SW6140402_Supplemental Info Review_20240104

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 1/4/2024 3:45:54 PM(Supplemental Submittal)
Accept by Kaitlin Peck 1/5/2024 8:16:54 AM (Supplemental Info Submittal)
• The task was assigned to Kaitlin Peck 1/4/2024 3:45:55 PM

=DEQ •
Submittal from 1/4/2024
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* SW6140402
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* The Preserve at Lake Upchurch
Owner/Operator* Bill Clark Homes
County: Cumberland
Submitter Name:* Landon Weaver
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 252-814-1481
Additional E-mail for (Optional)
Submittal
Confirmation:
State Stormwater (Post-Construction) Information Uploads
Choose file type and upload attachment(Reviewer may remove unnecessary submittals)
File Type* Application Form
File Upload Click the upload button,or drag and drop files to attach
permit transfer application.pdf 5.84MB
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
secretary of state documentation.pdf 1.67MB
Only PDF files are accepted.
File Type* O&M Agreement/Plan

File Upload Click the upload button,or drag and drop files to attach
O&M agreement.pdf 698.65KB
Only PDF files are accepted.
File Type* Change of Permittee Information
File Upload Click the upload button,or drag and drop files to attach
permit information update application form.pdf 458.91 KB
Only PDF files are accepted.
File Type* Property Deed
File Upload Click the upload button,or drag and drop files to attach
deeds for common area and two lots in question by
2.67MB
jim farkas.pdf
Only PDF files are accepted.
File Type* BUA Allocations
File Upload Click the upload button,or drag and drop files to attach
updated BUA spreadsheet.pdf 498.24KB
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
recorded covenants and deed restrictions.pdf 24.14MB
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:* Landon Weaver
Signature:
, ir�or J wzwt

Date Submitted: 01/04/2024

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW6140402
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* 01/05/2024