HomeMy WebLinkAboutNCC220482_Contact Update Record (Site Contact)_20230320Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by bethany.georgoulias 3/20/2023 11:43:30 AM (Contact Changes Submitted)
Certificate of
NCC220482
Coverage (COC) No.*
Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No.
NCG01-2022-0482
Original NOI No.*
79165
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Leoterra Olive Branch, LLC
Project Name Olive Branch Subdivision
Address West Olive Road, Clayton, NC
County Johnston
Latitude 35.5840
Longitude-78.4178
Date COC Issued* 01/25/2022
Prior Rescission Date This field will populate only if COC has already been rescinded.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? Q No
0 Yes
Billing Email buddy.lyons@leoterradevelopment.com
NEW Billing Email kat.lyons@leoterradevelopment.com
Billing Telephone No. 336-486-3653
NEW Billing (336) 682-1414
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Christopher Lyons
Individual (Previous)
First Name (New)* Christopher
Last Name (New) * Lyons
NEW Legally Reflects any revisions above
Responsible Christopher Lyons
Individual*
Permittee Email
buddy.lyons@leoterradevelopment.com
(Previous)
NEW Permittee
buddy.lyons@leoterradevelopment.com
Email*
Permittee Telephone
336-486-3653
No. (Previous)
NEW Permittee
336-486-3653
Telephone No.*
Permittee Mailing 110-A Shields Park Drive, 0, Kernersville, NC
Address (Previous) 27284
NEW Permittee Street Address
Mailing Address* 110-A Shields Park Drive
Address Line 2
City
State / Province / Region
Kernersville
NC
Postal / Zip Code
Country
27284
us
Permittee Street 110-A Shields Park Drive, 0, Kernersville, NC
Address (Previous) 27284
NEW Permittee Street Street Address
Address * 110-A Shields Park Drive
Address Line 2
City State / Province / Region
Kernersville NC
Postal / Zip Code Country
27284 us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Kye Bunker
(Previous)
Site Contact Title Land Aqcuistition Manager
(Previous)
Organization Leoterra Olive Branch LLC
(Previous)
First Name (New)* Kat
Last Name (New) * Lyons
NEW Site Contact* Reflects any revisions above
Kat Lyons
NEW Site Contact Senior Director of Entitlements
Title
NEW Organization LeoTerra Development Inc.
This field is not required on the NOI form and may not pre -populate.
Site Contact Email kye.bunker@leoterradevelopment.com
(Previous)
NEW Site Contact kat.lyons@leoterradevelopment.com
Email*
Site Contact 336-486-3653
Telephone No.
(Previous)
NEW Site Contact (336) 682-1414
Telephone No.*
Site Contact Mailing 110-A Shields Park Drive, 0, Kernersville, NC
Address (Previous) 27284
NEW Site Contact Street Address
Mailing Address* 110-A Shields Park Drive
Address Line 2
City
State / Province / Region
Kernersville
NC
Postal / Zip Code
Country
27284
us
Change Requested Jason Cheek via email requesting site contact updates on 3/10/2023.
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 03/20/2023