NCG160225_Supplemental Info Review_8/8/2017

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/8/2017 9:13:37 AM (Supplemental Submital)
Approve by Alexander, Laura 8/8/2017 9:30:15 AM (Supplemental Info Submittal)
• The task was assigned to Alexander, Laura 8/8/2017 9:13 AM

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upplemental Information Upload Fon
Staff Review:
Updated ID#: NCG160225
Updated Version: 1
Where is the project being reviewed?*
r Central Office r Regional Office
Select Reviewing Office*
Washington Regional Office — 252-946-6481
Central Office Reviewer:
Robert Patterson - eads\rdpatterson
Select RO Reviewer:*
[e-mail]
Submitted Information:
What type of project is this?
r Existing Project
r Pre -Application Information
Facility Name: Barnhill - 841 Sungro Drive
County: Pasquotank
Name: Jason A. Mizelle
Mo is subnitting the infornetion?
Email Address: [e-mail]
Describe the attachments:
E&S and Stormwater Plans as submitted to Washington Regional Office.
Please upload all files that need to be submitted.
170052 Permit Plans - sealed 072017.pdf
Only pdr files are accepted.
PF By checking the box and signing box below, I certify that:
6.19MB
Water Resources
ENVIRONMENTAL QUALITY
• 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 form.

Full Name: Jason A. Mizelle
Signature:
,Tasap A. A.Zelle