NCC220361_Contact Update Record (Legally Resp Change)_20230303

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by bethany.georgoulias 3/3/2023 11:05:39 AM (Contact Changes Submitted)

Certificate of NCC220361
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2022-0361
Original NOI No.* 78574
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Cranwood Carolina Capital LLC
Project Name Calabash 15
Address NC 179, Calabash, NC
County Brunswick
Latitude 33.8930
Longitude-78.5720
Date COC Issued* 01/19/2022
Prior Rescission Date This field will populate only if COC has already been rescinded.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? Q No
n Yes
Billing Email [e-mail]
NEW Billing Email [e-mail]
Billing Telephone No. 330-867-2400
NEW Billing [phone]
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Tom Charek
Individual (Previous)
First Name (New)* Bryan
Last Name (New) * Studer

NEW Legally Reflects any revisions above
Responsible Bryan Studer
Individual*
Permittee Email
[e-mail]
(Previous)
NEW Permittee
[e-mail]
Email*
Permittee Telephone
330-867-2400
No. (Previous)
NEW Permittee
[phone]
Telephone No.*
Permittee Mailing 381 Tanglewood Lane, 0, Bay Village, OH
Address (Previous) 44140-1132
NEW Permittee Street Address
Mailing Address* 381 Tanglewood Lane
Address Line 2
City
State / Province / Region
Bay Village
OH
Postal / Zip Code
Country
44140-1132
us
Permittee Street 381 Tanglewood Lane, 0, Bay Village, OH
Address (Previous) 44140-1132
NEW Permittee Street Street Address
Address * 381 Tanglewood Lane
Address Line 2
City
State / Province / Region
Bay Village
OH
Postal / Zip Code
Country
44140-1132
us
Change Requested Bryan Studer, Project Manager, via Modification request submitted 2/24/2023 and
by: * subsequent email communication on 3/3/2023.
Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 03/03/2023