NCC214505_Contact Update Record (Legally Resp Change)_20220714

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany A 7/14/2022 10:39:47 AM (Contact Changes Submitted)

Certificate of NCC214505
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2021-4505
Original NOI No.* 61540
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Taylor Morrison of Carolinas, Inc
Project Name Holden Creek Phase 6 Lots 19-23, 24-29, 30-36, 136, 160-164
Address Porterfield Drive, Youngsville, NC
County Franklin
Latitude 36.0206
Longitude-78.4949
Date COC Issued * 08/09/2021
Prior Rescission Date This field will populate only if COC has already been rescinded.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.
919-407-1232
NEW Billing
[phone]
Telephone No.
(Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Mark Altman
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
Change Requested Christian Sheppard via Modification request submitted 7/1/2022.
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 07/14/2022