NCG030255_Owner Affiliation Change Request_2/17/2020

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 2/17/2020 10:26:51 AM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 2/18/2020 2:37:54 PM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 2/17/2020 10:26 AM

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Default Page
NPDES Permit
Enter your MPDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG030255
NCS)00000(or NCC)00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
Curtis Daniels
Phone Number*
Reaseenter your phone number
7047683230
Any format is fine.
Email Address *
Rease enter a valid a-rrail 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 Reaseupload the signed "FbrmitCwnerAffiliation Designation Forn1'
Upload* NCG030255 Owner affliation change signed.pdf 689.52KB
pdf only

Initial Review
Project ID * Peviewer nay revise perrrit nunber below if incorrect.
NCG030255