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HomeMy WebLinkAboutNCC191652_Contact Update Record_20201209Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Selkane, Aziza 12/9/2020 2:49:19 PM (Contact Changes Submitted) Certificate of NCC191652 Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters) No.* NC Reference No. NCG01-2019-1652 Original NOI No.* 15360 Project information associated with this permit (cannot change): Permittee Listed Organizaiton cannot be changed (new OOC required) City of Hickory Project Name City Contract City of Hickory Riverwalk Address 2035 12th Street Drive NW, Hickory, NC County Burke Latitude 35.7654 Longitude -81.3686 Date COC Issued* 09/03/2019 Prior Rescission This field will populate only if COChas already been rescinded.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 Site Contact Information REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES! Site Contact Kevin Greer (Previous) Site Contact Title Public Services Director (Previous) Organization City of Hickory (Previous) First Name (New)* Shawn Last Name (New)* Pennell NEW Site Contact * Peflects any revisions above Shaven Pennell NEW Site Contact Public Services Director Title NEW Organization City of Hickory This field is not required on the NCI form and nay not pre -populate. Site Contact Email kgreer@hickorync.gov (Previous) NEW Site Contact spennell@hickorync.gov Email* Site Contact 828-323-7427 Telephone No. (Previous) NEW Site Contact 828-323-7427 Telephone No.* Site Contact Mailing 1441 9th Avenue, 0, Hickory, NC 28601 Address (Previous) NEW Site Contact Mailing Address* Street Address 1441 9th Avenue Address Line 2 city Hickory Fbstal / Zip Code 28601 State / Rovince / Fbgion NC Country us Change Requested Shaven Pennell by: * Include any additional correspondence records in the Fbpository 00Cfolder. Additional Information for this update to contact information: Addional Explanation (Optional) Date * 12/09/2020