NCC224181_FRO Submitted_20221228

GQu_�TY -,ro, APPLICATION' FOR PERMIT FOR A File #
LAND DISI"URBING ACTIVITY
Under the conditions set forth by LD Fee Review Fee
col The New Hanover County
Control Ordinance C i
di d Wi
Soil Erosion anSedimentation onz. Date Pd Date Pd
Engineering Department
Applicant or Applicant's Agent: NNP IV -Cape Fear River, LLC _ -
Mailing Address: 109 Pier Master Point, Suite 209 Telephone Number: [phone] Fax Number:
Wilmington, NC 28412 — _ _ Email Address: nick.vassala@brookfieldproperiiesdevelopment:com
Total Acres of Land Disturbance: 112.42 AC Purpose of Development: Residential Subdivision & Utility Installation
Description of Land Disturbance. 404 Residential Lots as ;art of the RiverLi hts Development Phase 7 & 8
Address of Land Disturbance 4410 River Roo 111lilminaton tdla 28412 Latitude: 34 T 47" N _ Longitude: 77 55' 17" W_
STATEMENT OF FINANCIAL RESPONSIBILITY
Land owner(s) of record: Person or firm(s) financially responsible for the
land disturbing activity. If not a North Carolina
resident, you MUST have a N.C. agent. (List Below)
Name: NNP IV -Cape Fear River, LLC Name: NNP IV -Cape Fear River LLC -
Address: 13777 Ballantyne Corporate Place, Suite 250 Address: 13777_Ballantyne Corporate Place, Suite 250
City/State: Charlotte NC T City/State: Charlotte NC _
Zip Code: 28277 __ Zip Code:.__28277 —
Telephone Number: 910 473-5409 Telephone Number: A(910) 473-5409
� nick.cassala brookfield ro ertiesdevelo ment.com
nick.cassala[a�brookfieldpropertiesdevely menl.com NSA � p p P FaxNurnber: NIA
Email: _ _ FaxNumber — _Email: -
Location of deed(s) or instruments): County: New Hanover Book: - Page: 428
The above information is true and correct to the best of my knowledge and belief and was provided by me while under oath.
(This form must be signed by the Financially responsible person if an individual and by an officer, director, partner, attorney -in -
fact, or other person of authority to execute instruments for the financially responsible person if not an individual.) I agree to
provide corrected information should there be any change in the information provided herein.
Date: Nance Nick Cassala Title Vice President - Operations
Siemature
I, _ a Notary Public of the County of State of
North Carolina, hereby certify that _— appeared personally before me, this day and
being duly sworn acknowledged that the above form was executed by him.
Witness my hand and notary seal, this _ day of - 20-
Notary —My commission expires -
SEAL
Permission to Enter on Land pucMVIY�
I certify that I am authorized to grant and do in fact grant permission to the Erosion Contr I Ins rs a enso enter
the land in question in connection related to this permit application.
AUG 2 5 2022
Application 5ionature and Dale ENGINEERING DEPARTMENT
PLEASE COMPLETE ALL PORTIONS OF APPLICA

SIGNATURE PAGE APPLICATION FOR PERMIT FOR A LAND DISTURBING ACTIVITY
made this of L—
IN TESTIMONY WHEREOF, this Agreementxn Y
2022.
Grantor:
NNP IV -CAPE FEAR RIVER, LLC,
a Delaware limited liability company
By: Brookfield NewIan&6e�Zo eat LLC,
a Delaware limiteJ liahidit* company
Its: AgentlDev -lol'lwe,1 Me alter
t
Name:
Nick Cassala
Title: Vice President
Date:
STATE OF NORTH CAROLINA
COUNTY OF NEW HANOVER
Address: 109 Pier Master Pt
Suite 209
Wilmington, NC 28412
1, Alyson T. Hicks, a Notary Public for the State of North Carolina, County of New Hanover, do hereby
certificy that NICK CASSALA personally appeared before me this day of sc, �y , 2022,
and executed the forgoing instrument.
SEAL
Alyson T. Kdcs
NOTARY PUSUC
New Hanwer County, NC
My Commission Expires October 14, 2026
NOTARY PUBLIC
My Commision Expires: ion lIt �tb
-
RECEIVED
AUG 2 5 2022
ENGINEERING DEPARTMENT