NCC216852_Contact Update Record (Leg Responsible)_20231206

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 12/6/2023 12:48:28 PM(Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC216852
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2021-6852
Original NOI No.* 75325
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
H&H Constructors of Fayettville, LLC
Project Name South Lakes SF-8 AR-1
Address 1517 Old Honeycutt Rd, Fuquay-Varina, NC
County Wake
Latitude 35.5810
Longitude -78.7410
Date COC Issued* 12/10/2021
Prior Rescission Date This field will populate only if COC has already been rescinded.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
C) Yes
Billing Email [e-mail]
Billing Telephone No. 919-215-6304
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Justin Heaton
Individual(Previous)
First Name(New)* Jon
Last Name(New)* McReynolds
NEW Legally Reflects any revisions above
Responsible Jon McReynolds
Individual*

Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 7200 Falls of Neuse Road,0, Raleigh, NC
Address(Previous) 27615-5384
NEW Permittee Street Address
Mailing Address* 7200 Falls of Neuse Road
Address Line 2
Suite 202
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27615-5384 us
Permittee Street 7200 Falls of Neuse Road,0, Raleigh, NC
Address(Previous) 27615-5384
NEW Permittee Street Street Address
Address* 7200 Falls of Neuse Road
Address Line 2
Suite 202
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27615-5384 us
Change Requested Kim Litman(Office Coordinator, Dream Finders Homes)via e-mail on 12/5/2023.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 12/06/2023