NCC222956_Contact Update Record (Site Contact)_20230525

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 5/25/2023 8:20:11 AM(Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC222956
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2022-2956
Original NOI No.* 102256
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Clayton Properties Group Inc
Project Name Fowler Tract-Phase 1
Address 705 Doc Nichols Road, Durham, NC
County Durham
Latitude 35.9620
Longitude -78.7844
Date COC Issued* 08/18/2022
Prior Rescission Date This field will populate only if COC has already been rescinded.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? No
Yes
Billing Email [e-mail]
Billing Telephone No. 919-901-2595
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Ed Lynch
(Previous)
Site Contact Title Entitlement and Engineering Manager
(Previous)
Organization
(Previous)
First Name(New)* Arnaldo

Last Name(New)* Echevarria
NEW Site Contact* Reflects any revisions above
Arnaldo Echevarria
NEW Site Contact Land Entitlements and Engineering Manager
Title
NEW Organization Clayton Properties Group Inc
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 919-901-2595
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 2521 Schieffelin Road,0,Apex, NC 27502-
Address(Previous) 4400
NEW Site Contact Street Address
Mailing Address* 2521 Schieffelin Road
Address Line 2
Suite 116
City State/Province/Region
Apex NC
Postal/Zip Code Country
27502 us
Change Requested Chris Simmering via Modification request submitted 5/22/2023.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 05/25/2023