SW3191001_Supplemental Info Review_11/5/2019

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/5/2019 8:16:32 AM (Supplemental Submittal)
Submit by Strickland, Shane 11/5/2019 12:42:47 PM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 11/5/2019 8:17 AM

Submittal Dated: 11/5/2019
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 pernit nunber for this project.
..............................................................................................................
D# * FL-rnit Narrber
SW3191001
Examples: SVVxxxxxxx, NOGKxxxxx, or NCSkxxxxx
Facility Name:* POPLIN MEADOWS PHASE II
County: Union
Name: ALLEN MCDOWELL
Who is subnitting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
nick the upload button or drag and drop files here to attach docurrent
Application.pdf
514.08KB
Poplin Meadows Ph II-Stormwater Report -
2.73MB
191015.pdf
check scan.pdf
82.71 KB
Deed.pdf
167.88KB
Deed Restrictions. pdf
213.52KB
Sunflower Study Phases 2 and 3.pdf
4.95MB
O+M Agreement.pdf
271.77KB
191015_Poplin Ph 2_Civil Plans.pdf
70.54MB
SuppEZForm.pdf
250.99KB
USGS Map.pdf
157.48KB
Only pdf files are accepted.
Please alert us to any confidential information contained in the uploaded documents.
Uploads contain r NO
Confidential r YES
Information * NCTE The following infornation cannot be clairred as confidential: the narre and address of any pernit applicant or
permttee, pernit applications, pernits, effluent data, inforrration required by WIDB application forrrs provided by
the Director inclusive of all forms and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:

* V 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:* ROBERT ALLEN MCDOWELL
Signature:
I P3�+Pf , ZXV AC-kUCZC
Date Submitted: 11/5/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW3191001
Who needs a V Central Office
copy?* F Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Select Reviewing Office*
Mooresville Regional Office — 704-663-1699
Select RO Reviewer:*
[e-mail]