NCC210951_Contact Update Record_20210318 (2)

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Selkane, Aziza 3/18/2021 3:54:19 PM (Contact Changes Submitted)

Certificate of NCC210951
Coverage (COC) Enter the Certificate of Coverage N.mber (Use capital letters)
No.*
NC Reference No. NCG01-2021-0951
Original NOI No.* 44619
Project information associated with this permit (cannot change):
Permittee Listed
Organizaitoncannot bechanged (new CCCrequired)
Little Bear Creek Properties, LLC
Project Name
Beaver Creek Subdivision -Phase 1 B
Address
Claude Lewis Road, Dry Wells TWSP, NC
County
Nash
Latitude
35.7688
Longitude
-78.1801
Date COC Issued*
03/18/2021
Prior Rescission
This field will populate only if CCChas already been rescinded.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
F Yes
Billing Email
[e-mail]
NEW Billing Email
[e-mail]
Billing Telephone
919-612-5531
No.
NEW Billing
919-612-5531
Telephone No.
(Cptional)
Change Requested
David Geiger
by: *
Include any additional correspondence records in the Pepository OOCfolder.
Additional Information
for this update to contact information:

Addional
Explanation
(Optional)
Date * 03/18/2021