NCC223445_Contact Update Record (Typo Correction)_20241004

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 10/4/2024 1:14:19 PM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC223445
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2022-3445
Original NOI No.* 108381
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
CWC Development, LLC
Project Name Cliffs at Walnut Cove-Phase 9B
Address Split Rock Trail,Arden, NC
County Buncombe
Latitude 35.4402
Longitude -82.5760
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Prior Rescission Date This field will populate only if COC has already been rescinded.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. [phone]
NEW Billing [phone]
Telephone No. (optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Rob Duckett
Individual(Previous)
First Name(New)* Rob
Last Name(New)* Duckett

NEW Legally Reflects any revisions above
Responsible Rob Duckett
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing PO Box 1047,0,Travelers Rest,SC 29690
Address(Previous)
NEW Permittee Street Address
Mailing Address* PO Box 1047
Address Line 2
City State/Province/Region
Travelers Rest SC
Postal/Zip Code Country
29690 us
Permittee Street 3851 SC-11,0,Travelers Rest, SC 29690
Address(Previous)
NEW Permittee Street Street Address
Address* 3851 SC-11
Address Line 2
City State/Province/Region
Travelers Rest SC
Postal/Zip Code Country
29690 us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Matthew Corn
(Previous)
Site Contact Title Development Manager
(Previous)
Organization CWC Development, LLC
(Previous)
First Name(New)* Matthew
Last Name(New)* Corn
NEW Site Contact* Reflects any revisions above
Matthew Corn

NEW Site Contact Development Manager
Title
NEW Organization CWC Development, LLC
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 PO Box 1047,0,Travelers Rest,SC 29690
Address(Previous)
NEW Site Contact Street Address
Mailing Address* PO Box 1047
Address Line 2
City State/Province/Region
Travelers Rest SC
Postal/Zip Code Country
29690 us
Change Requested [Corrected typo in email just now] Initially requested by Jack Weber(VP of
by:* Development)via email on 10/4/2024. Only updated contact email for R. Duckett,
who remains legally responsible individual. Billing and site contacts also updated.
Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 10/04/2024