SW3190505_Supplemental Info Review_1/7/2020

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 1/7/2020 7:33:49 AM (Supplemental Submittal)
Submit by Strickland, Shane 1/7/2020 10:27:21 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 1/7/2020 7:33 AM

Submittal Dated: 1/7/2020
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
SW3190505
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Courtyards On Lawyers Road
County: Union
Name: Vincent G. Keene, PE
Vft is subrritting the information?
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
CALCULATIONS 010320.pdf
7.32MB
Certificate of Incumbency, LR2, BKardos, 12-3-
113.8KB
19.pdf
CONSTRUCTION PLANS 010620.pdf
47.71 MB
RESPONSE TO COMMENTS.pdf
72.92KB
SIGNED APPLICATION FORM 010320.pdf
635.65KB
SIGNED DEED RESTRICTIONS 010320.pdf
155.89KB
SIGNED O&M AGREEMENTS 010320.pdf
370.94KB
SIGNED SUPPLEMENT 010320.pdf
311.81KB
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 information cannot be claimed as confidential: the name and address of any perrrit applicant or
perrrittee, perrrit applications, permits, 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:
Stormwater documents in response to Request for Additional Information letter.
* 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:* Vincent G. Keene, PE
Signature:
Date Submitted: 1/7/2020

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SW3190505
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Jim Farkas - eads\jjfarkas
Select Reviewing Office*
Mooresville Regional Office — 704-663-1699
Select RO Reviewer:*
[e-mail]