NCC223441_Contact Update Record_20241105

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Tev.Holloman 11/5/2024 7:30:26 AM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC223441
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2022-3441
Original NOI No.* 108339
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
North State HTC, LLC
Project Name Huntersville Town Center
Address 113 Gilead Road, Huntersville, NC
County Mecklenburg
Latitude 35.4093
Longitude -80.8446
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Prior Rescission Date This field will populate only if COC has already been rescinded.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
0 Yes
Billing Email [e-mail]
NEW Billing Email [e-mail]
Billing Telephone No. 6785264872
NEW Billing 704-902-7412
Telephone No. (Optional)
Change Requested Shane Seagle, LRP,via email on 11/4/2024
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 11/05/2024