NCG050139_Owner Affiliation Change Request_4/30/2018

Envirnnmun tat
Quality
Default Page
NPDES Permit
Enter your WDES stormwater permit number or Certificate of Coverage (00C) number.
Number*
ncg050139
NCS)00000(or NCG)00000(
Submittor's Name*
Reaseenter your FIRST and LAST nane
Tony Sain
Phone Number*
Reaseenter your phone number
704 889 2431 ext 50204
Any fornet is fine.
Email Address*
Rease enter a valid a-rreil address
[e-mail]
A confirmation of submission w ill be e-rrailed 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 "Ilermit Cwner Affiliation Designation Formi'
Upload * Storm water page 2.pdf 30.18KB
Storm Water page 1.pdf 47.6KB
pdt only

Initial Review
Project ID* ncg050139