NCG030574_Owner Affiliation Change Request_20210729

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 7/29/2021 1:39:42 PM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 7/30/2021 6:54:41 AM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 7/29/2021 1:39 PM

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Default Page
NPDES Permit
Enter your NPDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG030574
NCS)00000(orNCG)00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
James Martin
Phone Number*
Reaseenter your phone nunber
18283200768
Any format is fine.
Email Address *
Rease enter a valid a -mail address
[e-mail]
A confirmation of submission 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* Stormwater change form 2021.pdf 150.64KB
pdf only

Initial Review
Project ID * Peviewer nay revise perrrit nunber below if incorrect.
NCG030574