NCC205038_Contact Update Record_20210322

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Georgoulias, Bethany 3/22/2021 1:12:58 PM (Contact Changes Submitted)

Certificate of NCC205038
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
NC Reference No. NCG01-2020-5038
Original NOI No.* 34985
Project information associated with this permit (cannot change):
Permittee Listed Crganizaitoncannot bechanged (new OOCrequired)
Mattamy Homes, LLC
Project Name
Magnolia Park Subdivision
Address
New Bethel Church Road, Garner, NC
County
Wake
Latitude
35.6572
Longitude
-78.5720
Date COC Issued*
11/05/2020
Prior Rescission
This field will populate only if COChas already been rescinded.
Date
Which Contacts
f Billing Only
Have Changed?*
f Legally Responsible Individual Only
f 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. (Cptional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Rob Bailey
Individual
(Previous)

First Name (New)*
Joe
Last Name (New) *
Conlan
NEW Legally
Peflects any revisions above
Responsible
Joe Conlan
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee 919-235-2964
Telephone No.
(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 1210 Trinity Road, Suite 102, Raleigh, NC
Address (Previous) 27607-4945
NEW Permittee
Mailing Address*
Street Address
1210 Trinity Road
Address Line 2
Suite 102
Cty
Cary
Fbstal / Zip Code
27513
Permittee Street 1210 Trinity Road, Suite 102, Raleigh, NC
Address (Previous) 27607-4945
NEW Permittee Street Address
Street Address* 1210 Trinity Road
Address Line 2
Suite 102
Qty
Cary
Fbstal / Zip Code
27513
State / Rovince / Fbgion
NC
Country
us
State / Rovince / Region
NC
Country
us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Rob Bailey
(Previous)
Site Contact Title Land Development Manager
(Previous)
Organization Mattamy Homes, LLC
(Previous)

First Name (New)*
Joe
Last Name (New) *
Conlan
NEW Site Contact*
Reflects any revisions above
Joe Conlan
NEW Site Contact
Director of Land Development
Title
NEW Organization Mattamy Homes, LLC
This field is not required on the N01 form and nay not pre -populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact [e-mail]
Email *
Site Contact 919-235-2964
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 1210 Trinity Road, Suite 102, Raleigh, NC
Address (Previous) 27607-4945
NEW Site Contact
Mailing Address*
Street Address
1210 Trinity Road
Address Line 2
Suite 102
city
Cary
Fbstal / Zip Code
27513
State / Frovince / Region
NC
Country
us
Change Requested Joe Conlan via Modification request on 3/22/2021.
by: * Include any additional correspondence records in the Repository CDC folder.
Additional Information for this update to contact information:
Addional
Explanation
(Optional)
Date * 03/22/2021