Bennett Village Apartments - 3/14/2019 1:53:39 PM

Submittal Dated: 3/14/2019
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
SW8190113
Exarrples: SWxxxxxxx, NOC;axxxx, or NCSxxxxxx
Facility Name:* Bennett Village Apartments
County: New Hanover
Name: David L Menius
Who is subnitting the inforrration7
Email Address:* [e-mail]
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach docurrant
SUPPLEMENT rev.pdf 501.46KB
NCDEQ SW calc rev.pdf 331.06KB
NCDEQ SW plan rev.pdf 974.28KB
O&M rev.pdf 125.22KB
Only pdf files are accepted.
Describe the attachments:
Please see attached per the additional information request letter..
* 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');
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:* David Luther Menius

Signature:
Date Submitted: 3/14/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW8190113
Who needs a V Central Office
copy?* rJ Regional Office
Central Office Reviewer:
Corey Anen - eads\scanen
Select Reviewing Office*
Wilmington Regional Office — 910-796-7215
Select RO Reviewer:*
[e-mail]