NCC231041_FRO Submitted_20230414

.°° Gaston County
Gaston Natural Resources Department
1303 Cherryville Highway, Dallas, NC 28034 Telephone: [phone]
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Soil Erosion & Sedimentation Control
7' Financial Responsibility/Ownership
Po.dA Ctl
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.
(Please type or print and, if question is not applicable, place N/A in blank)
PART A:
1. Project Name National Gypsum Mt. Holly, NC - Rail Unloading & Rock Crushing
2. Location of land-disturbing activity
City Mount Holly Highway/Street 1725 Drywall Drive
3. Approximate date land-disturbing activity will commence February 2023
4. Purpose of development (residential, commercial, industrial, etc.) Industrial
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas) 15.8
6. Amount of fee enclosed $
7. Soil Erosion & Sedimentation Plan Filed? Yes No
8. Landowner(s) of Record (Use blank page to list additional owners)
Gold Bond Building Products LLC,
C/0 NG Corporate LLC Legal Dept
Name Name
2001 Rexford Road
Mailing Address Mailing Address
Charlotte NC 28211
City State Zip City State Zip
704-365-7300
Telephone Number Telephone Number
9. Indicate Deed Book and Page where deed(s)or instrument(s) are recorded
Deed Book 5239 Page 1330
Deed Book 4207 Page 697
DUKE ENERGY/CRESCENT DUKE ENERGY/CRESCENT
10. Tax Map No. 220785 Block RES NLN 14 078 015 00 000 Lot No.RES NLN 14 078 015 00 000
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PART B:
1. Person(s) or firm(s)who are financially responsible for this land-disturbing activity
WBCM Construction Services, LLC
Name Name
300 East Joppa Rd, Suite 200
Mailing Address Mailing Address
Baltimore MD 21286
City State Zip City State Zip
410-512-4513
Telephone Number 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.
Registered Agents, Inc
Name
4030 Wake Forest Road, STE 349
Mailing Address Street Address
Raleigh NC 27609 919-400-4138
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.
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.
Michael N. Baker President
Type or Print Name Title or Authority
12/16/22
Signature Date
Maryland
I, Lisa Erdman , a Notary Public of the County of '8a Him OrC , State of North
Carolina, hereby certify that appeared personally before me this day
and being duly sworn acknowledged thap-r21M5Ve49rm was executed by him.
Wi es m hand and notarial seal, th.iie eI d+ ''J ,s ber, 2 022..
�:••. TA :-7 •• Oa• Oil d 0 2S
ota ;QSLgL Ry i M%Commission Expires
File: Financial Responsibility-Ownership Form.mw
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