HomeMy WebLinkAboutNCC242680_FRO Submitted_20240829 0 BUNCOMBE COUNTY FINANCIAL RESPONSIBILITY/
-I .bunco NC nt re- -I C^'`Art\!T OWNERSHIP FORM FOR AN
(828)250�830•PlanninglnfoaBuncombeCourtty.org EROSION CONTROL PERMIT
vrew.buncombecounty.org/plannIng
INSTRUCTIONS All sections must be completed Section I must be CASE NUMBER:
completed in the presence of a Notars Public --
S. I:N.i+tin;;l'roperh Information
PIN(Numbers): 869507966300000 869507756300000 Project Name: 311 Sharon Ln
Latitude: 35.50004528682484 Longitude: -82.72727717665613 Amount of fee enclosed:S 2625.00
Project Location-Highway/Street:311 Sharon Ln,Carder,NC 28715
Proposed l'se: PI Singh'Ianrilc Residence n Muhl-Family a I'arwnon Rental (brnnrercral Industrial Other - (Rher
Proposed Disturbed Area dm lode(Wide borrow and waste areas): 2.5 acrets)
B. Cmit,act lntnm.uism-l'in.tns i.ilh Rc,Inm,il.l, I',
Section 26-228t h)of the Buncombe Counts Soil Erosion and Sedimentation Control Ordinance: "Erosion control plans shall be
accompanied by a notarized statement of financial responsibility and ownership".This statement shall be signed by the person
financially responsible for the land disturbing activity or his attorney in fact.The undersigned states that he she is the person
financially responsible for land disturbing activity described in this application and acknowledges receipt of a copy of the County of
Buncombe Soil Erosion and Sedimentation Control Ordinance and that heshe has thereby been advised of the requirements therein as
well as the penalties and resources available to the County in the event of violation of the Ordinance,including revocation of the Land
Disturbing Permit and all building permits issued in connection with the project covered by the application.
Name of Business: Name of Applicant:Clyde Motley
-
Mailing Address: 114 Medford Branch Rd,Cruder,NC 28715
Street address: 114 Medford Branch Rd,Candler,NC 28715 E-mail address: motleydyde112141Ipntail.eom
—
Telephone:828-231-9144 -- Cell: -- Fax
C. Lani.1uv.ncrtsl of Rcold
Name of Landowner(s)of Record: Clyde and Sharon M000Y -- —
Mailing Address: 114 Medford Branch Rd,Candler,NC 28715 -
Recorded in Deed Book No: 4249 _ Page: 1553
I) I tit is i Inl,in:hi:pm 'Vol'.I,.trolina A.,drnl (It 4lyihr.rh/e)
Section 26-228(bI of the Buncombe County Soil Erosion and Sedimentation Control Ordinance:"lithe person financially responsible
is not a resident of North Carolina a North Carolina agent must be designated in the statement for the purpose of receiving notice of
compliance or non-compliance with the plan,the Act,this ordinance,or rules or orders adopted or issued pursuant to this ordinance."
The person noted below is the designated North Carolina agent and is duly authorized by the financially responsible person to accept
and convey correspondence regarding the aforementioned project.
Name of Agent:
Mailing Address:
E-mail address: -- —
Telephone:- -- Cell: Fax: -
Signature:_ _ _ Date:I. l.cnilicatnui
1,the undersigned,attest that I am the financially responsible party or an authorized representative with signatory authority for the
financially responsible party,responsible for the construction activities and maintenance of the site until ownership is completed for the
above referenced project.I acknowledge receipt of a copy of the County of Buncombe Soil Erosion and Sedimentation Control
Ordinance and have thereby been advised of the requirements therein as well as the penalties and resources available to the County in
the event of violation of the Ordinance.The above information is true and correct to the best of my knowledge and belief and was
provided by me while under oath.
Name: Clyde Motley �-- - - — Title: � p� �
s� --- .
Signature: �M� — Date: ��'.tSG7 ' 2
,a Notary Public for the County of 0,,A,,,..„6 E ,
State of y441 (1�Q v.lA Y",hereby certify that - _Personally
appeared bef j;tplhis day and under oath acknowledged that the ab • rm was executed y hi and is correct to the best of his
ff Ii
know` t t'/r4
`NOi n anZf9iStffrj�J_day of N.d .201' --
PCC'' �x �QN'.dAa- Ci i&a4 41i1`
Notary Public ,+: No
El. Buncombe `t: l „IP' 0.,(r/
County = My Commission Expires
+ ('p 0 Permit No.: Check No:
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%il l-,fr f Rrmc o� discriminate on the basis of drmhility in she admission or access to,or treatment or employment in,
its pre? ..c Cr LL•C!I•h ass quests Joe appropriate aurilian•aids and services,when necessary to offer a person with a disability an
equal oppdhithiMilltliProcipate in or enjoy the benefits of County services,programs, or acwt:tiles, may be made by contacting
Buncombe('away Erosion Control,(82812S0-1848. Buncombe('ounty•s TI)I)number is(8210 250-4001.