Low Density Supplement.pdf
Deed Restrictions and Protective Covenants.pdf
Stormwater Management Permit Application
Form.pdf
4934-COZART UTILITY S-1.pdf
4934-COZART EROSION S-2.pdf
4934-COZART PROFILE S-3.pdf
4934-COZART PROFILE S-4.pdf
4934-COZART PROFILE S-5.pdf
4934-COZART DETAIL S-6.pdf
4934-COZART DETAIL S-7.pdf
4934-COZART DETAIL S-8.pdf
4934-COZART DETAIL S-9.pdf
Only pdf files are accepted.
34.08KB
290.51 KB
1.21 MB
67.76KB
305.47KB
106.23KB
526.21 KB
930.07KB
1004.37KB
679.42KB
678.44KB
694.01 KB
4.39MB
4.42MB
895.73KB
1.17MB
Describe the attachments:

Stormwater Management Application Form
Deed Restrictions & Protective Covenants
Low Density Supplement
Project Narrative
USGS Map
Current Deed
LLC Documentation
Full Set of Plans (S-1 thru S-9)
* 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)
• 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:* Peter E NTemple
Signature:
Date Submitted: 2/6/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW6190104
Who needs a V Central Office
copy?* rJ Regional Office
Central Office Reviewer:
Corey Anen - eads\scanen
Select Reviewing Office*
Fayetteville Regional Office — 910-433-3300
Select RO Reviewer:*
[e-mail]