NCC221456_FRO Submitted_20220504

No ce S=.: - 7 4 ,71- ate any activity on one or more acres as covered by the Act before this
fora a,�7 w a- e-ctab:e erosion and sedimentation control plan have been completed and approved by
;re ,o Q,� ity Section, N.C. Dvpartrnent of Environmental Quality. Submit the completed form to the
appr�cp ate Regional Office, (Pliease type or print and, if the question is not applicable or the e-mail and/
or fax in -Formation unavailable, place NfA in the blank.)
Part A. 850 US Hwy 17 N
1. Project Name
2. Location of land -disturbing activity: County Onslow City or Township Stump Sound
Highway/Street850 US Hwy 17 N Latitude34 30' 19" Longitude-77 32' 15"
3. Approximate date land -disturbing activity will commence: 2/1 /22
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Commercial
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas):12.16 acres
6. Amount of fee enclosed: $ 9/5 ($1300-$325)* The application fee of $100.00 per acre
(rounded up to the next acre) is assessed without a ceiling amount (Example: 8.10 ac = $900.00).
7. Has an erosion and sediment control plan been filed? Yes No Enclosed
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Will Alexander
Telephone [phone]
E-mail Address [e-mail]
Cell # 910-264-6782 Fax #
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Get Right Investments LLC 910-264-6782
Name
PO Box 296
Telephone
Fax Number
Current Mailing Address Current Street Address
Holly Ridge, NC 28445
City State Zip City State Zip
10. Deed Book No. 5329 _ Page No.246 Provide a copy of the most current deed.
Part B.
1. Company(ies) or firm(s) who are financially responsible for the land -disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet.) If the company or firm is a sole proprietorship,
the name of the owner or manager may be listed as the financially responsible party.
Get Right Investments LLC [e-mail]
Name E-mail Address
PO Box 296
Current Mailing Address Current Street Address
Holly Ridge, NC 28445
City State Zip City State Zip
Telephone[phone] Fax Number

"(a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina Agent:
Name
Current Mailing Address
City
Telephone
E-mail Address
Current Street Address
State Zip City State Zip
Fax Number
(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
Current Mailing Address
City
Telephone.
E-mail Address
Current Street Address
State Zip City State Zip
Fax Number
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 individ.ual, 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.
Will Alexander
Type me
Signature
Owner
Title or Authority
Date
a Notary Public of the County of
State of North Carolina, hereby certify that �U ,IV6 rAn (A appeared
personally before me this day and being duly sworn acknowledged that the above form was
executed by him.
Witness my hand and notarial 'soiIlj its ip day of,- ' � t a`�� 20
_ o �O TAB y N= 'otary t.a
Seal = U B L� `
A
My commission expires 0`4
LF/V C-OU01 V11
/,/rrIII�\\\\