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Home My WebLink AboutNCC233543_FRO Submitted_20231206 FlNANCIALRESPONSABILITY/OWNERSHIP FORM SEDIMENTATION POLLUTION CONTROL ACT EXPRESS PERMITTING OPTION No person may initiate any land-disturbing activity on one or more acres as covered by the Act before this form and an acceptable erosion and sedimentation control plan have been completed and approved by the Land Quality Section, N.C. Department of Environmental Quality. Submit the completed form to the appropriate Regional Office. (Please type or print and, K the question is not applicable or the e-mail address or phone number iounavailable, place N/A in the b|ank.) Part A. MAIN DAM AND SADDLE DAM DECOMMISSIONING EROSION AND SEDIMENT CONTROL PLAN 1. Project Name RUTHERFORD CL|FFS|DE/k8OQRES8ORO 2, Location of land-disturbing activity: County City orTownship Highway/Street MCCR/\W R(lA[1 Latitude wec,»mdegrees) 35,214613e Long itudew°amo/degrees) '81.7652858 ��1 �y��^1 3- Approximate date land-disturbing o��iviLywU|commence: ~� ' ^-~~"-` 4� Purpose of development(residential,commercial,industrial, institutional,etc.): |N[)USTR|AL � � �� 6- To�dacreage di��urbedur uncovered(including u8'uhebnnowand waa��aneao): ' ~^`~~° acres *oo(� *ou+uomo` O. Amount of fee enclosed ' ' ' The Express Permitting application fee is m dual charge. The normal fee of $100.00 per acre (rounded up to the next acre) is assessed without a ceiling amount. In addition,the Express Permitting supplement is$250 per acre up to eight acres,after which the Express Permitting supplemental fee is afixod$2.000.00 (Example: 8.10'acre application toe is$2.900). Checks should bo addressed!oNCDEO. 7. Has an erosion and sediment control plan been filed? Yes M Enclosed �� No E] 8. Person to contact should erosion and sediment control issues arise during land-disturbing activity: Name Duke Energy - Michael ClOUqh E-mail Address minhaeio|ough@duka'onergy.00m �1�-��1-O�71 Phone: Office # Mobile " '^- °= ' ~~' ' 3, Landnwnor(o) of Record(attach accompanied page\olist additional owners): DUKE ENERGY 704-387-3853 Name Phone: Office# Mobile# 526 SOUTH CHURCH ST. 526 SOUTH CHURCH ST. Current Mailing Address Current Street Address CHARLOTTE yA�� A�M� CHARLOTTE 0/� 28202 ��' " `' `^�^� ' ^ ^� ' `^� �� ' �� State ZipcityStateZipCity �1z1� OOO�� 10. Deed Book No."- '`" Page No. °"°° Provide a copy of the most current deed. Part B. 1. Company(ies)who are financially responsible for the land-disturbing activity(Provide a comprehensive list of all responsible parties on accompanied pa0eproprietorship or if the tanohwnoq(s)is anhndividua4s)L the name(s)of the owner(s)may be listed as the financially responsible party(ies). DUKE ENERGY CAR{}LINAS. LLC ---- E-mail Addr000 Company Name 526 SOUTH CHURCH ST. 526 SOUTH CHURCH ST_ Current Mailing ' naso Current Street Address CHARLOTTE NC 28202 CHARLOTTE NC 28202 State �p — - | citycityu� om=e ~r 7D�-�A�-��A�� Phone: Office ' " ' °^'^- ^~~~~ K8obUe# - Note: If the Financially Responsible Party is not the owner of the land to be disturbed, include with this form the landowner's signed and dated written consent for the applicant to submit a draft erosion and sedimentation control plan and toconduct the anticipated land disturbing activity. 