NCC193297_Contact Update Record Correction_20210331

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Selkane, Aziza 3/31/2021 4:23:31 PM (Contact Changes Submitted)

•
Certificate of NCC193297
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
NC Reference No. NCG25-2019-3297
Original NOI No.* 19828
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new CDC required)
NNP Briar Chapel, LLC
Project Name
Briar Chapel - Granite Mill Blvd. Force Main
Address
Granite Mill Blvd, Chapel Hill, NC
County
Chatham
Latitude
35.8158
Longitude
-79.1130
Date COC Issued*
01/14/2020
Prior Rescission
This field will populate only if COChas already been rescinded.
Date
Which Contacts
f Billing Only
Have Changed?*
r Legally Responsible Individual Only
f Site Contact Only
f BOTH Legally Responsible Individual and Site Contact
Has Billing Contact
Choose'Yes'torevise Billing Contact details.
Changed?
F No
r Yes
Billing Email
[e-mail]
Billing Telephone
919 951 0716
No.
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Mike Scisciani
Individual
(Previous)
First Name (New)* Chris
Last Name (New) * Ferraguto

NEW Legally Peflects any revisions above
Responsible Chris Ferraguto
Individual*
Permittee Email mscisciani@ne\Mandco.com
(Previous)
NEW Permittee [e-mail]
Email*
Permittee 919-822-8145
Telephone No.
(Previous)
NEW Permittee 919-951-0716
Telephone No.*
Permittee Mailing 4020 Westchase Blvd, Suite 150, Raleigh,
Address (Previous) NC 27607
NEW Permittee
Mailing Address*
Street Address
4020 Westchase Blvd
Address Line 2
Suite 150
Cty
Raleigh
Fbstal / Zip Code
27607
State / Rovince / Fbgion
NC
Country
USA
Permittee Street 4020 Westchase Blvd, 0, Raleigh, NC 27607
Address (Previous)
NEW Permittee Street Address
Street Address* 4020 Westchase Blvd
Address Line 2
city
State / province / FZegion
Raleigh
NC
postal / Zip Code
Country
27607
USA
Change Requested Chris Ferraguto
by: * Include any additional correspondence records in the %pository CDC folder.
Additional Information for this update to contact information:
Addional
Explanation
(Optional)
Date * 03/31 /2021