NCC242212_FRO Submitted_20240723

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
County Unified Development Ordinance before this form and an acceptable erosion and
COUNTY sedimentation control plan have been completed and approved by Wake County Department of
„ , 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 Homestead at Bryan Farm-Dam Breach
2. Location of land-disturbing activity: Jurisdiction Wake County/Town of Garner (Wake Co. or Municipality)
Highway/Street Hebron Church Road Latitude 35.6633 Longitude -78.5791
3. Approximate date land-disturbing activity will commence: April 2024
4. Type of development (residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off-site utilities and borrow/waste
areas): 1.68 ac
6. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Nick Williamson, PE E-mail Address [e-mail]
Telephone [phone] Cell # Fax#
7. Landowner(s) of Record (attach accompanied page to list additional owners):
RA Bryan Farms LLC
Name(s) Telephone Fax or E-mail address
8140 Hebron Church Road 8140 Hebron Church Road
Current Mailing Address Current Street Address
Garner, NC 27529 Garner,NC 27529
City State Zip City State Zip
8. Deed Book No. 018578 Page No. 02449 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):
Lennar Carolinas LLC [e-mail]
Name E-mail Address
1100 Perimeter Park Drive,Suite 112 1100 Perimeter Park Drive,Suite 112
Current Mailing Address Current Street Address
Morrisville,NC 27560 Morrisville, NC 27560
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:
Robert Smart [e-mail]
Name E-mail Address
1100 Perimeter Park Drive,Suite 112 1100 Perimeter Park Drive,Suite 112
Current Mailing Address Current Street Address
Morrisville, North Carolina 27560 Morrisville,North Carolina 27560
City State Zip City State Zip
Telephone [phone] 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:
Robert Smart [e-mail]
Name of Registered Agent E-mail Address
1100 Perimeter Park Drive, Suite 112
Current Mailing Address Current Street Address
Morrisville, NC 27614
City State -Zip City State Zip
Telephone [phone] 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.
Robert Smart Vice President
Type or nt am Title or Authority
7 ( 2:7 2cz-'S
Signature Date
I, R6Vo2 /J. ENn(IS , a Notary Public of the County of WAKE
State of North Carolina, hereby certify that 12Of 60? SMAQT appeared
personally before me this day and being duly sworn acknowledged that the above form was executed by him.
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Witness my hand and notarial seal, this 27 day of —3-6 Co`( , 20 23
se:10R N. t.
,<Q Notary
Seal ( NOTAIgy \
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