NCC216246_FRO Submitted_20211109

;A IIII 1iMNlfl ENGINEERING DEPARTMENT
F olly 128 South Main Street - PO Box 8 Holly Springs, NC 27540
Springs [phone] • FAX [phone]
l llR I II C \I{U I I� 1
Application for Construction Drawing Plan Approval, Erosion & Sedimentation Control Plan Approval, NPDES Stormwater
Review, Land Disturbance Permit Issuance, and Statement of Ownership and Financial Responsibility:
(Check All That Apply)
0 Construction Drawing Plan Review © Erosion & Sedimentation ❑ NPDES Stormwater Review
Control Plan Review
1. Project Name, Project ID, and Phase: Friendship Development -Mass Grading phase:
2. Description of Construction/Land Disturbance:
Timbering and Mass grading of the roads and stream crossings associated with initial phase of Project Titan.
3. Landowner(s) of Record: (Use additional pages if necessary and attach to application)
Helix Ventures LLC, Cara Hylton
Name
3717 National Drive, Suite 209
Address
Raleigh, NC 27612
Name
Address
City, State, Zip City, State, Zip
919-371-6208
Telephone Fax Telephone Fax
[e-mail]
Mobile Phone Email Address Mobile Phone Email Address
4. Future Landowner(s), If Applicable: (Use additional pages if necessary and attach to application)
Name Name
Address Address
City, State, Zip City, State, Zip
Telephone Fax Telephone Fax
Mobile Phone Email Address Mobile Phone Email Address
5. List Book & Page where Deed or Instrument is Filed in Wake County:
Location Description: Property along Friendship Road
Parcel Identification Number (PIN): Multiple Parcels Tax Map, Block, and Lot Number:
Book: Page: Book: Page:
6. Person(s) or Firm(s) Financially Responsible for Land -Disturbing Activity
Trustwell Property Group
Name Name
3717 National Drive, Suite 209
Address Address
Raleigh, NC 27612
City, State, Zip City, State, Zip
919-371-6208
Telephone Fax
[e-mail]
Mobile Phone Email Address
9001
5/2/ l4
Telephone
Mobile Phone
Fax
Email Address

Application for Construction Drawing Plan Approval, Erosion & Sedimentation Control Plan Approval, NPDES
Stormwater Review, Land Disturbance Permit Issuance, and Statement of Ownership and Financial Responsibility:
7. Registered Agent, if any, for Person(s) or Firm(s) Financially Responsible:
(NOTE: A North Carolina agent is required if the applicant is not a resident of North Carolina.)
Name
Address
City, State, Zip
8. Plans Prepared By:
Timmons Group
Name of Firm/Person
5410 Trinity Rd, Suite 102
Address
Raleigh, NC 27607
City, State, Zip
9. Site/Project Information:
Total Size of Tract: 108
Length of Sidewalk: N/A
Length of Water Line. N/A
Length of Greenway: N/A
# Stormwater BMPs < 5 acres:
Latitude: N35.67358378
Telephone
Mobile Phone
919-866-4935
Telephone
Fax
Email Address
Fax
Mobile Phone
[e-mail]
Email Address
acres Area Disturbed: 44.5 acres ft 2
linear feet Length of Streets: N/A linear feet
linear feet Length of Sewer Line: N/A linear feet
Length of Stormwater: 560 linear feet
# Stormwater BMPs > 5 acres: 0
Longitude: W78.90390688
FEMA/FIRM Map #: 310103370368 37200121111 Panel #: Effective Date:
Total Post Development Impervious Surface: 0 Ft
10. Approximate Date Land Disturbance Will Begin:
11. Signature and Witness: The above information is true and correct to the best of my knowledge and
belief and was pr 'de: e w ' under oath. 41Y
Si nature 'Person i ciall Responsible Type or Print Nam
Title or Authority Date
1, t�,J A-Ti4cra &A a Notary Public of the County of (A) .4 , hereby certify
thatN personally before me this day and under oath acknowledged that
this ApplicatZfors uction Drawing Plan Approval and Erosion & Sedimentation Control Plan Approval/Land
Disturbanceement of wnershipan ancial Responsibili was executed by him or her.
Witness m otarial se I, this day of U^ 20.
JFtur y ubfic My Commission Expires
SE
CJ
9001
5/2/14
FOR OFFICE USE ONLY
Date Completeness Verified:
Project Number: PN-
Fees Paid:
❑ Construction Drawing Review Fees
❑ Erosion & Sedimentation Control
Plan Review Fees