NCG030152_Owner Affiliation Change Request_20210714

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 7/14/2021 8:11:48 AM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 7/15/2021 7:09:02 PM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 7/14/2021 8:11 AM

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Default Page
NPDES Permit
Enter your NPD6 storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG030152
NCS)00000(orNQG)00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
Kurt Poythress
Phone Number*
Reaseenter your phone nunber
919-418-8463
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 Designation Fornl'
Upload* Owner Affiliation Change Request.pdf 600.32KB
pdf only

Initial Review
Project ID * Peviewer nay revise perrrit nunber below if incorrect.
NCG030152