NCC211938_Contact Update Record (Address Only)_20240530

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 5/30/2024 9:56:26 AM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC211938
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2021-1938
Original NOI No.* 48902
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Tribute Investment&Development, Inc.
Project Name Ironwood Development
Address 172 Asheland Avenue,Asheville, NC
County Buncombe
Latitude 35.5885
Longitude -82.5558
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Prior Rescission Date This field will populate only if COC has already been rescinded.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? Q• No
O Yes
Billing Email [e-mail]
Billing Telephone No. [phone]
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Matt Maynard
Individual(Previous)
First Name(New)* Matt
Last Name(New)* Maynard
NEW Legally Reflects any revisions above
Responsible Matt Maynard
Individual*

Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 10 South Cardinal Drive,0,Wilmington, NC
Address(Previous) 28403
NEW Permittee Street Address
Mailing Address* 332 Military Cutoff Rd.
Address Line 2
City State/Province/Region
Wilmington NC
Postal/Zip Code Country
28405 us
Permittee Street 10 South Cardinal Drive,0,Wilmington, NC
Address(Previous) 28403
NEW Permittee Street Street Address
Address* 332 Military Cutoff Rd.
Address Line 2
City State/Province/Region
Wilmington NC
Postal/Zip Code Country
28405 us
Change Requested Kiehli Gore(I&D Support Specialist,Tribute Companies)via email on 5/29/2024.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 05/30/2024