NCC215124_Contact Update Record_20230421

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 4/21/2023 12:52:05 PM(Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC215124
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2021-5124
Original NOI No.* 64541
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Beazer Homes, LLC
Project Name Shoccoree Residential
Address 4020 Shoccoree Dr., Durham, NC
County Durham
Latitude 36.0330
Longitude -78.9580
Date COC Issued* 09/13/2021
Prior Rescission Date This field will populate only if COC has already been rescinded.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? Q No
4) Yes
Billing Email [e-mail]
NEW Billing Email [e-mail]
Billing Telephone No. 925-683-0415
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)* Trevor
Last Name(New)* Dalton

NEW Legally Reflects any revisions above
Responsible Trevor Dalton
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 801 Corporate Center Dr,Suite 330, Raleigh,
Address(Previous) NC 27607
NEW Permittee Street Address
Mailing Address* 801 Corporate Center Dr
Address Line 2
Suite 330
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27607 Wake
Permittee Street 801 Corporate Center Dr,Suite 330, Raleigh,
Address(Previous) NC 27607
NEW Permittee Street Street Address
Address* 801 Corporate Center Dr
Address Line 2
Suite 330
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27607 Wake
Change Requested Trevor Dalton (Director of Land)via Modification request submitted 4/14/2023.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 04/21/2023