NCC192608_Contact Update Record (Leg Resp Change)_20220527

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany A 5/27/2022 2:11:55 PM (Contact Changes Submitted)

Certificate of NCC192608
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2019-2608
Original NOI No.* 17946
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Taylor Morrison of Carolinas, Inc.
Project Name Parc at Leesville
Address 7000 Leesville Rd., Raleigh, NC
County Wake
Latitude 35.8714
Longitude-78.6997
Date COC Issued* 11/01/2019
Prior Rescission Date This field will populate only if COC has already been rescinded.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 Jeremy Medlin
Individual (Previous)
First Name (New)* Christian
Last Name (New)* Sheppard

NEW Legally Reflects any revisions above
Responsible Christian Sheppard
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No. (Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 15501 Weston Parkway, Suite 100, Cary, NC
Address (Previous) 27513
NEW Permittee Street Address
Mailing Address* 15501 Weston Parkway
Address Line 2
Suite 100
City
State / Province / Region
Cary
NC
Postal / Zip Code
Country
27513
us
Permittee Street 15501 Weston Parkway, Suite 100, Cary, NC
Address (Previous) 27513
NEW Permittee Street Street Address
Address* 15501 Weston Parkway
Address Line 2
Suite 100
City
State / Province / Region
Cary
NC
Postal / Zip Code
Country
27513
us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Mark Altman
(Previous)
Site Contact Title Land Development Manager
(Previous)
Organization Taylor Morrison of Carolinas, Inc.
(Previous)
First Name (New)* Christian
Last Name (New) * Sheppard

NEW Site Contact* Reflects any revisions above
Christian Sheppard
NEW Site Contact Land Development Manager
Title
NEW Organization Taylor Morrison of Carolinas, Inc.
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 919-407-1232
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 15501 Weston Parkway, Suite 100, Cary, NC
Address (Previous) 27513
NEW Site Contact Street Address
Mailing Address* 15501 Weston Parkway
Address Line 2
Suite 100
City
State / Province / Region
Cary
NC
Postal / Zip Code
Country
27513
us
Change Requested Christian Sheppard via modification request submitted 5/24/2022.
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation Site Contact information was also updated because the previous Land Development
(Optional) Director was listed.
Date * 05/27/2022