HomeMy WebLinkAboutNCC233703_FRO Submitted_20231215 "VW WAKE COUNTY FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
WAKENo person may initiate any land-disturbing activity on one or more acres as covered by the Wake
County Development e bi ab
COUNTY sedimentationUnified control planevelopmen haveOrdinanc been completedefore and th s approvedform byand Wake Countyaccepta le Department erosion ofand
NORTH CAIWIINA Environmental Services, Water Quality Division. (Please type or print and, if the question is not
applicable, place N/A in the blank.)
Part A.
1. Project Name Mactavish 1, 2, 3, 4
2. Location of land-disturbing activity: Jurisdiction Wake County (Wake Co. or Municipality)
1800,1801, 35.969751 -78.702769
Highway/Street 1804,1805 Okeefe Lane Latitude Longitude
3. Approximate date land-disturbing activity will commence: 12/01/2023
4. Type of development(residential, commercial, industrial, institutional, etc.):_ Residential
5. Total acreage disturbed or uncovered (including off-site utilities and borrow/waste
areas): 3.076
6. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Robert Russotti E-mail Address rrussotti@exeterbuilding.com
Telephone N/A Cell# 919-360-6099 Fax# N/A
7. Landowner(s)of Record (attach accompanied page to list additional owners):
MARQUIS HOMES & COMPANY 919-870-6339 N/A
Name(s) Telephone Fax or E-mail address
8368 SIX FORKS RD STE 202 8368 SIX FORKS RD STE 202
Current Mailing Address Current Street Address
Raleigh NC 27615 Raleigh NC 27615
City State Zip City State Zip
8. Deed Book No. 019051 Page No. 00825 Provide a copy of the most current deed.
Part B.
1. Person(s) or firm(s) who are financially responsible for the land-disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet. Include requested information):
Exeter Building Company LLC jfinan@exeterbuilding.com
Name E-mail Address
900 Ridgefield Drive, STE 50 900 Ridgefield Drive, STE 50
Current Mailing Address Current Street Address
Raleigh NC 27609 Raleigh NC 27609
City State Zip City State Zip
Telephone 919-358-0873 Fax Number N/A
2. (a) If the Financially Responsible Party is not a resident of Wake County, identify a designated agent in
Wake County to receive any notice, process, pleading in any action or legal proceeding arising out of any
matter relating to the Wake County Erosion and Sedimentation Control Ordinance and/or Land
Disturbance Permit:
N/A N/A
Name E-mail Address
N/A N/A
Current Mailing Address Current Street Address
N/A N/A
City State Zip City State Zip
Telephone N/A Fax Number N/A
(b) If the Financially Responsible Party is a Partnership or other person engaging in business under an
assumed name, attach a copy of the Certificate of Assumed Name. If the Financially Responsible
Party is a Corporation, give name and street address of the Registered Agent:
John Finan jfinan@exeterbuilding.com
Name of Registered Agent E-mail Address
900 Ridgefield Drive, STE 50 900 Ridgefield Drive, STE 50
Current Mailing Address Current Street Address
Raleigh NC 27609 Raleigh NC 27609
City State Zip City State Zip
Telephone 919-360-6099 Fax Number N/A
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
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 Person). I agree to provide
corrected information should there be any change in the information provided herein.
John Finan Managing Member
Type n t name Title or Authority
11/13/2023
Sign re Date
t g-"m'l 611 1 1- , a Notary Public of the County of Wake
State of North Carolina, hereby certify that John Finan ppeared
personally before me this day and being duly sworn acknowledged that the ab form was exe ed by him.
Witness my hand and notarial seal, this 13th day of November 20 23
JEREMY GAGE Notar
Notary Pu8Wat North Carolina
( wake County fv1 mmission expires tit 3 94 2 9
My Commission Expires Apr 3, 2024 (