NCC223478_Contact Update Record (Legally Resp Change)_20230126

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany A 1/26/2023 11:36:45 AM (Contact Changes Submitted)

Certificate of NCC223478
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2022-3478
Original NOI No.* 108649
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Garman Homes, LLC
Project Name Tupelo Junction Lots for Garman Homes
Address Lebanon Road, Mebane, NC
County Orange
Latitude 36.1100
Longitude-79.2550
Date COC Issued * 10/07/2022
Prior Rescission Date This field will populate only if COC has already been rescinded.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? • No
Yes
Billing Email [e-mail]
Billing Telephone No. 336-552-4532
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible
Dan Rosati
Individual (Previous)
First Name (New) *
COsmO
Last Name (New)*
Muti
NEW Legally
Reflects any revisions above
Responsible
Cosmo Muti
Individual*

Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No. (Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 3725 Stonegate Drive, 0, Durham, NC 27705-
Address (Previous) 5477
NEW Permittee Street Address
Mailing Address* 1175 Revolution Mill Drive
Address Line 2
Suite 22
City
State / Province / Region
Greensboro
NC
Postal / Zip Code
Country
27405
us
Permittee Street 3725 Stonegate Drive, 0, Durham, NC 27705-
Address (Previous) 5477
NEW Permittee Street Street Address
Address* 1175 Revolution Mill Drive
Address Line 2
Suite 22
City
State / Province / Region
Greensboro
NC
Postal / Zip Code
Country
27405
us
Change Requested Cosmo Muti via Modification request submitted 1/19/2023.
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 01 /26/2023