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Home My WebLink AboutNCC241076_FRO Submitted_20240412 Financial Responsibility Ownership . ENGINEERING (Sedimentation Pollution Control Act) ` `°' ':' SERVICES One Exchange Plaza,Suite 304 Raleigh,NC 27601 This section to be completed by City of Raleigh staff Submittal Date Effective Date Transaction Number Permit Number LD- The remaining sections to be completed by the Applicant SECTION 1: GENERAL INFORMATION & INSTRUCTIONS This form is required to be completed, notarized and submitted with all Land Disturbing Permit applications. The information provided herein becomes an enforceable part of the approved Erosion and Sediment Control Plan and the Land Disturbing Permit listed above. Non-compliance may result in the assessment of civil penalties and could potentially affect all permits, inspections and/or Certificates of Occupancy for this Project. Should any of the information on this form change, a revised, executed form shall be submitted within thirty (30) days, said submission shall include a copy of any documents recorded with the Register of Deeds. The effective date of this form shall be the effective date as designated above by the City of Raleigh. No rights and liabilities associated with any designation shall incur until the effective date, or the effective date of transfer to any subsequent Party. Upon any delegation of an Applicant/Permittee or Financially Responsible Party, the Owner shall continue to receive notice at the address provided. A permit may not be transferred to a residential Home Owner's Association as the Applicant/Permittee or Financially Responsible Party, until the issued Land Disturbing Permit for this project is administratively closed by the Stormwater Management Division. Raleigh City Code §14-1011 sets forth that it shall be unlawful and a violation of this code for any person to give false information or misrepresentations in any application or permit required by this code. Failure to provide full disclosure of the requested information may be grounds for denial or revocation of a Land Disturbing Permit. Please complete all sections below. Type or print and, if information on the form is not applicable, place N/A in the blank. All pages of this form must be completed and submitted or the form will be rejected and returned. The property owner must initial each page of the form prior to submittal. SECTION 2: PROJECT INFORMATION PROJECT NAME Everlee Subdivision PERMITTED PHASE(S) PROJECT ADDRESS 2932, 2933, 3013, 3029 &3033 Watkins Town Rd; 1505 Old Watkins Rd & 0 Old Milburnie Rd WAKE COUNTY PARCEL ID NUMBER(S) 1746894942, 1747709196, 1747701824, 1747711222, 1747702102, 1746798664& 174804539 ANTICIPATEDDATE OF October 2023 PROOJECTCTINITIATION EXPECTED DURATION OF 2 PROJECT years ACREAGE OF LAND TO BE DISTURBED V G I .$0 acres PROPERTY OWNER'S INITIALS: Stormwater Inspections Form 112 08.01.16 9 ji1°1 )1C1 Page 1 of 5 /Z•eM ►NO 4 71'E.� SECTION 3: PROPERTY OWNER INFORMATION 'n Y CAL Y's &\)-e-Y\ , \—L - -61r-4e i\- Q Mar Av-\LL. PROPERTY OWNER OF RECORD I b I'a a�0 O (b UUa"}"k.1n5 l28 (c \c( ) 614 �81 MAILING ADDRESS(NO P.O. BOX) TELEPHONE NUMBER FAX NUMBER cil R-i.4\ 0 C al k:,r Jo b AAA<e Srl 0 3 Vnal i\ •LON% CITY, STAYE, ZIP E-MAIL ADDRESS The undersigned acknowledges that he is the Owner, or holds the Owner's power of attorney, of the property which is the subject of this application, and further states that the permitted land-disturbing activities are authorized to be conducted on the subject property with the full knowledge, permission and consent of the Owner. The undersigned acknowledges that he is the Property Owner for permit implementation, compliance and enforcement resulting under this Land Disturbing Permit and Unified Development Ordinance, Article 9.4. The Owner of the property upon which the land-disturbing activity is to be undertaken states and affirms that he has read and understands the statements and disclosures made in this form and that the information disclosed herein is true and correct to the best of his knowledge and belief. This form must be signed by the Owner of the property or by a person with authority to execute instruments, if the Owner is not an individual.