NCC192597_Contact Update Record_20201215

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Selkane, Aziza 12/15/2020 1:42:36 PM (Contact Changes Submitted)

Certificate of NCC192597
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
NC Reference No. NCG01-2019-2597
Original NOI No.* 17896
Project information associated with this permit (cannot change):
Permittee Listed
Organizaitoncannot bechanged (new 00Crequired)
Toll Bros. of North Carolina II, Inc.
Project Name
Castleberry Trails
Address
605 Wimberly Road, Apex, NC
County
Wake
Latitude
35.7695
Longitude
-78.9251
Date COC Issued*
11/01/2019
Prior Rescission
This field will populate only if OOC has already been rescinded.
Date
Which Contacts
f Billing Only
Have Changed?*
r Legally Responsible Individual Only
r Site Contact Only
r BOTH Legally Responsible Individual and Site Contact
Has Billing Contact
Choose'Yes'torevise Billing Contact details.
Changed?
r No
r Yes
Billing Email
Billing Telephone
No.
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Kirk Rightmyer
(Previous)
Site Contact Title Sr. Land Development Manager
(Previous)
Organization Toll Brothers
(Previous)

First Name (New)* Garth
Last Name (New) * De Blasio
NEW Site Contact* Peflects any revisions above
Garth De Blasio
NEW Site Contact Sr. Land Development Manager
Title
NEW Organization Toll Brothers
This field is not required on the NCI form and may not pre -populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact [e-mail]
Email*
Site Contact [phone]
Telephone No.
(Previous)
NEW Site Contact 7329775547
Telephone No.*
Site Contact Mailing 2310 TW Alexander Drive, 0, Raleigh, NC
Address (Previous) 27617-7755
NEW Site Contact Street Address
Mailing Address* 2310 TW Alexander Drive
Address Line 2
C7ty
State / Rovince / Fbgion
Raleigh
NC
Fbstal / Zip Code
Country
27617-7755
us
Change Requested Garth De Blasio
by: * Include any additional correspondence records in the Pepository 00Cfolder.
Additional Information for this update to contact information:
Addional
Explanation
(Optional)
Date * 12/15/2020