NCCU Student Center - 5/9/2019 11:34:39 AM

Submittal Dated: 5/9/2019
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
SW5190401
Exarrples: SWxxxxxxx, NOCaaxxxx, or NOSxxxxxx
Facility Name:* NCCU Student Center
County: Durham
Name: Jonathan Allen
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 document
BMP Supplement Form.pdf
301.64KB
NCCU Stormwater Calculations. pdf
25.35MB
O&M Agreement.pdf
191.41 KB
Property Deed.pdf
662.89KB
Stormwater Management Permit Application.pdf
533.06KB
NCCU Student Union Final Geotech Report 06 13
4.06MB
18.pdf
NCCU Student Center - Engr Dwg Set 5Aprl9.pdf
17.43MB
Only pdf files are accepted.
Describe the attachments:
Stormwater Submittal Items for NCCU Student Center
* 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:* Jonathan Allen
Signature:
Date Submitted: 5/9/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW5190401
Who needs a d Central Office
copy?* F Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Select Reviewing Office*
Raleigh Regional Office — 919-791-4200
Select RO Reviewer:*
[e-mail]