2. (a) If the Financially Responsible Party is a domestic company registered on the NC Secretary of State business registry, give name and street address uf the Registered Agent: CT CORPORATION SYSTEM 'Name of Registered Agent E-mail Address 160 MINE LAKE CT' STE 200 160 MINE LAKE CT, STE 200 � Current Street Address current Mailing Address cuem RA| E|GA NC 27615 RA| EIGA NC 27615 State Zip Phone: Zip city Phono: Office _ - Mobile # ' Name of Individual to Contact(if Registered Agent is a company (b) \f the Financially Responsible Party is not aresident of North Carolina, give name and street address of the designated North Carolina agent who is registered on the NC Secretary of State business registry: NA� NA Name of Registered Agent E-mail Address NA NA - ' Current�� Curren Mailing Address '"' ` NA —ty — State Zip City � State Zip Phone D#ice# /«A Mobile , `' ` Registered dA n�� company) Name cd|nd�idua|to Contact(� e�p�ora Agent acompeny (c) If the Financially Responsible Party is engaging in business under an assumed name, give name under which the company is Doing Business As. If the Financially Responsible Party is an individual, General �� Partnership, or other company not registered and doing business under an assumed name,attach a copy of the Certificate of Assumed Name. NA Company DBA Name (d) If order to facilitate Express Permitting, it is necessary to be able to contact the engineer or other consultant who can assist in providing any necessary information regarding the plan and its preparation: WSP USA ken.daly@wsp.com Engineering firm or other consultant E-mail Address Ken Daly (704) 417-5144 (704) 222-1438 Individual contact person (type or print) Phone: Office# Mobile# 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(s) 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 Party). I agree to provide corrected information should there be any change in the information provided herein. Mehdi Maibodi General Manager Type or print name Title or Authority /0-11-2023 Signature Date —-------- - -- --- erQ e )4, /viz) , a Notary Public of the County of State of North Carolina, hereby certify that NelA81.; Ycki boa II appeared personally before me this day and being duly sworn acknowledged that the above form was executed by him/her. Witness my hand and notarial seal, this // day of labQ , 20(i THERESA E MINTON Notary Public,North Carolina Notary ; - rg County My CO :On Expires *06/2028 My commission expires 07 0 G trrcord4d 08/!0/2D07 nt 0G:9@:!b NI wAt: 12d00 1 4 0144 Te w0 00 P,tpr of n$tri 200700002143 ath+rford county, NC ?I. Ntt fy Ilipint,r of pneda x940 a93-97 Excise. t":tx EX) Recording Time,Sook and Pane Iar Lot to, r'arecikktur[iertoi„,„916.3 1 L 91,489.91349O.90(A.5},91 S,9I 1624577. 162.01;', [637972,In3S714,I f).37974,911071,1642(XA),I(?12631:L4:rnion u4916312,tag['0152,49„aiI uthetre.:<<t` rein t t t C,tc's'Lint[Conttua 1 ar ParLet1 No.3l '�tslt 1 b_ C a,nt,cw do i t 3(N176y Neo dln; 6 A,G11nt Whitney,Jr.,.€'.ON:Poe Ad n & [ittitsts: t,L,L,P•T h t \k 1l t [d,'IruarCI?t <sa:ptcpauta lad: t' Ler P' .r\r ar, Hcrnz'=irr L..P. .GI': A4'it"1••a,sr Brie I)' rihtir:nt°orThe,frd=t. 7.a izs,,I'lakt Bc'rL , g ltttlhcrtirtd Count' Public Rcgi tr NORTH CAROL INA `SON-NV IRRA TV HEED 1./S D EQ 1 1 1S,r he..l [ ht`=r •€_'lit° b,=r rt1` qm.-e:11 °KANTOR GRA.'ffEE Dl)kF,=ENE-RG'Y C. ROLINA`, LL,C DUKE I R`L-.RG1 C.\KO:,INr\9, 1.1..0 a North Ca9totm a [iFnmPed t:aNlitV L'tipartr ( >rrit l I1 ,tlu sere'i ft1, ta"t ti1F,<�t�afatat,tt;t',tor e: ,rr.;+°r,tatt raipreofateC9araaaarefai!i1p:e.g_u'ataaratiafr,p;trtr-rathp. The designation Grantor€md Grantee ec,.used herein;hall include:said pates,tiscir hits successors and assigns, and strati include.singular MaS.Culine,Eomirsine or neuter as required Isy contest W,ITNIjSSETII, that tirtntttr. for a, ,tslu stile e trn.Sikieralisrti paid by Grantee.,nte4,the is;eikst of which is holes.}' acknowledged,hies and by these p sis does gram,bargain,sell and eon+ey°unto Grantee in fee simple.all that certain teat or parcel of land situated its High Shoal, too re,hsp, Rutherford County, onh('unlit a and nriire particularly cles'etileed so td+ItMusci• 4<F' f 1-t stall/idhdt'c°traut rtar�trtt�r�,r�-�Lfrt'�r, +e„�sr�l acesr(th Pt•:perfy Ttc;Naic pris'lstse.,7t t''s hxl rq t rctii uitsos.into one riot tlr Nil= ..sr.rktsert cstd s o F .