Agri Supply - 5/30/2018 3:45:34 PM

WW "Arpplemental Information Upload Fon
Staff Review:
Updated ID#: SW3180502
Updated Version: 1
Who needs a copy?* 17 Central
Office
r Regional
Office
Select Reviewing Office*
Mooresville Regional Office — 704-663-1699
Central Office Reviewer:
Corey Anen - eads\scanen
Select RO Reviewer:*
[e-mail]
SUBMITTED PROJECT INFORMATION
Existing Project Information:
ID# SW3180502
Version: 1
Facility Name: Agri Supply
County: Union
Name: clint lawrence
Vft is subrritting the inforrration?
Email Address: [e-mail]
Describe the attachments:
Design plans, calcs, permit, narrative, & forms
Please upload all files that need to be submitted.
5-3-18 Combined Civil Permit Drawings.pdf
6.29MB
1357 -Agri Supply Calcs rev 04.23.18.pdf
2.72MB
EZ Form.pdf
226.98KB
O&M Agreement.pdf
288.81 KB
SW Narrative. pdf
56.99KB
SW Permit App.pdf
627.59KB
Only pdr files are accepted.
Water Resources
ENVIRONMENTAL QUALITY

fJ By
checking
the
box
and
signing
box
below,
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 form.
Full Name: clinton d lawrence
Signature:
CL -J w(TVAI J> LAWPWCX
Date Submitted: