NCG060039_Owner Affiliation Change Request_20210322

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 3/22/2021 2:29:15 PM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 3/25/2021 11:52:13 AM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 3/22/2021 2:29 PM

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Default Page
NPDES Permit
Enter your MPDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG060039
NCS)00000(or NCGX)0000C
Submittor's Name*
Rease enter your FIRST and LAST narre
Samuel Vedder
Phone Number*
Reaseenter your phone nunber
9193594108
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 "FbrnitCwnerAffiliation Designation Fornl'
Upload* 2021-03-19 NPDES Stormwater Program Permit
150.41 KB
Form.pdf
pdt only

Initial Review
Project ID * Reviewer may revise permt nunber below if incorrect.
NCG060039