NCC205873_Contact Update Record_20230710

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Tev.Holloman 7/10/2023 1:28:59 PM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC205873
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2020-5873
Original NOI No.* 39438
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
KB Home Raleigh-Durham, Inc.
Project Name Junction Road Subdivision
Address 1309 Junction Road, Durham, NC
County Durham
Latitude 36.0240
Longitude -78.8450
Date COC Issued* 01/28/2021
Prior Rescission Date This field will populate only if COC has already been rescinded.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
Yes
Billing Email
NEW Billing Email [e-mail]
Billing Telephone No.
NEW Billing 919-768-7973
Telephone No. (optional)
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Jared Walton
(Previous)
Site Contact Title Project Manager
(Previous)

Organization Cardinal Civil Contracting LLC
(Previous)
First Name(New)* Scott
Last Name(New)* Johnson
NEW Site Contact* Reflects any revisions above
Scott Johnson
NEW Site Contact Sr. Director of Land Development
Title
NEW Organization KB Homes
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 984 867-6100
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 4441 Six Forks Road Suite 106, 1110 navaho
Address(Previous) dr suite 600, Raleigh, NC 27609-5729
NEW Site Contact Street Address
Mailing Address* 4506 S Miami Blvd
Address Line 2
Suite 100
City State/Province/Region
Durham NC
Postal/Zip Code Country
27703 us
Change Requested Ashish Patel(VP, Finance KBHome)via email on 7/5/2023.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 07/10/2023