NCGNE1417_Owner Affiliation Change Request_20210707

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/7/2021 4:30:12 PM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 7/15/2021 6:57:45 PM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 7/7/2021 4:30 PM

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Default Page
NPDES Permit
Enter your NRDES storrrwater pernit nunber or Certificate of Coverage (CCC) nunber.
Number*
NCGNE1417
NCS)00000(or N G)00000(
Submittor's Name*
Please enter your FIRST and LAST narre
Joseph Fuhr
Phone Number*
Rease enter your phone nurrber
3368221745
Any format is fine.
Email Address *
Rease enter a valid a -mail address
Joseph. [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 "Permit C,vner Affiliation Designation Form1'
Upload* NPDES-Owner-Affiliation-Change-20191104-
421.27KB
DEMLR-SW - HKY - signed.pdf
pdt only

Initial Review
Project ID * Fbviewer rmy revise perrrit nunber below if incorrect.
NCGNE1417