\ssFiiris contains I;SZ 47 acres Iheprot.rty Lc tsi.atao+e sic es led was aequired Its Giaustor to insitutrou ress'sided A step showing the;hitter described lueptty is recut-tied in Flits t'+(>ok fit,.._a:l-I I tluthcrIsti'sl County Public Registry TO FIAV1- A'i )TO IIC)I,D th aforesaid lot or p:ucu t cut baud and all pas lieges lard appurtenances tiletetea belonging to the Grantee in lee silt isle_ The Gnftlin' satees no warrants.cepres lniptied,a i.r dl`e to th., property her eitwl s,des.riFcd. is1F1ftitiSVuitPRiOF.th,.(Gra.s_torha:>eau,_IthisinurutttinrurIticdotecsecur°aIunsleru al he do amt ere first ahr'r e written. (SEE SIC 5\JI. KL AND NOTARY ACKNOWLEDGMENT}t'i\W'S ON 1''S fl I(iV°INt L i'A(l:'! _s f,X. 1.1:!IT:1 LEGAL DESCRIP ION ALL of that twain I82.47 acres shorn_j 11 plat enntked 'DUKE ENERGY CARO INA . LLC RE:CU\IBI A I Ev PLAT"recorded in Plat Book' .Pat,i "i•Rutherford County Public Registry. evirlity company By Tide- STATE or 9ga . `.4 a • CtTCS l'��fiOE4.t:,� cook,S€ac a i1 i, „ ref nanny y diti€ Ll. f t1 J4O6t c, {itte"Signatory").Ma_< e W . of DUKE ENERGY RGY CA OI I AS. Li a North Curolina limited liability company.LerziettLa cane before me this day rand by authority duly u%en acknowledged the due mx ctlion attic aagoing Mailman nt on behalf a the limited Its±[artn k.,,muparty rely that the Signatory atot r Normally appeared afore me taro clap,isnd OR *one of theplowins0 have persona Lonn ge of the identityoftheS€,crfor9.car t1 have seen satisfactory e iclentre.of the Signatory's ilea€taa h a CIII t(ru state or fedora' identification with the.Siat€aatory"r photograph in hu arm of [;heck one r ithc,treItr)winr1 adr€.ers iirerse or in the form of _ — ;or Sat credible mania ha-�,swan to the identity of the Signattarr'l. The Signatory,aek€t.3sslkcl ad to me that he tcalutataral>signed the begruiiirr document for rta purpose l k t cI€tereias and ai the rapacity indicated "Witness my hand and€rticial stamp or Eat this " thu of, ttgust.:aka Sala;a;s ttiha: OFF laAC EA4 foram° €ttt; tt. It) r, n ; Notm Public,North Car,ine [Nay Nokia tart Iic MS!Sigel s t rt t et°o tart notary trey,o Canty&Sally C'aactrzs as is> x att ,.� s`-° a }'Ties E`D ARD T,CONN t L My Qtmtarral l Ct VoIN.12.Eva tN()1ARY SEA, , 111 ST BE MI EN t f iiittt..i,t The roregoing Centligatets I or lame certified to be ral.ect t his instrument.and eatifteine are duly registered at do Art On tirt ae€_l to the IAAth arid page lean on the fat page hanttof Register cal Eaizct.s fit Rr;the tTrnd County. Bye Deputy rAugistant-Ward n:Mar:..& Cl rI;. DUKE ENERGY CORPORATION ASSISTANT CORPORATE SECRETARY CERTIFICATE I,Sue C,Harrington,Assistant Corporate Secretary of Duke Energy Corporation, do hereby certify that the Board of Directors of Duke Energy Corporation on April 4, 2006,approved and adopted the Approval of Business Transactions Policy Statement, which provides in relevant part that any direct report to the President and Chief Executive Officer of Duke Energy Corporation may approve,or delegate the authority to approve,business transactions(including acquisitions and divestitures)involving amounts of$50 million or less. I further certify that Christopher C.Rolfe,Group Executive and Chief Administrative Officer,Duke Energy Corporation,is a direct report to the President and Chief Executive Officer of Duke Energy Corporation, who,pursuant to the authority granted by the Approval of Business Transactions Policy Statement,has delegated to Angeline M.Clinton,Vice President,Enterprise Operations Services,Duke Energy Corporation,the authority to approve amounts up to$10,000,000 for capital projects, commitments to buy products or services,equity investments(including acquisitions, partnerships,joint ventures,etc),divestitures,operating leases,and termination of commodities contracts;and subsequently,Angeline