NCC193163_Contact Update Record_20210126

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Selkane, Aziza 1/26/2021 3:55:35 PM (Contact Changes Submitted)

Certificate of NCC193163
Coverage (COC) Enter the Certificate of Coverage Nmber (Use capital letters)
No.*
NC Reference No. NCG01-2019-3163
Original NOI No.* 19311
Project information associated with this permit (cannot change):
Permittee Listed
Organizaiton cannot be changed (new OOC required)
AMH NC Development LP, LLC
Project Name
Holleman Hills
Address
3024 & 3028 New Hill Holleman Road, New Hill, NC
County
Wake
Latitude
35.6750
Longitude
-78.9330
Date COC Issued*
12/12/2019
Prior Rescission
This field will populate only if COChas already been rescinded.
Date
Which Contacts
f Billing Only
Have Changed?*
f Legally Responsible Individual Only
f 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
NEW Billing Email [e-mail]
Billing Telephone
No.
NEW Billing 919 422 8606
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Richard Wolf
Individual
(Previous)

First Name (New)* Richard
Last Name (New) * Wolf
NEW Legally Peflects any revisions above
Responsible Richard Wolf
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee 919-201-8817
Telephone No.
(Previous)
NEW Permittee 919-201-8817
Telephone No.*
Permittee Mailing 2100 Gateway Centre Blvd, STE 120,
Address (Previous) Morrisville, NC 27560
NEW Permittee
Mailing Address*
Street Address
2100 Gateway Centre Blvd
Address Line 2
STE 120
Cly
Morrisville
Fbstal / Zip Code
27560
Permittee Street 2100 Gateway Centre Blvd, STE 120,
Address (Previous) Morrisville, NC 27560
NEW Permittee Street Address
Street Address* 2100 Gateway Centre Blvd
Address Line 2
STE 120
city
Morrisville
Fbstal / Zip Code
27560
State / Rovince / f;bgion
NC
Country
United States
State / Rovince / Region
NC
Country
United States
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Richard Wolf
(Previous)
Site Contact Title SVP
(Previous)
Organization AMH NC Development LP, LLC
(Previous)

First Name (New)* Richard
Last Name (New) * Wolf
NEW Site Contact* Reflects any revisions above
Richard Wolf
NEW Site Contact SVP
Title
NEW Organization AMH NC Development LP, 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
919-201-8817
Telephone No.
(Previous)
NEW Site Contact
919-201-8817
Telephone No.*
Site Contact Mailing
2100 Gateway Centre Blvd, STE 120,
Address (Previous)
Morrisville, NC 27560
NEW Site Contact
Street Address
Mailing Address*
2100 Gateway Centre Blvd
Address Line 2
STE 120
city
State / Frovince / Region
Morrisville
NC
Fbstal / Zip Code
Country
27560
United States
Change Requested Richard Wolf
by: * Include any additional correspondence records in the Repository CDC folder.
Additional Information for this update to contact information:
Addional
Explanation
(Optional)
Date * 01 /26/2021