NCC221234_Contact Update Record_20230420

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 4/20/2023 12:00:33 PM(Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC221234
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2022-1234
Original NOI No.* 85067
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
DR Horton, Inc
Project Name Carriage Place Townhomes
Address 1101 Gracie Lane, Carthage, NC
County Moore
Latitude 35.3261
Longitude -79.4089
Date COC Issued* 04/07/2022
Prior Rescission Date This field will populate only if COC has already been rescinded.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
(6) Yes
Billing Email [e-mail]
NEW Billing Email [e-mail]
Billing Telephone No. [phone]
NEW Billing [phone]
Telephone No. (optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Christopher Ahlers
Individual(Previous)
First Name(New)* Tracey
Last Name(New)* Davis

NEW Legally Reflects any revisions above
Responsible Tracey Davis
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 2000 Aerial Center Parkway Suite 110A,0,
Address(Previous) Morrisville, NC 27560-9294
NEW Permittee Street Address
Mailing Address* 7208 Falls of Neuse Road
Address Line 2
Suite 201
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27615 us
Permittee Street 2000 Aerial Center Parkway Suite 110A,0,
Address(Previous) Morrisville, NC 27560-9294
NEW Permittee Street Street Address
Address* 7208 Falls of Neuse Road
Address Line 2
Suite 201
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27615 us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Christopher Ahlers
(Previous)
Site Contact Title NPDES Technical Compliance Admin
(Previous)
Organization DR Horton, Inc
(Previous)
First Name(New)* Tracey
Last Name(New)* Davis

NEW Site Contact* Reflects any revisions above
Tracey Davis
NEW Site Contact Division NPDES Administrator
Title
NEW Organization DR Horton, Inc
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 3363126567
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 2000 Aerial Center Parkway,Suite 110A,0,
Address(Previous) Morrisville, NC 27560
NEW Site Contact Street Address
Mailing Address* 7208 Falls of Neuse Road
Address Line 2
Suite 201
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27615 United States
Change Requested Tracey Davis via Modification request submitted 4/17/2023.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 04/20/2023