NCC201542_Contact Update Record_20210518

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Selkane, Aziza 5/18/2021 2:02:54 PM (Contact Changes Submitted)

Certificate of NCC201542
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
NC Reference No. NCG01-2020-1542
Original NOI No.* 24460
Project information associated with this permit (cannot change):
Permittee Listed
Organizaiton cannot be changed (new OOC required)
JRN HOMES ON TYVOLA LLC
Project Name
West Tyvola Single Family Condos
Address
2828 Watuaga Ave, Charlotte, NC
County
Mecklenburg
Latitude
35.2062
Longitude
-80.9110
Date COC Issued*
04/22/2020
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This field will populate only if COChas already been rescinded.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 704-285-6463
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Rick Admani
Individual
(Previous)

First Name (New)* Rick
Last Name (New) * Admani
NEW Legally Reflects any revisions above
Responsible Rick Admani
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee 704-285-6490
Telephone No.
(Previous)
NEW Permittee 704-285-6490
Telephone No.*
Permittee Mailing 7224 Statesville Road, Suite -A, Charlotte,
Address (Previous) NC 28269
NEW Permittee
Mailing Address*
Street Address
7224 Statesville Road
Address Line 2
Suite -A
aty
Charlotte
Fbstal / Zip Code
28269
Permittee Street 7224 Statesville Road, Suite -A, Charlotte,
Address (Previous) NC 28269
NEW Permittee Street Address
Street Address* 7224 Statesville Road
Address Line 2
Suite -A
city
Charlotte
Fbstal / Zip Code
28269
State / Rovince / R gion
NC
Country
us
State / Rovince / Region
NC
Country
us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Rick Admani
(Previous)
Site Contact Title Owner
(Previous)
Organization JRN HOMES ON TYVOLA LLC
(Previous)

First Name (New)* Rick
Last Name (New) * Admani
NEW Site Contact* Reflects any revisions above
Rick Admani
NEW Site Contact Owner
Title
NEW Organization
JRN HOMES ON TYVOLA 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 7042856490
Telephone No.
(Previous)
NEW Site Contact 7042856490
Telephone No.*
Site Contact Mailing 7224 Statesville Road, Suite A, Charlotte, NC
Address (Previous) 28269
NEW Site Contact
Mailing Address*
Street Address
7224 Statesville Road
Address Line 2
Suite A
city
Charlotte
Fbstal / Zip Code
28269
State / Frovince / Region
NC
Country
us
Change Requested Gail Lenkiewicz
by: * Include any additional correspondence records in the Repository CDC folder.
Additional Information for this update to contact information:
Addional
Explanation
(Optional)
Date * 05/18/2021