Simmons Subdivision - 1/28/2019 4:21:50 PM

Submittal Dated: 1/28/2019
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Existing Project Information:
Rease supply the perrrit nunber for this project.
D# * FL-rrrit Narrber
SW6190101
Exarrples: SWxxxxxxx, NOC;axxxx, or NCSaxxxx
Facility Name:* Simmons Subdivision
County: Cumberland
Name: Myers Andrew Colvin Sr PE
Who is submitting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
Oick the upload button or drag and drop files here to attach docurrant
SS1. pdf
632.01 KB
SS2. pdf
489.67KB
SS3. pdf
637.91 KB
SS4. pdf
675.56KB
SS5. pdf
733.65KB
SS6. pdf
523.43KB
SS7. pdf
525.64KB
SS8. pdf
466.44KB
SS9. pdf
611.93KB
SS10.pdf
611.93KB
SS11. pdf
478.5KB
SS12. pdf
656.36KB
SS13. pdf
371.91 KB
scan6075. pdf
585.05KB
scan6076. pdf
882.28KB
scan6077. pdf
772.51 KB
scan6078. pdf
857.92KB
scan6079. pdf
1.23MB
scan608O. pdf
815.49KB
Only pdf files are accepted.

Describe the attachments:
1. PDF files of the signed & sealed stormwater plan set.
2. PDF files of the Stormwater Permit Application Completed Form SWU-101 pages 1 thru 6
3. PDF files of Low Density Supplement Completed Form SW401-Low Density - Rev.3-2/10/09 pages 1 thru 4
4. PDF files of Low Density Residential Subdivisions Deed Restrictions & Protective Covenanances Completed.
Form DRPC-5 Rev.2 05Nov2009 page 1 of 1
* V By checking the box and signing box below, I certify that:
o 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
o I intend to electronically sign and submit the Supplemental Information form."
Full Name:* Myers Andrew Colvin Sr PE
Signature:
Date Submitted: 1/28/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW6190101
Who needs a V Central Office
copy?* rJ Regional Office
Central Office Reviewer:
Rick Riddle - eads\rlriddle1
Select Reviewing Office*
Fayetteville Regional Office — 910-433-3300
Select RO Reviewer:*
[e-mail]