NCC222927_FRO Submitted_20220817

OKPC TOWN or ENGINEERING DEPARTMENT
Holly 128 South Main Street - PO Box 8 Holly Springs, INC 27540
Springs [phone] 9 FAX [phone]
IYORtti CAR0LI NA
Application for Construction Drawing Plan Approval, Erosion & Sedimentation Control Plan Approval, NPDES Stormwater
Review, Land Disturbance Permit Issuance, and Statement of Ownership and Financial Responsibility.
(Check All That Apply)
K Construction Drawing Plan Review O Erosion & Sedimentation NPDES Stormwater Review
Control Plan Review
1. Project Name, Project ID, and Phase: 150 Premier Flex
2. Description of Construction/Land Disturbance:
Site development for new +/- 10,000 SF building with parking, utilities and landscaping.
3. Landowner(s) of Record:
FOX PROPERTY HOLDING LLC
Name
312 MAGNOLIA MEADOW WAY
Address
HOLLY SPRINGS NC 27540
City, State, Zip
Telephone
Phase: NIA
(Use additional pages if necessary and attach to application)
Fax
Name
Address
City, State, Zip
Telephone Fax
Mobile Phone Email Address Mobile Phone Email Address
4. Future Landowner(s), If Applicable: (Use additional pages if necessary and attach to application)
Name
Address
City, State, Zip
Telephone
Fax
Telephone
Name
Address
City, State, Zip
Fax
Mobile Phone Email Address Mobile Phone Email Address
5. List Book & Page where Deed or Instrument is Filed in Wake County:
Location Description: 150 Premier Drive
Parcel Identification Number (PIN): 0649-13-9025 Tax Map, Block, and Lot Number:
Book: 18739 Page: 315 , Book:
6. Person(s) or Firm(s) Financially Responsible for Land -Disturbing Activity
Bobbitt Construction, Inc Attn: Tim Murphy
Name Name
600 Germantown Road
Raleigh, NC 27607
919-851-1980
Telephone
Mobile Phone
9001
5/2/14
Address
City, State, Zip
Fax
[e-mail]
Email Address
Telephone
Mobile Phone
Address
Page:
City, State, Zip
Fax
Email Address

Application for Construction Drawing Plan Approval, Erosion & Sedimentation Control Plan Approval, NPDES
StormwaterRewew, Land Disturbance Permit Issuance, and Statement ofOwnership and Financial Responsibility:
7' Registered Agent, if any, for Person(s) or Firm(s) Financially Responsible:
(NOTE: A North Carolina agent is required if the applicant is not a resident of North Carolina.)
Name Telephone Fax
Address Mobile Phone
City, State, Zip Email Address
8. Plans Prepared By:
Bobbitt Construction, Inc 919-851-1980 919-851-1982
Name of Firm/Person Telephone Fax
600Germantown Road
Address Mobile Phone
Raleigh, NC 27607 [e-mail]
City, State, Zip Email Address
9. Site/Project|nformatimn:
Total Size of Tract: 3.35 acres Area Disturbed: 1.27 acres 55�OO *c
Length of Sidewalk: O linear feet Length of Streets: O linear feet
Length ofWater Line: 134 linear feet Length ofSewer Line: O linear feet
Length ofGnuonway: O Length ofGto/mvvater: 571(pri»ote) linear feet
#Sbormvvabar8K4Pe<5acres: O #GhormvvaterBMPux5acres: 0
Latitude.3�'Gb3S Longitude: -78.8583
FEMAJF|RK4 K8op#: 37200 Panel #: 64900J Effective Date: May 22OOG
Total Post Development Impervious Surface: e4'/3/ Ft 2
10-Approximate Date Land Disturbance Will Begin: 15June 2O22
11' Signature and Witness: The above information is true and correct to the best of my knowledge and
belief and was PrUyidedbymnewhile under oath.
P Tim Murphy
ire of Pe6d) VnVally F:�esponsible Type or Print Name Legibly
Title or A—uth&itv Date
1, b:De-kUAQAk , a Notary Public of the County of \AlaKe- —, hereby certify
that --r; m Mwri>�Ll personally before me this day and under oath acknowledged that
this pplication for ConMruction Drawing Plan Approval and Erosion & Sedimentation Control Plan Approval/Land
Disturbance Permit Statement of Ownership and Financial Responsibility was executed by him or her.
Witness myhand and notarial seal, this 5- day of fy\!l 20����
12-1
LJ Signet Pudlic My Commission Expires
FOR OFFICE USE ONLY
Date Completeness Verified:
Project Number: PN-
Fees Paid:
El Construction Drawing Review Fees
LI Erosion & Sedimentation Control
Plan Review Fees
9001