NCC202291_Contact Update Record_20240424

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 4/24/2024 8:33:14 AM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC202291
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2020-2291
Original NOI No.* 26445
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Toll SE LP Company
Project Name Willow Hills
Address 3417 Olive Chapel Road,Apex, NC
County Wake
Latitude 35.7310
Longitude -78.9440
Date COC Issued* 04/01/2024
Prior Rescission Date This field will populate only if COC has already been rescinded.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
NEW Billing Email [e-mail]
Billing Telephone No.
NEW Billing [phone]
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible David Kelly
Individual(Previous)
First Name(New)* Edward B.
Last Name(New)* Pease

NEW Legally Reflects any revisions above
Responsible Edward B. Pease
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 2310 T.W.Alexander Drive,0, Raleigh, NC
Address(Previous) 27617
NEW Permittee Street Address
Mailing Address* 900 Perimeter Park Drive
Address Line 2
Suite B3
City State/Province/Region
Morrisville NC
Postal/Zip Code Country
27560 USA
Permittee Street 2310 T.W.Alexander Drive,0, Raleigh, NC
Address(Previous) 27617
NEW Permittee Street Street Address
Address* 900 Perimeter Park Drive
Address Line 2
Suite B3
City State/Province/Region
Morrisville NC
Postal/Zip Code Country
27560 USA
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Shawn Harling
(Previous)
Site Contact Title Sr. Land Development Manager
(Previous)
Organization Toll Brothers
(Previous)
First Name(New)* Peyton
Last Name(New)* Bowen

NEW Site Contact* Reflects any revisions above
Peyton Bowen
NEW Site Contact
Title
NEW Organization Toll Brothers
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 2310 T.W.Alexander Drive,0, Raleigh, NC
Address(Previous) 27617
NEW Site Contact Street Address
Mailing Address* 900 Perimeter Park Drive
Address Line 2
Suite B3
City State/Province/Region
Morrisville NC
Postal/Zip Code Country
27560 USA
Change Requested Edward B. Pease(Division President)via Modification Request submitted
by:* 04/18/2024
Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 04/24/2024