NCC200883_Contact Update Record_20210423

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Selkane, Aziza 4/23/2021 5:57:24 PM (Contact Changes Submitted)

Certificate of NCC200883
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
NC Reference No. NCG01-2020-0883
Original NOI No.* 22782
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new OOC required)
Nash Wendell Falls, LLC
Project Name
Wendell Falls Phase 9 Early Grading
Address
0 Big Falls Drive, Wendell, NC
County
Wake
Latitude
35.7760
Longitude
-78.4230
Date COC Issued*
03/11/2020
Prior Rescission
This field will populate only if COChas already been rescinded.
Date
Which Contacts
f Billing Only
Have Changed?*
r 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 919-951-0716
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Tanya Matzen
Individual
(Previous)

First Name (New)* Chris
Last Name (New) * Ferraguto
NEW Legally Reflects any revisions above
Responsible Chris Ferraguto
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee 919-951-0718
Telephone No.
(Previous)
NEW Permittee 919-951-0716
Telephone No.*
Permittee Mailing
4020 Westchase Boulevard, Suite 150,
Address (Previous)
Raleigh, NC 27607
NEW Permittee
Street Address
Mailing Address*
4020 Westchase Boulevard
Address Line 2
Suite 150
oty
State / Rovince / Fbgion
Raleigh
NC
Fbstal / Zip Code
Country
27607
us
Permittee Street
4020 Westchase Boulevard, Suite 150,
Address (Previous)
Raleigh, NC 27607
NEW Permittee
Street Address
Street Address*
4020 Westchase Boulevard
Address Line 2
Suite 150
city
State / Rovince / Region
Raleigh
NC
Fbstal / Zip Code
Country
27607
us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Tanya Matzen
(Previous)
Site Contact Title Vice President of Operations - Raleigh
(Previous)
Organization Nash Wendell Falls, LLC
(Previous)

First Name (New)* Gareth
Last Name (New) * Avant
NEW Site Contact* Reflects any revisions above
Gareth Avant
NEW Site Contact Vice President of Operations - Raleigh
Title
NEW Organization
Nash Wendell Falls, LLC
This field is not required on the NOI form and nay not pre -populate.
Site Contact Email
[e-mail]
(Previous)
NEW Site Contact
[e-mail]
Email *
Site Contact
919-951-0718
Telephone No.
(Previous)
NEW Site Contact
919-951-0716
Telephone No.*
Site Contact Mailing
4020 Westchase Boulevard, Suite 150,
Address (Previous)
Raleigh, NC 27607
NEW Site Contact
Street Address
Mailing Address*
4020 Westchase Boulevard
Address Line 2
Suite 150
City
State / province / Region
Raleigh
NC
Fbstal / Zip Code
Country
27607
us
Change Requested Chris Ferraguto
by: * Include any additional correspondence records in the Repository CDC folder.
Additional Information for this update to contact information:
Addional
Explanation
(Optional)
Date * 04/23/2021