NCC201459_Contact Update Record (Leg Resp Change)_20220516

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany A 5/16/2022 1:57:59 PM (Contact Changes Submitted)

Certificate of NCC201459
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2020-1459
Original NOI No.* 24148
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Taylor Morrison of Carolinas, Inc
Project Name Bridgeberry Phase 3
Address Rex Road, Holly Springs, NC
County Wake
Latitude 35.6182
Longitude-78.8830
Date COC Issued * 04/14/2020
Prior Rescission Date This field will populate only if COC has already been rescinded.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
NEW Billing Email [e-mail]
Billing Telephone No.
NEW Billing [phone]
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Jimmy Little
Individual (Previous)
First Name (New)* Christian
Last Name (New)* Sheppard

NEW Legally Reflects any revisions above
Responsible Christian Sheppard
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No. (Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 15501 Weston Parkway, Suite 100, Cary, NC
Address (Previous) 27513
NEW Permittee Street Address
Mailing Address* 15501 Weston Parkway
Address Line 2
Suite 100
City
State / Province / Region
Cary
NC
Postal / Zip Code
Country
27513
us
Permittee Street 15501 Weston Parkway, Suite 100, Cary, NC
Address (Previous) 27513
NEW Permittee Street Street Address
Address* 15501 Weston Parkway
Address Line 2
Suite 100
City
State / Province / Region
Cary
NC
Postal / Zip Code
Country
27513
us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Jlmmy Little
(Previous)
Site Contact Title Land Development Manager
(Previous)
Organization Taylor Morrison of Carolinas, Inc
(Previous)
First Name (New)* Christian
Last Name (New) * Sheppard

NEW Site Contact* Reflects any revisions above
Christian Sheppard
NEW Site Contact Land Development Director
Title
NEW Organization Taylor Morrison of Carolinas, 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 984.363.5453
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 15501 Weston Parkway, Suite 100, Cary, NC
Address (Previous) 27513
NEW Site Contact Street Address
Mailing Address* 15501 Weston Parkway
Address Line 2
Suite 100
City
State / Province / Region
Cary
NC
Postal / Zip Code
Country
27513
us
Change Requested Christian Sheppard via Modification request submitted 5/12/2022.
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 05/16/2022