NCC201060_Contact Update Record (Legally Resp Change)_20230126

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany A 1/26/2023 11:47:39 AM (Contact Changes Submitted)

Certificate of NCC201060
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2020-1060
Original NOI No.* 23075
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Beazer Homes LLC
Project Name Roberts Crossing
Address 7021 Roberts Road, Apex, NC
County Wake
Latitude 35.7624
Longitude-78.8861
Date COC Issued * 03/30/2020
Prior Rescission Date This field will populate only if COC has already been rescinded.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 Michael Snoberger
Individual (Previous)
First Name (New)* R. Scott
Last Name (New) * Johnson

NEW Legally Reflects any revisions above
Responsible R. Scott Johnson
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No. (Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 5400 Trinity Rd, Suite 313, Raleigh, NC
Address (Previous) 27607
NEW Permittee Street Address
Mailing Address* 5400 Trinity Rd
Address Line 2
Suite 313
City
State / Province / Region
Raleigh
NC
Postal / Zip Code
Country
27607
United States
Permittee Street 5400 Trinity Rd, Suite 313, Raleigh, NC
Address (Previous) 27607
NEW Permittee Street Street Address
Address* 5400 Trinity Rd
Address Line 2
Suite 313
City
State / Province / Region
Raleigh
NC
Postal / Zip Code
Country
27607
United States
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Michael Snoberger
(Previous)
Site Contact Title VP Land Development
(Previous)
Organization Beazer Homes LLC
(Previous)
First Name (New)* Scott
Last Name (New) * Johnson

NEW Site Contact* Reflects any revisions above
Scott Johnson
NEW Site Contact VP Land Development
Title
NEW Organization Beazer Homes 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 925-683-0415
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 5400 Trinity Road, Suite 313, Raleigh, NC
Address (Previous) 27607
NEW Site Contact Street Address
Mailing Address* 5400 Trinity Road
Address Line 2
Suite 313
City
State / Province / Region
Raleigh
NC
Postal / Zip Code
Country
27607
us
Change Requested Scott Johnson via Modification Request submitted 1/23/2023.
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