Long Chapel United Methodist Church - 3/6/2019 3:41:36 PM

Submittal Dated: 3/6/2019
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# * Ferrrit Narrber
SW 1190201
Ecanples: SWxxxxxxx, NOC;axxxx, or NCSxxxxxx
Facility Name:* Long Chapel United Methodist Church
County: Haywood
Name: Robert Daniel Hyatt
Who is submitting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
Qick the upload button or drag and drop files here to attach docurrant
Long's Chapel 20190222.pdf 37.51 MB
LCU_Stormwater_Manual_20190222.pdf 6.1MB
Only pdf files are accepted.
Describe the attachments:
Attached are the plans for the project and the storm water manual.
* W 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");
o 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:* Robert Daniel Hyatt
Signature:

Date Submitted: 3/6/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW 1190201
Who needs a d Central Office
copy?* F Regional Office
Central Office Reviewer:
Select Reviewing Office*
Asheville Regional Office — 828-296-4500
Select RO Reviewer:*
[e-mail]