NCC221560_Contact Update Record_20230912

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 9/12/2023 7:27:35 AM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC221560
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2022-1560
Original NOI No.* 88640
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
DR Horton, Inc
Project Name Summerhaven East
Address S. NC 119 HWY, Mebane, NC
County Alamance
Latitude 36.0510
Longitude -79.3200
Date COC Issued* 04/22/2022
Prior Rescission Date This field will populate only if COC has already been rescinded.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
0 Yes
Billing Email [e-mail]
NEW Billing Email [e-mail]
Billing Telephone No. 9192156561
NEW Billing [phone]
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Jessica Meyer
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,0, Morrisville,
Address(Previous) 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,0, Morrisville,
Address(Previous) 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
Change Requested Tracey Davis via Modification request submitted 9/11/2023.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 09/12/2023