NCC203284_Contact Update Record_20221215

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany A 12/15/2022 12:46:20 PM (Contact Changes Submitted)

Certificate of NCC203284
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2020-3284
Original NOI No.* 29135
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Lennar Carolinas, LLC
Project Name Ellis Road
Address 3714 Angier Avenue, Durham, NC
County Wake
Latitude 35.9520
Longitude-78.8580
Date COC Issued * 08/04/2020
Prior Rescission Date This field will populate only if COC has already been rescinded.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 Troy George
Individual (Previous)
First Name (New)* Robert
Last Name (New) * Smart

NEW Legally Reflects any revisions above
Responsible Robert Smart
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No. (Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 1100 Perimeter Park Drive, Suite 112,
Address (Previous) Morrisville, NC 27560
NEW Permittee Street Address
Mailing Address* 1100 Perimeter Park Drive
Address Line 2
Suite 112
City State / Province / Region
Morrisville NC
Postal / Zip Code Country
27560 United States
Permittee Street 1100 Perimeter Park Drive, Suite 112,
Address (Previous) Morrisville, NC 27560
NEW Permittee Street Street Address
Address* 1100 Perimeter Park Drive
Address Line 2
Suite 112
City State / Province / Region
Morrisville NC
Postal / Zip Code Country
27560 United States
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Troy George
(Previous)
Site Contact Title Division President
(Previous)
Organization Lennar Carolinas, LLC
(Previous)
First Name (New)* Robert
Last Name (New) * Smart

NEW Site Contact* Reflects any revisions above
Robert Smart
NEW Site Contact Division President
Title
NEW Organization Lennar Carolinas, 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 919-465-5935
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 1100 Perimeter Park Drive, Suite 112,
Address (Previous) Morrisville, NC 27560
NEW Site Contact Street Address
Mailing Address* 1100 Perimeter Park Drive
Address Line 2
Suite 112
City State / Province / Region
Morrisville NC
Postal / Zip Code Country
27560 United States
Change Requested Robert Smart via Modification request submitted 12/1/2022.
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 12/15/2022