NCC233068_FRO Submitted_20231012

"WI WAKE COUNTY FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
WAKENo person may initiate any land-disturbing activity on one or more acres as covered by the Wake
Countysedimentati Unified Development d bibo
COUNTY on control planevelopmen haveOr been completed inanceefore and th s approvedform byand an Wake Countyaccepta le Department ofand
N(IK111(:AKI)l IN\ Environmental Services, Water Quality Division. (Please type or print and, if the question is not
applicable, place N/A in the blank.)
Part A.
Morgan Pointe Lot 17
1. Project Name
2. Location of land-disturbing activity: Jurisdiction Wake County (Wake Co. or Municipality)
Highway/Street Brady Pointe Latitude_ 35.548557 -78.737578
Longitude
3. Approximate date land-disturbing activity will commence: 09/29/2023
4. Type of development(residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off-site utilities and borrow/waste
areas): .4742
6. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Tyler Appel E-mail Address [e-mail]
Telephone N/A Cell# 919-801-6433 Fax# N/A
7. Landowner(s)of Record (attach accompanied page to list additional owners):
The Drees Company 919-844-9288
Names) Telephone Fax or E-mail address
8521 Six Forks Road,#500 Same
Current Mailing Address Current Street Address
Raleigh NC 27615 Same
City State Zip City State Zip
8. Deed Book No. 19059 Page No. 676 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):
The Drees Company [e-mail]
Name E-mail Address
8521 Six Forks Road, #500 8521 Six Forks Raod, #500
Current Mailing Address Current Street Address
Raleigh NC 27615 Raleigh NC 27615
City State Zip City State Zip
919-256-5478 N/A
Telephone 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:
Reginald B. Gillespie, Jr. [e-mail]
Name of Registered Agent E-mail Address
400 Marriott Drive, Suite 400 4600 Marriott Drive, Suite 400
Current Mailing Address Current Street Address
Raleigh NC 27615 Raleigh NC 27615
City State Zip City State Zip
Telephone [phone] Fax Number 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.
Bradley Weekley Operations Manager
Type or print name / Title or Authority
Signature ( Date
I, �Q rP_ '` a Notary Public of the County of
State of North Carolina, hereby certify that 1>rCO1 I Q L L J Q 'Q L appeared
personally before me this day and being duly sworn acknowledged that the above form wls executed by him.
�
Witness my hand and notarial seal,thi4J 6 day of S , 200-
a
THERUA A. TREFFTZS Notary
-Notary Public M commission ex iresnt rC
Wake County,North Carolina Y p
My Commission Expires
March 6,2024