NCC221639_FRO Submitted_20220427

Financial Responsibility Ownership
(Sedimentation Pollution Control Act)
This section to be com leted by City of Raleigh staff
Submittal Date Effective Date
Transaction Number Permit Number LD-
The remaining sections to be completed by the
ENGINEERING
SERVICES
One Exchange Plaza, Suite 304
Raleigh, NC 27601
SECTION 1: GENERAL INFORMATION 8, INSTRUCTIONS
This form is required to be completed, notarized and submitted with all Land Disturbing Permit applications. The
information provided herein becomes an enforceable part of the approved Erosion and Sediment Control Plan
and the Land Disturbing Permit listed above. Non-compliance may result in the assessment of civil penalties
and could potentially affect all permits, inspections and/or Certificates of Occupancy for this Project. Should any
of the information on this form change, a revised, executed form shall be submitted within thirty (30) days, said
submission shall include a copy of any documents recorded with the Register of Deeds.
The effective date of this form shall be the effective date as designated above by the City of Raleigh. No rights
and liabilities associated with any designation shall incur until the effective date, or the effective date of transfer
to any subsequent Party. Upon any delegation of an Applicant/Permittee or Financially Responsible Party, the
Owner shall continue to receive notice at the address provided.
A permit may not be transferred to a residential Home Owner's Association as the Applicant/Permittee or
Financially Responsible Party, until the issued Land Disturbing Permit for this project is administratively closed
by the Stormwater Management Division.
Raleigh City Code §14-1011 sets forth that it shall be unlawful and a violation of this code for any person to give
false information or misrepresentations in any application or permit required by this code. Failure to provide full
disclosure of the requested information may be grounds for denial or revocation of a Land Disturbing Permit.
Please complete all sections below. Type or print and, if information on the form is not applicable, place N/A in
the blank. All pages of this form must be completed and submitted or the form will be rejected and returned.
The property owner must initial each page of the form prior to submittal.
SECTION 2:
PROJECT INFORMATION
PROJECT NAME
Bridle R u n
PERMITTED PHASE(S)
PROJECT ADDRESS
Refer to sheet
6 of this document
COUNTY PARCEL ID
WAKE NUMBER(S)
Refer to page
6 of this document
ANTICIPATED DATE OF
PROJECT INITIATION
Spring n 2022
p g
EXPECTED DURATION OF
PROJECT
1 year
DISTURBED ACREAGE F LAND TO BE
8.96 ac
PROPERTY OWNER'S INITIALS: N Stornmater Inspections Form 112
08.01.16
Page I of 5

SECTION 3: PROPERTY OWNER INFORMATION
CND -Bridle Run LLC
PROPERTY OWNER OF RECORD
1901 N. Harrison Ave Suite 200 919.659.1500
MAILING ADDRESS (NO P.O. BOX)
Cary, NC 27513
CITY, STATE, ZIP
TELEPHONE NUMBER FAX NUMBER
[e-mail]
E-MAIL ADDRESS
The undersigned acknowledges that he is the Owner, or holds the Owner's power of attorney, of the property
which is the subject of this application, and further states that the permitted land -disturbing activities are
authorized to be conducted on the subject property with the full knowledge, permission and consent of the
Owner.
The undersigned acknowledges that he is the Property Owner for permit implementation, compliance and
enforcement resulting under this Land Disturbing Permit and Unified Development Ordinance, Article 9.4. The
Owner of the property upon which the land -disturbing activity is to be undertaken states and affirms that he has
read and understands the statements and disclosures made in this form and that the information disclosed
herein is true and correct to the best of his knowledge and belief.
This form must be signed by the Owner of the property or by a person with authority to execute instruments, if
the Owner is not an individual.
This, the 3y, day of MOK)H , 20d-J, .
t1r, %1. )__
PROPE&V 7 ER SIGNATURE
TITLE
IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this
3 day of AJF_0 rJ , 20 .
Notary Publ c (print name)
My Commission Expires:
PROPERTY OWNER'S INITIALS:
NRtoY Publ��ature
WgCCl" -Sty_-TLoLa l
Notary Public Title / Position
,�C ICY Cros�ii
No to,
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counil
Storrmrater Inspections Forn7112
08.23.16
Page 2 of 5

