Loading...
HomeMy WebLinkAboutNCC215892_FRO Submitted_20211022Kvti-� 3 t a Z� rnu%Eo LND 1� Zo-60ogd APPLICATION FOR PERMIT FOR A n 3/A7 *25605 File k__&35 LAND DISTURBING ACTIVITY G Under the conditions set forth by XS8 LD Fee .4 Review Fee The New Hanover County Soil Erosion and Sedimentation Control Ordinance j25 mate Pu Jute Pd 1. � Engineering Department 't L Applicant or Applicant's Agent: Libby Shelton Mailing Address: 131 Racine Drive, Suite 201 wo : 2_5 R,3 Telephone Number: 843-709-0752 Fax Number: Wilmington, NC 28403 10 Email Address: LShelton@DRHorton.com Total Acres of Land Disturbance: 86 Purpose of Development: Residential Description of Land Disturbance: 258 residential lot subdivision and amenity center as part of Sidbury Farms development Address of Land Disturbance 6010 & 6220 Sidbury Road Land owner(s) of record: Name: John Rudolph, RMP Sidbury Road, LLC Address: 1401 Central Avenue, Suite 200-D City/State: Charlotte, NC Zip Code. 28205-5366 Telephone Number: 704-372-8000 Email: JRudolph57@gmail.com FaxNumber Latitude: 34.33 (34° 19' 45.876" N) Longitude: -77.115 (77° 51' 2.304" W) STATEMENT OF FINANCIAL RESPONSIBILITY Person or firm(s) financially responsible for the land disturbing activity. If not a North Carolina resident, you MUST have a N.C. agent. (List Belo Name: Libby Shelton c Address: 131 Racine Drive, Suite 20i _ City/State: Wilmington, NC Zip Code: 28403 Telephone Number: 843-709-0752 Email: LShelton@DRHorton.com FaxNumber: Location of deed(s) or instrument(s): County: New Hanover _ Book: 15, 20 Page: 89, 27 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 signed 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: _ f a Name . LV. N u _ Title 'SA* Signature -r I, l hrj a Notary Public of the County of r. u 4 AL;t Vr K State of North Carolina, hereby certify that c. H o!J appeared personally before me this day and being duly sworn acknowledged that the above form was executed by him. Witness my han-1 not seal, this Ti4 day of . Vf— i _ , 20c�a Notary My commission expires _ (r?S /17l���� _ N Y s U Z PUBUG �: Permissio Enter on Lan �,_ I certify that �Z rant and do in fact grant permission to the Erosion CoWA& Inspe l4r„�1[ldai ter on the land in questiol ii��iection related to this permit application. I (t L -�JV7 Application Signature and Date PLEASE COMPLETE ALL PORTIONS OF APPLI "ATION I�.' IYL#_T1I1t4