NCG130080_Owner Affiliation Change Request 4/26/2018 4:34:49 PM_20180426

Envirnnmun tat
Quality
Default Page
NPDES Permit
Enter your NRDES stormwater permit number or Certificate of Coverage (00C) number.
Number*
NCG130080
NCS)OOWO(or NCC -,J00000(
Submittor's Name*
Reaseenter your RRSTand LAST name
Chris Dickson
Phone Number*
Rease enter your phone nunter
704-463-2201
Any format is fine.
Email Address*
Reaseenter avalid e-nailaddress
[e-mail]
A confirmation of submission w ill 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 Laura Alexander at [phone] or e-mail her at laura.alexander(cDncdenr.gov.
Completed Form Rease upload the signed T brmit Cwner Affiliation Designation Formf
Upload * storm water 2018.pdf 713.24KB
pdb only

Initial Review
Project ID* NCG130080