WSCO_MOOR_WSWP Submittal Review_20220406

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 4/5/2022 11:27:00 PM (Supplemental Submittal)
Approve by Clark, Paul B 4/6/2022 10:42:30 AM (WSW Program Info Submittal Review)
* 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 B. The due date is: April 19, 2022 5:00 PM 4/5/2022 11:27 PM

+ WA V *
NORTH CAROLINA
EnOmnmertrCf Quduly
Submittal Dated: 4/5/2022
Water Supply Watershed Protection Program Info
Please supply the information below
County: * Moore
What Type of Municipality
Program?* County
Choose additional counties if applicable:
Additional County:
WSW Program WSCO_MOOR
Identifier: * Auto -populated from choices above
Name of Submitter: * David Allen Francis
Who is submitting this information?
Title: * Director, Planning/Zoning/Inspections
Email: * [e-mail]
Telephone:* 9106030034
Map: Click the upload button or drag and drop files here.
Only pdf files are accepted.
The current version Click the upload button or drag and drop files here.
of your WSWP Only pdf files are accepted.
ordinance(s):
Other information: Click the upload button or drag and drop files here.
Only pdf files are accepted.
Describe the
attachments:
* 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 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:* David Allen Francis
Signature
n�.iE`l� �ftzerc�
Date Submitted 4/5/2022
Submittal Date 20220405
Formatted

Review
Program Entity:
Moore
Edit if necessary
Verify Primary
Moore
County*
Update county if needed.
Verify WSW ID* Moore Co (WSCO_MOOR)
Update ID if needed.
Review Date 04/06/2022