HomeMy WebLinkAbout06015_Burkhart Carolina_LURU Model_20170914NC BROWNFIELDS
LAND USE RESTRICTIONS (“LUR”) UPDATE
Year Certification Made: 2017
Name: Burkhart Carolina
Project #: 06015-02-091
Address: Dabney Dr. & Prosperity Dr.
County: Vance
Property Owner (In part or whole): ____________________________
Read the following LURs and mark each restriction accordingly. Additional remarks may be added for compliance status clarification. Attach any required or supplemental documentation,
sign, notarize and submit to the following address:
NC Division of Waste Management
Attn: Brownfields Program Staff
1646 Mail Service Center
Raleigh, NC 27699-1646
No water supply wells may be installed or used at the Property.
☐ In compliance ☐ Out of compliance
Remarks: ______________________________________________________________
No mining activities may be conducted on the Property.
☐ In compliance ☐ Out of compliance
Remarks: ______________________________________________________________
No activities likely, as determined by the Department of Environmental Quality (“DEQ”) in its sole discretion, to result in direct exposure to or removal of groundwater in the area of
VOC-contaminated soil (including, but not limited to, excavation), may be conducted on the Property without prior sampling and analysis of groundwater in the area where such activities
are to be conducted, submittal to DEQ or its successor in function of the analytical results along with, if DEQ so requires, plans and procedures to protect public health and the environment
during those activities, and a written determination by DEQ or its successor in function that those activities will not pose a threat to public health or the environment.
☐ In compliance ☐ Out of compliance
Remarks: ______________________________________________________________
No basements may be constructed at the Property.
☐ In compliance ☐ Out of compliance
Remarks: ______________________________________________________________
No fountains, ponds, lakes, swimming pools or other items which are supplied, in whole or in part, by groundwater may be constructed on the Property.
☐ In compliance ☐ Out of compliance
Remarks: ______________________________________________________________
No chlorinated solvents, including but not limited to those listed in the tables in paragraphs (2)a. and (2)b. of the Notice of Brownfields Property (“Notice”), may be used, warehoused,
or otherwise stored at the Property, except for those used in de minimis amounts for cleaning and for other routine housekeeping activities incidental to the uses of the Property approved
in the Brownfields Agreement (“Agreement”), or offered for retail sale in household quantities by lessees, sublessees, assignees, and transferees in the normal course of their businesses.
☐ In compliance ☐ Out of compliance
Remarks: ______________________________________________________________
Within thirty (30) days of each anniversary of the effective date of the Agreement, the owner of each portion of the Property shall submit a notarized Land Use Restrictions Update to
DEQ certifying that the Notice remains recorded at the Vance County Register of Deeds office, and that the land use restrictions herein are being complied with. The Land Use Restrictions
Update shall also describe land uses and development activities that have occurred on the Property during the reporting period and that it is anticipated will occur on parcels adjacent
to the Property, and shall contain a certification that any building foundations and parking and driveway surfaces constructed on the Property are continuing to function as caps and
are being properly maintained.
☐ In compliance ☐ Out of compliance
Remarks: ______________________________________________________________
Notarized signing and submittal of this Land Use Restrictions Update constitutes certification that the Notice of Brownfields Property remains recorded at the Vance County Register of
Deeds office and that the Land Use Restrictions are being complied with.
This Land Use Restrictions Update is certified by _____________, owner of at least part of the Brownfields Property on this ___ day of _________, 20__.
Name typed or printed of party making certification: __________________
[Note: additional entities or owners may be added if appropriate (i.e. multiple managing members/entities)]
By: __________________________ (signature)
Name typed or printed: __________________
Title typed or printed: ___________________
NORTH CAROLINA
__________ COUNTY
I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or she voluntarily signed the foregoing document for the purpose stated
therein and in the capacity indicated: ______________________.
Date: ____________ ___________________________________ Official Signature of Notary
____________________________________
Notary’s printed or typed name, Notary Public
(Official Seal) My commission expires: _________________