NCC232877_FRO Submitted_20230927

DURHAM JCN
COUNTY Durham City/County (Office Use Only)
Sedimentation and Erosion Control
IMFINANCIAL RESPONSIBILITY/OWNERSHIP FORM
O WITH LANDOWNER CONSENT FORM
1881 •
No person may initiate any land-disturbing activity covered by the Durham City-County Unified Development Ordinance before a
Land Disturbing Permit is issued by the Sedimentation and Erosion Control Office.Issuance of a Land Disturbing Permit does not
relieve the permittee of the obligation to obtain any other licenses, permits and approvals as may be required by Federal, State,
County or Municipal governments. This office must be notified in writing of any change to the information on this form.
PLEASE TYPE OR PRINT
1. Project name: Mason Farms Subdivision Extension: Yes or No
Preston Andrews Road and Wetrock Farm Way
2. Road location of land-disturbing activity:
Tax Map-Block-Parcel: See attached table PIN: See attached table
3. Square footage of land to be disturbed or uncovered: 19.97 acres(869,893 sf)
4. List below the landowner of record. Each landowner must complete Item 8.
If there are multiple owners,please list on a separate page):
II CRE SPV 1 LLC
Name
777 Yamato Road, Suite 300
Address
Boca Raton FL 33431
City State Zip
[phone] [phone] legal@n,avmltd.com
Telephone Fax Email
5. List the person or entity financially responsible for this land-disturbing activity: The financially responsible party shall
be (1) the developer or other person who has or holds themselves as having financial or operational control over the land-
disturbing activity and/or (2) the land owner or person in possession or control of the land when they have directly or
indirectly allowed the land-disturbing activity or have benefited from it and (3) the named party on the Land Disturbing
Permit.
III CRE SPV 1 LLC
Name
777 Yamato Road, Suite 300
Street Address
Boca Raton FL 33431
City State Zip
[phone] [phone] legal(2 avmltd.com
Telephone Fax Email
The Sedimentation and Pollution Control Act (Act) and the Durham City-County Unified Development Ordinance
(Ordinance)includes,but is not limited to,the following legal obligations of the financially responsible party:
• Maintain a set of approved sedimentation and erosion control plans,if required,on site.
• Display permit on site.
• Understand and implement any required plan,including the construction sequence and details.
• Inspect,maintain and repair sedimentation and erosion control measures,especially after rainfall events.
• Provided adequate ground cover or otherwise stabilize all areas that have not been actively graded within 21 calendar
days.
• Plan and conduct all land-disturbing activity so as to prevent off-site sedimentation.
201 E.Main St,5th Floor,Durham,N.C.27701•[phone]•Fax[phone]
www.co.durham.nc.uskeng

6. For business applicants,list below the North Carolina registered agent for the financially responsible entity:
Capitol Corporate Services, Inc.
Name
120 Penmarc Drive, Suite 118
Street Address
Raleigh NC 27603
City State Zip
[phone] [phone] regagent a capitalservices.com
Telephone Fax Email
7. The above information is true and correct to the best of my knowledge and belief and was provided by me while under oath. I
understand that the person or entity listed on Line 5 above will be: (1) the owner of the Land Disturbing Permit when issued;
(2)responsible for ensuring compliance with the Act and Ordinance;and,(3)will be the only person or entity with standing to
appeal any action taken or decision made by the Sedimentation and Erosion Control Office.
4/6/2023 Karen Hansen
Date Type or Print Name
[phone] [phone] General Conned
Telephone Fax Title or ithorit-
legal gavmltd.comt
Email Signature
*#***************************#******#*********************$************************************************************************
Business Applicant(Provide corporate resolution on signatory authority)
I, i- s—k1.L / CQ(_/Z1. a Notary Public of the County of Pr rL. •--1 [?Fr -e{-j-
State of 6IZ10 P hereby certify that Karen Hansen
personally came before me this day and acknowledged thatshe is Authorized Signatory
of III CRE SPV 1 LLC and acknowledged,on behalf of
,the due execution of the foregoing instrument.
