NCC240356_FRO Submitted_20240209

MP" WAKE COUNTY 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 Wake
Countyseimentat Unifiedon contr Development be a
COUNTY dio plan haveOrdinance been completedefor and this approvedform bynd an Wake County acceptable Department
erosion ofand
NORTH C.AROLINA 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 Wendell Ridae
2. Location of land-disturbing activity: Jurisdiction Wendell (Wake Co. or Municipality)
Highway/Street Eaale Rock Rd. Latitude 35.755164 Longitude-78.392113
3. Approximate date land-disturbing activity will commence: 2/14/2024
4. Type of development(residential, commercial, industrial, institutional, etc.):residential
5. Total acreage disturbed or uncovered (including off-site utilities and borrow/waste
areas):31.34
6. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Mark Altman E-mail Address maltman a( davidsonhomesllc.com
Telephone [phone] Cell# Fax#
7. Landowner(s)of Record (attach accompanied page to list additional owners):
DRP NC 3 LLC
Name(s) Telephone Fax or E-mail address
590 Madison Ave. Fl 13 same
Current Mailing Address Current Street Address
New York, NY 10022-2524
City State Zip City State Zip
8. Deed Book No. 019469 Page No. 00295 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 AL Homes,LLC bnelson(c davidsonhomeslic.com
Name E-mail Address
336 James Record Road same
Current Mailing Address Current Street Address
Huntsville AL 35824
City State Zip City State Zip
Telephone [phone] Fax Number

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:
Brad Nelson [e-mail]
Name E-mail Address
1093 N. Harrison Ave. Ste. 200 same
Current Mailing Address Current Street Address
Cary, NC 27601
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:
Brad Nelson [e-mail]
Name of Registered Agent E-mail Address
1093 N. Harrison Ave. Ste. 200 same
Current Mailing Address Current Street Address
Cary, NC 27601
City State Zip City State Zip
Telephone [phone] 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.
Brad Nelson Authorized Person bT�SIdr-) eiecS-TAberi
Type or . 'nt name Title or Authority
Signature Date
I, IV ay)CL 5. Mari k e v,)a Notary Public of the County of W a k es
State of North Carolina, hereby certify that t rot d 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 Zi day of 3-0 11 , 20 2 3
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