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HomeMy WebLinkAboutNCC222956_Contact Update Record (Billing)_20230525 Action History (UTC-05:00)Eastern Time(US&Canada) Submit by bethany.georgoulias 5/25/2023 10:50:53 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-78.7844 Date COC Issued* 08/18/2022 Prior Rescission Date This field will populate only if COC has already been rescinded.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 csimmering@mungo.com NEW Billing Email nechevarria@mungo.com Billing Telephone No. 919-901-2595 NEW Billing (919)302-1024 Telephone No. (Optional) Change Requested Arnaldo(Naldo)Echevarria via email on 5/25/2023. 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