NCC213764_Contact Update Record_20230706

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 7/6/2023 4:27:03 PM(Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC213764
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2021-3764
Original NOI No.* 56981
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Dream Finders Homes, LLC
Project Name Medlin Forest Subdivision
Address 1298 Medlin Road, Monroe, NC
County Union
Latitude 34.9653
Longitude -80.5260
Date COC Issued* 07/14/2021
Prior Rescission Date This field will populate only if COC has already been rescinded.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 [e-mail]
NEW Billing Email [e-mail]
Billing Telephone No. 980-267-3423
NEW Billing [phone]
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Jack Rostetter
Individual(Previous)
First Name(New)* Dan
Last Name(New)* Zalinsky

NEW Legally Reflects any revisions above
Responsible Dan Zalinsky
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 14701 Philips Highway,0,Jacksonville, FL
Address(Previous) 32256
NEW Permittee Street Address
Mailing Address* 301 McCullough Drive
Address Line 2
Suite 109
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28262 us
Permittee Street 14701 Philips Highway,0,Jacksonville, FL
Address(Previous) 32256
NEW Permittee Street Street Address
Address* 301 McCullough Drive
Address Line 2
Suite 109
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28262 us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Chris Granelli
(Previous)
Site Contact Title Developer
(Previous)
Organization Altura Development Group
(Previous)
First Name(New)* Chris
Last Name(New)* Robusto

NEW Site Contact* Reflects any revisions above
Chris Robusto
NEW Site Contact Vice President of Land
Title
NEW Organization Dream Finders Homes, LLC
This field is not required on the NOI form and may not pre-populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact [e-mail]
Email*
Site Contact 704-534-4898
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 1012 Shippon Lane,0,Waxhaw, NC 28173-
Address(Previous) 7362
NEW Site Contact Street Address
Mailing Address* 301 McCullough Drive
Address Line 2
Suite 109
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28262 us
Change Requested John Osinga(Dream Finders Homes)via email on 7/5/2023.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 07/06/2023