SW5240402_Supplemental Info Review_20240422

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 4/22/2024 8:54:13 AM (Supplemental Submittal)
Accept by Kaitlin Peck 4/22/2024 9:35:18 AM (Supplemental Info Submittal)
• The task was assigned to DEMLR Post-Construction Team 4/22/2024 8:54:15 AM
• The task was assigned to Kaitlin Peck by round robin distribution 4/22/2024 8:54:15 AM

=DEQ •
Submittal from 4/22/2024
Permit Information:
Please provide specific permit details below.
................................................................................................................................................................................................................................................................................................................................................................................................
What Type of Permit? Choose one:
* NPDES Industrial or MS4 Permit
State Stormwater(Post-Construction)Permit
Other
Permit Number* SW5240402
Begins with"SW","NCG",or"NCS"
What DEQ Office is Reviewer:Please correct if misidentified,close this review form,and reassign task to the appropriate contact.
the Primary Contact? Central Office
*
Washington Regional Office(Attn: Carl Dunn)
Wilmington Regional Office(Attn:Christine Hall)
................................................................................................................................................................................................................................................................................................................................................................................................
Project Name* Highland Place Subdivision
Owner/Operator* David Bradley Walker
County: Person
Submitter Name:* Jesse W.Wilson, P.E.
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 3367369267
Additional E-mail for [e-mail]
Submittal (Optional)
Confirmation:
State Stormwater (Post-Construction) Information Uploads
Choose file type and upload attachment(Reviewer may remove unnecessary submittals)
File Type* Application Form
File Upload Click the upload button,or drag and drop files to attach
4-10-24-PCSM Application Scanned&Signed.pdf 1.17MB
Only PDF files are accepted.
File Type* Wetland Determination/Report
File Upload Click the upload button,or drag and drop files to attach
4-11-24-Wetland Solutions Letter-Highland
96.95KB
Place.pdf
Only PDF files are accepted.

File Type* Stormwater Narrative
File Upload Click the upload button,or drag and drop files to attach
3-18-24-Stormwater Project Narrative W SIGNED
1.91 M B
ATTACH MENTS(1).pdf
Only PDF files are accepted.
File Type* Design Calculations
File Upload Click the upload button,or drag and drop files to attach
3-8-24-IMPERVIOUS SEALED.pdf 71.97KB
Only PDF files are accepted.
File Type* USGS Topographic Site Map
File Upload Click the upload button,or drag and drop files to attach
Roxboro-USGS-SITE.pdf 3.39MB
Only PDF files are accepted.
File Type* Deed Restriction/Protective Covenant Form
File Upload Click the upload button,or drag and drop files to attach
Deed Restriction Form-signed.pdf 274.15KB
Only PDF files are accepted.
File Type* Property Deed
File Upload Click the upload button,or drag and drop files to attach
Deed_Bk364_Pg304.pdf 168.13KB
Only PDF files are accepted.
File Type* O&M Agreement/Plan
File Upload Click the upload button,or drag and drop files to attach
O&M-Signed.pdf 318.05KB
Only PDF files are accepted.
File Type* Supplement-EZ Form
File Upload Click the upload button,or drag and drop files to attach
2-12-24-SuppEZ-2020-Version-2.1-Signed.pdf 289.9KB
Only PDF files are accepted.
File Type* Plansheet-Cover Sheet
File Upload Click the upload button,or drag and drop files to attach
HIGHLAND-SITE-DWG COVER(1R).pdf 636.05KB
Only PDF files are accepted.
File Type* Plansheet-Existing Conditions/Survey
File Upload Click the upload button,or drag and drop files to attach
HIGHLAND-SITE-DWG 1-EXISTING-COND(1R).pdf 1.34MB
Only PDF files are accepted.
File Type* Plansheet-Proposed Conditions/Site Plan

File Upload Click the upload button,or drag and drop files to attach
HIGHLAND-SITE-DWG 4-FINAL GRADES(1 R).pdf 2.13MB
Only PDF files are accepted.
File Type* Plansheet-Grading/Drainage Plan
File Upload Click the upload button,or drag and drop files to attach
HIGHLAND-SITE-DWG 2-PERIMETER-EC(1R).pdf 2.2MB
Only PDF files are accepted.
File Type* Plansheet-Grading/Drainage Plan
File Upload Click the upload button,or drag and drop files to attach
HIGHLAND-SITE-DWG 3-G&EC(1R).pdf 2.64MB
Only PDF files are accepted.
File Type* Plansheet-Grading/Drainage Plan
File Upload Click the upload button,or drag and drop files to attach
HIGHLAND-SITE-DWG 1of 1-DRAINAGE(1R).pdf 2.34MB
Only PDF files are accepted.
File Type* Plansheet-Misc. Detail
File Upload Click the upload button,or drag and drop files to attach
HIGHLAND-SITE-DWG 5-EC-DETAILS(1R).pdf 1.38MB
Only PDF files are accepted.
Is this project funded No
with ARPA grant Yes
funds?*
Uploads contain NO
Confidential YES
Information* NOTE:The following information cannot be claimed as confidential:the name and address of any permit applicant
or permittee,permit applications,permits,effluent data,information required by NPDES application forms provided
by the Director inclusive of all forms and attachments[Ref.40 CFR 122.7(b)and(c)].
Notes about the attachments:
* By checking the box and signing box below, I certify that:
o I have given true,accurate,and complete information on this form;
o 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)
o 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
d I intend to electronically sign and submit the Supplemental Information Upload form.
Full Name:* Jesse W.Wilson
Signature:
/G�lG IV. lU(,L�O/G

Date Submitted: 04/22/2024

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW5240402
Who needs a Copy?* Reviewer selections will only be required for offices checked here.
Central Office Staff
Regional Office Stormwater Contact
State Stormwater RO Staff
No Copy Needed
Central Office Reviewer:*
Notifies CO Staff with Email
Brianna Holland
Any Comments or
Added Info for CO
Staff Reviewer?
Review Date* 04/22/2024