NCC243750_Contact Update Record_20250318

Action History(UTC-05:00)
Submit by Anonymous User 3/14/2025 10:27:34 AM (Contact Changes Submitted)
Approve by bethany.georgoulias 3/18/2025 5:19:00 PM (NCG01 Contact Update Review Step)
• The task was assigned to bethany.georgoulias.The due date is: March 21,2025 5:00 PM
3/14/2025 10:27:38 AM

ContactNCGO1 Construction Stormwater Permit
• • Request
This request must be submitted by the legally responsible individual or someone withir. _.
Permittee organization authorized to do so.
Certificate of Coverage(COC)No.* General Permit
NCC243750 NCGO10000
Use capital letters General Permit No.
Originally Issued* NC Reference No. Original NOI No.*
12/6/2024 NCG01-2024-3750 231537
Project information associated with this permit(Cannot Change)
Please note: Permitted Entity name changes or ownership transfers are not possible at this time.An ownership
transfer requires the new responsible entity to obtain a separate Certificate of Coverage(COC).
Permittee Entity Lennar Carolinas, LLC
Listed
Project Name Hillcrest Townhomes Phase 2
Address 1725 Eagle Creek Drive,Winston-Salem, NC
County Forsyth
Latitude 36.0545
Longitude -80.3237
COC Effective Date* Prior Rescission Date
12/06/2024 (Stays blank if COC active)
(May reflect most recent renewal)
IMPORTANT. Where no changes are needed, please leave information in the field as is.
Which Contacts Have Changed?Scroll down to sections below to review details if necessary.*
BOTH Legally Responsible Individual and Site Contact
Legally Responsible Individual Only
Site Contact Only
Billing Only
Has Billing Contact Changed?*
Choose'Yes'to revise Billing Contact details.
No
Yes
Billing Email [e-mail]
May be blank if COC issued before we collected billing-specific contacts.
Billing Telephone No. 704-759-6000
May be blank if COC issued before we collected billing-specific contacts.
Legally Responsible Individual Contact Information

REVISE ONLY WHERE NECESSARY.KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Individual(Previous)
Mark Henninger
First Name(New)* Mark
Last Name(New)* Henninger
Legally Responsible Individual(NEW)*
Reflects any revisions above
Mark Henninger
Permittee Email(Previous)
[e-mail]
Permittee/Legally Resp. Individual Email(NEW)*
[e-mail]
Permittee/Legally Resp. Individual Telephone No.(Previous)
704-759-6000
Permittee/Legally Resp. Individual Telephone No.(NEW)*
704-759-6000
Permittee Mailing Address(Previous)
6701 Carmel Road, Suite 425,0, Charlotte, NC 29226
Permittee Mailing Address(NEW)*
Street Address
11605 N Community House Rd.,Suite 400
Address Line 2
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28277 US
Permittee Street Address(Previous)
6701 Carmel Road, Suite 425,0, Charlotte, NC 29226
Permittee Street Address(NEW)*
Street Address
11605 N Community House Rd.,Suite 400
Address Line 2
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28277 United States
For changes to the legally responsible individual,you must complete a copy of this form
and upload it below to submit this request.

Legally Responsible Individual Please upload completed and signed copy
Change Form NCDEQ Address
Change_Triad
745.98KB
Communities
(Signed).pdf
Must be PDF format
Site Contact Information
REVISE ONLY WHERE NECESSARY.KEEP INFORMATION THE SAME IF NO CHANGES!
Site Contact(Previous)
Chelsea Ferrara
Site Contact Title(Previous)
Division Environmental Manager
Organization(Previous)
Lennar
First Name(New)* Justin
Last Name(New)* Gray
Site Contact(NEW)*
Reflects any revisions above
Justin Gray
Site Contact Title(NEW)
Division Environmental Manager
Organization(NEW)
Lennar
This field was not required on the NOI form and may not pre-populate.
Site Contact Email(Previous)
[e-mail]
Site Contact Email(NEW)*
[e-mail]
Site Contact Telephone No.(Previous)
980-445-8374
Site Contact Telephone No.(NEW)*
704-280-6615
Site Contact Mailing Address(Previous)
6701 Carmel Road, Suite 425,0, Charlotte, NC 28277
Site Contact Mailing Address(NEW)*
Street Address
11605 N Community House Rd.,Suite 400
Address Line 2
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28277 us

