NCC212078_NOI Signed Certification_20210412

NCG01 Notice of Intent (NOI) Certification Form
Directions:
Print this form, complete, scan and upload to the electronic NOI.
Then, mail the original form to the NC DEMLR Stormwater Program (with $100 check if paying by check) at:
Division of Energy, Mineral & Land Resources Stormwater Program
512 N. Salisbury Street, 6th Floor (Office 640K)
1612 Mail Service Center
Raleigh, NC 27699-1612
DO NOT MAIL THIS FORM OR PAYMENT
UNTIL YOUR APPLICATION HAS BEEN REVIEWED AND ACCEPTED AS COMPLETE
Per NC General Statute 143-215.68 (i), any person who knowingly makes any false statement, representation, or
certification in any application, record, report, plan, or other document filed or required to be maintained under this
Article or a rule implementing this Article ... shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed ten thousand dollars ($10,000).
Under penalty of law, I certify that (check all boxes to indicate your agreement):
V I am the person responsible for the construction activities of this project, for satisfying the requirements of this
permit, and for any civil or criminal penalties incurred due to violations of this permit.
5 The information submitted in this NOI is, to the best of my knowledge and belief, true, accurate, and complete
based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
�gathering the information.
5 / 1 will abide by all conditions of the NCG010000 General Permit and the approved Erosion and Sediment Control
Plan.
If the approved Erosion and Sediment Control Plan is not compliant with Part II (Stormwater Pollution
Prevention Plan) of the NCG010000 General Permit, I will nonetheless ensure that all conditions of Part II of the
permit are met on the project at all times.
NK I hereby request coverage under the NCG010000 General Permit and understand that coverage under this
permit will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
Name of Project (must match Ala): The Preserve at Kipling Creek
Specific Lot Numbers (must match Alb): 117 Lots
Legally Responsible Organizational Entity (must match 81): Garden Street Communities Southeast, LLC
Legally Responsible Person (must match 82 & 83): Zach Daugherty
Title of Legally Responsible Person (must match 83b): Development Manager
Name & Title of Signed if Authorized Individual
Differs from Legally Responsible Person:
Phone Number;_ 91
ure of
or Authorized Individual
3- ZZ- -o -Li
Date
��—� -
IMPORTANT NOTE: This forte. �.be signed by a responsible corporate officer that owns or operates the construction activity,
such as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part 1V, Section B,
Item (6) of the NCG010000 permit.

NORTH CAROLINA
Department of the Secretary of State
To all whom these presents shall come, Greetings:
I, ELAINE F. MARSHALL, Secretary of State of the State of North Carolina, do hereby
certify the following and hereto attached to be a true copy of
APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY
OF
GARDEN STREET COMMUNITIES SOUTHEAST, LLC
the original of which was filed in this office on the 31 st day of March, 2021.
DEPARTiy
"PIN 20. 17)' F
Ty
10
6� RVol, 076
0 12.
OUAM ^�+ Scan to verify online.
SF � D
IN WITNESS WHEREOF, I have hereunto set my
hand and affixed my official seal at the City of
Raleigh, this 31st day of March, 2021.
Certification# C202106200509-1 Reference# C202106200509-1 Page: 1 of 3 Secretary Of State
Verify this certificate online at https://www.sosnc.gov/verification

SOSID: 1748380
Date Filed: 3/31/2021 10:40:00 AM
State of North Carolina Elaine F. Marshall
Department of the Secretary of State North Carolina Secretary of State
C2021 062 00509
APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY
FOR LIMITED LIABILITY COMPANY
Pursuant to §57D-7-04 of the General Statutes of North Carolina, the undersigned limited liability company hereby applies for an
Amended Certificate of Authority to transact business in the State of North Carolina, and for that purpose submits the following
statement.
Name of Limited Liability Company
a. The name of the limited liability company exactly as it appears on the Certificate of Authority currently on file with the
North Carolina Department of the Secretary of State:
ESPLANADE COMMUNITIES OF FLORIDA, LLC
b. The fictitious name, if any, of the limited liability company currently on file with the NC Department of the Secretary of
State is:
N/A
The state or country of formation is: F L O R I DA, USA
3. The date the limited liability company was authorized to transact business in the State of North Carolina is: 09/07/2018
4. The changes being made are as follows: (See instructions for the speck uses of this document.)
The company hereby adopts the following amendment changing the name of the company
identified as SOS ID1748380 to Garden Street Communities Southeast, LLC.
5. Attached is a certificate of existence (or document of similar import), duly authenticated by the Secretary of State or other official
having custody of limited liability company records in the state or country of formation. The certificate of existence must be less
than six months old. A photocopy of the certification cannot be accepted.
6. This application will be effective upon filing, unless a date and/or time is specified:
This the 24 day of March , 20 21
Notes:
1. Filing fee is $50. This application must be filed with the Secretary of State.
BUSINESS REGISTRATION DIVISION
(Revised July 2017)
Esplanade Communites of Florida, LLC
Name of Limited Liability Company
Signa e
William Bryan Adams, Manager
P. O. BOX 29622
Type or Print Name and Title
RALEIGH, NC 27626-0622
(Form L-10)
Certification# C202106200509-1 Reference# C202106200509- Page: 2 of 3

State qf Florida
Department of State
I certify from the records of this office that GARDEN STREET
COMMUNITIES SOUTHEAST, LLC is a limited liability company organized
under the laws of the State of Florida, filed on September 21, 2016.
The document number of this limited liability company is L 16000176904.
I further certify that said limited liability company has paid all fees due this
office through December 31, 2020, that its most recent annual report was filed
on January 14, 2020, and that its status is active.
Given under my hand and the
Great Seal of the State of Florida
at Tallahassee, the Capital, this
the Twenty-fourth day of March,
2021
*Wleyole—
Secretary of 'State
Tracking Number: 7788961069CU
To authenticate this certificate,visit the following site,enter this number, and then
follow the instructions displayed.
h ttps: //services. su n biz.org/Filings/Certifica teOfStatu sICertifica teAuthen tication
n# C202106200509-1 Reference# C202106200509- Page: 3 of 3