NCC200839_Contact Update Record (Site Contact)_20230313

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by bethany.georgoulias 3/13/2023 9:51:59 AM (Contact Changes Submitted)

Certificate of
NCC200839
Coverage (COC) No.*
Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No.
NCG01-2020-0839
Original NOI No.*
22537
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Four Farms Road Apartments LLC
Project Name Four Farms at Horse Pen Creek Road
Address 3316 Horse Pen Creek Rd., Greensboro, NC
County Guilford
Latitude 36.1449
Longitude-79.8728
Date COC Issued * 03/03/2020
Prior Rescission Date This field will populate only if COC has already been rescinded.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? Q No
n Yes
Billing Email
NEW Billing Email
Billing Telephone No.
NEW Billing
Telephone No.
Site Contact
(Previous)
Site Contact Title
(Previous)
[e-mail]
[phone]
(Optional)
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Hunter Oglesby

Organization
(Previous)
First Name (New)* Matthew
Last Name (New)* Dunbar
NEW Site Contact* Reflects any revisions above
Matthew Dunbar
NEW Site Contact Development Associate
Title
NEW Organization Four Farms Road Apartments 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
336-889-1570
Telephone No.
(Previous)
NEW Site Contact
[phone]
Telephone No.*
Site Contact Mailing
5826 Samet Drive, Suite 105, High Point, NC
Address (Previous)
27265
NEW Site Contact Street Address
Mailing Address* 5826 Samet Drive
Address Line 2
Suite 105
City
State / Province / Region
High Point
NC
Postal / Zip Code
Country
27265
us
Change Requested Matthew Dunbar via e-mail on 3/10/2023.
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 03/13/2023