Belmont Estates - 4/22/2019 9:29:22 AM

Submittal Dated: 4/22/2019
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
SW6190401
Exarrples: SWxxxxxxx, NOC;axxxx, or NCSxxxxxx
Facility Name:* Belmont Estates
County: Cumberland
Name: Scott Brown, PE
Who is submitting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
tick the upload button or drag and drop files here to attach document
1368-PERMITTING PLANS (SIGNED & SEALED).pdf
17.29MB
1368 ADG SOS Info.pdf
55.02KB
01 DB 10418-842 SUBJECT DEED.pdf
246.96KB
1368 DeedRestric.pdf
15.94KB
1368 Low Density Supplement.pdf
160.02KB
1368 SWU-1 01 -Application. pdf
225.44KB
1368-Stormv,ater Narrative.pdf
232.97KB
Only pdf files are accepted.
Describe the attachments:
* W By checking the box and signing box below, I certify that:
• 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
• I intend to electronically sign and submit the Supplemental Information form."

Full Name:* C. Scott Brown
Signature:
Date Submitted: 4/22/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW6190401
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]