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HomeMy WebLinkAboutNCC223525_FRO Submitted_20221012mg�
Gaston County
Gaston Natural Resources Department
1303 Cherryville Highway, Dallas, NC 28034 Telephone: 704-9224181
Soil Erosion & Sedimentation Control
14.
q Financial Responsibility/Ownership
No person may initiate any land -disturbing activity on one (1) or more acres of property in all portions of
Gaston County, except for that property within the city limits of the incorporated municipalities of Gaston
County who have not adopted the Gaston County Soil Erosion & Sedimentation Control Ordinance,
before this form and an acceptable Soil Erosion & Sedimentation Control Plan have been completed and
approved by the Gaston County Natural Resources Department's staff.
PART A: (Please type or print and, if question is not applicable, place NIA in blank)
1. Project Name Gateway Northwest Logistics Center
2. Location of land -disturbing activity
City —Gastonia Highway/Street Northwest Boulevard
3. Approximate date land -disturbing activity will commence September 1 2022
4. Purpose of development (residential, commercial, industrial, etc.) industrial
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas) 17.3 acres
6. Amount of fee enclosed $ 5,400.00
7, Soil Erosion & Sedimentation Plan Filed? Yes x No
E
9
10
Landowner(s) of Record (Use blank page to list additional owners)
P9 GCP GASTONIA LLC
Name
1 801 Fifth Avenue North
Mailing Address
Birmingham AL 35203
City State Zip
Telephone Number
N/A
Name
Mailing Address
City State Zip
Telephone Number
Indicate Deed Book and Page where deed(s) or instrument(s) are recorded
Deed Book 5326 Page 1702
Deed Book N ZA Page
Tax Map No. 201 884 Block N/A Lot No. _ N/A
Page l
PART B:
9. Person(s) or firm(s) who are financially responsible for this land -disturbing activity
Phelan -Bennett Development
Name
2626 Westheimer Drive, Ste 21 1
Mailing Address
Houston TX 77098
City State Zip
832-209-8152
Telephone Number
Justin Bennett
Name
ibennett@phelandevco.com
Mailing Address
713-502-2704
city
NSA State Zip
Telephone Number
2. If the Financially Responsible Party is not a resident of North Carolina, give name and street
address of a North Carolina agent.
P9/GCP Gastonia, LLC
Name
160 Mine Lake Ct., STE 200
Mailing Address Street Address
Raleigh NC 27615-6417
City State Zip Telephone Number
3. If the Financially Responsible Party is a Partnership or other person engaging in business under
an assumed name, attach a copy of the certificate of assumed name. If the Financially
Responsible Part is a Corporation give name and street address of the Registered Agent.
N A
Name
Mailing Address Street Address
City State Zip Telephone Number
4. The above information is true and correct to the best of my knowledge and belief and was
provided by me under oath. (This form must be signed by the financially responsible person if an
individual or his attorney -in -fact, or, if not an individual, by an officer, director, partner, or
registered agent with authority to execute instruments for the financially responsible person). I
agree to provide corrected information should there be any change in the information provided
herein.
S t� E . eAl)NE
Type or Print Name
Sign re
mew
Title or Authohty
ifl I Z 1 Z 2-Z
Date
1, tAu 7PeA i` a Notary Public of the County of i-4A9_V,S State of Ales �
CScekrra, hereby certify that , C�xa,ti1i-11 appeared personally before me this day
and being duly sworn acknowledged that the above form was executed by him.
Witness my hand and notarial seal, this _1day of -V NIL 2—,2
Notary SEAL My Commission Expires
File: Financial Responsibility -Ownership Form.mw
01MY
LSAUREN V BENNET)
Notary PublicSTATE= OF TEXASComm, Ex . Oct, d, 2023
Page 2