WSMU_THOM_WSWP Submittal Review_20230825

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 8/25/2023 12:19:25 PM (Supplemental Submittal)
Approve by Paul.Clark 8/25/2023 12:39:10 PM(WSW Program Info Submittal Review)
0 Thank you for note and for completing and submitting the survey.
• The task was assigned to Paul.Clark.The due date is: September 8,2023 5:00 PM
8/25/2023 12:19:26 PM

Water Supply Watershed E-Submittal
s
NORTH CAROLINA
Environmental Quality
Submittal Dated: 8/25/2023
Water Supply Watershed Protection Program Info
Please supply the information below
.....................................................................................................................................................................................................................................................................................................................................................................................................
County:* Davidson
What Type of Municipality
Program?* County
Municipality:* Thomasville
Choose additional counties if applicable:
Additional County:
WSW Program WSMU_THOM
Identifier:* Auto-populated from choices above
Name of Submitter:* Trenton Novelli
Who is submitting this information?
Title:* Other
Email:* [e-mail]
Telephone:* 336-226-5534
Map: Click the upload button or drag and drop files here.
Only pdf files are accepted.
The current version Click the upload button or drag and drop files here.
of your WSWP Only pdf files are accepted.
ordinance(s):
Other Information: Click the upload button or drag and drop files here.
Only pdf files are accepted.
Describe the Map and Ordinances previously submitted
attachments:
* 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');

• 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:* Trenton Novelli
Signature
T�AITDAI WO✓E[-1-1,
Date Submitted 8/25/2023
Submittal Date 20230825
Formatted

Review
Program Entity: Thomasville
Edit if necessary
Verify Primary Davidson
County* Update county if needed.
Verify WSW ID* Thomasville(WSMU_THOM)
Update ID if needed.
Review Date 08/25/2023