NCC215178_FRO Submitted_20210915

Gaston County
Gaston Natural Resources Department
1303 Cherryville Highway, Dallas, NC 28034 Telephone: [phone]
Soil Erosion & Sedimentation Control
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Financial Responsibility/Ownership
No person may initiate any land -disturbing activity on one (1) or more acres of property in all portions of
Gaston County, except for that property within the city limits of the incorporated municipalities of Gaston
County who have not adopted the Gaston County Soil Erosion & Sedimentation Control Ordinance,
before this form and an acceptable Soil Erosion & Sedimentation Control Plan have been completed and
approved by the Gaston County Natural Resources Department's staff.
(Please type or print and, if question is not applicable, place NIA in blank)
PART A:
Project Name EDA Holdings Storage Facility
2. Location of land -disturbing activity
City Gastonia NC Highway/Street Union Road (Hwy 274)
3. Approximate date land -disturbing activity will commence Feburary 2021
4. Purpose of development (residential, commercial, industrial, etc.)
5.
6.
7.
8.
a
10.
Commercial
Total acreage disturbed or uncovered (including off -site borrow and waste areas) 3.53 Ac
Amount of fee enclosed $ 1400.00
Soil Erosion & Sedimentation Plan Filed? Yes No X
Landowners) of Record (Use blank page to fist additional owners)
EDA Holdings, LLC
Name
608 East Second Ave
Mailing Address
Gastonia NC 28054
City State Zip
_(704) 865-3555
Telephone Number
Name
Mailing Address
City State Zip
Telephone Number
Indicate Deed Book and Page where deed(s) or instrument(s) are recorded
Deed Book 5112 Page 1802
Deed Book Page
Tax Map No. 192577, 192556. 192557, 192578 Block
Lot No,
Page I

PART B;
1, Person(s) or firm(s) who are financially responsible for this land -disturbing activity
Tony Duncan - EDA Holdings, LLC
Name
608 East Second Ave
Mailing Address
Gastonia NC 28054
City State Zip
[phone]
Telephone Number
Name
Mailing Address
City State Zip
Telephone Number
If the Financially Responsible Party is not a resident of North Carolina, give name and street
address OT a Nona Carolina agent.
NIA
Name
Mailing Address Street Address
City State Zip Telephone Number
3_ 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 Part is a Corporation give name and street address of the Registered Agent.
NIA
Name
Mailing Address Street Address
City State Zip Telephone Number
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 attomey-in-fact, or, if not an individual, by an officer, director, partner, or
registered agent with authority to execute instruments for the financially responsible person).
agree to provide corrected information should there be any change in the information provided
herein.
Tony Duncan Manager
Type or Print e Title or Authority
Siona ur Date
I, � C 'iC�lolEt-� a Nota Public of the County of ' lCn State of North
Carolina, hereby certify that nt j lit IC(Un appeared personally before me this day
and being duly sworn acknowledged that t e above form was executed by him.
Hess my h nd and notarial seal, this If) day of 2t .
Notary SEAL My C�ion Expires
File' Financial Responsibility -ownership FOnli.11lw
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