NCC223776_FRO Submitted_20221108

JCN
Durham City/County (Office Use Only)
Sedimentation and Erosion Control
FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
WITH LANDOWNER CONSENT FORM
No person may initiate any land -disturbing activity covered by the Durham City -County Unified Development Ordinance before a
Land Disturbing Permit is issued by the Sedimentation and Erosion Control Office. Issuance of a Land Disturbing Permit does not
relieve the permittee of the obligation to obtain any other licenses, permits and approvals as may be required by Federal, State,
County or Municipal governments. This office must be notified in writing of any change to the information on this form.
PLEASE TYPE OR PRINT
1. Project name: Alexander Crossing
2. Road location of land -disturbing activity:_405 T.W. Alexander Drive, 5604 Solutions Drive, Durham. NC. 27713
Tax Map - Block - Parcel: _Parcel 1Ds: 154068, 154038 PINs: 0737-35-45-4162- 0737-35-74-2693
3. Square footage of land to be disturbed or uncovered: 357,766 SF 8.21 AC
4. List below the landowner of record. Each landowner must complete Item 8.
(If there are multiple owners, please list on a separate page):
Piedmont Alexander Crossing Owner. LLC
Name
_4 West Red Oak Lane, Suite 325
Address
_White Plains NY 10604
City State Zip
_(914) 831-0095 [e-mail]
Telephone Fax Email
5. List the person or entity financially responsible for this land -disturbing activity: The financially responsible party shall
be (1) the developer or other person who has or holds themselves as having financial or operational control over the land -
disturbing activity and/or (2) the land owner or person in possession or control of the land when they have directly or
indirectly allowed the land -disturbing activity or have benefited from it and (3) the named party on the Land Disturbing
Permit.
Piedmont Alexander Crossing Owner. LLC
Name
_4 West Red Oak_ Lane, Suite 325
Street Address
White Plains NY 10604
City State Zip
[phone] dsmolev@a,sr-rep.com
Telephone Fax Email
The Sedimentation and Pollution Control Act (Act) and the Durham City -County Unified Development Ordinance
(Ordinance) includes, but is not limited to, the following legal obligations of the financially responsible party:
■ Maintain a set of approved sedimentation and erosion control plans, if required, on site.
■ Display permit on site.
• Understand and implement any required plan, including the construction sequence and details.
■ Inspect, maintain and repair sedimentation and erosion control measures, especially after rainfall events.
■ Provided adequate ground cover or otherwise stabilize all areas that have not been actively graded within 21 calendar
days.
201 E. Main St, 5"' Floor, Durham, N.C. 27701 w [phone] • Fax [phone]
www.co.durham.nc.us/ceng

■ Plan and conduct all land -disturbing activity so as to prevent off -site sedimentation.
6. For business applicants, list below the North Carolina registered agent for the financially responsible entity:
Name Corporation Service Company
Street Address 2626 Glenwood Ave Suite 550
City Raleigh State NC Zip 27608
Telephone Fax Email
7. The above information is true and correct to the best of my knowledge and belief and was provided by me while under oath. I
understand that the person or entity listed on Line 5 above will be: (1) the owner of the Land Disturbing Permit when issued;
(2) responsible for ensuring compliance with the Act and Ordinance; and, (3) will be the only person or entity with standing to
appeal any action aken or decision made by the Sedimentation and Erosion Control Office.
Date
Telephone [phone]
Email [e-mail]
Fax
Type or Print Name Douglas Smolev
Title a,r ikuthority Managing Member
Signature
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Business Applicant (Provide corporate resolution on signatory authority), `
1, �( 11Q 6-1 (F`j]x0_Z_ , a Notary Public of the County of
State of hereby certify that bo ugj oLs �� m cY e. V �
personally came before me this day and acknowledged that he is
and acknowledged, on behalf of �► �C �jt°.Y(11'�C er �VCr75 ► v
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L�'C410\r �[ _ , the due execution of the foregoing instrument.
Witness my hand and official seal, this L9 day of -T VQ. _l 20
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p, Notary Public
My commission expires 10 — 1 ( 20 a3 TRISHA MARTINEZ
NOTARY PUBLICS $jf *q Y.
s**sss » * + ORK
No. 01 MA6331843
Individual Applicant Qualified in Dutchess County
I, , a Notary Public of the County of My COmmis$ion Expires 10-19-2023
State of , hereby certify that
personally appeared before me this date and under oath acknowledged that the above form was executed by them.
Witness my hand and official seal, this,
My commission expires
20
day of 20
Notary Public
LAND DISTURBING PERMITS ARE NON -TRANSFERABLE

