NCC230393_FRO Submitted_20230213

FINANCIAL RESPONSIBILITYIOWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
No person may initiate any land -disturbing activity on one or more acres as covered by the Act before this form
and an acceptable erosion and sedimentation control plan have been completed and approved by the Land
Quality Section, N.C. Department of Environmental Quality. Submit the completed form to the appropriate
Regional Office. (Please type or print and, if the question is not applicable or the e-mail address or phone
number is unavailable, place NIA in the blank.)
Part A.
1. project Name6010 MILL GROVE ROAD
2. Location of land -disturbing activity: County UNION city or Township INDIAN TRAIL
Highway/StreetMILL GROVE ROAD Latitudeidecimaidegrees)
35.105607 Long itude(decimaldegrees) 80,630981
3. Approximate date land -disturbing activity will commence: 12/14/2022
TEMPORARY MATERIAL STOCKPILE
4. Purpose of development (residential, commercial, industrial, institutional, etc.);
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 2.00
6. Amount of fee enclosed; $ 200.00 The application fee of $100.00 per acre (rounded
up to the next acre) is assessed without a ceiling amount (Example: 8.10-acre application fee is $900).
Checks should be addressed to NCDEQ.
7. Has an erosion and sediment control plan been filed? Yes ❑ Enclosed p No ❑
8. Person to contact should erasion and sediment control issues arise during land -disturbing activity:
Name KEVIN PRESSLEY E-mail Address [e-mail]
Phone: Office # Mobile # [phone]
9. Landowner(s) of Record (attach accompanied page to list additional owners):
PRESSLEY INVESTMENT HOLDINGS, LLC 704.400.5665
Name Phone: Office # Mobile #
7125 SECREST SHORTCUT ROAD 7125 SECREST SHORTCUT ROAD
Current Mailing Address Current Street Address
INDIAN TRAIL NC 28079 INDIAN TRAIL NC 28079
City State Zip City State Zip
10. Deed Book No. 8508 Page No. 392 Provide a copy of the most current deed.

Part B.
1. Company(ies) who are financially responsible for the land -disturbing activity (Provide a comprehensive list
of all responsible parties on accompanied page.) if the company is a sole proprietorship or if the landowner(s) is
an individual(s), the name(s) of the owner(s) may be listed as the financially responsible party(ies).
PRESSLEY INVESTMENT HOLDINGS, LLC
Company Name
7125 SECREST SHORTCUT ROAD
Current Mailing Address
INDIAN TRAIL NC 28079
MAYORPRESt7a AOL.COM
E-mail Address
7125 SECREST SHORTCUT ROAD
Current Street Address
INDIAN TRAIL NC 28079
City State Zip City State Zip
Phone: Office # Mobile # [phone]
Note: If the Financially Responsible Party is not the owner of the land to be disturbed, include with this form
the landowner's signed and dated written consent for the applicant to submit a draft erosion and sedimentation
control plan and to conduct the anticipated land disturbing activity.
2. (a) If the Financially Responsible Party is a domestic company registered on the NC Secretary of State
business registry, give name and street address of the Registered Agent:
KEVIN PRESSLEY
Name of Registered Agent
7125 SECREST SHORTCUT ROAD
Current Mailing Address
INDIAN TRAIL NC 28079
City
Phone: Office #
KEVIN PRESSLEY
[e-mail]
E-mail Address
7125 SECREST SHORTCUT ROAD
Current Street Address
INDIAN TRAIL NC 28079
State Zip City
Mobile # [phone]
Name of Individual to Contact (if Registered Agent is a company)
State Zip
(b) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina agent who is registered on the NC Secretary of State business registry:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office # Mobile #
Name of Individual to Contact (if Registered Agent is a company)

(c) If the Financially Responsible Party is engaging in business under an assumed name, give name under
which the company is Doing Business As. If the Financially Responsible Party is an individual, General
Partnership, or other company not registered and doing business under an assumed name, attach a copy
of the Certificate of Assumed Name.
Company DBA Name
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(s)
or his attorney -in -fact, or if not an individual, by an officer, director, partner, or registered agent with
the authority to execute instruments for the Financially Responsible Party). I agree to provide
corrected information should there be any change in the information provided herein.
Kevin Pressley
Type o,pr-i na :e
Signature
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Owner
Title or Authority
1,2
Date
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I, 66Z-SLE4- +:. , h�d�r , a Notary Public of the County of Li )�LCM% _
State of North Carolina, hereby certify that t)j'1y% �V p 55 1t`I appeared personally
before me this day and being duly sworn ackno ledged that the above fQdm was executed by him/her.
Witness my hand and notarial seal, this 1-3 V�—day of
ELIZABETH SNYDER — �'. - A'. -A.' —416m4LA.
NOTARY PUBLIC No a6 I I
UNION Cou' ity,lNorth Carolina
My Commission Expires 041118/2027 My commission expires