Witness my hand and official seal,this (O day of ) 9P1t/ ,20 2--2
Notary Public taNtive9vA014M N AN/Mon „***
My commission expires )19"y �'/ ,20 .1•ZOb'ii;L+Yt 132114:1)(3 ;;� •t.•
LQ£194 00 A NOISSiI't1W0O A1Y '_,' '•• yz
***********************************tit*************************#****#********************************* ****** * '.4 ,.1'
Individual Applicant
I, ,a Notary Public of the County of - ,,.•.• tiASHLE YC
OURTNEY
;.! ,• A MY COMMISSION O 00 951397
State of hereby certify that
��� �Q} F.XPIItF.Q'May 24,2024
gto Bonded Dm Notary Pubic tMdarwiNers
personally appeared before me this date and under oath acknowledged that the above form was ekecuteu uy wend • ""
Witness my hand and official seal,this day of ,20
Notary Public
My commission expires 20
LAND DISTURBING PERMITS ARE NON-TRANSFERABLE

Provide a Notarized Item 8 for each landowner listed in Item 4.
8. Land Owner Consent. As a landowner,I provide my consent for land-disturbing activities to occur on the property listed in
Item 2 by the person or entity listed in Item 5.
4/6/2023 Karen Hansen
Date Type or Print Name
[phone] [phone] General Counsel
Telephone Fax T,itl r Authors
[e-mail]
Email Signa de
Business Landowner(Provide corporate resolution on signatory authority)
I, ,<f-t CL �`
A -- a Notary Public of the County of Pp9-J—I-1 J?E c9..}-r
State of �)_ . ID ' ,hereby certify that /-1 i./
personally came before me this day and acknowledged that he is 'f 7Z/7r ,�,(���77j1�
oftIf CRC' SPV 1 -24—c. and acknowledged,on behalf of // 7
,the due execution of the foregoing instrument.
Witness my hand and official seal,this (p day of fr9p IL_ ,20 a3
Notary Public ASM.EY COURTNEY
My commission expires 1`-1r=-\� ,20 f .sicimtk*i MYCpi Iq 0 00 051 4
11
'V A. EXPIRES:May 24,2024
************************************************************************************************* * ; ,..?, o'r lif�tFlilr i�9DYbtfidermitve
_A _ r - ► . S•
Individual Landowner
I, ,a Notary Public of the County of
State of ,hereby certify that
personally appeared before me this date and under oath acknowledged that the above form was executed by them.
Witness my hand and official seal,this day of ,20
Notary Public
My commission expires 20
SE-03 Rev.07/06

OB€ECT1D PARCEL 10 PIN OWNAM1 DEED_BOOK DEED_PAGE PLAT_BOOK PLAT PAGE SUBD_ID SITE ADORE
110140 188062 0836-04-01-1798 Ill CRE SPY 1 LLC 9244 404 201 44 376 5130 109 ORANGE FACTORY RD
114104 188142 0825.94.01-2780 III CRE SPV 1 LLC 9244 404 201 371 5130 7001 N R0080RO RD
114106 226837 0826-74-37-0508 III CRE SPV 1 LLC 9244 404 201 374 5130 17 LOCAL F000 iN
114108 226838 0826-74-17-4144 Ill CRE SPY 1 LLC 9244 _ 404 201 374 5130 14 LOCAL FOOD IN
