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HomeMy WebLinkAboutNCC241123_FRO Submitted (2)_20240417 TOWN OF KNIGHTDALE FINANCIAL RESPONSIBILITY/OWNERSHIP FORM SEDIMENTATION POLLUTION CONTROL ACT . No person may initiate any land-disturbing activity on one or more acres as covered by the Town of Knightdale Unified Development Ordinance before this form and an acceptable erosion and sedimentation control plan have been completed and approved by Town of Knightdale, Public Works Department, Stormwater Division. (Please type or print and, if the question is not applicable, place N/A in the blank.) Part A. 1. Project Name Stoneriver Phases 1 & 2 2. Location of land-disturbing activity: Wake (Town Limits or ETJ) Hodge Road/Panther Rock Blvd 35.766420 -78.531739 Highway/Street Latitude Longitude 3. Approximate date land-disturbing activity will commence: April 2024 4. Type of development(residential, commercial, industrial, institutional, etc.): Single Family&Townhomes 5. Total acreage disturbed or uncovered (including off-site utilities and borrow/waste areas):52.43 _ 6. Person to contact should erosion and sediment control issues arise during land-disturbing activity: Name Wesley Smith E-mail Address Wesley.smith@lennar.com Phone# 919-608-7567 Cell# 919-608-7567 7. Landowner(s)of Record (attach accompanied page to list additional owners): AG EHC II (LEN) Multi State 4, LLC 602-418-0443 steve.benson@essentialhousing.com Name(s) Telephone E-mail address 8585 E Hartford Dr Suite 118 Current Mailing Address /� Current Street Address Scottsdale AZ 85255 City State Zip City State Zip 8. Deed Book No.018283 Page No.02180-02184 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): Lennar Carolinas, LLC robert.smart@lennar.com Name E-mail Address 1100 Perimeter Park Dr Suite 112 1100 Perimeter Park Dr Suite 112 Current Mailing Address Current Street Address Morrisville NC 27560 Morrisville NC 27560 City State Zip City State Zip Phone# 919-465-5900 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 Town of Knightdale Erosion and Sedimentation Control Ordinance and/or Land Disturbance Permit: Name E-mail Address Current Mailing Address Current Street Address City State Zip City State Zip Phone# (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: Name of Registered Agent E-mail Address Current Mailing Address Current Street Address City State Zip City State Zip Phone# 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. Robert Smart Vice President Type • int A e Title or Authority 11 3 • 21 - w2 Signature Date I, 0,11m-b\-int kfm/{et4t + tiykt)(, a Notary Public of the County of Vvc --- State of North Carolina, hereby certify that I`Cb ,rf- (5016,1' appeared personally before me this day and being duly sworn acknowledged that the above form was executed by him. •- •• . ��-�• :Ntopt. I,this _\ day of O k 0 � CHRISTI Public,Nor• th Caroiu�- Notary wake County. - My Commission expires A.11110 2028 _ ` !Gtary .a My commission expires Li I ( 0[7-0 Z