NCC224014_FRO Submitted_20221216

FINANCIAL RESPONSIBILITYIOWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
EXPRESS PERMITTING OPTION
No person may initiate any land -disturbing activity on one or more acres as covered by the Act before this form
and an acceptable erosion and sedimentation control plan have been completed and approved by the Land
Quality Section, N.C. Department of Environmental Quality. Submit the completed form to the appropriate
Regional Office. (Please type or print and, if the question is not applicable or the e-mail address or phone
number is unavailable, place NIA in the blank.)
Part A.
1
2
3
4
Project Name Aberdeen Solar Electric Power Plant
Location of land -disturbing activity: County Scotland City or Township Laurinburg
Plant Road 34.813111-79.464252
Highway/Street Latitude(decimal degrees) LOngltude(decimat degrees)
Approximate date land -disturbing activity will commence: November 2022
Purpose of development (residential, commercial, industrial, institutional, etc.): Solar
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 37.5
6. Amount of fee enclosed 5,800.00 . The Express Permitting application fee is a dual charge.
The normal fee of $100.00 per acre (rounded up to the next acre) is assessed without a ceiling amount.
In addition, the Express Permitting supplement is $250 per acre up to eight acres, after which the Express
Permitting supplemental fee is a fixed $2,000.00 (Example: 8.10-acre application fee is $2,900). Checks
should be addressed to NCDEQ.
7. Has an erosion and sediment control plan been filed? Yes ❑ Enclosed © No ❑
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Clay Holliday
E-mail Address [e-mail]
Phone: Office # 919-960-6015x733 Mobile #
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Phillip H. & Ellen W. Futrell 910-369-2370
Name
PO Box 840
Current Mailing Address
Wagram, NC, 28396
City State
10. Deed Book No. 1752
Phone: Office #
23580 Wagram Road
Current Street Address
Wagram, NC, 28396
Zip City
Page No. 30-32
State
Mobile #
Zip
Provide a copy of the most current deed.

Part B.
` 1. Company(les) who are financially responsible for the land -disturbing activity (Provide a comprehensive list
of all responsible parties on accompanied page.) if the company is a sole proprietorship or if the landowner(s) is
an individual(s), the name(s) of the owner(s) may be listed as the financially responsible party(ies).
Strata Solar Development, LLC
Company Name
800 Taylor Street, Suite 200
Current Mailing Address
Durham, NC, 27701
[e-mail]
E-mail Address
800 Taylor Street, Suite 200
Current Street Address
Durham, NC, 27701
City State Zip City State Zip
Phone: office # 919-960-6015
Mobile #
Note: if the Financially Responsible Party is not the owner of the land to be disturbed, include with this form
the landowner's signed and dated written consent for the applicant to submit a draft erosion and sedimentation
control plan and to conduct the anticipated land disturbing activity.
2. (a) If the Financially Responsible Party is a domestic company registered on the NC Secretary of State
business registry, give name and street address of the Registered Agent:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office # Mobile #
Name of Individual to Contact (if Registered Agent is a company)
(b) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina agent who is registered on the NC Secretary of State business registry:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Name of Individual to Contact (if Registered Agent is a company)
(c) If the Financially Responsible Party is engaging in business under an assumed name, give name under
which the company is Doing Business As. If the Financially Responsible Party is an individual, General

Partnership, or other company not registered and doing business under an assumed name, attach a copy
of the Certificate of Assumed Name.
NA
Company DBA Name
(d) If order to facilitate Express Permitting, it is necessary to be able to contact the engineer or other
consultant who can assist in providing any necessary information regarding the plan and its preparation:
Ballentine Associates, P.A.
Engineering firm or other consultant
Lee Price
[e-mail]
E-mail Address
919-929-0481 252-531-3203
Individual contact person (type or print) Phone: Office # Mobile #
The above information is true and correct to the best of my knowledge and belief and was provided
by me under oath. (This form must be signed by the Financially Responsible Person if an individual(s)
or his attorney -in -fact, or if not an individual, by an officer, director, partner, or registered agent with
the authority to execute instruments for the Financially Responsible Party). I agree to provide
corrected information should there be any change in the information provided herein.
Markus Wilhelm CEO
Type, or print name
Title or Authority
.-/ --. Lm2�—
Date
I, � k<�'L�) „kt/ , a Notary Public of the County of Lyh C'
State of North Carolina, hereby certify that r` I kdm appeared personally
before me this day and being duly sworn acknowledged that the above form was executed by him/her.
Witness my hand and notarial seal, this^day of ���' 20 2�
c
Notary
Seal My commission expires , )I aJZ
ELISE N. MUDD
Nora�tY PUBLIC
Durham County 46
North Carolina
y Commission Expires March !26,20

Continued from Items 9 & 10 in Part A of the Financial Responsibility/Ownership Form for multiple
pwners. Attach copies of this page as needed to list all landowners.
Landowner 2 of Record:
Craig & Diane Van Pelt
719-339-4688
Name
Phone: Office # Mobile #
17700 Aberdeen Road
17700 Aberdeen Road
Current Mailing Address
Current Street Address
Laurinburg, NC, 28352
Laurinburg, NC, 28352
City State
Zip City State Zip
Deed Book No. 1628
Page No. 71-73 Provide a copy of the most current deed.
Landowner 3 of Record:
Westwood Associates (Hew
Fulton) 910-462-2122
Name
Phone: Office # Mobile #
502 West Church Street
502 West Church Street
Current Mailing Address
Current Street Address
Laurinburg, NC, 28352
Laurinburg, NC, 28352
City State
Zip City State Zip
Deed Book No. 1460
Page No. 193 200 Provide a copy of the most current deed.
Landowner 4 of Record:
Westwood Associates (Hew Fulton) 910-462-2122
Name
Phone: Office # Mobile #
502 West Church Street
502 West Church Street
Current Mailing Address
Current Street Address
Laurinburg, NC, 28352
Laurinburg, NC, 28352
City State
Deed Book No. 7N
Zip City State Zip
Page No. 483 Provide a copy of the most current deed.
Landowner 5 of Record:
Floyd H. Wilson III 910-506-7362
Name Phone: Office # Mobile #
8088 Mcleod Road 8088 Mcleod Road
Current Mailing Ad4fee-,—
Laurinburg, NC, 28352 Laurinburg, NC, 28352
City State Zip City State Zip
Deed Book No. 1302 Page No. 128 Provide a copy of the most current deed.