NCG030170_Owner Affiliation Change Request_20210616

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 6/16/2021 11:20:26 AM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 7/1/2021 7:37:52 AM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 6/16/2021 11:20 AM

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Default Page
NPDES Permit
Enter your NPD6 storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG030170
NCS)00000(or NCC)00000(
Submittor's Name*
Rease enter your FIRST and LAST narre
Brian Freeman
Phone Number*
Rease enter your phone number
7044732440
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 Rease upload the signed "FbrmitCwner Affiliation Designation Form'
Upload* Owner Affiliation SW Permit.pdf 413.86KB
pdf only

Initial Review
Project ID * Peviewer rmy revise perrrit nunber below if incorrect.
NCG030170