NCC205588_Contact Update Record_20230710

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Tev.Holloman 7/10/2023 1:30:15 PM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC205588
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2020-5588
Original NOI No.* 38014
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
KB Home
Project Name Birchwood Grove Subdivision Phase 1 &2
Address U.S.401, Hectors Creek Township, NC
County Harnett
Latitude 35.4660
Longitude -78.8290
Date COC Issued* 12/08/2020
Prior Rescission Date This field will populate only if COC has already been rescinded.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
Yes
Billing Email [e-mail]
Billing Telephone No. 919-768-7973
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Scott Johnson
(Previous)
Site Contact Title Sr. Director of Land Development
(Previous)
Organization KB Home
(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 Home
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 [phone]
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 4506 South Miami Boulevard,Suite 100,
Address(Previous) Durham, NC 27703
NEW Site Contact Street Address
Mailing Address* 4506 South Miami Boulevard
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