NCC192108_Contact Update Record_20201204

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Georgoulias, Bethany 12/4/2020 1:12:07 PM (Contact Changes Submitted)

Certificate of NCC192108
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
NC Reference No. NCG01-2019-2108
Original NOI No.* 16399
Project information associated with this permit (cannot change):
Permittee Listed Organizaitoncannot bechanged (new COCrequired)
University of North Carolina at Chapel Hill
Project Name Odum Village Student Apartment Complex Demolition
Address Hibbard Drive, Chapel Hill, NC
County Orange
Latitude 35.9000
Longitude-79.0500
Date COC Issued* 11/14/2019
Prior Rescission This field will populate only if CCChas already been rescinded.
Date
Which Contacts F Legally Responsible Individual Only
Have Changed?* f Site Contact Only
f BOTH Legally Responsible Individual and Site Contact
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Jonathan Pruitt
Individual
(Previous)
First Name (New)* George
Last Name (New) * Battle, III
NEW Legally Peflects any revisions above
Responsible George Battle, III
Individual*
Permittee Email
(Previous)
NEW Permittee
Email *
[e-mail]
[e-mail]

Permittee 919-962-2080
Telephone No.
(Previous)
NEW Permittee 919-962-2080
Telephone No.*
Permittee Mailing 200 East Cameron Avenue, 300 South
Address (Previous) Building, Chapel Hill, NC 27599
NEW Permittee
Mailing Address*
Street Address
200 East Cameron Avenue
Address Line 2
300 South Building
Cty
Chapel Hill
Fbstal / Zip Code
27599
Permittee Street 200 East Cameron Avenue, 300 South
Address (Previous) Building, Chapel Hill, NC 27599
State / Rovince / f;bgion
NC
Country
us
NEW Permittee Street Address
Street Address* 200 East Cameron Avenue
Address Line 2
300 South Building
Qty
State / Rovince / Region
Chapel Hill
NC
Fbstal / Zip Code
Country
27599
us
Change Requested Janet Clarke via email on 12/4/2020.
by: * Include any additional correspondence records in the Repository CDC folder.
Additional Information for this update to contact information:
Addional Originally notified Program about this change in March 2020, before Modification
Explanation form was set up with option to provide paperwork for legally responsible person
(Optional) change. Confirmed contact details and all affected COCs on 12/4/2020.
Date * 12/04/2020