NCC204625_Contact Update Record_20230501

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by bethany.georgoulias 5/1/2023 4:36:58 PM (Contact Changes Submitted)

Certificate of
NCC204625
Coverage (COC) No.*
Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No.
NCG01-2020-4625
Original NOI No.*
32915
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Calabash Townhomes, LLC
Project Name Calabash Palms
Address Calabash Road NW (SR 1300), Shallotte, NC
County Brunswick
Latitude 33.9185
Longitude-78.6028
Date COC Issued * 10/28/2020
Prior Rescission Date This field will populate only if COC has already been rescinded.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? Q No
O Yes
Billing Email
Billing Telephone No.
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Kerry Avant
Individual (Previous)
First Name (New) * David
Last Name (New) * Vannoy
NEW Legally Reflects any revisions above
Responsible David Vannoy
Individual*

Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No. (Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 2919 Breezewood Avenue, 0, Fayetteville,
Address (Previous) NC 28303-5283
NEW Permittee Street Address
Mailing Address* 2919 Breezewood Avenue
Address Line 2
City
State / Province / Region
Fayetteville
NC
Postal / Zip Code
Country
28303-5283
us
Permittee Street 2919 Breezewood Avenue, 0, Fayetteville,
Address (Previous) NC 28303-5283
NEW Permittee Street Street Address
Address * 2919 Breezewood Avenue
Address Line 2
City
State / Province / Region
Fayetteville
NC
Postal / Zip Code
Country
28303-5283
us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Bryant Spencer
(Previous)
Site Contact Title Director of Land Development
(Previous)
Organization Calabash Townhomes, LLC
(Previous)
First Name (New)* Bryant
Last Name (New) * Spencer
NEW Site Contact* Reflects any revisions above
Bryant Spencer
NEW Site Contact Director of Land Development
Title
NEW Organization Calabash Townhomes, LLC
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 [phone]
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 2919 Breezewood Avenue, 0, Fayetteville,
Address (Previous) NC 28303-5283
NEW Site Contact Street Address
Mailing Address* 2919 Breezewood Avenue
Address Line 2
Suite 100
City
Fayetteville
Postal / Zip Code
28303-5283
State / Province / Region
NC
Country
us
Change Requested David Vannoy (Manager, Calabash Townhomes, LLC) via Modification request
by: * submitted 3/24/2023 and subsequent correspondence with Bryant Spencer (site
contact) on 5/1/2023. Bryant's email was also updated.
Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 05/01 /2023