WSCO_BERT_WSWP Submittal Review_20210505

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 5/3/2021 12:59:42 PM (Supplemental Submittal)
Approve by Clark, Paul B 5/5/2021 10:07:17 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 B. The due date is: May 17, 2021 5:00 PM 5/3/2021 12:59 PM

d� #
NORTH CAROLINA
Ernvlronmental qualily
Submittal Dated: 5/3/2021
Water Supply Watershed Protection Program Info
Rease supply the information below
County:*
What Type of
Program?*
Bertie
f Municipality
IT County
Choose additional counties if applicable:
Additional County:
WSW Program WSCO_BERT
Identifier:* Auto -populated from choices above
Name of Submitter:* Traci White
Vft is subrritting this inforrration?
Title:* Director, Planning/Zoning/Inspections
Email:* [e-mail]
Telephone:* 2527946185
Map:
Click the upload button or drag and drop files here.
Roanoke River - Martin Co - WSIV map.pdf 558.99KB
Only pdf files are accepted.
The current version
Click the upload button or drag and drop files here.
of your WSWP
Bertie WSPO. Final. 2013.pdf 256.7KB
ordinance(s):
Only pdf files are accepted.
Other information:
Cickthe upload button ordrag and drop files here.
Only pdf files are accepted.
Describe the
attachments:
rJ 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:* Traci White
Signature
Date Submitted 5/3/2021
Submittal Date 20210503
Formatted

Review
Program Entity: Bertie
Edit if necessary
Verify Primary Bertie
County * Update county if needed.
Verify WSW ID* Bertie Co (WSCO_BERT)
Update ID if needed.
Review Date 05/05/2021