NCC216915_FRO Submitted_20211216

* , WAKE COUNTY FINANCIAL RESFONSIBILITY!OWNERSHI P CORM
SEDIMENTATION POLLUTION CONTROL ACT
A TAtK;11 No person may initiate any land -disturbing activity on one or more acres as covered by the Wake
County Unified Development Ordinance before this form and an acceptable erosion and
COUNTY sedimentation control plan have been completed and approved by Wake County Department of
040143 1 ( A I: t , < < NA Environmental Services , Water Quality Division . ( Please type or print and , if the question is not
- - applicable , place NIA in the blank . )
Part A.
1 . Project Name Kioti Tractor Expansion Site Pad Redevelopment _ —
.___.
2 , Location of land - disturbing activity : Jurisdiction Wendell (Wake Co . or Municipality) -
HighwayiStreet_ Kioti Read _ - - Latitude_ 358117 Longitude
3 . Approximate date land - disturbing activity will commence - December 2021
__________ _ _ _
4 . Type of d•eve(opment ( residential , commercial , industrial , institutional , etc . ) Industrial . . _ _ . __ _
5 . Total acreage disturbed or uncovered. ( including off-site utilities and borrow/waste
areas ) : 14. 46
6 . Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Nick Watkin E-mail Address nwatkin@kiotitractorcom
Telephone 919. 374 . 5098 Celt # 91! 143 Fax #
7 . Landowner( s ) of Record (attach accompanied page to list additionaI owners ) :
Daedong USA , Inc _ 919 . 374. 5001 - - -
........___
Name( s ) Telephone Fax or E-mail address
6300 Kioti Drive 6300 Kioti Drive
Current Mailing Address � Current Street Address
Wendell NC 27591 Wendell NC 27591
City State Zip City State Zip
8 . Deed Book NoH0 4 Page No . 1349 Provide a copy of the most current deed .
Part B .
I . Person( s ) or firm( s ) who are financially responsible for the Iand -dts.turbing activity ( Provide a - -
comprehensive list of all responsible parties on an attached sheet . Include requested information ) : . - -
Daedong USA, _,Inc . __ _ _ _ yparkkiotitractor. com
_..„__
Name E - mail Address
6300 Kioti Drive 6300 Kioti Drive
Current Mailing Address Current Street Address - - - - - - - -
Wendell NC 27591 Wendell NC 27591
City _ _ State Zip City State Zip
Telephone919001 _ _ _ Fax Number _ _ __ _ _ _ _ ________ _

2 - ( a ) If the Financially Responsible Party is not a resident of Wake County , identify a desinated agent in
Wake County to receive any notice , process , pleading in any action or I �matter relating to the Wake County Erosion and Sedimentation eorftroPIoceed,ng
j ansnig °� of any
Disturbance Permit: finance and/or Land
-
Name — - - E-mail Address - - - - -
. _
Current Mailing Address Currerrt Street Address � — fr
�y - - — - - - State Zip City State — -- Zip
Telephone - - _ FaxNumber_ _ _
(b ) Iyifthe Responsible Party is a Partnership or other person engaging in business under an
assumed name, attach a copy of the Certificate of Assumed Name.. ff the FwiancaUy Responsible
Party .is a Corpori-on , o ive nar e iand street address of the RegLste.red Agent:
Name of Registered Agent E-mail Address
•
Current Mailing, Address Current 'Street Address ---- - --- - -- - - -
'City — State 'City State - Zip
Telephone _ _ _ _ _ _ _ Fax Mimi'. r
The above information is true and correct to the best of my knowledge and belief and was provided
by me under . 0 . 4. , (This. 'form must be ' iv the FI'y Resnse ' Pe • n if an individual
or his attorney- in -fact , or if not an individual , by an officer, director , partner , or registered agent with
the authory to execute Th truirtstrumerpts for the Fin . ncia'Hy Pecson ). . I agree to provide
corrected information should there be any change in the information provided herein .
Yung Park Chief Financial Officer
Type or print name Title or Authority
le? /
Sig • at - Date
........MirMP -41Mri=i!=l1FEMIAM1=EMMUMIdibM11=141.1.04=JPEAMIMPE.4pEMEriMAME1WMEREm=w1=F+ •MIE Moll=1=i1Mh IM•
elle.eiC, D145aNtaTYP0 '0fth 0UfltY0tL� 91� e
State of North Carolina, hereby certify that � "� A�1 - - - -- - - - - appeared
personally before me this day and being duly sworn acknowledged that the above form was executed by him .
Witness my hand and notarial seal , this � day of :1) -e Cr,frili cam' , 2 �� k. —
id6*7
Rebecca M . Lew- Hobbs Notary
Seal NOTARY PUBLIC
WAKE COUNTY , N My commission expire5 _L26GZPY
L1Y50Tb0n-- fires � --�6 ay : I