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Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System AGENCY USE ONLY
Date Received
Year
Month
Day
Certificate of Coverage
Check #AmountPermit
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01
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02
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03
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04
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Who needs permit assigned to?
01
Individuals or organizations engaging in regulated activities
02
Builders or contractors undertaking construction projects
03
Event organizers planning large gatherings or events
04
Businesses involved in activities that require permits
05
People conducting activities in specified areas or facilities
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What is permit assigned to?
Permit is assigned to a specific individual or entity.
Who is required to file permit assigned to?
The individual or entity assigned the permit is required to file it.
How to fill out permit assigned to?
The permit assigned to can be filled out by providing all relevant information requested.
What is the purpose of permit assigned to?
The purpose of permit assigned to is to authorize the holder to perform certain activities.
What information must be reported on permit assigned to?
The permit assigned to must include information such as the name of the holder, permit number, and expiration date.
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