�/y� ,, T , a k ItoYT\day of clr _k ,20 P3 . ----- W' /�I ,t --- J-Q_„__________ VN\ Ci...V\attic' ` PROPERTY •, NER SIGNATURE TITLE IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this 14 day of Maidn , 20 t 3 . .rietlissa.\-a,' Nife ":,:tillocRiu r, Notary Public (print name) f(\QiaThJ ry Public Signature My Commission Expires: %-- 1--- r). .3 N Notary ub is itle/ Position olliiii , OTARy (SEAL) o 'OUBL1G PROPERTY OWNER'S INITIALS: Storn:water Inspections Form 112 v 08.23.16 14 ( ofS �r 01 /f / Page 2 5 /<EpI Prm0 1#0 SECTION 3: PROPERTY OWNER INFORMATION uyvoAck aC nk-CAJ3,rnWYr I0cc&kt Try - .q�-Y - S PROPERTY OWNER OF REC D J 3o/3 zt.- ohs 2 -- /gt/ (c wq a\te) MAILING ADDRESS (NO P.O. BOX) TELEPHONE NUMBER FAX NUMBER CITY, STAB, ZIP EMAIL ADDRESS The undersigned acknowledges that he is the Owner, or holds the Owner's power of attorney, of the property which is the subject of this application, and further states that the permitted land-disturbing activities are authorized to be conducted on the subject property with the full knowledge, permission and consent of the Owner. The undersigned acknowledges that he is the Property Owner for permit implementation, compliance and enforcement resulting under this Land Disturbing Permit and Unified Development Ordinance, Article 9.4. The Owner of the property upon which the land-disturbing activity is to be undertaken states and affirms that he has read and understands the statements and disclosures made in this form and that the information disclosed herein is true and correct to the best of his knowledge and belief. This form must be signed by the Owner of the property or by a person with authority to execute instruments, if the Owner is not an individual. y�� This, the day of Onod r \ PROPERTY OWNER SIGNATI TITLE IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this _ ay of 1 r ' l , 20 . W\Vr-e. Mokagt-- Notary Public (print name) Not�•-y Public Signature My Commission Expires: Notary Public itle/Position \w\\\\, S SA SPA 1/,// NO TARS (SEAL) io�1(CQUt�I .�� PROPERTY OWNER'S INITIALS: Stormwater Inspections Form 112 A.P 08.23.16o f5 � Page2 SECTION 3: PROPERTY OWNER INFORMATION S `_` Cd,crc� PROPERTY OWNER OF REC \Yye_VC)ca.\ 4-Tr t - 'Muxto- 700 Chow' 1, k.4'e 97 l W3 -S213 MAILING ADDRESS (NO P.O. BOX) TELEPHONE NUMBER FAX NUMBER fief.l e,g Li Ne, 2 7 C/ 6 ' \Oc -Q k LC-k-`F110 9 @ 1c\b-k-rnu.4\ . u CITY, STATE, ZIP E-MAIL ADDRESS The undersigned acknowledges that he is the Owner, or holds the Owner's power of attorney, of the property which is the subject of this application, and further states that the permitted land-disturbing activities are authorized to be conducted on the subject property with the full knowledge, permission and consent of the Owner. The undersigned acknowledges that he is the Property Owner for permit implementation, compliance and enforcement resulting under this Land Disturbing Permit and Unified Development Ordinance, Article 9.4. The Owner of the property upon which the land-disturbing activity is to be undertaken states and affirms that he has read and understands the statements and disclosures made in this form and that the information disclosed herein is true and correct to the best of his knowledge and belief. This form must be signed by the Owner of the property or by a person with authority to execute instruments, if the Owner is not an individual. This, the /-( day of mace✓C I7 , 20 2 .3 PERTY OWNER SIGN URE TITLE IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this LP day of�(Y\a,V' 'CYIQL , Notary Public(print name) Notar Public Signature My Commission Expires: Notary Public Ti / Position \\\ \SSAI PA ‘,4OTAip1- (SEAL) PUSLkG // COON,``\N PROPERTY OWNER'S INITIALS: Storinwater Inspections Form 112 \ 08.23.16 /V,`/1 Page 2 of 5 404 PraC 442 P SECTION 3: PROPERTY OWNER INFORMATION 2 i �x PROPERTY OWNER OF RECORD la/3 4%041 S Tc1(/r) (cA19) aabc MAILING ADDRESS (NO P.O. BOX) TELEPHONE NUMBER FAX NUMBER Agee IV G- , 7I/ \ rmr4s@smatI .