Additional Information for this update to contact information:
Addional Explanation Updating new address and contact information.
(Optional)
Requester's Name* Justin Gray
Requester's Title* Division Environmental Manager
Requester's Lennar Carolinas, LLC
Organization* Requester must be associated with Permittee Entity listed above
Requester's Email* Please enter a valid email address:
[e-mail]
A confirmation of submission will be e-mailed to this address.
Requester's Phone [phone]
Number*
* By checking the box and signing below, I certify that:
I have given true,accurate,and complete information on this form;
I am authorized to submit changes and updates to contact information associated with this NPDES construction
stormwater permit on behalf of the Permittee entity;
I agree that submission of this form is a"transaction"subject to Chapter 66,Article 40 of the NC General Statutes(the
"Uniform Electronic Transactions Act');
I agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes(the
"Uniform Electronic Transactions Act');
I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature(except for any uploaded Legally Responsible Individual Change Change form,which also must be mailed in
with original signature);AND
I intend to electronically sign and submit this Construction Stormwater Permit Contact Update Request form.
Signature
0 4ptl?y
Date and Time 03/14/2025
Signed
10:27:34 AM
Summary of Contact Names Pre-and Post-Submission for Review Purposes:
Legally Responsible Individual(Current) Legally Responsible Individual(As Submitted)
Mark Henninger Mark Henninger
Prior to approval As it will be updated(if changes)
Site Contact Name(Current) Site Contact(As Submitted)
Chelsea Ferrara Justin Gray
Prior to approval As it will be updated(if changes)
Billing Email(Current) Billing Email(As Submitted)
[e-mail] [e-mail]
Prior to approval As it will be updated(if changes)
Change Requested Justin Gray(Division Environmental Manager)
by: Include any additional correspondence records in the Repository COC folder if needed.

Review Date 3/18/2025

Georgoulias, Bethany
From: lase [e-mail]
Sent: Tuesday, March 18, 2025 5:19 PM
To: [e-mail];[e-mail]
Cc: Georgoulias, Bethany; Holloman, Tevye L; [e-mail];
[e-mail]
Subject: [External] Construction SW Permit Contact Information Update for NCC243750
CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu bar on the Home tab.
This email is to notify you that contact information has been updated for Hillcrest Townhomes Phase 2,
under COC No. NCC243750.You can review the information in the permit folder in our Laserfiche
Repository. Please note that original contacts have been copied on this notification.
The following contact information is now associated with this permit record. If anything is in error, please
contact Bethany Georgoulias at bethan eorgoulias _ deq.nc.gov.
Legally Responsible Individual
Mark Henninger
[e-mail]
704-759-6000
(Mailing Address) 11605 N Community House Rd., Suite 400, , Charlotte, NC, 28277, US
(Street Address) 11605 N Community House Rd., Suite 400, , Charlotte, NC, 28277, United States
Site Contact
Justin Gray
(Organization) Lennar
[e-mail]
704-280-6615
(Mailing Address) 11605 N Community House Rd., Suite 400, , Charlotte, NC, 28277, US
Billing Contact (if available)
[e-mail]
704-759-6000
This change was requested by:Justin Gray(Division Environmental Manager) on 3/14/2025
Additional Information(if provided): Updating new address and contact information.
Be sure to add laserfiche.ncdenr.gov@mccic loud.io to your contacts to avoid future a-mails about this
application from going into Spam filters.
The NC DEMLR Stormwater Program
512 N. Salisbury Street,Archdale Building 6th Floor, 1612 Mail Service Center, Raleigh, NC 27699-1612
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This email was automatically generated by Laserfiche. Please do not respond to this email address, as
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