Loading...
HomeMy WebLinkAboutNCC233395_FRO Submitted_20231205 C,*.RY A NORTH CAROLINA Stormwater Division FINANCIAL RESPONSIBILITY - OWNERSHIP FORM No person may initiate any land-disturbing activity covered by Cary's Sedimentation and Erosion Control Ordinance before completing and filing this form with the Cary Stormwater Division. Indicate N/A if a question is not applicable. Section 1 PROJECT NAME: Millstone Subdivision PROJECT DEVELOPMENT PLAN #: 22-DP-7419 PROJECT LOCATION: 0724-71-6063 &0724-70-6260 Property Tax ID#/PIN 0 Mills Road and 7824 Emery Gayle Lane Street Address APPROXIMATE DATE OF PROJECT INITIATION: October 2, 2023 ACREAGE OF LAND TO BE DISTURBED: 23.8 acres APPLICANT SUBMITTING PLAN: (must match the financially responsible party named in Section 2 of the Financial Responsibility/Ownership (FR/O) Form.) Toll Bros. Inc. - Edward B. Pease Name(Person or Firm) Section 2 PERSON(S) OR FIRM(S) FINANCIALLY RESPONSIBLE FOR THIS LAND-DISTURBING ACTIVITY: (If out of state, a registered agent in North Carolina must be used.) Toll Bros. Inc. - Edward B. Pease Name(Person or Firm) 900 Perimeter Park Drive, Suite B3 Street Address(No PO Box) Morrisville, NC 27560 City State Zip Cary 316 North Academy Street, Cary, NC 27513 PO Box 8005, Cary, NC 27512-8005 Tel: 311 or 919-469-4000 outside Cary limits www.carync.gov updated:04/2023 (919) 321-4800 Telephone Number N/A Fax Number tpease@tollbrothers.com E-Mail Address REGISTERED AGENT FOR THE PERSON OR FIRM WHO IS FINANCIALLY RESPONSIBLE: (If out of state, a registered agent in North Carolina must be used.) Name Street Address(No PO Box) City State Zip Telephone Number Fax Number E-Mail Address The Town reserves the right to contact either the financially responsible person or registered agent listed below in case of violation. Please indicate your preference below. Toll Bros. Inc. - Edward B. Pease OR Financially Responsible Person Registered Agent Section 3 LANDOWNER OF RECORD: Toll Southeast LP Company, Inc. Name(Person or Firm) 0724-71-6063 & 0724-70-6260 Property Tax ID#/PIN 1140 Virginia Drive Street Address(No PO Box) Fort Washington, PA 19034 City State Zip Cary 316 North Academy Street, Cary, NC 27513 PO Box 8005, Cary, NC 27512-8005 Tel: 311 or 919-469-4000 outside Cary limits www.carync.gov Page 2 of 3 updated:04/2023 STATEMENT OF LANDOWNER CONSENT: In accordance with NCGS 113A-54.1(a), I hereby declare that I am the owner or legally authorized representative of the owner of the property described above and provide my consent for the applicant cited in Section 1 above to submit an erosion control plan to the Town of Cary Stormwater Division and to conduct the planned land-disturbing activities on the property listed in Section 1 above. Edward B. Pease Division President Name Title or Authority 6'2 9J41J2 Signature Date tpease@tollbrothers.com (919)321-4800 Email Telephone Number THE ABOVE INFORMATION is true and correct to the best of my knowledge and belief and as provided by me while under oath. (This form must be signed by the financially responsible person, if an individual or by an officer, director, partner, attorney-in-fact, or other person with authority to execute instruments for the financially responsible person if not an individual.) Type or Print Name Title or Authority Signature Date , N jaiti - 8w0-he_r , a Notary Public of the County of 36k115f off) State of North Carolina, hereby certifies that E0t.40.rd e. f&.S•e personally appeared before me this day and under oath acknowledged that the above form was executed by him/her. Witness my hand and notarial seal,this day of a "• '161Ad NOTAliy - fA/•• _ ary/ ublic l PUBLIC .' My commission expires 51 417 Cary 316 North Academy Street, Cary, NC 27513 PO Box 8005, Cary, NC 27512-8005 Tel: 311 or 919-469-4000 outside Cary limits www.carync.gov Page 3 of 3 updated:04/2023