NCC231930_FRO Submitted_20230621

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. Submit the completed form to the appropriate
Regional Office. (Please type or print and, if the question is not applicable or the e-mail address or phone
number is unavailable, place N/A in the blank.)
Part A.
1. Project Name 78 NORTH - LOTS 1 , 2, 3, 4
2. Location of land-disturbing activity: County LEE City or Township SAN FOR D
Highway/Street N.C. HWY 78 Latitude(decimaldegrees) 35.449902 LongitUde(decimaldegrees) -79.167399
3. Approximate date land-disturbing activity will commence: 7/28/23
4. Purpose of development(residential, commercial, industrial, institutional, etc.): RESIDENTIAL
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): 1 .01 ACRES
6. Amount of fee enclosed $700 . The Express Permitting application fee is a dual charge.
The normal fee of$100.00 per acre(rounded up to the next acre) is assessed without a ceiling amount.
In addition,the Express Permitting supplement is$250 per acre up to eight acres,after which the Express
Permitting supplemental fee is a fixed$2,000.00 (Example: 8.10-acre application fee is$2,900). Checks
should be addressed to NCDEQ.
7. Has an erosion and sediment control plan been filed? Yes ❑ Enclosed NI No ❑
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name BRIAN ROMANCHOK E-mail Address [e-mail]
Phone: Office# 919-987-1930 Mobile# [phone]
9. Landowner(s) of Record (attach accompanied page to list additional owners):
McKEE HOMES, LLC 919-669-2521 919-669-2521
Name Phone: Office# Mobile#
4208 SIX FORKS RD, STE. 810
Current Mailing Address Current Street Address
_RALEIGH NC 27609 RALEIGH NC 27609
City State Zip City State Zip
10. Deed Book No. 1614 Page No. 0001-0003 Provide a copy of the most current deed.

Part B.
1. Company(ies)who are financially responsible for the land-disturbing activity (Provide a comprehensive list
of all responsible parties on accompanied page.) If the company is a sole proprietorship or if the landowner(s)is
an individual(s), the name(s)of the owner(s)may be listed as the financially responsible party(ies).
NVR, INC. [e-mail]/ [e-mail]
Companir Name E-mail Address
LOCAL MAILING ADDRESS: CORPORATE HEADQUARTERS OFFICE
5734 TRINITY RD. STE 200 11700 PLAZA AMERICA DR #500
Current Mailing Address Current Street Address
RALEIGH NC 27606 RESTON VA 20190-4792
City State Zip City State Zip
Phone: Office# 919-987-1930 Mobile# [phone]
Note: If the Financially Responsible Party is not the owner of the land to be disturbed, include with this form
the landowner's signed and dated written consent for the applicant to submit a draft erosion and sedimentation
control plan and to conduct the anticipated land disturbing activity.
2. (a) If the Financially Responsible Party is a domestic company registered on the NC Secretary of State
business registry, give name and street address of the Registered Agent:
CORPORATE SERVICE COMPANY [e-mail]
Name of Registered Agent E-mail Address
2626 GLENWOOD AVE, STE. 550 2626 GLENWOOD AVE, STE. 550
Current Mailing Address Current Street Address
RALEIGH NC 27608 RALEIGH NC 27608
City State Zip City State Zip
Phone: Office# 800-927-9800 Mobile#
Name of Individual to Contact(if Registered Agent is a company)
(b) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina agent who is registered on the NC Secretary of State business registry:
*SEE ATTACHED INCUMBENCY CERTIFICATE*
JOE SCHMIDTKE (NVR, INC.) [e-mail]
Name of Registered Agent E-mail Address
LOCAL MAILING ADDRESS: CORPORATE HEADQUARTERS OFFICE:
5734 TRINITY RD. STE 200 11700 PLAZA AMERICA DR #500
Current Mailing Address Current Street Address
RALEIGH NC 27606 RESTON VA 20190-4792
City State Zip City State Zip
Phone: Office# 919-987-1930 Mobile# [phone]
JOE SCHMIDTKE
Name of Individual to Contact(if Registered Agent is a company)

Partnership, or other company not registered and doing business under an assumed name, attach a copy
of the Certificate of Assumed Name.
Company DBA Name
(d) If 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:
[e-mail]/
MORRIS AND RITCHIE ASSOCIATES OF NC, PC [e-mail]
Engineering firm or other consultant E-mail Address
JAMIE B. GUERRERO/DARYN ALLGEIER 410-515-9000 919-618-1932
Individual contact person (type or print) Phone: Office# Mobile#
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(s)
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 Party). I agree to provide
corrected information should there be any change in the information provided herein.
JOE SCHMIDTKE VP/ DIVISION MANAGER
Type or pr',....7_ Title or Authority
5/31/23
Signatu Date
I, NADINE S. LEWIS , a Notary Public of the County of JOHNSTON
State of North Carolina, hereby certify that JOE SCHMIDTKE appeared personally
before me this day and being duly sworn acknowledged that the above form was executed by him/her.
Witness my hand and notarial seal, this 31 st day of MAY , 20 23
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NADINE S.LEWIS Notary
NOTARY PUBLIC y
AtOR JOHNSTON COUNTY
My expires /0 /7/��
SRTH GARUt_INA commission V!/
MY COMMISSION EXPIRES 10[712023,