� CITY, ATE, ZIP E1AIL ADDRESS The undersigned acknowledges that he is the Owner, or holds the Owner's power of attorney, of the property which is the subject of this application, and further states that the permitted land-disturbing activities are authorized to be conducted on the subject property with the full knowledge, permission and consent of the Owner. The undersigned acknowledges that he is the Property Owner for permit implementation, compliance and enforcement resulting under this Land Disturbing Permit and Unified Development Ordinance, Article 9.4. The Owner of the property upon which the land-disturbing activity is to be undertaken states and affirms that he has read and understands the statements and disclosures made in this form and that the information disclosed herein is true and correct to the best of his knowledge and belief. This form must be signed by the Owner of the property or by a person with authority to execute instruments, if the Owner is not an individual. This, the day of f ThirCh , 20 'PlROPERTY O ER SIGNATUh TITLE IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this _ day of c�1' \ , 20 cif . \\'S%_ fe_, mawzL,' Notary Public (print name) Not ry Public Signature My Commission Expires: Notary Publi itle/ Position • ‘4,OTARy (SEAL) PUBLUG /1// COUNI �v`v 01/111\1PROPERTY OWNER'S INITIALS: Stormwater Inspections Form 112 D C ,, ge.2 Z 3 � l/J�I{/ !VlIA/ Page 2 o off 5 5 IV) Qp RED SECTION 3: PROPERTY OWNER INFORMATION I.... r a W . 5\.11 \rr evocaibtt ynAWcc S. 9ey r3 j n .:e PROPERTY OWNER OF RECORD 560% Rt1I-e.� tA-i11 I ( 19) ' -13- 54 MAILING ADDRESS (NO►P.O. BOX) TELEPHONE NUMBER FAX NUMBER \i)entie11 . 3.1 S9 1 h and c\ik&LI Q \oe_l` auc` ' ksr' CITY, STATE,ZIP E-MAIL ADDRESS The undersigned acknowledges that he is the Owner, or holds the Owner's power of attorney, of the property which is the subject of this application, and further states that the permitted land-disturbing activities are authorized to be conducted on the subject property with the full knowledge, permission and consent of the Owner. The undersigned acknowledges that he is the Property Owner for permit implementation, compliance and enforcement resulting under this Land Disturbing Permit and Unified Development Ordinance, Article 9.4. The Owner of the property upon which the land-disturbing activity is to be undertaken states and affirms that he has read and understands the statements and disclosures made in this form and that the information disclosed herein is true and correct to the best of his knowledge and belief. This form must be signed by the Owner of the property or by a person with authority to execute instruments, if the Owner is not an individual. 4+1 This,the 15 day of MetkrVfn ,20 3. (1 ,244,z, PR ERTY OWNER SIGNATURE U TITLE IN WITNESS WHEREOF,the undersigned Notary Public has hereunto set his hand and seal,this 1 day of , 20 a 3 . Me}15SOL�O.U'C�e, “Vgailtk,V101j2„. Notary Public(print name) Notary Public Signature My Commission Expires: 14a1:Ya3 Notary Public tle/Position ��S S q Fq�i// .\\� t<`NOTARY (SEAL) ////�j OlU �'I\\.