NCC210767_Contact Update Record_20240617

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 6/17/2024 10:44:01 AM(Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC210767
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2021-0767
Original NOI No.* 42902
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Tri Pointe Homes, Inc.
Project Name Towns at Cannon Ave
Address 1415 West Sugar Creek Road,Charlotte, NC
County Mecklenburg
Latitude 35.2807
Longitude -80.7974
Date COC Issued* 04/01/2024
Prior Rescission Date This field will populate only if COC has already been rescinded.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. 8034316188
NEW Billing [phone]
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Luke Woodburn
Individual(Previous)
First Name(New)* Ben
Last Name(New)* Taylor

NEW Legally Reflects any revisions above
Responsible Ben Taylor
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 3436 Toringdon Way,Suite 210, Charlotte,
Address(Previous) NC 28277-2450
NEW Permittee Street Address
Mailing Address* 6325 Ardrey Kell Road
Address Line 2
Suite 125
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28277 us
Permittee Street 3436 Toringdon Way,Suite 210, Charlotte,
Address(Previous) NC 28277-2450
NEW Permittee Street Street Address
Address* 6325 Ardrey Kell Road
Address Line 2
Suite 125
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28277 us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Luke Woodburn
(Previous)
Site Contact Title Director of Land Development
(Previous)
Organization
(Previous)
First Name(New)* Ben
Last Name(New)* Taylor

NEW Site Contact* Reflects any revisions above
Ben Taylor
NEW Site Contact Director of Land Development
Title
NEW Organization Tri Pointe Homes, 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 8034316188
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 3436 Torington Way, Suite 210, Charlotte, NC
Address(Previous) 28277
NEW Site Contact Street Address
Mailing Address* 6325 Ardrey Kell Road
Address Line 2
Suite 125
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28277 USA
Change Requested Jeanine Hay(Land Development Coordinator)via Modification request submitted
by:* 6/13/2024.
Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 06/17/2024