NCC233302_Contact Update Record (Billing)_20241113

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Tev.Holloman 11/13/2024 9:01:54 AM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC233302
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2023-3302
Original NOI No.* 167499
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Refuel Operating Company
Project Name Refuel Market-Riverlights
Address 505 ARNOLD RD,Wilmington, NC
County New Hanover
Latitude 34.1340
Longitude -77.9200
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Prior Rescission Date This field will populate only if COC has already been rescinded.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. 5405335093
NEW Billing 843-388-4966
Telephone No. (Optional)
Change Requested Anita Harris, Paralegal,via email on 11/13/24.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 11/13/2024