\ �C II11�� PROPERTY OWNER'S INITIALS: StormwaterInspection. Form 112 08.23.16 02_ 2_ F�� Page 2 .16 ,f, 4 b SECTION 3: PROPERTY OWNER INFORMATION 1--4 ld OL PROPERTY OWNER OF RECORD Sabo b1d m,Ibu.YYN\e l GRA— arS- MAILING `l ADDRESS(NO P.O. BOX) TELEPHONE NUMBER FAX NUMBER 1RcCITY, STATE,i , C ��k,Lio E-MA L ADDRESS The undersigned acknowledges that he is the Owner, or holds the Owner's power of attorney, of the property which is the subject of this application, and further states that the permitted land-disturbing activities are authorized to be conducted on the subject property with the full knowledge, permission and consent of the Owner. The undersigned acknowledges that he is the Property Owner for permit implementation, compliance and enforcement resulting under this Land Disturbing Permit and Unified Development Ordinance, Article 9.4. The Owner of the property upon which the land-disturbing activity is to be undertaken states and affirms that he has read and understands the statements and disclosures made in this form and that the information disclosed herein is true and correct to the best of his knowledge and belief. This form must be signed by the Owner of the property or by a person with authority to execute instruments, if the Owner is not an individual. This,the cX-I day ofkpz? ,it, ,20 3 cac (%). (AJ1( �ILG dWVL2X� PROPERTY OWNER SIGNATURE TITLE IN WITNESS WHEREOF,_the undersigned Notary Public has hereunto set his hand and seal,this P day of n ILA,Y- , 20 . ( (Le . C d s Ll:r 0-►--i C iL Notary Public (print name) ota Public Signature My Commission Expires: f1 lur Notary Public Titl /Position \\\\\ C,\EI MI cP NOTARY My Commission Expires _ (SEAL) - 3-11-2025 PUBLIC i��F COUN1�0\\�� PROPERTY OWNER'S INITIALS: Storn,water Inspections Form 112 08.23.16 �� Page 2 of 5 /6f/11mc3 k110 eF0 SECTION 3: PROPERTY OWNER INFORMATION `\ " V°`'` n l'e- �). r Iraq ,rytj CK.c��e 1 PROPERTY OWNER OF RECORD ?70 LA) / 9- 2/$'- 29'5— MAILING� ADDRESS(NO P.O. BOX) TELEPHONE NUMBER FAX NUMBER i?c 8' ' ZIP r 2 76,/ E-MAILADDR A � �rt�il a C C The undersigned acknowledges that he is the Owner, or holds the Owner's power of attorney, of the property which is the subject of this application, and further states that the permitted land-disturbing activities are authorized to be conducted on the subject property with the full knowledge, permission and consent of the Owner. The undersigned acknowledges that he is the Property Owner for permit implementation, compliance and enforcement resulting under this Land Disturbing Permit and Unified Development Ordinance, Article 9.4. The Owner of the property upon which the land-disturbing activity is to be undertaken states and affirms that he has read and understands the statements and disclosures made in this form and that the information disclosed herein is true and correct to the best of his knowledge and belief. This form must be signed by the Owner of the property or by a person with authority to execute instruments, if the Owner is not an individual. This,the /7 day of J Iacc t , 20 23. e � PROPER OWNER SIGNATUR TITLE IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this I I d 1 ► ay of arC\,, , 20 . ri\d\ avf-e, Notary Public (print name) Not ry Public Signature My Commission Expires: Notary Public tie/Position \\�\\\�S S A'Fq lii \• 4.OTARy (SEAL) • 'UBL\C' F COUNCN\\`\ PROPERTY OWNER'S INITIALS: Storm water Inspections Form 112 ,,- �L ,� „_n j , ` Page ( �//1J 1A 16 Page 2 .f 5 g /1/1 JJ12 j' SECTION 3: PROPERTY OWNER INFORMATION 'tip} 1 -buIxt PROPERTY OWNER OF RECORD 1 aao old Wafkim Qc 9la-(0 1(4-50g1 MAILING ADDRESS(NO P.O. PDX) TELEPHONE NUMBER FAX NUMBER .G-et-- k NC ca-x0C10 ‘,. cutka. 59 Q lma.)1 , exne-v--\ CITY, STATIP E-MAIL ADDRESS The undersigned acknowledges that he is the Owner, or holds the Owner's power of attorney, of the property which is the subject of this application, and further states that the permitted land-disturbing activities are authorized to be conducted on the subject property with the full knowledge, permission and consent of the Owner. The undersigned acknowledges that he is the Property Owner for permit implementation, compliance and enforcement resulting under this Land Disturbing Permit and Unified Development Ordinance, Article 9.4. The Owner of the property upon which the land-disturbing activity Is to be undertaken states and affirms that he has read and understands the statements and disclosures made in this