WSCO_RAND_WSWP Submittal Review_20200817

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/14/2020 12:45:01 PM (Supplemental Submittal)
Approve by Clark, Paul 8/17/2020 11:44:02 AM (WSW Program Info Submittal Review)
p Thank you very much for the quick response. 1 will contact you with any questions, updates, etc. thx
again.
paul
• The task was assigned to Clark, Paul. The due date is: August 28, 2020 5:00 PM 8/14/2020 12:45 PM

d� #
NORTH CAROLINA
Ernvlronmental qualily
Submittal Dated: 8/14/2020
Water Supply Watershed Protection Program Info
Rease supply the information below
County:* Randolph
What Type of f Municipality
Program?* IT County
Choose additional counties if applicable:
Additional County:
WSW Program
WSCO_RAND
Identifier:*
Auto -populated from choices above
Name of Submitter:*
Tim Mangum
Vft is subrritting this inforrration?
Title:*
Planner
Email:*
[e-mail]
Telephone:*
[phone]
Map:
Cickthe upload button or drag and drop files here.
SizeEWatershed Map. pdf
2.03MB
Only pdf files are accepted.
The current version Cickthe upload button ordrag and drop fileshere.
of your WSWP
Watershed Protection Ord inance.pdf
3.77MB
ordinance(s):
Only pdf files are accepted.
Other information:
Cickthe upload button ordrag and drop files here.
2017WSPermits.pdf
557.52KB
2018WSPermits.pdf
559.27KB
2019WSPermits.pdf
557.21 KB
MasterWatershedSummary.pdf
579.7KB
Only pdf files are accepted.
Describe the
Watershed permits issued from 2017 to 2019. Watershed Summary Report
attachments:
17 By checking the box and signing box below, I certify that:

o I have given true, accurate, and complete information on this form;
o I 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');
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');
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 this form."
Full Name:* Tlmothy V. Mangum
Signature
Date Submitted 8/14/2020
Submittal Date 20200814
Formatted

Review
Program Entity: Randolph
Edit if necessary
Verify Primary Randolph
County * Update county if needed.
Verify WSW ID* Randolph Co (WSCO_RAND)
Update ID if needed.
Review Date 08/17/2020
Review Date 20200817
Formatted