NCC190872_NOT Closeout Documents_20201130

Engineering Services Department
Terry Kuneff, P.E.
INTERIM DIRECTOR
NORTH CAROLINNS INTERNATIONAL CITY"'
November 19, 2020
Provider of Erosion Control Surety
CCT High Point, LLC
3825 Edwards Road
Suite 630
Cincinnati, OH 45203
Financially Responsible Party
CCT High Point, LLC
3825 Edwards Road
Suite 630
Cincinnati, OH 45203
RE: EROSION CONTROL SURETY RELEASE/RETURN
Project: Panera Bread Shell — High Point
Location: 1911 North Main Street, High Point, NC 27260
Land -Disturbing Permit # EN 19 0126 2268
Dear Sir or Madame:
Per your request, the Erosion Control Surety that was provided for the site at the Panera Bread Shell — High
Point located at/near 1911 North Main Street, High Point, NC 27260 is hereby released. The project is
completed and in compliance with the City of High Point Development Ordinance, Section 6.3.
A refund check from the City of High Point, in the amount of $2000, will be processed and sent to the CCT
High Point, LLC, provider of the surety, within the next two weeks.
In addition, the Land -Disturbing Permit will be closed out also.
Thank you for your efforts in controlling sedimentation.
Please call me if you have any questions or comments.
Sincerely,
§kE��
Engineering Services Department
[phone]

cc: File
Marianne Janiszewski, c/o Engineering Services, City of High Point, PO Box 230, High Point, NC 27261
(via email)
attachment: City of High Point Report of Collections Package Dated October 17, 2019

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CENTRAL BANK & TRUST C® 100 j
CCT HIGH. POINT, L C 73-14M21
3825 EDWARDS RD, SUITE 630
CINCINNATI, OH 45209
[phone] 8/22/2019
y.
City of High Point **2,000.00
Two Thousand and 00/100**�*�**�********************�
City.of High Point
_ 211 S. Hamilton
High Point, NC 27260
,o
Soil Erosion Surety Permit #E.N1901262268

CCT HIGH POINT, LLC 1005
City of Nigh Point 8/22/2019
Date Type Reference Original Amt. Balance Due Discount Payment
8/22/20.19 Bill Soil Erosion Surety 2,000.00 2,000.00 2,000.00
Check Amount. 2,000.00
Central Bank- Checki Soil .Erosion Surety -Permit #E.N190.1262268 2,000.0.0 ,

Engineering Services Department
Terry Kuneff, P.E.
INTERIM DIRECTOR
October 17, 2019
F19F
r =_'
NORTH CAROLINA'S INTERNATIONAL CITYTM
Marianne Janiszewski, Administrative Specialist II
Engineering Services
City of High Point
PO Box 230
High Point, NC 27261
RE: COLLECTIONS OF SURETY
Project: Panera Bread
Location: 1911 North Main Street, High Point, NC 27262
Violation Number: EN1900202268
Dear Mrs. Janiszewski:
Attached is Check Number 1005 issued to the City of High Point for the required Erosion
Control Surety for the above site. The amount of the check is $2000.00. Please forward the check
to the Finance Department.
Please call me if you have any questions or comments.
Sincerely,_
Scott E. Ford
Engineering Services Department
[phone]
cc: File
CCT High Point, LLC, 3828 Edwards Road, Suite 630, Cincinnati, Ohio 45209
attachment: Check Number 1005
City of High Point, P.O. Box 230, 211 South Hamilton Street, High Point, NC 27261 USA
Fax:[phone] Phone:[phone] TDD:336.883.8517

No person may initiate any land -disturbing activity on one or more acres as covered bytheAct before this
form and an acceptableenomion and sedimentation control plan have been completed and approved bythe
Lend C)ue|Ky Semtkzn, N.C. Department of Environment and Natural Resources, (Please type orprint and, if
the question is not applicable or the e-mail and/or fax information unavailable, place N/A in the blank.)
Part A.
1. Project Name paDen8Bread Shell - High Point, NC
2. Location ofland-disturbing activity: County Guilford City or Township t
H Main St Latitude 35980389 —Longitude 80021000
3\ Approximate date land -disturbing activity will commence: 06012019
4. Purpose ofdevelopment (msaidenbal.commercial, industrial, institutional, etc.): Commercial
S. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 1.5 acres
8. Amount offee enclosed: $ 130.00 . Theapplication fee cf $85.OUper acre (rounded
uphothe next acre) iaassessed without oceiling amount (Example: aQ-aoraapplication fee is $585).
7. Has anerosion and sediment control plan been filed? Yes X No Eno|oaed_______
D. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Doug Compton E-mail Address DC
, Telephone [phone] Cell # Fax# [phone]
Q. Landowner(s) of Record (attach accompanied page to list additional owners):
~ [|CTHigh Point, LLC 513,784.0010 513J84.7814
Name Telephone Fax Number
3825 Edwards Rd, Suite 830
Current Mailing Address Current Street Address
Cincinnati {)H 45209 '
City State Zip City State Zip
10. Deed Book No. Page No. Provide mcopy ofthe most current deed.
PaotB.
1. Person(s) who are financially responsible for the land -disturbing activity (Provide a
comprehensive list of all responsible parties onenattached nhae0:
CCT High Point, LLC bco
Name E-mail Address
3825 Edwards Roed, Suite83O SAK81E-
Current Mailing Address Current Street Address
Cincinnati [)H 45209

2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina Agent:
Cogency Global [e-mail]
Name E-mail Address
212 South Tyron Street, Suite 1000
Current Mailing Address
Current Street Address
Charlotte NC 28281
City
State Zip City
Telephone [phone]
Fax Number
State Zip
(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:
CCT High Point, LLC [e-mail]
Name of Registered Agent E-mail Address
3825 Edwards Road, Suite 620
Current Mailing Address Current Street Address
Cincinnati OH 45209
City State Zip city
Telephone [phone]
Fax Number
State Zip
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 flinancially Responsible Person). 1 agree to provide
corrected infQrmatio[L should there be any change in the;nf-rm on provided herein.
mi" U&
Type or name Title or Auth6rity
Signat7
Date
�WYK , a Notary Public of the County of
U
State of 040 ' hereby certify that DOJA�
appeared personally before me this day and being duly sworn--6cknowledged that the above form
was executed by him. -
Witness my hand and notarial seal, this day of 20
JOY JONES Notary U
NOTARY PUBLIC My commission expires .1-111 T z-
STATE OF OHIO
My Commission Expires
April 10, 2022