SECTION 4: OWNER'S APPOINTED AGENT INFORMATION
The Owner of the property upon which land -disturbing activities will be undertaken is required to either reside in
or appoint an agent for service with business and residence addresses within Wake County, North Carolina.
Section 4 must be completed if the Property Owner listed in Section 3 does not reside in Wake County,
North Carolina and is optional for all others.
The Owner of the subject property hereby appoints the following person as an agent to receive service of any
notice, process, or pleading in any action or legal proceeding arising out of any matter relating to Unified
Development Ordinance, Article 9.4. The Owner agrees that any notice, process, or pleading may be served by
and through the undersigned appointed agent and such service shall have the same force and effect as if
service was accomplished upon the Owner.
NAME
COMPANY, IF APPLICABLE
STREET ADDRESS (NO P.O. BOX)
CITY, STATE, ZIP
TITLE
TELEPHONE NUMBER
FAX NUMBER
E-MAIL ADDRESS
The undersigned acknowledges that he/she is the Owner's appointed agent.
This, the day of
APPOINTED AGENT SIGNATURE
20
TITLE
IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his/her hand and seal, this
day of , 20
Notary Public (print name)
My Commission Expires:
PROPERTY OWNER'S INITIALS:
Notary Public Signature
Notary Public Title / Position
(SEAL)
Stonmvater Inspections Form 112
08.23.16
Page 3 of 5

SECTION 5: FINANCIALLY RESPONSIBLE PARTY INFORMATION
The Owner of the subject property authorizes the following person or firm as the Financially Responsible Party
for this Land Disturbing Permit. The Financial Responsible Party shall receive service of any notice, process,
civil assessment or pleading in any action or legal proceeding arising out of any matter relating to the Land
Disturbing Permit issued under this permit application and Unified Development Ordinance, Article 9.4.
Eric Hamalainen Project Manager
FINANCIALLY RESPONSIBLE PARTY
Weekley Homes, LLC
COMPANY, IF APPLICABLE
TITLE
•3 7
r TELEPHONE NUMBER
1901 N. Harrison Ave Suite 200 `,919.659.1500
STREET ADDRESS (NO P.O. BOX) FAX NUMBER
Cary, NC 27513 [e-mail]
CITY, STATE, ZIP E-MAIL ADDRESS
The undersigned acknowledges that he is the Financially Responsible Party for permit implementation,
compliance and enforcement resulting under this Land Disturbing Permit and Unified Development Ordinance,
Article 9.4. He has read and understands the statements and disclosures made in this form, that the information
disclosed herein is true and correct to the best of his knowledge and belief.
This form must be signed by the person or firm financially responsible for the land developing activity or other
person with authority to execute instruments for the financially responsible party, if not an individual.
This, the day of 20" .
✓J �0�:;�i41 !''�ANhG�1�.
FINANCIALLY RESPONSIBLE PARTY SIGNATURE TITLE
IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this
3 2i° day of "MARC 120 .
--r7'<A,0,J 0KQS,2J k O-ISQA
Notary Public (print name) N tar PublEcjbrfature L
My Commission Expires: x�ZLLl rua e
Notary Public Title / Position
PROPERTY OWNER'S INITIALS: I✓ .! 'y
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Stornnvater Inspections Form 112
08.23.16
Page 4 of 5

