NCC213435_Contact Update Record_20240110

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 1/10/2024 7:33:21 AM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC213435
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2021-3435
Original NOI No.* 54823
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
DR Horton, Inc.
Project Name Bryson Park-DR Horton Lots
Address 503 Hege Road, Lexington, NC
County Davidson
Latitude 35.9646
Longitude -80.2757
Date COC Issued* 06/07/2021
Prior Rescission Date This field will populate only if COC has already been rescinded.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
4) 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 Tracey Davis
Individual(Previous)
First Name(New)* Neil
Last Name(New)* Uldrick

NEW Legally Reflects any revisions above
Responsible Neil Uldrick
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 7208 Falls of Neuse Road, Suite 201,
Address(Previous) Raleigh, NC 27615
NEW Permittee Street Address
Mailing Address* 4150 Mendenhall Oaks Parkway
Address Line 2
City State/Province/Region
High Point NC
Postal/Zip Code Country
27265 US
Permittee Street 7208 Falls of Neuse Road, Suite 201,
Address(Previous) Raleigh, NC 27615
NEW Permittee Street Street Address
Address* 4150 Mendenhall Oaks Parkway
Address Line 2
City State/Province/Region
High Point NC
Postal/Zip Code Country
27265 US
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Tracey Davis
(Previous)
Site Contact Title Division NPDES Administrator
(Previous)
Organization DR Horton, Inc.
(Previous)
First Name(New)* Neil
Last Name(New)* Uldrick
NEW Site Contact* Reflects any revisions above
Neil Uldrick

NEW Site Contact Division Stormwater Compliance Specialist III
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 [phone]
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 7208 Falls of Neuse Road, Suite 201,
Address(Previous) Raleigh, NC 27612
NEW Site Contact Street Address
Mailing Address* 4150 Mendenhall Oaks Parkway
Address Line 2
City State/Province/Region
High Point NC
Postal/Zip Code Country
27265 US
Change Requested Neil Uldrick via Modification request submitted 1/5/2024.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 01/10/2024