WSCO_PASQ_WSWP Submittal Review_20210406

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 4/1/2021 3:34:31 PM (Supplemental Submittal)
Approve by Clark, Paul 4/6/2021 8:25:58 AM (WSW Program Info Submittal Review)
p Thank you very much for the response. I will contact you with any questions, updates, etc. thx again.
paul
• The task was assigned to Clark, Paul. The due date is: April 15, 2021 5:00 PM 4/1/2021 3:34 PM

d� #
NORTH CAROLINA
Ernvlronmental qualily
Submittal Dated: 4/1/2021
Water Supply Watershed Protection Program Info
Rease supply the information below
County:*
What Type of
Program?*
Pasquotank
f Municipality
IT County
Choose additional counties if applicable:
Additional County:
WSW Program WSCO_PASQ
Identifier:* Auto -populated from choices above
Name of Submitter:* Shelley Cox
Vft is subrritting this inforrration?
Title:* Director, Planning/Zoning/Inspections
Email:* [e-mail]
Telephone:* 2525624408
Map:
Cickthe upload button or drag and drop files here.
20210401153124604. pdf 457.62KB
Only pdf files are accepted.
The current version
Click the upload button or drag and drop f iles here.
of your WSWP
20210401150745653.pdf 1.09MB
ordinance(s):
Only pdf files are accepted.
Other information:
Cickthe upload button ordrag and drop files here.
Only pdf files are accepted.
Describe the
attachments:
rJ By checking the box and signing box below, I certify that:
have given true, accurate, and complete information on this form;
agree that submission of this 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 this form."
Full Name:* Shelley Cox
Signature
Date Submitted 4/1/2021
Submittal Date 20210401
Formatted

Review
Program Entity: Pasquotank
Edit if necessary
Verify Primary Pasquotank
County * Update county if needed.
Verify WSW ID* Pasquotank Co (WSCO_PASQ)
Update ID if needed.
Review Date 04/06/2021