NCC220917_Contact Update Record_20230421

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 4/21/2023 1:58:35 PM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC220917
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2022-0917
Original NOI No.* 82370
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Union County Board of Education
Project Name Central Academy of Technology and Arts Field Renovations
Address 600 Brewer Drive, Monroe, NC
County Union
Latitude 34.9733
Longitude -80.5675
Date COC Issued* 03/07/2022
Prior Rescission Date This field will populate only if COC has already been rescinded.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? No
Yes
Billing Email [e-mail]
NEW Billing Email [e-mail]
Billing Telephone No. 7042963160
NEW Billing [phone] ext 6777
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible David Burnett
Individual(Previous)
First Name(New)* Danny
Last Name(New)* McManus

NEW Legally Reflects any revisions above
Responsible Danny McManus
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone] ext 6777
Telephone No.*
Permittee Mailing 400 North Church Street,0, Monroe, NC
Address(Previous) 28112-4804
NEW Permittee Street Address
Mailing Address* 201 Venus Street
Address Line 2
City State/Province/Region
Monroe NC
Postal/Zip Code Country
28112 us
Permittee Street 400 North Church Street,0, Monroe, NC
Address(Previous) 28112-4804
NEW Permittee Street Street Address
Address* 201 Venus Street
Address Line 2
City State/Province/Region
Monroe NC
Postal/Zip Code Country
28112 us
Change Requested Danny MacManus(Assistant Director-Facilities)via Modification request submitted
by:* 4/18/2023.
Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 04/21/2023