NCC222751_FRO Submitted_20220802

NW-0 WAKE COUNTY FINANCIAL RESPONSIBILITYIOWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
No person may initiate any land -disturbing activity on one or more acres as covered by the Wake
WAKE
County Unified Development Ordinance before this form and an acceptable erosion and
COUNTY sedimentation control plan have been completed and approved by Wake County Department of
NOR1,, L %IkOt 1 Environmental Services, Water Quality Division. (Please type or print and, if the question is not
applicable, place NIA in the blank.)
Part A.
1. Project Name SPARK - Phase 1
2. Location of land -disturbing activity: Jurisdiction Morrisville (Wake Co. or Municipality)
Highway/Street 514 Airport Blvd Latitude35.84639 Longitude-78.82290
3. Approximate date land -disturbing activity will commence: June 2022
4. Type of development (residential, commercial, industrial, institutional, etc.): Industrial
5. Total acreage disturbed or uncovered (including off -site utilities and borrow/waste
areas): 73.0
6. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Tyson Strutzenberg E-mail [e-mail]
Telephone [phone] Cell # Fax #
7. Landowner(s) of Record (attach accompanied page to list additional owners):
Spark Infrastructure Property Owner, L.P 310-405-4367 [e-mail]
Name(s) Telephone Fax or E-mail address
3020 Carrington Mill Suite 425 3020 Carrington Mill Suite 425
Current Mailing Address Current Street Address
Morrisville NC 27650 Morrisville NC 27650
City State Zip City State Zip
8, Deed Book No. 18854 Page No. 00435 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):
Spark Infrastructure Property Owner, L.P [e-mail]
Name
3020 Carrington Suite 425
Current Mailing Address
E-mail Address
3020 Carrington Mill Suite 425
Current Street Address
Morrisville NC 27560 Morrisville NC 27560
City State Zip City State Zip
Telephone[phone] Fax Number

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
NIA
Current Mailing Address
Current Street Address
N/A
N/A
City State
Zip City State Zip
N/A
N/A
Telephone
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.
N/A
N/A
Name of Registered Agent
E-mail Address
N/A
N/A
Current Mailing Address
Current Street Address
N/A
N/A
City State
Zip City State Zip
N/A
N/A
Telephone
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 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 informLLation should there be any change in the information pn�rovided herein.
Type br print name U Title or Authority
Sign
L�- L-2,14a Z_
Date
a Notary Public of the County of U/ c4 J.0 P
State of North Carolina, hereby certify that To !�hruf en berm appeared
personally before me this day and being duly sworn acknowledged that the above fortn was executed by him.
Witness my hand and notarial seal, this _"%day of T u �_ 20 _19
CHRISTINE A MURTHA
Notary Public, North Carolina
Wake County
Notary
My Commission Expires
Seal January 13, 2026
My commission expires Sao k3 ao �cn