NCG030588_Owner Affiliation Change Request_20211020

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/20/2021 2:08:54 PM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 10/20/2021 2:42:57 PM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 10/20/2021 2:09 PM

.s"
NORYH CAkOLINF
ErtYiYOhRIPrtMI Qr101Ry
Default Page
NPDES Permit
Number*
Submittor's Name*
Phone Number*
Email Address*
Enter your NPDES stormwater permit number or Certificate of Coverage (COC) number.
NCG030588
NCSXXXXXX or NCGXXXXXX
Please enter your FIRST and LAST name
Kyna McBurrows
Please enter your phone number
9197776340
Any format is fine.
Please enter a valid e-mail address
[e-mail]
A confirmation of submission 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 [e-mail].
Completed Form Please upload the signed "Permit Owner Affiliation Designation Form"
Upload* Permit Owner Affiliation Designation Form.pdf 70.8KB
pdf only

Initial Review
Project ID * Reviewer may revise permit number below if incorrect.
NCG030588