NCC231614_FRO Submitted_20230525

"WI WAKE COUNTY FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
WAKE
� No person may initiate any land-disturbing activity on one or more acres as covered by the Wake
County Unified Development Ordinance before this form and an acceptable erosion and
COUNTY sedimentation control plan have been completed and approved by Wake County Department of
N ,. �1 Environmental Services, Water Quality Division. (Please type or print and, if the question is not
applicable, place N/A in the blank.)
Part A.
1. Project Name Wilmington Courtyard
2. Location of land-disturbing activity: Jurisdiction Garner (Wake Co. or Municipality)
Highway/Street Wilmington Road Latitude 35°43'21.63"N Longitude 78°35'35.04"W
3. Approximate date land-disturbing activity will commence: May, 2023
4. Type of development(residential, commercial, industrial, institutional, etc.):Residential (Townhomes)
5. Total acreage disturbed or uncovered (including off-site utilities and borrow/waste
areas): 10.70 acres
6. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Jinsong Yang E-mail Address [e-mail]
Telephone [phone] Cell# N/A Fax# N/A
7. Landowner(s) of Record (attach accompanied page to list additional owners):
Wilmington Town LLC [e-mail]
Name(s) Telephone Fax or E-mail address
4030 Wake Forest Rd, Suite 349 4030 Wake Forest Rd, Suite 349
Current Mailing Address Current Street Address
Raleigh NC 27609 Raleigh NC 27609
City State Zip City State Zip
8. Deed Book No. 019223 Page No. 02225 Provide a copy of the most current deed.
Part B.
1. Person(s) or firm(s) who are financially responsible for the land-disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet. Include requested information):
McKinley Homes US, LLC [e-mail]
Name E-mail Address
655 Engineering Drive, Suite 208 655 Engineering Drive, Suite 208
Current Mailing Address Current Street Address
Peachtree Corners GA 30092 Peachtree Corners GA 30092
City State Zip City State Zip
Telephone [phone] Fax Number N/A

2. (a) If the Financially Responsible Party is not a resident of Wake County, identify a designated agent in
Wake County to receive any notice, process, pleading in any action or legal proceeding arising out of any
matter relating to the Wake County Erosion and Sedimentation Control Ordinance and/or Land
Disturbance Permit:
Jim Donahue [e-mail]
Name E-mail Address
5909 Falls of Neuse Rd, Suite 202 5909 Falls of Neuse Rd, Suite 202
Current Mailing Address Current Street Address
Raleigh NC 27609 Raleigh NC 27609
City State Zip City State Zip
Telephone [phone] Fax Number
(b) 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
Party is a Corporation, give name and street address of the Registered Agent:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone Fax Number
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
the 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.
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Type or print n e Title or Authority
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Si ature Date
I, -d(-' i O't J\Lb Notary Public of the County of eio) "vt-Q'-T
State of Nor#h—C , hereby certify that ��visofi Qnn appeared
personally before me this and being duly sworn acknowledges hat the above form was executed by him.
Witness my hand and notarial seal, th•is ��4 day of KID th• , 20 Z3
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Notary
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Z GEORGIA ; U' _ My commission expires ep. II
Sept.I,2024
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