SW5201001_Supplemental Info Review_20230622

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 6/22/2023 4:34:06 PM (Supplemental Submittal)
Accept by Kaitlin Peck 6/26/2023 7:39:41 AM(Supplemental Info Submittal)
• The task was assigned to bethany.georgoulias 6/22/2023 4:34:07 PM
• bethany.georgoulias reassigned the task to Kaitlin Peck 6/23/2023 3:42:11 PM

=DEQ •
Submittal from 6/22/2023
Permit Information:
Please provide specific permit details below.
................................................................................................................................................................................................................................................................................................................................................................................................
What Type of Permit? Choose one:
* NPDES Industrial or MS4 Permit
State Stormwater(Post-Construction)Permit
Other
Permit Number* SW5201001
Begins with"SW","NCG",or"NCS"
What DEQ Office is Reviewer:Please correct if misidentified,close this review form,and reassign task to the appropriate contact.
the Primary Contact? Central Office
*
Washington Regional Office(Attn: Carl Dunn)
Wilmington Regional Office(Attn:Christine Hall)
................................................................................................................................................................................................................................................................................................................................................................................................
Project Name* Walnut Cove Subdivision
Owner/Operator* Axiom Holdings, LLC.
County: Nash
Submitter Name:* Isaac Hardison
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 2524598196
Additional E-mail for [e-mail]
Submittal (Optional)
Confirmation:
State Stormwater (Post-Construction) Information Uploads
Choose file type and upload attachment(Reviewer may remove unnecessary submittals)
File Type* Plansheet-Cover Sheet
File Upload Click the upload button,or drag and drop files to attach
CE-OO.pdf 693.12KB
Only PDF files are accepted.
File Type* Signing Official Title&Position Information

File Upload Click the upload button,or drag and drop files to attach
Axiom Holdings LLC-Savings Account-Signature
Card CBO Form Auto Draft Form-4-12-2023 1 AMB
copy.pdf
Secretary of State Business Standing Axiom
113.27KB
Development.pdf
Secretary of State Business Standing Axiom
97.71 KB
Holdings.pdf
Only PDF files are accepted.
File Type* Property Deed
File Upload Click the upload button,or drag and drop files to attach
DEED.pdf 151.28KB
Only PDF files are accepted.
File Type* As-Built-Certification
File Upload Click the upload button,or drag and drop files to attach
Partial AS-Built Designer Cert.pdf 1015.73KB
Partial Designers Certificaiton.pdf 995.54KB
Only PDF files are accepted.
File Type* Recorded Document
File Upload Click the upload button,or drag and drop files to attach
Phase 1 Lots 1 Thru 10, 36 thru 47 sheet 1.pdf 2MB
Phase 1 Lots 1 Thru 10, 36 thru 47 sheet 2.pdf 1.46MB
Phase 2 Lots 11 thru 35.pdf 6.74MB
Only PDF files are accepted.
File Type* Deed Restriction/Protective Covenant Form
File Upload Click the upload button,or drag and drop files to attach
Restrictive covenants.pdf 6.99MB
Only PDF files are accepted.
File Type* Design Calculations
File Upload Click the upload button,or drag and drop files to attach
Signed Calcs Cover 6-21-23.pdf 428.52KB
Only PDF files are accepted.
File Type* Application Form
File Upload Click the upload button,or drag and drop files to attach
SSW-SWU-1 0 1-Application Modification-Walnut
2.76MB
Cove.pdf
Only PDF files are accepted.
File Type* Supplement-EZ Form
File Upload Click the upload button,or drag and drop files to attach
Updated Supp-EZ Form(Cover and Low Density
910.4KB
page).pdf
Only PDF files are accepted.

File Type* Response To Comments
File Upload Click the upload button,or drag and drop files to attach
Comment Response Letter 6-15-23 for Walnut Cove
25.04KB
Phase 2 stormwater.pdf
Only PDF files are accepted.
Is this project funded No
with ARPA grant Yes
funds?
Uploads contain NO
Confidential YES
Information* NOTE:The following information cannot be claimed as confidential:the name and address of any permit applicant
or permittee,permit applications,permits,effluent data,information required by NPDES application forms provided
by the Director inclusive of all forms and attachments[Ref.40 CFR 122.7(b)and(c)].
Notes about the attachments:
* 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 Upload form.
Full Name:* Isaac Mitchel Hardison
Signature:
65aa.-IWW to'Jar
Date Submitted: 06/22/2023

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW5201001
Who needs a Copy?* Reviewer selections will only be required for offices checked here.
Central Office Staff
Regional Office Stormwater Contact
State Stormwater RO Staff
No Copy Needed
Central Office Reviewer:*
Notifies CO Staff with Email
Jim Farkas
Any Comments or
Added Info for CO
Staff Reviewer?
Review Date* 06/26/2023