NCG170125_Owner Affiliation Change Request_20210315

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 3/15/2021 3:09:48 PM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 3/19/2021 6:45:33 AM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 3/15/2021 3:10 PM

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Default Page
NPDES Permit
Enter your NFDES storrrwater pernit nunber or Certificate of Coverage (CCC) nunber.
Number*
NCG170125
NCS)00000(or NCC)OOWO(
Submittor's Name*
Reaseenter your FIRST and LAST narre
Michele Long
Phone Number*
Reaseenter your phone nurrber
828-217-1619
Any format is fine.
Email Address *
Rease enter a valid a -mail address
[e-mail]
A confirmation of submssion will be e-mailed to this address.
Need a copy of the Permit Owner Affiliation Designation Form? You must upload a signed copy of that form below.
Questions? Call Bethany Georgoulias at [phone] or e-mail her at.bethany.georgouliasencdenr.gov.
Completed Form Rease upload the signed "Permit Cwner Affiliation Designation Forn1'
Upload* NCDENR Form.pdf 714.2KB
pdf only

Initial Review
Project ID * Peviewer nay revise perrrit nunber below if incorrect.
NCG170125