NCC221669_FRO Submitted_20220429

APPLICATION FOR PERMIT FOR A File 4-
LAND DISTURBING ACTIVITY
Under the conditions set forth by LD Fee Review Fee
The New Hanover County
Soil Erosion and Sedimentation Control Ordinance
Date Pd Date Pd
Engineering Department
Applicant or Applicant's Agent. BRC Wrightsboro Commons, LLC
Mailing Address: 5826 Samet Drive, Suite 105 Telephone Number: _Fax Number: _ 910-791-6760 High Point, NC
27265 Email Address:
tclinkscale kparamounte-eng.com Total Acres of Land Disturbance: 12.60 Purpose of Development:
Residential Development Description of Land Disturbance: Grading and Drainage for Mixed
Use Development
Address of Land Disturbance: 2539 Castle Ha ne Road Latitude: 34'09' 34"N Longitude. 77°53' 28"W
STATEMENT OF FINANCIAL RESPONSIBILITY
Land owner(s) of record: 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 Below)
Name: BRC Wrightsboro Commons;, LLC Name: BRC Wrightsboro Commons, LLC
Address: 5826 Samet Drive Suite 105 Address: 5826 Samet Drive, Suite 105
City/State: High Point NC City/State: High Point NC
Zip Code: 27265 Zip Code: 27265
Telephone Number: 336 889-1546 Telephone Number: [phone] Email: Fax Number 336-
889-1501 Email: [e-mail] Fax Number: same
Location of deed(s) or instrument(s): County: New Hanover County_Book: 6270 Paize 1088
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.
j!nP---Z—
I, M S 1 U SU-►' d,&e -` -h a Notary Public of the County of Fur6c k State of
North Carolina, hereby certify that -Fh0ff)Q15 personally before me this day and
being duly sworn acknowledged that the above form was executed by him.
Witness rA hand and not�ry seal, this +`'' �'11WIP+`' _Q� NoVCmbea' 12021
Notary
SEAL
commission expires Su.. 4 13. 2Q2Ip
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I certify that 1 am authorized to grant anii'"am+fttLi grant permission to the Erosion Control Inspector and his agents to enter on
uestion in connection related to this permit application.
Application Signature

STATE OF NORTH CAROLINA
ROUTE Castle Hayne Road PROJECT Wrightsboro COUNTY OF New Hanover
Commons
Apartments Phase 1
DEPARTMENT OF TRANSPORTATION
-AND-
BRC Wrightsboro Commons, LLC
5826 Samet Drive, Suite 105
High Point, NC 27265
-AND-
THREE PARTY RIGHT OF WAY
ENCROACHMENT AGREEMENT ON
PRIMARY AND SECONDARY SYSTEM
Cape Fear Public Utility Authority
Jeff Theberge, PE Engineering Manager
THIS AGREEMENT, made and entered into this the day of 120 by and between the Department
of Transportation, party of the first part; and BRC Wrightsboro Commons, LLC
party of the second part; and Cape Fear Public Utility Authority
party of the third part,
W I T N E S S E T H
THAT WHEREAS, the party of the second part desires to encroach on the right of way of the public road designated as
Route(s) Castle Hayne Road
Castle Hayne Road and Riverside Drive
, located
0.1 miles South from the intersection of
with the construction and/or erection of: 82 LF of 8-inch PVC Carrier Pipe across Castle Hayne Road by directional drill.
WHEREAS, it is to the material advantage of the party of the second part to effect this encroachment, and the party of
the first part in the exercise of authority conferred upon it by statute, is willing to permit the encroachment within the limits of the
right of way as indicated, subject to the conditions of this agreement;
NOW, THEREFORE, IT IS AGREED that the party of the first part hereby grants to the party of the second part the right
and privilege to make this encroachment as shown on attached plan sheets), specifications and special provisions which are
made a part hereof upon the following conditions, to wit:
That the installation, operation, and maintenance of the above described facility will be accomplished in accordance with the party of
the first part's latest POLICIES AND PROCEDURES FOR ACCOMMODATING UTILITIES ON HIGHWAY RIGHTS -OF -WAY, and such
revisions and amendments thereto as may be in effect at the date of this agreement. Information as to these policies and procedures
may be obtained from the Division Engineer or State Utility Agent of the party of the first part.
That the said party of the second part binds and obligates himself to install and maintain the encroaching facility in such safe and proper
condition that it will not interfere with or endanger travel upon said highway, nor obstruct nor interfere with the proper maintenance
thereof, to reimburse the party of the first part for the cost incurred for any repairs or maintenance to its roadways and structures
necessary due to installation and existence of the facilities of the party of the second part, and if at any time the party of the first part shall
require the removal of or changes in the location of the said facilities, that the said party of the second part binds himself, his successors
and assigns, to promptly remove or alter the said facilities, in order to conform to the said requirement, without any cost to the party of the
first part.
That the party of the second part agrees to provide during construction and any subsequent maintenance proper signs, signal lights,
flagmen and other warning devices for the protection of traffic in conformance with the latest Manual on Uniform Traffic Control Devices
for Streets and HighwaVs and Amendments or Supplements thereto. Information as to the above rules and regulations may be obtained
from the Division Engineer of the party of the first.
That the party of the second part hereby agrees to indemnify and save harmless the party of the first part from all damages and
claims for damage that may arise by reason of the installation and maintenance of this encroachment.
That the party of the second part agrees to restore all areas disturbed during installation and maintenance to the satisfaction of the
Division Engineer of the party of the first part. The party of the second part agrees to exercise every reasonable precaution during
construction and maintenance to prevent eroding of soil; silting or pollution of rivers, streams, lakes, reservoirs, other water
impoundments, ground surfaces or other property; or pollution of the air. There shall be compliance with applicable rules and regulations
of the North Carolina Division of Environmental Management, North Carolina Sedimentation Control Commission, and with ordinances
and regulations of various counties, municipalities and other official agencies relating to pollution prevention and control. When any
installation or maintenance operation disturbs the ground surface and existing ground cover, the party of the second part agrees to
remove and replace the sod or otherwise reestablish the grass cover to meet the satisfaction of the Division Engineer of the party of the
first part.
That the party of the second part agrees to assume the actual cost of any inspection of the work considered to be necessary by the
Division Engineer of the party of the first part.
That the party of the second part agrees to have available at the construction site, at all times during construction, a copy of this
agreement showing evidence of approval by the party of the first part. The party of the first part reserves the right to stop all work unless
evidence of approval can be shown.
Provided the work contained in this agreement is being performed on a completed highway open to traffic; the party of the second part
agrees to give written notice to the Division Engineer of the party of the first part when all work contained herein has been completed.
Unless specifically requested by the party of the first part, written notice of completion of work on highway projects under construction will
not be required.
That in the case of noncompliance with the terms of this agreement by the party of the second part, the party of the first part reserves
the right to stop all work until the facility has been brought into compliance or removed from the right of way at no cost to the party of the
first part.
FORM RAN 16.6
Rev. July 1, 1977

