SW6220101_Supplemental Info Review_20240618

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 6/18/2024 1:44:15 PM (Supplemental Submittal)
Accept by Kaitlin Peck 6/18/2024 3:55:09 PM(Supplemental Info Submittal)
• The task was assigned to DEMLR Post-Construction Team 6/18/2024 1:44:15 PM
• The task was assigned to Kaitlin Peck by round robin distribution 6/18/2024 1:44:15 PM

=DEQ •
Submittal from 6/18/2024
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* SW6220101
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* Creekside Oaks South
Owner/Operator* Creekside Oaks, LLC
County: Harnett
Submitter Name:* Scott Brown
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 9104266777
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
signed permit transfer application.pdf 438.67KB
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
signed deed restriction.pdf 110.4KB
Only PDF files are accepted.
File Type* O&M Agreement/Plan

File Upload Click the upload button,or drag and drop files to attach
signed O&M.pdf 333.54KB
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
1070-Creekside Oaks SOS.pdf 56.85KB
Only PDF files are accepted.
File Type* Property Deed
File Upload Click the upload button,or drag and drop files to attach
DB 4196-559.pdf 107.24KB
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:
documents for the permit transfer
* By checking the box and signing box below, I certify that:
d 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:* Scott Brown
Signature:
sW1?`�t14r1 '
Date Submitted: 06/18/2024

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW6220101
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* 06/18/2024