NCC212549_Contact Update Record_20220309

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Selkane, Aziza 3/9/2022 12:12:50 PM (Contact Changes Submitted)

Certificate of NCC212549
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2021-2549
Original NOI No.* 51063
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
City of High Point
Project Name City of High Point, Waterview Forcemain Extension
Address Penny Road, High Point, NC
County Guilford
Latitude 36.0300
Longitude-79.9600
Date COC Issued * 04/28/2021
Prior Rescission Date This field will populate only if COC has already been rescinded.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?
U No
Yes
Billing Email
[e-mail]
NEW Billing Email
[e-mail]
Billing Telephone No.
336-883-3279
NEW Billing
336-883-3829
Telephone No.
(Optional)
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Scott Dingus
(Previous)
Site Contact Title
(Previous)

Organization
(Previous)
First Name (New)*
Last Name (New) *
City of High Point
C Allan
Hicks
NEW Site Contact* Reflects any revisions above
C Allan Hicks
NEW Site Contact Project Engineer
Title
NEW Organization City of High Point
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 336-883-3829
Telephone No.
(Previous)
NEW Site Contact 336-883-3829
Telephone No.*
Site Contact Mailing PO Box 230, 0, High Point, NC 27261
Address (Previous)
NEW Site Contact Street Address
Mailing Address* 211 S Hamilton
Address Line 2
Room 210
City
State / Province / Region
High Point
NC
Postal / Zip Code
Country
27261
United States
Change Requested C Allan Hicks by email on 3/9/2022
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 03/09/2022