form and that the information disclosed herein is true and correct to the best of his knowledge and belief. This form must be signed by the Owner of the property or by a person with authority to execute instruments, if the Owner is not an individual. d T . ' i� a Y of al-J.. 20 a3 Geg OWKer P OPERTY OWN SIG( Td E TITLE IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this 1 1 o day of 1 t l m , 20 p�3 . “Af,1Ws . vre, M.QQ kLaNL �R , Notary Public(print name) No Public Signature My Commission Expires: S— cO a3 Notary Public Ti- Position \\011III/// �\•'SSA P. Lsss 4OTA/Y I (SEAL) p UBL,G ` i Os/6'COUN �\\\ PROPERTY OWNER'S INITIALS: Stormwater Inspections Form 112 `¢�` ( el � I 11(�J` 08.23.16 r/ J e Page 2 of 5 i SECTION 4: OWNER'S APPOINTED AGENT INFORMATION • The Owner of the property upon which land-disturbing activities will be undertaken is required to either reside in or appoint an agent for service with business and residence addresses within Wake County, North Carolina. Section 4 must be completed if the Property Owner listed in Section 3 does not reside in Wake County, North Carolina and is optional for all others. The Owner of the subject property hereby appoints the following person as an agent to receive service of any notice, process, or pleading in any action or legal proceeding arising out of any matter relating to Unified Development Ordinance, Article 9.4. The Owner agrees that any notice, process, or pleading may be served by and through the undersigned appointed agent and such service shall have the same force and effect as if service was accomplished upon the Owner. NAMEQ Y -k 1t lOr" Yl k O W TITLE qlq a " `-) cO 6 COMPANY, IF APPLICABLE TELEPHONE NUMBER Ne 'JAe [7r' STREET ADDRESS((NO P.O. BOX) ��.r� FAX NUMBERe \- CITY, 1— STATE otr-'I" ✓C� IOC Q � `� E-MA �Y8. p102%►" e y,,\Acyo.esiynADDRESS The undersigned acknowledges that he/she is the Owner's appointed agent. This, t e /4 da of , 20 7-(>. r1e U —TITLE AP INT AGENT SIG AT IN WITN SS WHEREOF, thero undersigned Notary Public has hereunto set his/her hand and seal, this 1 day of r IlJr1, , 20a . Melssa__Va\ re, Qa . Notary Public(print name)Q Not ry Public Signature My Commission Expires: O-4' a 3 Notary Public T. I /Position J;� \SSA i,( NOTAR (SEAL) Ave t G r/�CQUNT�v�G\` PROPERTY OWNER'S INITIALS: k r ate Inspections Form 112 ,,� 08.23.16 jZ (,�O 1 / 0 \ Page 3 of 5 k�� • J/O SECTION 4: OWNER'S APPOINTED AGENT INFORMATION The Owner of the property upon which land-disturbing activities will be undertaken is required to either reside in or appoint an agent for service with business and residence addresses within Wake County, North Carolina. Section 4 must be completed if the Property Owner listed in Section 3 does not reside in Wake County, North Carolina and is optional for all others. The Owner of the subject property hereby appoints the following person as an agent to receive service of any notice, process, or pleading in any action or legal proceeding arising out of any matter relating to Unified Development Ordinance, Article 9.4. The Owner agrees that any notice, process, or pleading may be served by and through the undersigned appointed agent and such service shall have the same force and effect as if service was accomplished upon the Owner. / d awark Ou-Le. bw rrze� NAME TITLE • COMPANY, IF APPLICABLE TELEPHONE NUMBER /5 Pia ticce STREET ADDRESS(N P.O. BOX) FAX NUMBER • Lit Vl Gt m/ '1 mutt,-,L�� Y ooLit CITY, STATE, ZIP E-MAIL ADDRESS The undersigned acknowledges that he/she is the Owner's appointed agent. This,the eA day of C , 20 a 3 LA), pd APPOINTED AGENT SIGNATURE TITLE IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his/her hand and seal, this , _day of rc fC\ , 20 0. 