SECTION 6: APPLICANT / PERMITTEE
The Owner of the subject property authorizes the following person or firm as the Applicant/Permittee to receive
service of any notice, process, civil assessment or pleading in any action or legal proceeding arising out of any
matter relating to the Land Disturbing Permit issued under this permit application and Raleigh Unified
Development Ordinance, Article 9.4. The Applicant/Permittee designated below is the person responsible for
implementation of permit conditions and violation under Article 9.4 of the Raleigh Unified Development
Ordinance.
The Applicant/Permittee may be the landowner or another party who acknowledges that he is the Contractor
responsible for completion of the project as approved.
Robin Caparell Project Coordinator
APPLICANT/PERMITTEE
Weekley Homes, LLC
TITLE
919.659.1505
COMPANY, IF APPLICABLE TELEPHONE NUMBER
1901 N. Harrison Ave Suite 200
STREET ADDRESS (NO P.O. BOX) FAX NUMBER
Cary, NC 27513 [e-mail]
CITY, STATE, ZIP E-MAIL ADDRESS
The undersigned acknowledges that he is the Applicant/Permittee for permit implementation, compliance and
enforcement resulting under the Land Disturbing Permit listed above and Unified Development Ordinance,
Article 9.4. He has read and understands the statements and disclosures made in this form and that the
information disclosed herein is true and correct to the best of his knowledge and belief.
This form must be signed by the person or firm responsible for the permit or by a person with authority to
execute instruments for the Applicant/Permittee, if not an individual.
This, the day of 20,W
i - , Tfa i eG C_onr j ii y4oc—
APPLI NT/P SIGNATURE TITLE
IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this
day of 120 , L.
J-Km'� A A 0A
Notary Public (print name) Nota Pub "i ature
My Commission Expires: Rbm--en—, 0:f90)2Dt P�
Notary Public Title / Position
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PROPERTY OWNER'S INITIALS: /8 ,30 2,3 CJ
Stornnrater Inspections Fornt 1 !2
,y `I 0823.16
Page 5 of 5
AgIpAAlAR�►��,`

Single Family Homes
Lot Number
PIN
Address
1
782474582
4528 Bridle Run Dr
2
782474582
4524 Bridle Run Dr
3
782475499
4520 Bridle Run Dr
4
782476457
4516 Bridle Run Dr
5
782477433
5616 Horsewalk Cir
6
782477433
5612 Horsewalk Cir
7
782477556
5608 Horsewalk Cir
8
782478621
5604 Horsewalk Cir
9
782479610
5600 Horsewalk Cir
10
782479479
5609 Horsewalk Cir
11
782479453
5613 Horsewalk Cir
12
782479318
5617 Horsewalk Cir
13
782570365
4416 Bridle Run Dr
14
782571325
4408 Bridle Run Dr
15
782571387
4404 Bridle Run Dr
16
782571435
5612 Brisk Gallop Way
17
782570590
5608 Brisk Gallop Way
18
782570565
5604 Brisk Gallop Way
19
782572640
5605 Brisk Gallop Way
20
782572575
5609 Brisk Gallop Way
21
782573500
5613 Brisk Gallop Way
22
782573411
4316 Bridle Run Dr
23
782573473
4312 Bridle Run Dr
24
782574434
4308 Bridle Run Dr
25
782575405
4304 Bridle Run Dr
26
782575217
4305 Bridle Run Dr
27
782574247
4309 Bridle Run Dr
28
782573285
4313 Bridle Run Dr
29
782573233
4317 Bridle Run Dr
30
782572271
4401 Bridle Run Dr
31
782572220
4405 Bridle Run Dr
32
782571168
4409 Bridle Run Dr
33
782571107
4413 Bridle Run Dr
34
782570139
4417 Bridle Run Dr
35
782479280
4421 Bridle Run Dr
36
782479222
4425 Bridle Run Dr
37
782478273
4429 Bridle Run Dr
38
782478215
4433 Bridle Run Dr
39
782477247
4505 Bridle Run Dr
40
782476298
4509 Bridle Run Dr
41
782476330
4513 Bridle Run Dr
42
782475381
4517 Bridle Run Dr
43
782475323
4521 Bridle Run Dr
44
782474374
4525 Bridle Run Dr