NCC241201_Contact Update Record_20240430

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Tev.Holloman 4/30/2024 1:45:08 PM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC241201
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2024-1201
Original NOI No.* 192717
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Rowan-Cabarrus Young Men's Christian Association
Project Name Harrisburg YMCA
Address Z-Max Boulevard, Harrisburg, NC
County Cabarrus
Latitude 35.3163
Longitude -80.6632
Date COC Issued* 04/30/2024
Prior Rescission Date This field will populate only if COC has already been rescinded.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? Q No
Yes
Billing Email [e-mail]
Billing Telephone No. 704-213-3339
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Alex Deaton
(Previous)
Site Contact Title Project Manager
(Previous)
Organization Edifice Construction
(Previous)
First Name(New)* Alex

Last Name(New)* Deaton
NEW Site Contact* Reflects any revisions above
Alex Deaton
NEW Site Contact Project Manager
Title
NEW Organization Edifice Construction
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 704-330-9422
Telephone No.
(Previous)
NEW Site Contact 704-330-9422
Telephone No.*
Site Contact Mailing 4111 South Boulevard,0,Charlotte, NC
Address(Previous) 28209-2618
NEW Site Contact Street Address
Mailing Address* 4111 South Boulevard
Address Line 2
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28209-2618 us
Change Requested Morgan Woolner, Project Manager,via email on 4/30/24
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 04/30/2024