HomeMy WebLinkAboutNCC215562_FRO Submitted_20211007APPLICATION FOR PERMIT FOR A rile #
LAND DISTURBING ACTIVITY
Under the conditions set forth by LD Fee Review FCC
The New Hanover County
Soil Erosion and Sedimentation Control Ordinance
Dale Pd Date Pd
Engineering Dcpartnsent
Applicant or Applicant's Agent: Ralei h Wilmington Investors LLC
Mailing Address; 6131 Falls of Neuse Rd. Telephone Number: 919-277-1108 Fax Number:
Raleigh NC 27609 Entail Adciress:sbisliop a i•obticklion3es.coni
Total Acres of Land Disturbance: 49.I Ac Purpose of Development: Residential
Description of Land Disturbance: Grading for residential neighborhood
Address of Land Disturbance 7420 &7500 Masonboro Sound Road Latitude: N34"16'28" Longitude: W77°49101"
Land owner(s) of record:
Elizabeth Harris Macdonald, Thomas M Harriss,
Mary Harriss, Thomas M Harriss,
Name:
Address: 2305 Route 62 N
STATEMENT Or FINANCIAL RESPONSIBILITY
Person or firns(s) financially responsible for the
land disturbing activity. If not a North Carolina
resident, you MUST havea, N.C. agent. (List Below)
Name: Ralei h-Wilmin ton Investors LLC
Address: 6131 Falls of Neuse Road
City/State: Blanch, NC City/State: Raleigh NC
Zip Code: 27212 Zip Code: 27609
Telephone Number:
TelephoneNu nber: 919-277-1108
Email: Fax Number Email: Fax Number:
instrument(s): County: New Hanover Book: Page;
Location of deed(s) or
The above information is true and correct to the best of my knowledge. and belief and was provided by me while under oath.
(This form must be signet{ by the financially responsible person if an individual and by an officer, director, partner, attorney -in -
fact, or other person of authority to execute instruments for the financially responsible person if not an individual.) I agree to
provide corrected information should there be any change in the information provided herein.
Date: y�r u % 2 , Name Shelly Bishop Title
Signature
1, J,L' e . IVj,.1,"6-\ a Notary Public of the County of W•&&L State of
North Carolina, hereby certify that 51nr.1 jam! 4. 131-Ad-' appeared personally before me this day and
being duty sworn acknowledged that the abov lform was executed by him.
Witness m and and iota�y seal, this /6 day of NA , M 0
Notary _ `��� l i t 1 My commission expires I
VV SEAL ``�`�a` C AtO,p�i�,
�ll9t?d
4 Ud1.O� R
Permission to Esher on Land`oUg
L I C.
I certify that I am authorized to grairt�� dye. �fn` Rgegrant permissz the ErosronGCo\+�1'oI Inspector and his agents to enter on
the land in question in eomsection relater bli<ll s permit application. '�i'COUN 1I
u 'L.
Application Signature Ond Date u
PLEASE COMPLETE ALL PORTIONS OF APPLICATION