NCC190118_Contact Update Record_20201205

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany 12/5/2020 10:27:26 AM (Contact Changes Submitted)

Certificate of NCC190118
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
NC Reference No. NCG01-2019-0118
Original NOI No.* 10458
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new OOC required)
NNP IV -Cape Fear River, LLC
Project Name
RiverLights Conventional Phase V &VI -clearing and grading
Address
4410 River Road, Wilmington, NC
County
New Hanover
Latitude
34.0000
Longitude
-78.0000
Date COC Issued*
04/29/2019
Prior Rescission
This field will populate only if COChas already been rescinded.
Date
Which Contacts
r Legally Responsible Individual Only
Have Changed?*
f Site Contact Only
r BOTH Legally Responsible Individual and Site Contact
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Donald J. Henry
Individual
(Previous)
First Name (New)*
Nick
Last Name (New) *
Cassala
NEW Legally
Pleflects any revisions above
Responsible
Nick Cassala
Individual*
Permittee Email
[e-mail]
(Previous)
NEW Permittee
[e-mail]
Email *

Permittee
910-473-5409
Telephone No.
(Previous)
NEW Permittee
910-405-1234
Telephone No.*
Permittee Mailing
109 Pier Master Point, Suite 209, 0,
Address (Previous)
Wilmington, NC 28277
NEW Permittee
Street Address
Mailing Address*
13777 Ballantyne Corp. Place
Address Line 2
Suite 250
City
State / Rovince / f;bgion
Charlotte
NC
Fbstal / Zip Code
Country
28277
us
Permittee Street
13777 Ballantyne Corporate Place, Suite
Address (Previous)
250, 0, Charlotte, NC 28277
NEW Permittee
Street Address
Street Address*
13777 Ballantyne Corporate Place
Address Line 2
Suite 250
City
State / Rovince / Region
Charlotte
NC
Fbstal / Zip Code
Country
28277
us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Andy Kerkhoff
(Previous)
Site Contact Title Project Manager
(Previous)
Organization NNP IV -Cape Fear River, LLC
(Previous)
First Name (New)* Kenny
Last Name (New) * Johnson
NEW Site Contact* Reflects any revisions above
Kenny Johnson
NEW Site Contact Project Manager
Title
NEW Organization NNP IV -Cape Fear River, LLC
This field is not required on the N01 form and rray not pre -populate.
Site Contact Email [e-mail]
(Previous)

NEW Site Contact [e-mail]
Email*
Site Contact 910-442-2846
Telephone No.
(Previous)
NEW Site Contact 910-443-2355
Telephone No.*
Site Contact Mailing 109 Pier Master Point, Suite 209, 0,
Address (Previous) Wilmington, NC 28412
NEW Site Contact
Mailing Address*
Street Address
109 Pier Master Point
Address Line 2
Suite 209
Cty
Wilmington
Fbstal / Zip Code
28412
State / Rovince / Fbgion
NC
Country
us
Change Requested Nick Cassala via Modification request submitted 11/23/2020.
by: * Include any additional correspondence records in the Pepository CDC folder.
Additional Information for this update to contact information:
Addional Mailing address for site contact not given; preserved original entry.
Explanation
(Optional)
Date * 12/05/2020