NCC220494_Contact Update Record_20240109

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 1/9/2024 12:35:42 PM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC220494
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2022-0494
Original NOI No.* 79204
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Tribute Investment and Development, Inc.
Project Name Onslow RV Campground
Address Harbor Point Road,Stump Sound Township, NC
County Onslow
Latitude 34.4960
Longitude -77.4560
Date COC Issued* 01/26/2022
Prior Rescission Date This field will populate only if COC has already been rescinded.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]
Billing Telephone No. 910-465-4104
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Mark Maynard
Individual(Previous)
First Name(New)* Mark
Last Name(New)* Maynard
NEW Legally Reflects any revisions above
Responsible Mark Maynard
Individual*

Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee 910-465-4104
Telephone No.*
Permittee Mailing 10 S.Cardinal Drive,0,Wilmington, NC
Address(Previous) 28403
NEW Permittee Street Address
Mailing Address* 332 Military Cutoff Road
Address Line 2
City State/Province/Region
Wilmington NC
Postal/Zip Code Country
28405 United States
Permittee Street 10 S.Cardinal Drive,0,Wilmington, NC
Address(Previous) 28403
NEW Permittee Street Street Address
Address* 332 Military Cutoff Road
Address Line 2
City State/Province/Region
Wilmington NC
Postal/Zip Code Country
28405 United States
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Michael Maynard
(Previous)
Site Contact Title Project Manager
(Previous)
Organization Tribute Investment and Development, Inc.
(Previous)
First Name(New)* Michael
Last Name(New)* Maynard
NEW Site Contact* Reflects any revisions above
Michael Maynard
NEW Site Contact Project Manager
Title
NEW Organization Tribute Investment and Development, 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 910-465-4104
Telephone No.
(Previous)
NEW Site Contact 910-465-4104
Telephone No.*
Site Contact Mailing 10 S.Cardinal Drive,0,Wilmington, NC
Address(Previous) 28403
NEW Site Contact Street Address
Mailing Address* 332 Military Cutoff Road
Address Line 2
City State/Province/Region
Wilmington NC
Postal/Zip Code Country
28405 United States
Change Requested Mark L Maynard via Modification Request submitted 1/4/2024
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 01/09/2024