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HomeMy WebLinkAboutNCC201203_Contact Update Record (Site Contact)_20230320Action History (UTC-05:00) Eastern Time (US & Canada) Submit by bethany.georgoulias 3/20/2023 11:02:08 AM (Contact Changes Submitted) Certificate of NCC201203 Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters) NC Reference No. NCG01-2020-1203 Original NOI No.* 23339 Project information associated with this permit (cannot change): Permittee Listed Organizaiton cannot be changed (new COC required) LeoTerra Greenville, LLC Project Name Carter Ridge Subdivision Address B's Barbeque Road, Greenville, NC County Pitt Latitude 35.6178 Longitude-77.4266 Date COC Issued * 03/26/2020 Prior Rescission Date This field will populate only if COC has already been rescinded.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 0 Yes Billing Email NEW Billing Email kat.lyons@leoterradevelopment.com Billing Telephone No. NEW Billing (336) 682-1414 Telephone No. (Optional) Legally Responsible Individual Contact Information REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES! Legally Responsible Christopher Lyons Individual (Previous) First Name (New)* Christopher Last Name (New) * Lyons NEW Legally Reflects any revisions above Responsible Christopher Lyons Individual* Permittee Email buddy.lyons@leoterradevelopment.com (Previous) NEW Permittee buddy.lyons@leoterradevelopment.com Email* Permittee Telephone 336-671-1858 No. (Previous) NEW Permittee (336) 671-1858 Telephone No.* Permittee Mailing 3608 West Friendly Avenue, Suite 202, Address (Previous) Greensboro, NC 27410-4833 NEW Permittee Street Address Mailing Address* 110-A Shields Park Drive Address Line 2 City State / Province / Region Kernersville NC Postal / Zip Code Country 27284 us Permittee Street 3608 West Friendly Avenue, Suite 202, Address (Previous) Greensboro, NC 27410-4833 NEW Permittee Street Street Address Address * 110-A Shields Park Drive Address Line 2 City State / Province / Region Kernersville NC Postal / Zip Code Country 27284 us Site Contact Information REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES! Site Contact Kye Bunker (Previous) Site Contact Title Manager (Previous) Organization LeoTerra Greenville, LLC (Previous) First Name (New)* Kat Last Name (New) * Lyons NEW Site Contact* Reflects any revisions above Kat Lyons NEW Site Contact Senior Director of Entitlements Title NEW Organization LeoTerra Development Inc. This field is not required on the NOI form and may not pre -populate. Site Contact Email kye.bunker@leoterradevelopment.com (Previous) NEW Site Contact kat.lyons@leoterradevelopment.com Email* Site Contact 336-486-3653 Telephone No. (Previous) NEW Site Contact (336) 682-1414 Telephone No.* Site Contact Mailing 3608 West Friendly Avenue, 0, Greensboro, Address (Previous) NC 27410-4833 NEW Site Contact Street Address Mailing Address* 110-A Shields Park Drive Address Line 2 City State / Province / Region Kernersville NC Postal / Zip Code Country 27284 us Change Requested Jason Cheek via email requesting site contact updates on 3/10/2023. Address for by: * current legally responsible individual updated. Include any additional correspondence records in the Repository COC folder. Additional Information for this update to contact information: Addional Explanation (Optional) Date * 03/20/2023