NCC212265_Contact Update Record_20220202

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany A 2/2/2022 11:43:36 AM (Contact Changes Submitted)

Certificate of NCC212265
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2021-2265
Original NOI No.* 50192
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Swinerton Builders
Project Name Stony Knoll Access Road
Address Old Wagon Trail, Dobson, NC
County Surry
Latitude 36.2983
Longitude-80.6669
Date COC Issued * 04/15/2021
Prior Rescission Date This field will populate only if COC has already been rescinded.
Which Contacts Have Billing Only
Changed?* Legally Responsible Individual Only
Site Contact Only
• BOTH Legally Responsible Individual and Site Contact
Has Billing Contact Choose'Yes'to revise Billing Contact details.
Changed? U No
Yes
Billing Email
Alexandra. [e-mail]
NEW Billing Email
[e-mail]
Billing Telephone No.
760-520-5415
NEW Billing
[phone]
Telephone No.
(Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible David Grubb
Individual (Previous)
First Name (New)* David
Last Name (New) * Grubb

NEW Legally Reflects any revisions above
Responsible David Grubb
Individual*
Permittee Email Alexandra. [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No. (Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 16680 WEST BERNARDO DRIVE, 0, San
Address (Previous) Diego, CA 29127
NEW Permittee
Street Address
Mailing Address*
16680 WEST BERNARDO DRIVE
Address Line 2
City
State / Province / Region
San Diego
CA
Postal / Zip Code
Country
92127
United States
Permittee Street
16680 WEST BERNARDO DRIVE, 0, San
Address (Previous)
Diego, CA 29127
NEW Permittee Street Street Address
Address*
16680 WEST BERNARDO DRIVE
Address Line 2
City
State / Province / Region
San Diego
CA
Postal / Zip Code
Country
92127
United States
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Jennifer Kirby
(Previous)
Site Contact Title
(Previous)
Organization
(Previous)
First Name (New)* Kate
Last Name (New) * Norskog
NEW Site Contact* Reflects any revisions above
Kate Norskog

NEW Site Contact
Title
NEW Organization SOLV Energy, LLC
This field is not required on the NOI form and may not pre -populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact [e-mail]
Email*
Site Contact 858-357-5006
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 16680 WEST BERNARDO DRIVE, 0, San
Address (Previous) Diego, CA 927127
NEW Site Contact Street Address
Mailing Address* 16680 WEST BERNARDO DRIVE
Address Line 2
City
State / Province / Region
San Diego
CA
Postal / Zip Code
Country
92127
United States
Change Requested David Grubb Jr via Modification request submitted 1/26/2022 and Taylor Welby via
by: e-mail on 2/1/2022.
Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation Permitted entity is the same, but the company name has changed.
(Optional)
Date * 02/02/2022