NCC222153_Contact Update Record_20250219

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 2/19/2025 11:29:56 AM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC222153
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2022-2153
Original NOI No.* 93802
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Leoterra Smith Crossing, LLC
Project Name Cottages At Smith Crossing
Address Solomon Drive, Kernersville, NC
County Forsyth
Latitude 36.0780
Longitude -80.0998
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Prior Rescission Date This field will populate only if COC has already been rescinded.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. [phone]
NEW Billing [phone],x 105
Telephone No. (optional)
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Kat Lyons
(Previous)
Site Contact Title Senior Director of Entitlements
(Previous)

Organization LeoTerra Development Inc.
(Previous)
First Name(New)* Jason
Last Name(New)* Cheek
NEW Site Contact* Reflects any revisions above
Jason Cheek
NEW Site Contact Development Associate
Title
NEW Organization LeoTerra Development Inc.
This field is not required on the NOI form and may not pre-populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact [e-mail]
Email*
Site Contact [phone]
Telephone No.
(Previous)
NEW Site Contact [phone],x 105
Telephone No.*
Site Contact Mailing 110 Shields Park Drive,Suite A, Kernersville,
Address(Previous) NC 27284-3567
NEW Site Contact Street Address
Mailing Address* 110 Shields Park Drive
Address Line 2
Suite A
City State/Province/Region
Kernersville NC
Postal/Zip Code Country
27284-3567 us
Change Requested Jason Cheek, LeoTerra Development Inc.,via email on 1/31/2025.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 02/19/2025

Georgoulias, Bethany
From: lase [e-mail]
Sent: Wednesday, February 19, 2025 11:30 AM
To: [e-mail];[e-mail]
Cc: Georgoulias, Bethany; Holloman, Tevye L
Subject: [External] Construction SW Permit Contact Information Update for NCC222153
CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu bar on the Home tab.
This email is to notify you that contact information has been updated for Cottages At Smith Crossing,
under COC No. NCC222153. You can review the information in the permit folder in our Laserfiche
Repository.
The following contact information is now associated with this permit record. If anything is in error,
please contact Bethany Georgoulias at [e-mail] gov.
Legally Responsible Individual
Christopher Lyons
[e-mail]
[phone]
(Mailing Address) 110 Shields Park Drive, Suite A, Kernersville, NC, 27284-3567, US
(Street Address) 110 Shields Park Drive, Suite A, Kernersville, NC, 27284-3567, US
Site Contact
Jason Cheek
(Organization) LeoTerra Development Inc.
[e-mail]
[phone], x 105
(Mailing Address) 110 Shields Park Drive, Suite A, Kernersville, NC, 27284-3567, US
Billing Contact (if available)
[e-mail]
[phone], x 105
This change was requested by:Jason Cheek, LeoTerra Development Inc.,via email on 1/31/2025.
Be sure to add laserfiche.ncdenr.gov@mccic loud.io to your contacts to avoid future e-mails about this
application from going into Spam filters.
The NC DEMLR Stormwater Program
512 N. Salisbury Street,Archdale Building 6th Floor, 1612 Mail Service Center, Raleigh, NC 27699-1612
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