114109 226836 0826-74-36.6961 III CRE SPV 1 LLC 9244 mm 404 201 374 5130 13 LOCAL FOOD LN
114110 226839 0826-74-19-2122 III CRE SPV 1 LLC 9244 404 201 374 5130 10 LOCAL FOOD LN
114112 226840 0826-75-10-4059 III CRE SPV 1 LLC 9244 404 201 374 5130 6 LOCAL F000 LN
114113 226835 0826.74-39-9908 III CRE SPV 1 LLC 9244 404 201 374 5130 9 LOCAL FOOD IN
114114 226841 0826-75.10-4954 ill CRE SPV 1 LLC 9244 404 201 374 5130 2 LOCAL FOOD LN
114116 226834 0826-75-41-1007 III CRE SPV 1 LLC 9244 404 201 374 5130 5 LOCAL FOOD IN
114118 226833 0826-75.32.8214 2 111 CRE SPV I LLC 9244 _ 404 201 374 5130 1 LOCAL FOOD IN
114119 226832 0826-75-52-3309 III CRE SPY 1 LLC 9244 404 201 373 5130 345 WETROCK FARM WAY
114120 226831 0826-75.62-6719 III CRE SPV 1 LIC 9244 404 201 373 5130 341 WETROCK FARM WAY
114121 226830 0826-75-73-3804 III CRE SPV 1 LLC 9244 404 201 379 5130 337 WETROCK FARM WAY
114122 226842 0826-75-23.1699 III CRE SPV 1 LLC 9244 404 201 373 5130 348 WETROCK FARM WAY
114125 226829 0826-75-74-7916 III CRE SPV 1 LIC 9244 404 201 373 5130 333 WETROCK FARM WAY
114126 226843 0826-75-24.8587 _ III CRE SPV 1 LLC 9244 404 201 373 5130 344 WETROCK FARM WAY
114129 226844 0826-75-35-8006 III CRE SPV 1 LLC 9244 _ 404 201 373 5130 340 WETROCK FARM WAY
114131 188124 0826.55-74-2961 III CRE SPV I LLC 9244 404 54 90 0 243 PRESTON ANDREWS RD
114132 226845 0826-75.45-8403 III CRE SPV 1 LLC 9244 404 201 373 5330 336 W61ROCK FARM WAY
114133 226846 0826-75.56-1398 III CRE SPV 1 LLC 9244 404 201 373 4 5330 332 WETROCK FARM WAY
114134 226854 0826.84-63-3263 III CRE SPV 1 LLC 9244 404 201 374 5130 ON ROXBORO ST
_ 114135 226815 0826.85-07-3615 III CRE SPV 1 LLC 9244 404 201 372 5130 - 120 PERMACULTURE PL
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114336 226816 0826-75-98-9032 III CRESPV 1 LLC 9244 404 201 372 5130 118 PERMACULTURE PL
114137 226853 0826.65.22-7139 III CRESPV 1 LLC 9244 404 201 374 5130 0 PRESTON ANDREWS RO
114138 226828 0826.75.78.9525 III CRESPV 1 LLC 9244 404 201 372 5130 313 WETROCK FARM WAY
114139 226817 0826.75.98.6404 III CRE SPV 1 LLC 9244 404 201 372 5130 116 PERMACULTURE PL
114140 226814 0826.85-18-3779 III CRESPV 1 LLC 9244 404 201 372 5130 119 PERMACULTURE PL
114141 226818 0826-75-98-3930 III CRESPV 1 LLC 9244 404 201 372 5330 114 PERMACULTURE PL
114142 226827 0826-75-79-8055 III CRE SPV 1 LLC 9244 404 201 372 5130 311 WETROCK FARM WAY
114143 226813 0826-85-19-0120 III CRE SPV 1 LLC 9244 404 201 372 5130 117 PERMACULTURE PL
114144 226819 0826-75.99-1339 III CRE SPV 1 LLC 9244 404 201 372 5130 112 PERMACULTURE PL
114145 226826 0826.75.79-7574 III CRE SPV 1 LLC 9244 404 201 372 5130 309 WETROCK FARM WAY
114146 226812 0826-85-09-7468 III CRE SPV 1 LLC 9244 404 201 372 5130 115 PERMACULTU RE PL
