NCC230762_FRO Submitted_20230321

N-W WAKE COUNTY FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
P=7 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
NORTH CAROLINA Environmental Services, Water Quality Division. (Please type or print and, if the question is not
applicable, place N/A in the blank.)
Part A.
1. Project Name Grand Highland Estate - Lots 9 & 10
2. Location of land -disturbing activity: Jurisdiction Wake County (Wake Co. or Municipality)
Legacy Ridge Lane Lot 9 is 36.026654 Lot 9 is-78.594643
Highway/Street g Y g Latitude Lot 10 is 36.027137 Longitude Lot 10 is-78.594477
3. Approximate date land -disturbing activity will commence: 02/17/2023
4. Type of development (residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off -site utilities and borrow/waste
areas): 1.222
6. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Robert Russotti E-mail Address [e-mail]
Telephone N/A Cell #
919-360-6099 Fax # N/A
7. Landowner(s) of Record (attach accompanied page to list additional owners):
BIG SKY ESTATES LLC 406-995-6333
Name(s)
8310 BANDFORD WAY
Current Mailing Address
RALEIGH NC 27615-2752
City State
8. Deed Book No. 018713
Part B.
Telephone
8310 BANDFORD WAY
Current Street Address
RALEIGH NC 27615-2752
Zip City
State
N/A
Fax or E-mail address
Zip
Page No. 01748-01756 Provide a copy of the most current deed.
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):
Exeter Building Company LLC [e-mail]
Name
900 Ridgefield Drive
Current Mailing Address
Raleigh NC 27609
City State Zip
Telephone [phone]
E-mail Address
900 Ridgefield Drive
Current Street Address
Raleigh NC 27609
City State Zip
Fax Number N/A

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
Name
N/A
Current Mailing Address
N/A
City State
Telephone
N/A
N/A
E-mail Address
N/A
Current Street Address
N/A
Zip City
Fax Number N/A
State Zip
(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:
Exeter Building Company LLC [e-mail]
Name of Registered Agent E-mail Address
900 Ridgefield Drive 900 Ridgefield Drive
Current Mailing Address
Raleigh NC
City State
Telephone [phone]
Current Street Address
27601 Raleigh
Zip City
Fax Number
NC 27601
State Zip
N/A
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.
Alexander Yost
Type or print name
Signature
Jeremy Gage
Registered Agent
Title or Authority
02/17/2023
Date
a Notary Public of the County of
State of North Carolina, hereby certify that Alexander Yost
personally before me this day and being duly sworn acknowledged that the ab
Witness my hand and notarial seal, this 1 TV. day of D
JEREMY GAGE
Notary Public - North Carolina Notary
Seal Wake County
My Commission Expires Apr 3, 2024 My cor
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