NCC190981_Contact Update Record_20201221

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany 12/21/2020 9:49:07 AM (Contact Changes Submitted)

Certificate of NCC190981
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
NC Reference No. NCG01-2019-0981
Original NOI No.* 13555
Project information associated with this permit (cannot change):
Permittee Listed
Organizaiton cannot be changed (new OOCrequired)
Pulte Home Company, LLC
Project Name
RiverLights Age Qualified Phase 2 & 3 Lots 233-234, 278, 283-284, 310, 329 &
352
Address
4410 River Road, Wilmington, NC
County
New Hanover
Latitude
34.1489
Longitude
-77.9319
Date COC Issued*
07/17/2019
Prior Rescission
This field will populate only if OOChas already been rescinded.
Date
Which Contacts
f Billing Only
Have Changed?*
r Legally Responsible Individual Only
r Site Contact Only
r BOTH Legally Responsible Individual and Site Contact
Has Billing Contact
Choose'Yes'torevise Billing Contact details.
Changed?
r No
r Yes
Billing Email
NEW Billing Email [e-mail]
Billing Telephone
No.
NEW Billing [phone]
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!

Legally Responsible Matthew Raines
Individual
(Previous)
First Name (New)* Chris
Last Name (New) * Raughley
NEW Legally Feflects any revisions above
Responsible Chris Raughley
Individual*
Permittee Email Matthew. [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee [phone]
Telephone No.
(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 4000 Faber Place Drive, Suite 110, 0, North
Address (Previous) Charleston, SC 29405
NEW Permittee Street Address
Mailing Address* 1225 Crescent Green Drive
Address Line 2
Suite 250
C ly
State / Rovince / Fbgion
Cary
NC
Fbstal / Zip Code
Country
27518
us
Permittee Street 4000 Faber Place Drive, Suite 110, 0, North
Address (Previous) Charleston, SC 29405
NEW Permittee Street Address
Street Address* 1225 Crescent Green Drive
Address Line 2
Suite 250
oty
State / province / Region
Cary
NC
postal / Zip Code
Country
27518
us
Change Requested Chris Raughley via Modification request on 12/21/2020.
by: * Include any additional correspondence records in the Repository CDC folder.
Additional Information for this update to contact information:
Addional Billing contact populated with new legally responsible person info. Also confirmed
Explanation Suite number via e-mail because it was cut-off on the scan of the change form.
(Optional)

Date * 12/21 /2020