Kindercare - Cameron, NC - 5/9/2019 3:40:19 PM

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
SW6190503
Exarrples: SWxxxxxxx, NOCaaxxxx, or NOSxxxxxx
Facility Name:* Kindercare - Cameron, NC
County: Harnett
Name: Monica Pomroy
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 document
2017.0643 StormNar SproutSpgs - 6-8-18.pdf 46.61 MB
Kindercare Spout Springs Phase II PostConstruction
8.82MB
Permit Submittal Package.pdf
2017-0643-Rainbow CCC-Spout Sprin, NC-S&S 05
14.08MB
02-19.pdf
Only pdf files are accepted.
Describe the attachments:
KinderCare Civil plans, stormwater report and supporting documents submitted via hard copy to the office are
included.
* 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');
• 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:* Monica Pomroy

Signature:
Date Submitted: 5/9/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW6190503
Who needs a V Central Office
copy?* F Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Select Reviewing Office*
Fayetteville Regional Office — 910-433-3300
Select RO Reviewer:*
[e-mail]