20061787 Ver 1_More Info Received_20061113

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RECEIVED
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II. Applicant Information
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I . Owner/Applicant Information ~ ~i ~ ~ ~" ~ ~ ~'
Name: Blue Ridge Companies
Mailing Address: Attn: Jim Grdich ~ ~ ~>,~~u
5826 Samet Drive
High Point, NC 27265
Telephone Number: 336.889.1512 Fax Number: 33b.889.150i
E-mail Address: j.grdich(c~blueridgecompanies.com
2. AgentlConsultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: Charles Johnston
Company Affiliation: Environmental Services Inc.
Mailing Address: 3661 Alamance Rd.
Burlington. NC 27215
Telephone Number: 336.570.3002 Fax Number: 336.570.9566
E-mail Address: cjohnston(a~esinc.cc
1. Name of project: The Reserve at Adams Farms
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 149470350093300002
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BLUE RIDGE DEVELOPMENT SERVICES LLC
PETTY CASH
5826 SameY Drive Suite 105
High Point NC 27265
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66-1621531
B(,Rt/A~NCH 04111
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WACHOVIA
Wachovia Bank, N.A.
wachovia.com
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