NCC232176_Contact Update Record_20241007

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 10/7/2024 2:51:49 PM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC232176
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2023-2176
Original NOI No.* 150743
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Crescent River District, LLC
Project Name River District-Preserve East
Address Sadler Road, Charlotte, NC
County Mecklenburg
Latitude 35.1980
Longitude -80.9890
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Prior Rescission Date This field will populate only if COC has already been rescinded.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. 980-312-6284
NEW Billing [phone]
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Chase Kerley
Individual(Previous)
First Name(New)* Rainer
Last Name(New)* Ficken

NEW Legally Reflects any revisions above
Responsible Rainer Ficken
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 601 South Tryon Street, Suite 800, Charlotte,
Address(Previous) NC 28202
NEW Permittee Street Address
Mailing Address* 601 South Tryon Street
Address Line 2
Suite 800
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28202 us
Permittee Street 601 South Tryon Street, Suite 800, Charlotte,
Address(Previous) NC 28202
NEW Permittee Street Street Address
Address* 601 South Tryon Street
Address Line 2
Suite 800
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28202 us
Change Requested Rainer Ficken(Senior Managing Director)via Modification request submitted
by:* 10/7/2024.
Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 10/07/2024