NCC190751_Contact Update Record_20201203

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Georgoulias, Bethany 12/3/2020 3:20:55 PM (Contact Changes Submitted)

Certificate of NCC190751
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
NC Reference No. NCG01-2019-0751
Original NOI No.* 12853
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Renew Petra Construction, LLC
Project Name
Cruise Solar, LLC
Address
Dawson Cabin Road, Stump Sound, NC
County
Onslow
Latitude
34.6913
Longitude
-77.5436
Date COC Issued*
06/27/2019
Prior Rescission
This field will populate only if 00Chas already been rescinded.
Date
Which Contacts
r Legally Responsible Individual Only
Have Changed?*
f Site Contact Only
r BOTH Legally Responsible Individual and Site Contact
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible
Wayne Marshall
Individual
(Previous)
First Name (New)*
Wayne
Last Name (New) *
Marshall
NEW Legally
Peflects any revisions above
Responsible
Wayne Marshall
Individual*
Permittee Email
[e-mail]
(Previous)
NEW Permittee
[e-mail]
Email *

Permittee 7048970713
Telephone No.
(Previous)
NEW Permittee 7048970713
Telephone No.*
Permittee Mailing 11330 Vanstory Drive, Suite 101,
Address (Previous) Huntersville, NC 28078
NEW Permittee
Mailing Address*
Street Address
11330 Vanstory Drive
Address Line 2
Suite 101
Cty
Huntersville
Fbstal / Zip Code
28078
Permittee Street 11330 Vanstory Drive, Suite 101,
Address (Previous) Huntersville, NC 28078
NEW Permittee Street Address
Street Address* 11330 Vanstory Drive
Address Line 2
Suite 101
city
Huntersville
Fbstal / Zip Code
28078
State / Rovince / f;bgion
NC
Country
us
State / Rovince / Region
NC
Country
us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Jason Sparks
(Previous)
Site Contact Title Director of Construction
(Previous)
Organization Renew Petra Construction, LLC
(Previous)
First Name (New)* Jason
Last Name (New) * Sparks
NEW Site Contact* Reflects any revisions above
Jason Sparks
NEW Site Contact Director of Construction
Title
NEW Organization Renew Petra Construction, LLC
This field is not required on the N01 form and nay not pre -populate.
Site Contact Email [e-mail]
(Previous)

NEW Site Contact [e-mail]
Email*
Site Contact 7043090629
Telephone No.
(Previous)
NEW Site Contact 7043090629
Telephone No.*
Site Contact Mailing 11330 Vanstory Drive, Suite 101,
Address (Previous) Huntersville, North Carolina 28078
NEW Site Contact
Mailing Address*
Street Address
11330 Vanstory Drive
Address Line 2
Suite 101
Cty
Huntersville
Fbstal / Zip Code
28078
State / Rovince / Fbgion
North Carolina
Country
United States
Change Requested Jason Sparks (site contact) via e-mail on 11/30/2020.
by: * Include any additional correspondence records in the Pepository CDC folder.
Additional Information for this update to contact information:
Addional E-mail address updates for both legally responsible person and site contact.
Explanation
(Optional)
Date * 12/03/2020