114147 226811 0826.85.09.5981 III CRE SPV 1 LLC 9244 404 201 372 5130 113 PERMACULTURE FL
114148 226820 0826.75.99.0921 III CRE SPV 1 LLC 9244 404 201 372 5130 110 PERMACULTURE FL
114149 226825 0826-76-70-6082 III CR0 SPY 1 LLC 9244 404 201 372 5130 307 WETROCK FARM WAY
114150 226821 0826.76.80-9451 III CRE SPY 1 LIC 9244 404 201 372 5130 108 PERMACULTURE PL
114151 226810 0826.86 00.5339 III CRC SPV 1 LLC 9244 404 201 372 5130 111 PERMACULTURE AL
114152 226824 0826-76-70-6540 III CRE SPV 1 LLC 9244 404 201 372 5130 305 WETROCK FARM WAY
114153 226823 0826-76-70-7905 III[RESIN 1 LLC 9244 404 201 372 5130 303 WET ROCK FARM WAY
114154 226850 0826-76-80-8942 III CRE SPV 1 LLC 9244 404 201 372 5130 106 PERMACULTURE PI
114155 226809 0825-86-00-4942 III CRE SPY 1 LLC 9244 404 201 372 5130 109 PERMACULTURE PL
114156 _ 226848 0826-74-73-6790 III CRE SPV 1 LLC 9244 404 201 374 5130 0 N ROXBORO ST
114157 226822 0826-76.71-8368 III CRE SPV 1 LLC 4 9244 404 201 372 5130 301 WETROCK FARM WAY
114158 226808 0826.86-01-1482 III CRE SPV 1 LLC 9244 404 201 V 372 5130 107 PERMACULTURE PL
114159 226807 0826-76-91-8824 III CRE SPV 1 LLC 9244 404 201 372 5130 105 PERMACULTURE PL
114160 226805 0826-76-82-2239 III CRE SPV 1 LLC 9244 404 201 371 _ 5130 223 WETROCK FARM WAY
114161 226806 0826-76-92-3128 III CAE SPY 1 LLC 9244 404 201 372 5130 103 PERMACULTURE PL
1_14162 226804 0826-76.82-3785 III CAE SPV 1 LLC 9244 404 201 371 5130 221 WETROCK FARM WAY
�114163 226803 0826-76-83.5189 ill CRE SPV 1 LLC 9244 404 201 371 5130 219 WETROCK FARM WAY
114164 226802 0826-76-83.8651 III CRE SPY 1 LLC 9244 404 201 371 5130 217 WETROCK FARM WAY
114165 226801 0826-76-94-1034 III CRE SPV 1 LLC 9244 404 201 _ 371 5130 215 WETROCK FARM WAY
114166 226800 0826-76-94-3570 III CRE SPV 1 TLC 9244 404 201 371 5130 213 WETROCK FARM WAY
114167 226799 0826-76-95-5041 III CRE SPV 1 TLC 9244 404 201 371 5130 211 WETROCK FARM WAY
114168 226798 0826-76-95-6534 III CRE 5PV 111C 9244 404 201 371 5130 209 WETROCK FARM WAY
114169 226797 0826-76-96-6057 III CRE SPV 1 LIC 9244 404 201 371 5130 207 WETROCK FARM WAY
114170 226796 0826-76-96-6600 III CRE SPV 1 TLC 9244 404 201 371 5130 205 WETROCK FARM WAY
114171 226852 0826-76-75.3202 III CRE SPV 1 LLC 9244 _ 404 201 374 5130 0 WETROCK FARM WAY
114172 226795 0826-76-97-4161 III CRE SPV 1 LLC 9244 404 201 4 373 5130 203 WETROCK FARM WAY
114173 226794 0826-76-97-3509 III CRE SPV 1 LLC 9244 404 201 371 5130 201 WETROCK FARM WAY
114175 22685I 0826-76-11-2656 III CRE SPV 1 LLC 9244 404 201 374 5130 0 PRESTON ANDREWS RD
114177 226847 0826.36-14.9766 III CRE SPV 1 LLC 9244 404 201 374 5130 0 N ROXBORO ST
114178 226849 0826-66-46.3077 III CRE SPV 1 LIC 9244 404 201 372 5130 0 PRESTON ANDREWS RD