NCC230640_Contact Update Record (Billing Contact)_20240418

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 4/18/2024 4:07:45 PM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC230640
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2023-0640
Original NOI No.* 131199
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
ARROWROCK IV LONG MILL, LLC
Project Name US-1 NORTH COMMERCE CENTER
Address Long Mill Road,Youngsville, NC
County Franklin
Latitude 36.0382
Longitude -78.5047
Date COC Issued* 04/01/2024
Prior Rescission Date This field will populate only if COC has already been rescinded.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]
NEW Billing Email [e-mail]
Billing Telephone No. 314-584-6222
NEW Billing [phone]
Telephone No. (Optional)
Change Requested LISA M. DUNSWORTH via email on 4/18/2024.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 04/18/2024