HomeMy WebLinkAboutNCC230136_FRO Submitted_20230119Durham City/County
Sedimentation and Erosion Control
JCN
(Office Use Only)
W OR[ I liLlIrlm,rAll N' I I I! W r1i
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No person may initiate any land -disturbing activity covered by the Durham City -County Unified Development Ordinance before a
Land Disturbing Permit is issued by the Sedimentation and Erosion Control Office. Issuance of a Land Disturbing Permit does not
relieve the permittee of the obligation to obtain any other licenses, permits and approvals as may be required by Federal, State,
County or Municipal governments. This office must be notified in writing of any change to the information on this form.
PLEASE TYPE OR PRINT
1. Project name:_ NextGen
2. Road location of land -disturbing activity: Genesis Way on north side of E Cornwallis Rd
Tax Map - Block - Parcel: 229518 PIN: 0738-99-60-4950.008
3. Square footage of land to be disturbed or uncovered: 1,439,658 SF (33.05 ac)
4. List below the landowner of record. Each landowner must complete Item 8.
(If there are multiple owners, please list on a separate page):
ARE -NC REGION NO. 25 LLC
Name
12 Davis Drive
Address
REASEARCH TRIANGLE PARK NC 27709
City State Zip
919-313-6645 OSHERRILLaARE.COM
Telephone Fax Email
5. List the person or entity financially responsible for this land -disturbing activity: The financially responsible party shall
be (1) the developer or other person who has or holds themselves as having financial or operational control over the land -
disturbing activity and/or (2) the land owner or person in possession or control of the land when they have directly or
indirectly allowed the land -disturbing activity or have benefited from it and (3) the named party on the Land Disturbing
Permit.
ARE -NC REGION NO.25, LLC
Name
12 David Drive
Street Address
RESEARCH TRIANGLE PARK NC 27709
City State Zip
919-313-6645 OSHERRILLAARE.COM
Telephone Fax Email
The Sedimentation and Pollution Control Act (Act) and the Durham City -County Unified Development Ordinance
(Ordinance) includes, but is not limited to, the following legal obligations of the financially responsible party:
■ Maintain a set of approved sedimentation and erosion control plans, if required, on site.
■ Display permit on site.
■ Understand and implement any required plan, including the construction sequence and details.
■ Inspect, maintain and repair sedimentation and erosion control measures, especially after rainfall events.
■ Provided adequate ground cover or otherwise stabilize all areas that have not been actively graded within 21 calendar
days.
201 E. Main St, 5" Floor, Durham, N.C. 27701 e (919) 560-0735 • Fax (919) 560-0740
www.co.durham.nc.us/ceng
® Plan and conduct all land -disturbing activity so as to prevent off -site sedimentation.
6. For business applicants, list below the North Carolina registered agent for the financially responsible entity:
OLIVER SHERRILL
......_.._-__
Name
12 Davis Drive
Street Address
RESEARCH TRIANGLE PARK NC 27709
City State Zip
919-313-6645 OSHERRILLkARE.COM
Telephone Fax Email
7. The above information is hue and correct to the best of my knowledge and belief and was provided by me while under oath. I
understand that the person or entity listed on Line 5 above will be: (1) the owner of the Land Disturbing Permit when issued;
(2) responsible for ensuring compliance with the Act and Ordinance; and, (3) will be the only person or entity with standing to
appeal any action taken or decision made by the Sedimentation and Erosion Control Office.
a' E0 w_ OLIVER SHERRILL
Date Type or Print Name
919-313-6645
Telephone
Email Signature
Business Applicant (Provide corporate resolution on siunatory authori
1, )�6'n& N )Un V6 nn i a Notary Public of the County of `i U ry,,aWj
State of NOVA '1 f okra tt r\C) hereby certify that b l I V" shel r i
personally came before me this day and acknowledged that he is SVP- &;')r A m6ru°-N�faep--
of AC Regfa n Nd. Z5 ,I_LL and acknowledged, on behalf of &eXandr►& g j`F
the due execution of the foregoing instrument.
Witness my hand and official seal, this 12- � day of CC 20®P```I111111// Al®®,®®
Notary Public 4
My commission expires C 20 ®C 'PA Z
Individual Applicant ®®,�
I, a Notary Public of the County of ®411f.. UN i';®®®®®®®
State of
hereby certify that
personally appeared before me this date and under oath acknowledged that the above form was executed by them.
Witness my hand and official seal, this day of
My commission expires
20
Notary Public
LAND DISTURBING PERMITS ARE NON -TRANSFERABLE
0
Provide a Notarized Item S for each landowner listed in Item 4.
8. Land Owner Consent. As a landowner, I provide my consent for land -disturbing activities to occur on the property listed in
Item 2 by the person or entity listed in Item 5.
at(_&CA t 1? ,.j_OW . OLIVER SHERRILL
Date Type or Print Name
919-313-6645 SENIOR VICE PRESIDE REGIONAL MARKET DIRECTOR _
Telephone Fax ,Altor Authogity,
Email
Business Landowner (Provide corporate resolution on signatory authority)
1, S ivx Cbj S�tv i 't nS a Notary Public of the County of y�
State of.tAt)yAlh Ce roti c,, hereby certify that 0 tj VW SYUjVLi � 1
personally came before me this day and acknowledged that he is q iorn�{
of p1f(y (�caiF3rl � - ,(-LC- and acknowledged, on behalf of hdr f C,- 64-fik Ca u ib-'es.�
the due execution of the foregoing instrument.
Witness my hand and official seal, this C day of Duem 20 j %®®t��@611p��dy®®9
Notary Public TKO,
My commission expires J 4 20 2.(v ®C i
v.
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Individual Landowner ®®®i®19�1-26
h a Notary Public of the County of
State
hereby certify that
personally appeared before me this date and under oath acknowledged that the above form was executed by them.
Witness my hand and official seal, this day of 20
Notary Public
My commission expires 20
SE-03
Rev.07/06