3 . SSa. rav Notary Public(print name) otary Public Signature • My Commission Expires: q' aaa a t\1 Notary Publi itle/Position \�\\\ ��\5 S A ,9 ///i F ' OTARy (SEAL) = 1"U B L i G PROPERTY OWNER'S INITIALS: Jtlngrvater Inspections Form 112 08.23.16 , 010 Page 3 of 5 SECTION 5: FINANCIALLY RESPONSIBLE PARTY INFORMATION The Owner of the subject property authorizes the following person or firm as the Financially Responsible Party for this Land Disturbing Permit. The Financial Responsible Party shall receive service of any notice, process, civil assessment or pleading in any action or legal proceeding arising out of any matter relating to the Land Disturbing Permit issued under this permit application and Unified Development Ordinance, Article 9.4. Robert Smart Division President FINANCIALLY RESPONSIBLE PARTY TITLE Lennar Carolinas, LLC 919-906-0664 COMPANY, IF APPLICABLE TELEPHONE NUMBER 1100 Perimeter Park Drive Suite 112 STREET ADDRESS (NO P.O. BOX) FAX NUMBER Morrisville, NC 27560 robert.smart@lennar.com CITY, STATE, ZIP E-MAIL ADDRESS The undersigned acknowledges that he is the Financially Responsible Party for permit implementation, compliance and enforcement resulting under this Land Disturbing Permit and Unified Development Ordinance, Article 9.4. He has read and understands the statements and disclosures made in this form, that the information disclosed herein is true and correct to the best of his knowledge and belief. This form must be signed by the person or firm financially responsible for the land developing activity or other person with authority to execute instruments for the financially responsible party, if not an individual. This, the Z� / 1,, of \ , 202— . r V (C Pst FINANCIALLY RI SPONSIBLE PARTY SIGNATURE TITLE IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this 11Aday of t- CzoaAe-Ni , 20 23 . Notary Public (print name) Notary Public Signature My Commission Expires: lM.►`( I 2--o27 ^(aTAQY A 1 Notary Public Title/ Position JO N. el, �, !�`r �' NOTAR . ��(SEAL) I PUBLIC PROPERTY OWNER'S INITIALS: y14) i ,COUN,;t, brnrwater Inspections Form 112 nnnnl 081112 r� Page4of5 �_ I / G.� SECTION 6: APPLICANT/PERMITTEE The Owner of the subject property authorizes the following person or firm as the Applicant/Permittee to receive service of any notice, process, civil assessment or pleading in any action or legal proceeding arising out of any matter relating to the Land Disturbing Permit issued under this permit application and Raleigh Unified Development Ordinance, Article 9.4. The Applicant/Permittee designated below is the person responsible for implementation of permit conditions and violation under Article 9.4 of the Raleigh Unified Development Ordinance. The Applicant/Permittee may be the landowner or another party who acknowledges that he is the Contractor responsible for completion of the project as approved. Robert Smart Division President APPLICANT/PERMITTEE TITLE Lennar Carolinas, LLC 919-906-0664 COMPANY, IF APPLICABLE TELEPHONE NUMBER 1100 Perimeter Park Drive Suite 112 STREET ADDRESS (NO P.O. BOX) FAX NUMBER Morrisville, NC 27560 robert.smart@lennar.com CITY, STATE, ZIP E-MAIL ADDRESS The undersigned acknowledges that he is the Applicant/Permittee for permit implementation, compliance and enforcement resulting under the Land Disturbing Permit listed above and Unified Development Ordinance, Article 9.4. He has read and understands the statements and disclosures made in this form and that the information disclosed herein is true and correct to the best of his knowledge and belief. This form must be signed by the person or firm responsible for the permit or by a person with authority to execute instruments for the Applicant/Permittee, if not an individual. This, the 2� f , 20 Pee516644— APPLICANT/ ERMITTEE SIGNATURE TITLE IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this 7 71IA day of Fi;-g 2-u t , 20 23 . Tevc- /J. E,N I \S Notary Public (print name) Notary Public Signature My Commission Expires: MP( MoTM`/ Pw51A L Notary Public Title / Position u�Nwi,I,,�y NOTAR), (P (SEAL) P UBL1G PROPERTY OWNER'S INITIALS: 1'71, pO'U�N,h�� t`mwater Inspections Form 112 _ 14 Page /� / Paof5