NCG190007_Renewal COC Request_20201028 1:06:30 PM

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 10/28/2020 1:06:30 PM (COC Request Submission)

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
Number*
Name of Person
Obtaining COC*
Phone Number*
NCG 190007
Enter the Certificate of Coverage (COC) nun ber, not the General Rarnit nurrber (e.g., NOG030222 is the COC, not
N00030000) M-ST BEGIN WTTH CARTAL "NCG'
Hezekiah Harper
First and Last Nacre
2526364707
Email * [e-mail]
The COC w ill be e-nailed to this contact.
Additional Email [e-mail]
(Optional) Enter an additional errail address to whom to send the CDC
Did you check the permit COC file in our repository to ensure this COC was not already available from a previous
request? If it is, please obtain it from there instead of this form.
V Yes, this COC was not already there.
Please review the information below for accuracy before submitting. If there are inconsistencies, please
contact Bethany Georgoulias at [phone] or [e-mail].
Master General
NCG190000
Permit No.
COC No.
NCG190007
Permittee
Hatteras/Cabo Yachts LLC
Facility Name
Hatteras/Cabo Yachts LLC
Address
110 N Glenburnie Rd
City
New Bern
County
Craven
Waterbody
NEUSE RIVER
Classification
SC;Sw,NSW
River Basin
Neuse
RENEWAL STATUS
Active
Issuance Date*
10/01/2020
Effective Date
10/01/2020
Effective Date
20201001
Reformatted
I 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.
In addition, I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act"); and 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");
Signature *
. &° (; Va,"
Date * 10/28/2020