NCG170297_Renewal COC Request_20191008 4:02:03 PM

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Permit COC
NCG170297
Number *
Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
Stephanie Boggs
Obtaining COC*
First and LastNarra
Phone Number* 828-668-3436
Email * [e-mail]
The COC will be e-rrailed to this contact.
Additional Email (Optional) Enter an additional email address to whom to send the CDC
Please review the information below for accuracy before submitting. If there are inconsistencies, please
contact Bethany Georgoulias at [phone] or [e-mail].
Master General NCG170000
Permit No.
COC No.
NCG170297
Permittee
Auria Old Fort II LLC
Facility Name
Auria Old Fort II LLC
Address
1506 E Main Street
City
Old Fort
County
McDowell
Waterbody
Burgen Creek (Butch Branch)
Classification
C
River Basin
Catawba
RENEWAL STATUS
Active
Issuance Date*
08/01/2019
Effective Date
08/01/2019
1 hereby request a copy of the Certificate of Coverage (COC) entered above. I understand that the COC e-mailed as a
result of this request will serve as the Permittee's record of renewed coverage under the General Permit, and that this
record must be maintained with the Permittee's NPDES Stormwater Permit records.
Signature *
Date * 10/08/2019