NCC192681_Contact (Site) Update Record_20211116

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany A 11/16/2021 7:52:53 AM (Contact Changes Submitted)

Certificate of
NCC192681
Coverage (COC) No.*
Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No.
NCG01-2019-2681
Original NOI No.*
18151
Project information associated with this permit (cannot change):
Permittee Listed
Organizaiton cannot be changed (new COC required)
Corbinton at Kildaire Farm LLC
Project Name
Corbinton at Kildaire Farm
Address
3401 Arthur Pierce Road, Cary, NC
County
Wake
Latitude
35.6945
Longitude
-78.7887
Date COC Issued*
11/08/2019
Prior Rescission Date
This field will populate only if COC has already been rescinded.
Which Contacts Have
Billing Only
Changed?*
Legally Responsible Individual Only
• Site Contact Only
BOTH Legally Responsible Individual and Site Contact
Has Billing Contact
Choose'Yes'to revise Billing Contact details.
Changed?
• No
Yes
Billing Email
Billing Telephone No.
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact
Whitt Cozart
(Previous)
Site Contact Title
Land Development Manager
(Previous)
Organization
Corbinton at Kildaire Farm LLC
(Previous)
First Name (New)*
Lee

Last Name (New) *
Bowman
NEW Site Contact*
Reflects any revisions above
Lee Bowman
NEW Site Contact
Project Manager
Title
NEW Organization Blue Heel Development
This field is not required on the NOI form and may not pre -populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact [e-mail]
Email*
Site Contact 919.632.1164
Telephone No.
(Previous)
NEW Site Contact 919.800.0460
Telephone No.*
Site Contact Mailing 3708 Forestview Dr, Suite 103, 0, Raleigh,
Address (Previous) NC 27612
NEW Site Contact Street Address
Mailing Address* 3633 Harden Road
Address Line 2
Suite 102
City State / Province / Region
Raleigh NC
Postal / Zip Code Country
27607 United States
Change Requested Whitt Cozart via email on 11/12/2021.
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation Whitt Cozart is no longer on this project.
(Optional)
Date * 11 /16/2021