NCC222746_Contact Update Record_20230829

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 8/29/2023 8:20:08 AM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC222746
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2022-2746
Original NOI No.* 100651
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
AC-Asheville LLC
Project Name AutoCamp Asheville
Address 1030 Old Marshall Hwy,Asheville, NC
County Buncombe
Latitude 35.6773
Longitude -82.6121
Date COC Issued* 08/12/2022
Prior Rescission Date This field will populate only if COC has already been rescinded.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? Q No
(.) Yes
Billing Email [e-mail]
NEW Billing Email [e-mail]
Billing Telephone No. 9256285050
NEW Billing [phone]
Telephone No. (optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Shawn Tooley
Individual(Previous)
First Name(New)* Tim
Last Name(New)* Landon

NEW Legally Reflects any revisions above
Responsible Tim Landon
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 121 East Mason Street Ste b,0,Santa
Address(Previous) Barbara, CA 93101-1852
NEW Permittee Street Address
Mailing Address* 121 East Mason Street
Address Line 2
Suite B
City State/Province/Region
Santa Barbara CA
Postal/Zip Code Country
93101-1852 us
Permittee Street 121 East Mason Street Ste b,0,Santa
Address(Previous) Barbara, CA 93101-1852
NEW Permittee Street Street Address
Address* 121 East Mason Street
Address Line 2
Suite B
City State/Province/Region
Santa Barbara CA
Postal/Zip Code Country
93101-1852 us
Change Requested Tim Landon(Sr Director of Construction)via Modification request submitted
by:* 8/15/2023.
Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 08/29/2023