NCC233431_FRO Submitted_20231128

TOWN OF KNIGHTDALE FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
. No person may initiate any land-disturbing activity on one or more acres as covered by the Town
of Knightdale Unified Development Ordinance before this form and an acceptable
erosion and sedimentation control plan have been completed and approved by Town of
Knightdale, Public Works Department, Stormwater Division. (Please type or print and, if the
question is not applicable, place N/A in the blank.)
Part A.
1. Project Name SEC075995-2022 Glenmere Phase 3 Lots 124-126,137-140,182 transfer from Caviness and Cates to Davidson Homes LLC
2. Location of land-disturbing activity: Knightdale/Town Limits (Town Limits or ETJ)
Highway/Street Highridge Ln/Poplar Summit Ln Latitude 35.780184 Longitude -78.474279
3. Approximate date land-disturbing activity will commence: As soon as possible
4. Type of development (residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off-site utilities and borrow/waste
areas): 1.75
6. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Josh Clowes E-mail Address [e-mail]
Phone# Cell# 919-609-6340
7. Landowner(s) of Record (attach accompanied page to list additional owners): (LIST ATTACHED)
Glenmere, LLC 919-946-6955 [e-mail]
Name(s) Telephone E-mail address
5956 Sherry Lane, Suite 1000 5956 Sherry Lane, Suite 1000
Current Mailing Address Current Street Address
Dallas TX 75225 Dallas TX 75225
City State Zip City State Zip
8. Deed Book No. (LIST ATTACHED) Page No. 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):
Davidson Homes, LLC [e-mail]
Name E-mail Address
1903 N. Harrison Avenue Suite 200 1903 N. Harrison Avenue Suite 200
Current Mailing Address Current Street Address
Cary NC 27513 Cary NC 27513
City State Zip City State Zip
Phone# [phone]

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 Town of Knightdale Erosion and Sedimentation Control Ordinance and/or
Land Disturbance Permit:
Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone #
(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:
Cogency Global, Inc. statrepPcogencyglobal.com
Name of Registered Agent E-mail Address
212 South Tryon Street, Suite 1000 212 South Tryon Street, Suite 1000
Current Mailing Address Current Street Address
Charlotte NC 28281 Charlotte NC 28281
City State Zip City State Zip
Phone# [phone]
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.
Brad Nelson Division President
Typ '';or . na Title or Authority
is j0ILS (Z3
Signature Date
Celinda Howell , a Notary Public of the County of Wake
State of North Caroliina , hereby certify that Brad Nelson
appeared personally before me this day and being duly sworn acknowledged that the above form was
executed by him.
Witness my hand and notarial seal, this t day of ucb h , 20
(ri64:(A-- t-4(
Seal Celinda Howell Notary
NOTARY PUBLIC
Wake County My commission expiresec ))'L( 27 2OVo
North Carolina
My Commission Expires December 27,2026

ADDITIONAL OWNERS:
Caviness&Cates Building and Development Company
A North Carolina corporation
639 Executive Place, Suite 400
Fayetteville, N.C.28305
Phone#:[phone]
E-mail: [e-mail]
Cates Building, Inc.
A NC corporation
639 Executive Place,Suite 400
Fayetteville, N.C. 28305
Phone#:[phone]
E-mail : [e-mail]
DEED BOOK AND PAGE:
LOT# PHASE ADDRESS OWNER OF RECORD Wake County Permit PIN# DEED B/P Acres
124 3 205 Poplar Summit Lane CATES BUILDING INC SEC-075995-2022 1753597045 19417/0408 0.28
125 3 209 Poplar Summit Lane CAVINESS&CATES BUILDING AND DEVEL SEC-075995-2022 1753598017 19094/0046 0.24
126 3 213 Poplar Summit Lane CAVINESS&CATES BUILDING AND DEVEL SEC-075995-2022 1753598099 18922/2587 0.24
137 3 230 Highland Ridge Lane CAVINESS&CATES BUILDING AND DEVEL SEC-075995-2022 1753598280 19094/0046 0.20
138 3 226 Highland Ridge Lane GLENMERE LLC SEC-075995-2022 1753598210 15931/2160 0.18
139 3 222 Highland Ridge Lane GLENMERE LLC SEC-075995-2022 1753597149 15931/2160 0.18
140 3 218 Highland Ridge Lane GLENMERE LLC SEC-075995-2022 1753596189 15931/2160 0.19
182 3 318 Poplar Summit Lane CAVINESS&CATES BUILDING AND DEVEL SEC-075995-2022 1753682964 18922/2587 0.24
TOTAL ACRES 1.75