NCC232646_FRO Submitted_20230901

WAKE COUNTY FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
WAKE No person may initiate any land-disturbing activity on one or more acres as covered by the Wake
Development de bobs
COUNTY sedimentationCountyUnified control planevelopmen haveOr beeninanc completedefore and this approvedfrm byand an Wake Countyaccepta le Depa erortm ionent ofand
NOR,r+CAROL iNn 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_ Cadence Meadows Subdivision
2. Location of land-disturbing activity: Jurisdiction Zebulon (Wake Co. or Municipality)
Highway/Street 705 Pony Rd Latitude 35.815240 Longitude-78.338345
3. Approximate date land-disturbing activity will commence: July 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): 88
6. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Don Sever, PE E-mail Address [e-mail]
Telephone [phone] Cell# 919.810.7950 Fax#
7. Landowner(s) of Record (attach accompanied page to list additional owners):
Meritage Homes of the Carolinas 919.926.2610 [e-mail]
Name(s) Telephone Fax or E-mail address
8800 E Raintree Dr Suite 300 Same
Current Mailing Address Current Street Address
Scottsdale, AZ 8560
City State Zip City State Zip
8. Deed Book No. 19366 Page No. 1 120 Provide a copy of the most current deed.
Part B.
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):
Meritage Homes of the Carolinas, Inc [e-mail]
Name E-mail Address
3300 Paramount Pkwy Ste 120 Same
Current Mailing Address Current Street Address
Morrisville, NC 27560 Same
City State Zip City State Zip
Telephone [phone] Fax Number

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:
Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone Fax Number
(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:
[e-mail]
Meritiage Homes of the Carolinas, Inc.
Name of Registered Agent E-mail Address
same
3300 Paramount Parkway Suite 120
Current Mailing Address Current Street Address
Morrisville NC 27560
City State Zip City State Zip
919 926-2610
Telephone Fax Number
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.
Typ r'print name Title or Authority
- Z�,
Signature Date
I, 3O Pph /J , a Notary Public of the County of L,c)C,14
State of North Carolina, hereby certify that ..5Co j 1 P v j ��y"/c/Le appeared
personally before me this day and being duly
sworn acknowledged that the above form was executed by him.
Witness my hand and notarial seal, this day of _SUt y , 20
7otary
Seal ` _. /
My commission expires /� / -
JOSEPH A SURETTE
NOTARY PUBLIC
WAKE COUNTY, N.C.
My Commission Expires 10-02-2023.