NCC222910_FRO Submitted_20220818

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 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 N/A in the blank.)
Part A.
1. Project Name McLean Solar
2. Location of land -disturbing activity: : County City or Township Scotland County Laurinburg
Fieldcrest Road 34,76615185-7949749133
Highway/Street LatltUde(decimal degrees) LOngltUde(decimal degrees)
3 Approximate date land -disturbing activity will commence. -
Is
Purpose of development (residential, commercial, industrial, institutional, etc.): Commercial
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas).32.91 acres
6. Amount of fee enclosed: $3.300.00 . The application fee of $100.00 per acre (rounded
up to the next acre) is assessed without a ceiling amount (Example: 8.10-acre application fee is $900).
Checks should be addressed to NCDEQ.
7. Has an erosion and sediment control plan been filed? Yes ❑ Enclosed ❑x No ❑
L-1
Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Mark Caddell (NARENCO) E-mail Address [e-mail]
Phone: Office #
[phone] Mobile [phone]
9. Landowner(s) of Record (attachaccompaniedpage to list additional owners)
James M. Bullard
Name
408 Forest Road
Current Mailing Address
Laurinburg, NC 28352
City State
10. Deed Book No.1711
Phone: Office # Mobile #
Current Street Address
Zip City State Zip
Page No 46
Provide a copy of the most current deed.

Part B.
1. Company(ies) 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).
National Renewable Energy Corporation [e-mail]
Company Name
227 Southside Drive - Suite B
Current Mailing Address
Charlotte, NC 28217
City State Zip
Phone: Office # [phone]
E-mail Address
227 Southside Drive - Suite B
Current Street Address
Charlotte, NC 28217
City State Zip
Mobile # [phone]
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
Phone: Office # Mobile #
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.
Company DBA Name
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.
Type or rint nam Title or Authority
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Signature Date
I, a Notarryt APublic of the County of
State of North Carolina, hereby certify that L.G[ 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_
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Continued from Items 9 & 10 in Part A of the Financial Responsibility/Ownership Form for multiple
owners. Attach copies of this page as needed to list all landowners.
Landowner 2 of Record:
William E. Brady
Name
1312 Surry Drive
Current Mailing Address
Greensboro, NC 27408
Phone: Office #
Current Street Address
City State Zip City
Deed Book No. 1711 Page No.46
Landowner 3 of Record
Robert A. Brady
Name
160 Iowa Lane, Ste 104
Mobile #
State Zip
Provide a copy of the most current deed
Phone: Office # Mobile #
Current Mailing Address
Current Street Address
Cary, NC 27511
City State
Zip
City State Zip
Deed Book No. 1711
Page No 46
Provide a copy of the most current deed.
Landowner 4 of Record:
Judson D. Brady
Name
Phone: Office # Mobile #
516 Peden St.
Current Mailing Address
Current Street Address
Laurinburg, NC 28352
City State
Zip
City State Zip
Deed Book No. 1711
Page No.46
Provide a copy of the most current deed.
Landowner 5 of Record:
John W. Bullard
Name
Phone: Office # Mobile #
102 White Craigs Court
Current Mailing Address
Current Street Address
Pinehurst, NC 28374
City State
Zip
City State Zip
Deed Book No 1711
Page No.46
Provide a copy of the most current deed.

Continued from Item 1 in Part 8 of the Financial Responsibility/Ownership Form for multiple parties.
Attach copies of this page as needed to list all financially responsible parties.
TBD
Company 2 Name
Current Mailing Address
E-mail Address
Current Street Address
City State
Zip
City
State
Zip
Phone: Office #
Mobile #
TBD
Company 3 Name
E-mail Address
Current Mailing Address
Current Street Address
City State
Zip
City
State
Zip
Phone: Office #
Mobile #
TBD
Company 4 Name
E-mail Address
Current Mailing Address
Current Street Address
City State
Zip
City
State
Zip
Phone: Office #
Mobile #
TBD
Company 5 Name
E-mail Address
Current Mailing Address
Current Street Address
City State
Zip
City
State
Zip
Phone: Office #
Mobile #