NCC230157_Contact Update Record (Site Contact)_20240206

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 2/6/2024 8:14:14 AM(Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC230157
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2023-0157
Original NOI No.* 123124
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Town of Mount Pleasant
Project Name Mount Pleasant USDA Sewer Improvements
Address NC-49, Empire Drive,Circle Drive,A Street, B Street,C Street, Reid Street,Wade
Street,Town of Mount Pleasant, NC
County Cabarrus
Latitude 35.4023
Longitude -80.4558
Date COC Issued* 01/27/2023
Prior Rescission Date This field will populate only if COC has already been rescinded.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 [e-mail]
Billing Telephone No. [phone]
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Rob McIntyre
(Previous)
Site Contact Title Project Manager
(Previous)
Organization LKC Engineering, PLLC
(Previous)
First Name(New)* Zach

Last Name(New)* Bennett
NEW Site Contact* Reflects any revisions above
Zach Bennett
NEW Site Contact Project Manager
Title
NEW Organization LKC Engineering, PLLC
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 980-622-0376
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 140 Aqua Shed Ct,0,Aberdeen, North
Address(Previous) Carolina 28315
NEW Site Contact Street Address
Mailing Address* 140 Aqua Shed Ct
Address Line 2
City State/Province/Region
Aberdeen North Carolina
Postal/Zip Code Country
28315 USA
Change Requested Zach Bennett via email on 2/6/2024
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 02/06/2024