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This field will populate only if COChas already been rescinded.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