NCC231475_FRO Submitted_20230519

,��°"°`�°,y BUNCOMBE COUNTY FINANCIAL RESPONSIBILITY/
°� ` PLANNING & DEVELOPMENT OWNERSHIP FORM FOR AN
, (828)[e-mail]
` % www.buncombecounty.orglplanning EROSION CONTROL PERMIT
INSTRUCTIONS:All sections must be completed.Section E must be CASE NUMBER:
completed in the presence of a Notary Public.
PIN(Numbers): 9643-19-4556 Project Name: Ashevil e Mulch Yard South
Latitude: 35.455336 Longitude: -82.556398 Amount of fee enclosed:$ 2362.50
Project Location-Highway/Street: 1230 Glenn Bridge Rd.,Asheville,NC 28704
Proposed Use: o Single Family Residence o Multi-Family ❑Vacation Rental Do Commercial/Industrial/Other ❑Other
/ Proposed Disturbed Area(Include offsite borrow and waste areas): 4.50 acre(s)
N Section 26-228(b)of the Buncombe County Soil Erosion and Sedimentation Control Ordinance: "Erosion control plans shall be
accompanied by a notarized statement of financial responsibility and ownership".This statement shall be signed by the person
financially responsible for the land disturbing activity or his attorney in fact.The undersigned states that he/she is the person
financially responsible for land disturbing activity described in this application and acknowledges receipt of a copy of the County of
Buncombe Soil Erosion and Sedimentation Control Ordinance and that he/she has thereby been advised of the requirements therein as
well as the penalties and resources available to the County in the event of violation of the Ordinance,including revocation of the Land
Disturbing Permit and all building permits issued in connection with the project covered by the application.
Name of Business: Asheville Mulch Yard,Inc. Name of Applicant: Mike Schoeppler
Mailing Address: 42 Weaver Road,Weaverville,NC 28787
Street address: 42 Weaver Road,Weaverville,NC 28787
E-mail address: vibr8tRyahoo.com
Telephone: [phone] Cell: Fax:
Name of Landowner(s)of Record: Judith Bonham
Mailing Address: 90 Bonham Rd.,Arden,NC 28704
Recorded in Deed Book No: 020E Page: 0653
D. Contact Information—North Carolina Agent(IfApp/ic:rble)
Section 26-228(b)of the Buncombe County Soil Erosion and Sedimentation Control Ordinance:"If the person financially responsible
is not a resident of North Carolina,a North Carolina agent must be designated in the statement for the purpose of receiving notice of
compliance or non-compliance with the plan,the Act,this ordinance,or rules or orders adopted or issued pursuant to this ordinance."
The person noted below is the designated North Carolina agent and is duly authorized by the financially responsible person to accept
and convey correspondence regarding the aforementioned project.
Name of Agent:
Mailing Address:
E-mail address:
Telephone:
Cell: Fax:
Signature: Date:
1,the undersigned,attest that I am the financially responsible party or an authorized representative with signatory authority for the
financially responsible party,responsible for the construction activities and maintenance of the site until ownership is completed for the
above referenced project.I acknowledge receipt of a copy of the County of Buncombe Soil Erosion and Sedimentation Control
Ordinance and have thereby been advised of the requirements therein as well as the penalties and resources available to the County in
the event of violation of the Ordinance.The above information is true and correct to the best of my knowledge and belief and was
provided byme pile under th. / n /- -
2, kl t!" lei Title: ///`-`Si W''==r
Name: / ' /c�i~et� S� rs�' (/j
Signature: /&-ii / = /z / Date: I S//�
a Notary Public for the Conn of nCbP ,R. "+i rll l l r"rNr l
/VOe i't DI ,rt,. hereby certify that /r1 i C O Cis OrAder �} ....�i,� ',,�
Statepp reof r fit
appeared before me this day and under oath acknowledged that the above form was executed by h and is correct tp`the- est cifP.p1.d• �
knowledge and belief. S,l- 20 a� `" 2 =
Witness my hand and seal,this 3 day of �J G�41�0 = a ' NOT
.,
�y-,4 `-a 0inif\ C , c PUBLjC ;0 Not4. ''/�'"' n .2'i, 1, �:
My Commission Expires /2—,`f —a / -,O` i4``,`'- ,`�
Permit No.: ! Check No: ',s'; � al is OFFICE Reviewi Fee:$ uwttr
USE Date Paid: Received by: Date Issued:
The County of Buncombe does not discriminate on the basis of disability in the admission or access to,or treatment or employment in,
its programs or activities.Requests for appropriate auxiliary aids and services,when necessary to offer a person with a disability an
equal opportunity to participate in or enjoy the benefits of County services,programs, or activities, may be made by contacting
Buncombe County Erosion Control,[phone]. Buncombe County's TDD number is(828)250-4001.