NCC223945_Contact Update Record_20240814

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 8/14/2024 2:54:09 PM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC223945
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2022-3945
Original NOI No.* 114260
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
D.R. Horton, INC
Project Name Raven Ridge Phase 2 lots
Address Arnold Road, Lexington, NC
County Davidson
Latitude 35.8660
Longitude -80.2590
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Prior Rescission Date This field will populate only if COC has already been rescinded.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
4) Yes
Billing Email [e-mail]
NEW Billing Email [e-mail]
Billing Telephone No. 9194972163
NEW Billing [phone]
Telephone No. (optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Tracey Davis
Individual(Previous)
First Name(New)* Neil
Last Name(New)* Uldrick

NEW Legally Reflects any revisions above
Responsible Neil Uldrick
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 7208 Falls of Neuse Road suite 201,0,
Address(Previous) Raleigh, NC 27615-3244
NEW Permittee Street Address
Mailing Address* 4150 Mendenhall Oaks Pkwy
Address Line 2
City State/Province/Region
High Point NC
Postal/Zip Code Country
27265 Us
Permittee Street 7208 Falls of Neuse Road suite 201,0,
Address(Previous) Raleigh, NC 27615-3244
NEW Permittee Street Street Address
Address* 4150 Mendenhall Oaks Pkwy
Address Line 2
City State/Province/Region
High Point NC
Postal/Zip Code Country
27265 Us
Change Requested Neil Uldrick via Modification request submitted 8/6/2024.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 08/14/2024