NCC223069_FRO Submitted_20220829

FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
EXPRESS PERMITTING OPTION
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. (Please type or print and, if the question is
not applicable or the e-mail and/or fax information unavailable, place N/A in the blank.)
Part A.
1. Project Name The Hudson at Carolina Colours
2
Location of land -disturbing activity: County Craven
Highway/Street waterscape Way Latitude 35.031258
City or Township
ongitude,
3. Approximate date land -disturbing activity will commence: May 1, 2021
New Bern
-77.009488
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 23.05
6. Amount of fee enclosed: $ 3,560 . The Express Permitting application fee is a dual
charge. The normal fee of $65.00 per acre (rounded up to the next acre) is assessed without a ceiling
amount. In addition, the Express Permitting supplement is $250.00 per acre up to eight acres, after
which the Express Permitting supplemental fee is a fixed $2,000.00 (Example: 9 acres total is $2,585).
7. Has an erosion and sediment control plan been filed? Yes x No Enclosed
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Terry Morris E-mail Address morrisand on (cDmbargmail com
Telephone Cell # 252-670-6749 Fax #
9. Landowner(s) of Record (attach accompanied page to list additional owners):
New Market HDS LLC
Name
1131-B Military Cutoff
Current Mailing Address
Wilmington NC 28405
City State Zip
252-636-2146
Telephone Fax Number
Current Street Address
City State Zip
10. Deed Book No. 2359 Page No. 0855 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.
Hudson Capital Acquisitions LLC
Name
400 Frank W. Burr Blvd. Ste. 8
Current Mailing Address
Teaneck NJ
City State
Same
Current Street Address
07666 Same
Zip City State Zip
Telephone [phone] Fax Number N/A

2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina Agent:
CT Corporation System
Name
160 Mine Lake Court, Ste. 200
Current Mailing Address
Raleigh NC 27615
City State Zip
Telephone [phone]
E-mail Address
Same
Current Street Address
Same
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:
CT Corporation System
Name of Registered Agent
160 Mine Lake Court, Ste. 200
Current Mailing Address
Raleigh
City
NC 27615
State Zip
E-mail Address
Same
Current Street Address
Same
City State Zip
Telephone [phone] Fax Number.
(c) In order to facilitate Express Permitting, it is necessary to be able to contact the Engineer or other
consultant who can assist in providing any necessary information regarding the plan and its preparation:
Engin , ring Firm d other cons tant E-mail Address
TVn b"..' 13Ln -Zei6
Individual contact person (type or print) 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 information should there be
any change in the information provided herein.
James S. Col•
Type or print
Si
Manager
Title or Authority
,�' i Z/
Date
s"c-<— e - A c st� `� , a Notary Public of the County of i'o1(r7\ �-P a-�—�
State of North Carolina, hereby certify that :3,;)S S` Cohe- n appeared personally
before me this day and being duly sworn acknowledged that the above form was executed by him.
Witness my hand and notarial seal, this �-7 day of P l / 20 L- I
ARMSrRoi�,�
Notary
Seal P y
�' NOTARY �
PUBLIC _
Comm., u GG 153527 —
Dec 29. 2021
sTgr �'e
E or- Fro
My commission expires