NCC220358_Contact Update Record (Legally Resp Change)_20221209

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany A 12/9/2022 8:11:21 AM (Contact Changes Submitted)

Certificate of NCC220358
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2022-0358
Original NOI No.* 78569
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Garman Homes
Project Name Holding Village Single Lots
Address 0 Dr Calvin Jones Hwy, Wake Forest, NC
County Wake
Latitude 35.9630
Longitude-78.5100
Date COC Issued* 01/19/2022
Prior Rescission Date This field will populate only if COC has already been rescinded.
Which Contacts Have Billing Only
Changed?* • Legally Responsible Individual Only
Site Contact Only
BOTH Legally Responsible Individual and Site Contact
Has Billing Contact Choose'Yes'to revise Billing Contact details.
Changed? U No
Yes
Billing Email
[e-mail]
NEW Billing Email
[e-mail]
Billing Telephone No.
9194529769
NEW Billing
[phone]
Telephone No.
(Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible James Garman
Individual (Previous)
First Name (New)* Stacy
Last Name (New) * Brown

NEW Legally Reflects any revisions above
Responsible Stacy Brown
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No. (Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 3725 Stonegate Drive, 0, Durham, NC 27705-
Address (Previous) 5477
NEW Permittee Street Address
Mailing Address* 2052 Renaissance Park Place
Address Line 2
Suite #200
City
State / Province / Region
Cary
NC
Postal / Zip Code
Country
27513
us
Permittee Street 3725 Stonegate Drive, 0, Durham, NC 27705-
Address (Previous) 5477
NEW Permittee Street Street Address
Address* 2052 Renaissance Park Place
Address Line 2
Suite #200
City
State / Province / Region
Cary
NC
Postal / Zip Code
Country
27513
us
Change Requested Stacy Brown via Modification request submitted 12/5/2022.
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 12/09/2022