NCC205244_Contact Update Record (Legally Resp Change)_20230203

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by bethany.georgoulias 2/3/2023 12:02:36 PM (Contact Changes Submitted)

Certificate of NCC205244
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2020-5244
Original NOI No.* 35884
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Grubb Properties
Project Name Herrin Stock Pile
Address 315 E. 36th Street, Charlotte, NC
County Mecklenburg
Latitude 35.2501
Longitude-80.8063
Date COC Issued * 01 /11 /2021
Prior Rescission Date This field will populate only if COC has already been rescinded.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 Eric Applefield
Individual (Previous)
First Name (New)* Connor
Last Name (New) * Marshall

NEW Legally Reflects any revisions above
Responsible Connor Marshall
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No. (Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 4601 Park Road, Suite 450, Charlotte, NC
Address (Previous) 28209
NEW Permittee Street Address
Mailing Address* 117 Edinburgh S. Drive
Address Line 2
Suite 110
City
State / Province / Region
Cary
NC
Postal / Zip Code
Country
27511
us
Permittee Street 4601 Park Road, Suite 450, Charlotte, NC
Address (Previous) 28209
NEW Permittee Street Street Address
Address* 117 Edinburgh S. Drive
Address Line 2
Suite 110
City
State / Province / Region
Cary
NC
Postal / Zip Code
Country
27511
us
Change Requested Connor Marshall (Development Project Manager) via e-mail on 2/2/2023.
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 02/03/2023