That it is agreed by both parties that this agreement shall become void if actual construction of the work contemplated herein is not
begun within one (1) year from the date of authorization by the party of the first part unless written waiver is secured by the party of the
second part from the party of the first part.
During the performance of this contract, the second party, for itself, its assignees and successors in interest (hereinafter referred to as
the "contractor'), agrees as follows:
a. Compliance with Regulations: The contractor shall comply with the Regulations relative to nondiscrimination in Federally -
assisted programs of the U. S. Department of Transportation, Title 49, Code of Federal Regulations, Part 21, as they may be
amended from time to time, (hereinafter referred to as the Regulations), which are herein incorporated by reference and
made a part of this contract.
b. Nondiscrimination: The contractor, with regard to the work performed by it during the contract, shall not discriminate on the
grounds of race, color, or national origin in the selection and retention of subcontractors, including procurements of materials
and leases of equipment. The contractor shall not participate either directly or indirectly in the discrimination prohibited by
Section 21.5 of the Regulations, including employment practices when the contract covers a program set forth in Appendix B
of the Regulations.
c. Solicitations for Subcontracts including Procurements of Materials and Equipment: In all solicitations either by competitive
bidding or negotiation made by the contractor for work to be performed under a subcontract, including procurements of
materials or leases of equipment, each potential subcontractor or supplier shall be notified by the contractor of the
contractor's obligations under this contract and the Regulations relative to nondiscrimination on the grounds of race, color, or
national origin.
d. Information and Reports: The contractor shall provide all information and reports required by the Regulations, or directives
issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its
facilities as may be determined by the Department of Transportation or the Federal Highway Administration to be pertinent
to ascertain compliance with such Regulations or directives. Where any information required of a contractor is in the
exclusive possession of another who fails or refuses to furnish this information, the contractor shall so certify to the
Department of Transportation, or the Federal Highway Administration as appropriate, and shall set forth what efforts it has
made to obtain the information.
e. Sanctions for Noncompliance: In the event of the contractor's noncompliance with the nondiscrimination provisions of this
contract, the Department of Transportation shall impose such contract sanctions as it or the Federal Highway Administration
may determine to be appropriate, including, but not limited to,
(1) withholding of payments to the contractor under the contract until the contractor complies, and/or
(2) cancellation, termination or suspension of the contract, in whole or in part.
Incorporation of Provisions: The contractor shall include the provisions of paragraphs "a" through 'T' in every subcontract,
including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued
pursuant thereto. The contractor shall take such action with respect to any subcontract or procurement as the Department
of Transportation or the Federal Highway Administration may direct as a means of enforcing such provisions including
sanctions for noncompliance: Provided, however, that, in the event a contractor becomes involved in, or is threatened with,
litigation with a subcontractor or supplier as a result of such direction, the contractor may request the Department of
Transportation to enter into such litigation to protect the interests of the State, and, in addition, the contractor may request
the United States to enter into such litigation to protect the interests of the United States.
That when title to the subject that constitutes the aforesaid encroachment passes from the party of the second part
and vests in the party of the third part, the party of the third part agrees to assume all responsibilities and rights and to
perform all obligations as agreed to herein by the party of the second part.
R/W (166) : Parry of the Second Part certifies that this agreement is true and accurate copy of the form
R/W (166) incorporating all revisions to date.
IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the day and
year first above written.
DEPARTMENT OF TRANSPORTATION
BY:
DIVISION ENGINEER
WITNESS:
1
BRC Wrightsb2X�— -Iaz—
oro Commons, LLC
WITNESS:
5826 Samet Drive, Suite 105
High Point, NC 27265
336-889-1546
Second Party
Cape Fear Public Utility Authority
Jeff Theberge, PE Engineering Manager
235 Government Center Dr.
Wilmington, NC 28403
[phone]
Third Party