NCC201488_Contact Update Record (Leg Resp Change)_20220419

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany A 4/19/2022 4:28:17 PM (Contact Changes Submitted)

Certificate of NCC201488
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2020-1488
Original NOI No.* 24293
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Townes at Seaside, LLC
Project Name Townes at Seaside
Address Hwy 904 at Sunset Creek Way, Sunset Beach, NC
County Brunswick
Latitude 33.9062
Longitude-78.4880
Date COC Issued * 04/16/2020
Prior Rescission Date This field will populate only if COC has already been rescinded.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
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 Kerry Avant
Individual (Previous)
First Name (New)* David
Last Name (New)* Vannoy

NEW Legally Reflects any revisions above
Responsible David Vannoy
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No. (Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 2919 Breezewood Avenue, Suite 100,
Address (Previous) Fayetteville, NC 28303-5283
NEW Permittee Street Address
Mailing Address* 2919 Breezewood Avenue
Address Line 2
Suite 100
City
State / Province / Region
Fayetteville
NC
Postal / Zip Code
Country
28303
us
Permittee Street 2919 Breezewood Avenue, Suite 100,
Address (Previous) Fayetteville, NC 28303-5283
NEW Permittee Street Street Address
Address* 2919 Breezewood Avenue
Address Line 2
Suite 100
City
State / Province / Region
Fayetteville
NC
Postal / Zip Code
Country
28303
us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Kerry Avant
(Previous)
Site Contact Title Manager
(Previous)
Organization Townes at Seaside, LLC
(Previous)
First Name (New)* David
Last Name (New)* Vannoy

NEW Site Contact* Reflects any revisions above
David Vannoy
NEW Site Contact Manager
Title
NEW Organization Townes at Seaside, 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 910-486-4864
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 2919 Breezewood Avenue, Suite 100,
Address (Previous) Fayetteville, NC 28303-5283
NEW Site Contact Street Address
Mailing Address* 2919 Breezewood Avenue
Address Line 2
Suite 100
City
State / Province / Region
Fayetteville
NC
Postal / Zip Code
Country
28303
us
Change Requested Amanda E. Jacobs via Modification request submitted 4/13/2022. Confirmed with
by: * company representative that site contact should be updated to the same individual.
Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation Townes at Seaside LLC is overseen by RHH Land Investors.
(Optional)
Date * 04/19/2022