NCC232347_FRO Submitted_20230804

nrr ItAN-11 ENGINEERING DEPARTMENT
(lolly 128 South Main Street - PO Box 8 Holly Springs, NC 27540
'ipriixl� [phone]• FAX [phone] aK
1.r{lfrl` 1
Application for Construction Drawing Plan Approval, Erosion & Sedimentation Control Plan Approval, NPDES Stormwater
Review, Land Disturbance Permit Issuance, and Statement of Ownership and Financial Responsibility:
(Check All That Apply)
0 Construction Drawing Plan Review Fill Erosion & Sedimentation NPDES Stormwater Review
Control Plan Review
1. Project Name, Project ID, and Phase: Regency Subdivision Phase: Amenity
2. Description of Construction/Land Disturbance:
Construction of Amenity site(pool,clubhouse,rec courts,maO kiosk,etc.)along with the associated parking lot,utilities.&other supporting infrastructure
3. Landowner(s) of Record: (Use additional pages if necessary and attach to application)
Toll Southeast LP Company, Inc
Name Name
1140 Virginia Drive
Address Address
Fort Washington, PA 19034-3204
City, State, Zip City, State, Zip
919.321 .4800
Telephone Fax Telephone Fax
Mobile Phone Email Address Mobile Phone Email Address
4. Future Landowner(s), If Applicable: (Use additional pages if necessary and attach to application)
Name Name
Address Address
City, State, Zip City, State, Zip
Telephone Fax Telephone Fax
Mobile Phone Email Address Mobile Phone Email Address
5. List Book& Page where Deed or Instrument is Filed in Wake County:
Location Description: South side of Holly Springs New Hill Road
Parcel Identification Number(PIN): 0639-31-1837 Tax Map. Block, and Lot Number:
Book: 018556 Page: 00422 Book: Page:
6. Person(s) or Firm(s) Financially Responsible for Land-Disturbing Activity
Toll Southeast LP Company, Inc local mailing address
!Name Name
1140 Virginia Drive 900 Perimeter Park Drive, Suite B3
Address Address
Fort Washington, PA 19034-3204 Morrisville, NC 27560
City, State, Zip City, State, Zip
919.321 .4800
Telephone- Fax Telephone Fax
704.430.9392 drossi@tollbrothers,com
Mobile Phone Email Address Mobile Phone Email Address
9001
5/2/14
7

Application for Construction Drawing Plan Approval, Erosion&Sedimentation Control Plan Approval, NPDES
Stormwater Review, Land Disturbance Permit Issuance, and Statement of Ownership and Financial Responsibility.
7. Registered Agent, if any,for Person(s)or Firm(s)Financially Responsible:
(NOTE: A North Carolina agent Is required if the applicant is not a resident of North Carolina,)
United Agent Group, Inc
Name Telephone Fax
15720 Brixham Hill Avenue, #300
Address Mobile Phone
Charlotte, NC 28277
City,State,Zip Email Address
8. Plans Prepared By:
McAdams/Jeremy Finch, PE 919-361-5000
Name of Firm/Person Telephone Fax
2905 Meridian Parkway 919-624-3672
Address Mobile Phone
Durham, NC 27713 [e-mail]
City,State,Zip Email Address
9. Site/Project Information:
Total Size of Tract: 119.50 acres Area Disturbed: 4.25 acres ft2
Length of Sidewalk: 852 linear feet Length of Streets: 500 linear feet
Length of Water Line: 400 linear feet Length of Sewer Line: n/a linear feet
Length of Greenway: 1 ,709 (private Trail) Length of Stormwater: 516 linear feet
#Stormwater BMPs < 5 acres: 0 #Stormwater BMPs >5 acres: 0
Latitude: 35.652241 Longitude: -78-891482
FEMNFIRM Map#: 3720062800J panel#: 0628 Effective Date: May 2, 2006
Total Post Development Impervious Surface: Fe
10.Approximate Date Land Disturbance Will Begin: Summer 2022
11. Signature and ess: The above information is true and correct to the best of my knowledge and
belief and was_pkervided Oy me while under oath.
gnatur of Person Financially Responsible Type or Print Name Legibly
Title or Authority 1 Date
1, h 10 o tf le. /30&�'I e-i ' a Notary Public of the County of I�IJL , hereby certify
that LI)Q!! personally before me this day and under oath acknowledged that
this Application for Construction Drawing Plan Approval and Erosion&Sedimentation Control Plan ApprovatlLand
Disturbance Permit Statement of Ownership and Financial Responsibility was executed by him or her.
Witne hand and notarial seal, this 1 Q day of QI311_ 20 .
Signature of Notary Public My Commission Expires
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SEA +•+ti-1 R aotx I �, FOR OFFICE USE ONLY
Date Completeness Verified:
�� = Project Number: PN-
Fees Paid:
❑ Construction Drawing Review Fees
a1$L1G ``� ❑ Erosion & Sedimentation Control
Plan Review Fees
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