M.Clinton,in accordance with the Delegation of Authority for Enterprise Business Services,has delegated to Dennis F. Wood,ill,General Manager for Real Estate Services,Duke Energy Business Services, LLC,the authority to approve up to$5,000,000 for land acquisitions and divestitures and building rent;and subsequently, Dennis F.Wood,HI,in accordance with the Delegation of Authority for Enterprise Business Services:Enterprise Operations,has delegated to R.Steven Bodenheimer,Director of Transaction Management,and George E.Toft. Director of Land Services,the authority to approve$1,500,000 to execute deeds,leases, and similar real estate documents on behalf of Duke Energy Corporation and its affiliates for land and facility acquisitions and divestitures,which authority includes the authorization to execute any contract,lease,deed,easements,rights of way or other instruments related to the authorized transaction;and to George W.Christian,Jr., Manager,Real Estate Acquisitions and Valuations Harold L.Glorius,Jr.,Supervisor, Engineering Support;and Christopher E.Arbuckle,Supervisor,Engineering Support,the authority to approve up to$750,000 to execute deeds,leases and simUar real estate documents on behalf of Duke Energy Corporation and its affiliates for land and facility acquisitions and divestitures,which authority includes the authorization to execute any contract,lease,deed.easements,rights of way or other instruments related to the authorized transaction IN WITNESS WHEREOF I have hereunto set my hand and affiXed the Corporate Seal of said Duke Energy Corporation th s 20th day of July,2007. �� I C`�'�o Ass°1 Corpora aerator" ll ( i •p . n Itz i W DA2157 25 DUKE ENERGY CAROLINAS, LLC 41IN DUKE 400 S TRYON STREET ACCOUNTS PAYABLE - ST25B E N E RGY® Page 1 of 1 CHARLOTTE, NC 28202 Date: 10/13/2023 Check#: 1000202645 000013 R3K1SDA Payment Amount: 2,000.00 NORTH CAROLINA DEPARTMENT OF Vendor#: 0000071949 ENVIRONMENTAL QUALITY LAND QUALITY SECTION - SEDIMENT & EROSION CONTROL PROGRAM 610 EAST CENTER AVENUE MOORESVILLE NC 28115 Remittance Advice Invoice Date Invoice# Voucher ID# Invoice Gross Amt Discount Amount Invoice Net Amt 10/11/2023 CSIABE 12755284 2,000.00 0.00 2,000.00 IAB MIDDLE DAM ESC APPLICATION PLEASE DETACH BEFORE DEPOSITING CHECK THIS CHECK CONTAINS MULTIPLE FRAUD DETERRENT SECURITY FEATURES 1 DUKE ENERGY CAROLINAS, LLC �/� 50-937/213 4@0 S TRYON STREET DUKE K E VIl ACCOUNTS PAYABLE ST256 fai• /'� Date: 10/13/2023 CHARLOTTE, NC. 28202.. ENERGY Check#: 1000202645 L ro Pay Exactly **Two Thousand and 00/100 -US Dollars** Amount - $****2,000.00 8 1TOTHE NORTH CAROLINA DEPARTMENT OF IORDER ENVIRONMENTAL QUALITY VOID AFTER180DAYS EOF I 1 'Oi/Z--+Z==> J-P MORGAN CHASE BANK,N.A. A thorized Signer SYRACUSE, NY 13206 1 DA2157 23 DUKE ENERGY CAROLINAS, LLC (. DUKE 400 S TRYON STREET ACCOUNTS PAYABLE - ST25B E N E RGY, Page 1 of 1 CHARLOTTE, NC 28202 Date: 10/13/2023 Check#: 1000202644 000012 R3K1SDA Payment Amount: 1,400.00 NORTH CAROLINA DEPARTMENT OF Vendor#: 0000071949 ENVIRONMENTAL QUALITY LAND QUALITY SECTION - SEDIMENT & EROSION CONTROL PROGRAM 610 EAST CENTER AVENUE MOORESVILLE NC 28115 Remittance Advice Invoice Date Invoice# Voucher ID# Invoice Gross Amt Discount Amount Invoice Net Amt 10/12/2023 CSIABS 12755281 1,400.00 0.00 1,400.00 IAB MIDDLE DAM ESC APPLICATION PLEASE DETACH BEFORE DEPOSITING CHECK THIS CHECK CONTAINS MULTIPLE FRAUD DETERRENT SECURITY FEATURES DUKE ENERGY CAROLINAS LLC - 400 S TRYON;STREET Ar 937/213 ACCOUNTS PAYABLE - 5T25B :! DU KE 50 Date 10/13/2023 CHARLOTTE, :NC ;28202 ENERGY Check#: 1000202644 Amount Pay Exactly **one Thousand Four Hundred and 00/100-US Dollars** $****1,400.00 TO THE NORTH CAROLINA DEPARTMENT OF ORDER ENVIRONMENTAL QUALITY VOID AFTER 180 DAYS 1,OF JP MORGAN CHASE BANK, N.A. A thorized Signer SYRACUSE,NY 13206 i I