Provide a Notarized Item 8 for each landowner listed in Item 4.
8. Land Owner Consent. As a landowner, 1 provide my consent for land -disturbing activities to occur on the property listed in
Item 2 the p son or entity listed in Item 5.
/ Zj ( Douglas Smolev
Date
Typegr Print Name
Telephone Fax Title or t kthgrity Managing Member
Email
Signature
Business Landowner (Provide corporate resolution on si ng atory authority)
I, Y{ }S, (r`1Q GL-l'� Gt tv`}�t ✓�f_-_Z_a Notary Public of the County of
State of t\1p.1+t} t-iU`�h• , hereby certify that
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ersonally came before me this day and acknowledged that he is _ w Q-` -o' I t7\ 4
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f�' 'fJfi��'i A),2x"d&665ii and acknowledged, on behalf of 7£d G1}" i t QhC C� cfoSSIT
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the due execution of the foregoing instrument.
Witness my hand and official seal, this t' 01114\ day of ;j; , 6L5:21 , 20
Notary Public
My commission expires l > 203-3 TRISHA MARTINEZ
NOTARY PUBLIC -STATE OF NEW YORK
No. 01 MA6331843
Individual Landowner Qualified in Dutchess County
My Commission Expires 10-19-2023
a Notary Public of the County of
State of
hereby certify that
personally appeared before me this date and under oath acknowledged that the above form was executed by them.
Witness my hand and official seal, this day of 20,
Notary Public
My commission expires 20
SE-03 Rev.07t06

Piedmont Alexander Crossing Owner, LLC
a Delaware limited liability company
Joint Written Consent of the Member and Manager of
Piedmont Alexander Crossing Owner, LLC
Effective as of Januar3r , 2022
The undersigned, being the sole member (the "Member") and sole manager (the "Manage ") of
Piedmont Alexander Crossing Owner, LLC, a Delaware limited liability company (the "Company'), do
hereby agree, consent to, order and adopt the following resolution and by the execution hereof, hereby
waive any and all formalities of meeting, including, but not limited to, notice, time, date, place and purpose
of said meeting.
WHEREAS, the Company is in the process of developing property with parcel numbers of
154068 and 154038 (the "Pro e "); and
WHEREAS, the Member and Manager have deemed it to be in the best interest of the Company
to obtain a Land Disturbing Permit from the Durham City Erosion Control Office (the "Permit") for the
Property and enter into all documentation related thereto and such documents and instruments as are
necessary to effectuate the Permit.
NOW, THEREFORE, BE IT RESOLVED, that Douglas Smolev (hereinafter called
"Designated Officer"), is hereby authorized, directed and empowered to execute and/or deliver, in the
name and on behalf of the Company, any and all documents, certificates, and schedules to be executed
and/or delivered in connection with the Permit, all in such form as the Designated Officer shall approve,
such approval to be conclusively presumed through execution thereof by such officer, and to take all other
steps and do all other acts and things, including, without limitation, the execution and delivery of any and
all other agreements, certificates, instruments and documents which Designated Officer shall deem
necessary or appropriate to effect the purposes and intent of the recitals and resolutions stated herein and
to consummate the transactions contemplated by the Permit.
FURTHER RESOLVED, that any such Designated Officer, acting only, is hereby authorized
and directed to take or cause to be taken all such further action in connection with the transactions
contemplated by the foregoing resolutions, and to execute and deliver or cause to be delivered in the name
of and on behalf of the Company, all such agreements or instruments in regard thereto or as may be
required by the aforesaid transactions, and to take all such other action, as such Designated Officer may
deem to be necessary or advisable or convenient or proper to carry out the intent of the foregoing
authorization and to fully perform the provisions of any and all instruments and documents executed in
the name of and on behalf of the Company, pursuant to the foregoing authorization (such necessity,
advisability, convenience or appropriateness being conclusively evidenced by the taking of any such
action); and
FURTHER RESOLVED, any and all actions taken or caused to be taken by any such Designated
Officer, acting only, or any other person, in the name of and on behalf of the Company, prior to the date
hereof in connection with the foregoing resolutions are hereby ratified, confirmed and approved as the
duly authorized acts of Company; and
FURTHER RESOLVED, that any and all actions previously taken by the Company or any of its
officers in connection with the documents, transactions and actions contemplated by the foregoing
resolutions hereby are adopted, ratified, confirmed and approved in all respects as and for the acts and
deeds of the Company; and

FURTHER RESOLVED, that the actions taken by this written consent shall have the same force
and effect as if taken by the undersigned at a special meeting of the Member and Manager duly called and
constituted pursuant to the Operating Agreement of the Company and applicable Delaware law.
[Remainder of page intentionally left blank. Signature page to follow.]
4870-2663-0923, V. 4

This Written Consent shall be effective as of the date first above written.
MEMBER:
Piedmont Alexander Crossing Holdings, LLC, a Delaware
limited liability company
By: SR Alexander Crossing LLC, a Delaware limited
liabili company, its Managing Member
By:
Name: Douglas Smolev
Its: Authorized Person
IM/fer-T" of ,;
Piedmont Alexander Crossing Holdings, LLC, a Delaware
limited liability company
By: SR Alexander Crossing LLC, a Delaware limited
liabili company, its Managing Member
By: ✓��
Name: Douglas Smolev
Its: Authorized Person
4870-2663-0923, v. 4