NCC222182_Contact Update Record_20230710

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Tev.Holloman 7/10/2023 1:15:25 PM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC222182
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2022-2182
Original NOI No.* 93975
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
KB Home Raleigh-Durham Inc.
Project Name Birchwood Grove Subdivision(Phase 3 and 4)
Address US 401, Hectors Creek, NC
County Harnett
Latitude 35.4661
Longitude -78.8286
Date COC Issued* 06/13/2022
Prior Rescission Date This field will populate only if COC has already been rescinded.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? Q No
(.) Yes
Billing Email [e-mail]
NEW Billing Email [e-mail]
Billing Telephone No. [phone]
NEW Billing [phone]
Telephone No. (Optional)
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Doug Schwartz
(Previous)
Site Contact Title President
(Previous)

Organization KB Home Raleigh-Durham Inc.
(Previous)
First Name(New)* Scott
Last Name(New)* Johnson
NEW Site Contact* Reflects any revisions above
Scott Johnson
NEW Site Contact Sr. Director of Land Development
Title
NEW Organization KB Home Raleigh-Durham 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 [phone]
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 4506 S. Miami Blvd,Suite 100, Durham, NC
Address(Previous) 27703
NEW Site Contact Street Address
Mailing Address* 4506 S. Miami Blvd
Address Line 2
Suite 100
City State/Province/Region
Durham NC
Postal/Zip Code Country
27703 us
Change Requested Ashish Patel(VP, Finance KBHome)via email on 7/5/2023.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 07/10/2023