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INCUMBENCY CERTIFICATE
NVR,INC.
The undersigned hereby certifies that she is Assistant Secretary of NVR, Inc., a corporation
organized and existing under the laws of the Commonwealth of Virginia, and that:
The following serve as officers appointed by the Board of Directors of NVR, Inc. as of the
date of this certification:
Paul C. Saville Chief Executive Officer and President
Eugene J. Bredow President Financial Services
Daniel D. Malzahn Senior Vice President, Chief Financial Officer and Treasurer
Gary F. Brown Senior Vice President of Human Resources
T. Kent LaMotta Senior Vice President, Chief Operating Officer
Jason Schlosser Senior Vice President of Marketing
Matthew Kelpy Vice President, Chief Accounting Officer and Controller
James M. Sack Vice President, General Counsel and Secretary
Appointed Senior Vice Presidents
John E. Harper Brian Moyer Keith W. Tomlinson
Brett Hetrick Keith Neiman
Kirk Kubista Paul Praylo
*Appointed Vice Presidents
Jeffrey C. Ambrose Scott Eckley Scott Kalman
Ryan Arnold Anne Emison William Kane
Matthew T. Arnoldy Scott Faber Thomas King IV
G. Louis Baker, III Jesse Faisant Greg Knapp
James Bales, Jr. Tiffany Ferri Michael Kohowski
Joseph Battaglia James R. Forsyth Michael Kotowski
Ryan Borleis Seth Foster Robert E. Lattanzi
Brian Bowe Stephen Gallo Joshua Lemoi
David Branch Nick J. Gargasz Kris Lightcap
Jason Brant Chris M. Garner Jon Long
Kelly Brod Richard S. Goldberg Ryan C. MacCauley
Seth Brohawn David Greminger Mark Maier
Katherine Burke Robert Grothmann Misty Mashburn
Jon Cherry Charles Hart John McConnell
Michael Ciabattoni John Hedden Robert W. McCracken
Sean Clancy Douglass Hensel Lisa McCulley
Kevin Connery Jonathan Hess Patrick McGivern
Michael Scott Daniel Todd Hickman Matthew McHale
Desiree Davis David Hilton Curtis McKay
David Deal Nathan T. Holston Patrick McNeally
Tom Delaney Brian Huewe Jason McNee
Eugene DiMenna Gregory James Dan Meador
Patrick Donahue Henry Johnsen Brad Messenger
James Duszynski Ryan Johnson Peter A. Mielnik
Thomas Eckhoff Douglas Jones Jon Moats

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Appointed Vice Presidents(cont)
Paul Mock Stephen Power Gregory Staufer
John Monacci Christian Riesch Steven Stauffer
Marty Moore Peter Robertson Kevin Summerville
Joshua Mowrey Matthew W. Rost Michael Urian
Danielle Mullins Evan Ruggiero Justin Valdez
Stephen Neuberger Michael Schaeffer Aaron VanDyke
Richard Ohmann *Joseph Schmidtke Nicholas Wade
Ronald C. Orie, Jr. Patrick Schulz David J. Whitaker
Josh Pardue Thomas C. Sear Benjamin A. Wilson
Giles P. Patterson Brett Sechler Courtney Wilt
Christopher Pearson Eric Shirey Matthew Winkler
David Peterson Tim Sievers Paul Wishnok
S. Scott Pjesky Dylan Sinclair Nadia Wong Sang
Catherine Pollack David H. Smithgall Aaron York
Cameron Powell
Appointed Assistant Vice Presidents
Justin Brod Rick Coscia Mark Madigan
David F. Bruckner Eva Melissa Daniels John McAfee
Brett Cameron Thomas Frazier III Jerry Smith
Jimmy Shawn Colvin
Appointed Assistant Secretaries
Denise Amspacher Brittany Fraser Dayna Mitchell
Dana Andrews Melissa Gallagher Stephanie Moore
Barbara Bailey Jessica Geisler Trina Morgan
Kelani Bailey Alexandra Gil Deborah Mueller
Lisa Baldwin Jessica Gonzalez-Vega Victoria A. Nelson
Lisa Berman Sally Claire Griffith Ellen Ormsby
Emily Bianca Katelyn Hertenstein Nancy Patti
Brittany Bnnie Drusilla Holm Jennifer Pfister
Robert J. Busch Diane Holt Sherry Rehage
Carol Caramanico Matthew A. Horsley Lynette Reilly
Kathleen Lilly Cleary Wendy Hughes Nicole Richardson
Annemarie Cousino Belinda Jarrell Greg D. Sarver
Lauren Crain Kimberly S. Kearns Elizabeth Selvage
Julie Davis Gina Kerstetter Danielle Shelton
Lisa Day Julie Koch Jeremie Smith
Samantha Dionne Jennifer Kuse Teresa Taylor-Johnson
Amy Dolbow Suzanne B. Lemley Aimee Telegraphis
Karen Dombrauskas Dennis W. Littell Laura Thornton
Sara Dunn Lori Martin Rebecca Weiss
Hilda Duran Stephanie D. McCraw Patricia Wieman
Karen Eichinger Angela Mejias Deborah J. Wisniewski
Christina Engel Jill E. Meyer Minnie Woodley
Lora Enwright Patricia English Mirabelli Kelly Wroten
Melissa Evans

IN WITNESS WHEREOF,I have signed this Incumbency Certificate and affixed the seal of the
Corporation as of March 21,2022.
A . ,1Q
Alexandra Gil
Assistant Secretary