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HomeMy WebLinkAboutNCG190033_Renewal COC Request_20210216 11:31:34 AMAction History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 2/16/2021 11:31:34 AM (COC Request Submission) NORTH C W Q-rA EnHmnmertm! dafny Permit COC NCG190033 Number * Enter the Certificate of Coverage (COC) nun ber, not the General Pen-rit nurrber (e.g., N00030222 is the ODC, not N00030000) M-ST BEGIN WTTH CARTAL "NOG' Name of Person Steven M Tulevech Obtaining COC* First and Last Name Phone Number* 2527286111 Email * carol@towncreekmarina.com The COC w ill be e-nailed to this contact. Additional Email (Optional) Enter an additional enailaddress towhom tosend the OOC 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. rJ 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 (919) 707-3641 or bethany.georgoulias@ncdenr.gov. Master General NCG190000 Permit No. COC No. NCG190033 Permittee Conscience Bay LLC DBA Town Creek Marina Facility Name Town Creek Marina - Beaufort Address 232 W Beaufort Rd City Beaufort County Carteret Waterbody Town Creek Classification SC River Basin White Oak 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 * Date * 02/16/2021