NCG060286_Owner Affiliation Change Request_20201218

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 12/18/2020 3:26:05 PM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 12/31/2020 1:02:25 PM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 12/18/2020 3:26 PM

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Default Page
NPDES Permit
Enter your BIDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG060286
NCS)00000(orNCG)00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
Mark Logue
Phone Number*
Reaseenter your phone nunber
919-677-3292
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 Reaseupload the signed "FbrnitCWnerAffiliation DesignationForn'
Upload* NCG060286 Permit Owner Affiliation Designation
1.12MB
Chagne 12.18.20.pdf
pdt ony

Initial Review
Project ID * Reviewer may revise permt nunber below if incorrect.
NCG060286