HomeMy WebLinkAboutNCC241762_FRO Submitted_20240609 FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
EXPRESS PERMITTING OPTION 08012007
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, if the question is not applicable or the e-mail and/or
fax information unavailable, place N/A in the blank.)
Part A.1. Project Name Aria at Idlewild
2. Location of land-disturbing activity: County Union City or Township Stallings
Highway/Street 14812 Boyd Funderburk Drive Latitude 35.120809 Longitude-80.655684
3. Approximate date land-disturbing activity will commence:June 2021
4. Purpose of development(residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas):20
6. Amount of fee enclosed: $3300 . The Express Permitting application fee is a dual charge.
The normal fee of $65.00 per acre is assessed without a ceiling amount. In addition, the Express
Permitting supplement is $250.00 per acre up to eight acres, after which the Express Permitting
supplemental fee is a fixed $2,000.00 (Example: 9 acres total is $2,585). NOTE: Both fees are
rounded up to the next whole acre and need to be paid by separate checks to NCDENR.
7. Has an erosion and sediment control plan been filed? Yes No Enclosed X
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Brian Miller E-mail Address bmiller@bohlereng.com
Telephone 980-272-3400 Cell# 919-357-5989 Fax#
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Idlewild Apartments LLC $O3- 1 - V- Sy613 ( o3) 33► - q 9 q
Name Telephone Fax Number
3368 Lake Wylie Dr 14812 Boyd Funderburk Drive
Current Mailing Address Current Street Address
Rock Hill SC 29732 Matthews NC 28104
City State Zip City State Zip
10. Deed Book No.7770 Page No.0762 Provide a copy of the most current deed.
Part B.
1. Company(ies) or firm(s) who are financially responsible for the land-disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet.) If the company or firm is a sole proprietorship,
the name of the owner or manager may be listed as the financially responsible party.
!c..,-} .13 p r-ye_14s u_cgutrusingh@gmail.com
Name E-mail Address
3 0 c1 Pv s-4' 04 t 1 cc,D r tn\ (3-V-T tJG ® (A1M \
Current Mailing Address Current Street Address
•
irwiLNC 2
City State Zip
� City State Zip
Ts,-H„v„€ 0 �-�Z.- 5L1L9) Fax Number(e03 \ 433‘ - Ck q Ct
2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina Agent:
Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone 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:
•
e9� S NN O S c)rA t�hi+.� Sam to t4t*) sc1l�travAk . coo-,
Name of R tered Agent E-mail Address
3o % ?® Fri et- br
Current Mailing Address Current Street Address
I o 141 r) $
Tr aq I t� N�. 2 C)1 l e
City ( State Zip City State Zip
Telephone\1 0`) (, ( - 0 U 3 3 Fax Number<, CVA) (o s '4 -GO 3 5"
(c) In 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:
Bohler Engineering NC, PLLC bmiller@bohlereng.com
Engineering Firm or other consultant E-mail Address
Brian Miller 980-272-3400
Individual contact person (type or print) Telephone 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.
•
Or\t‘<e., S co V N M Flr .$ 0.9 t N S ni 6c
Type or print name Title or Authority
Mrs I I � 7--0 �1
Signature Date
, a Notary Public of the County of
State of North Carolina, hereby certify that 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 �--1 day of J 3YI(J C I) , 20 3 1
:.�. Notary
. . L Seal=
My commission expires 1 -•c a0ag
4 ,c . ,
aIRS
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Hel. A..1 for New EIN Exit
EIN
Assistant
• Your Progress:
• 1. Identity'/
• 2.Authenticate I
• 3.Addresses"
• 4.Details
• 5. EIN Confirmation
Congratulations! The EIN has been successfully assigned.
EIN Assigned: 85-1678895
Legal Name: IDLEWILD APARTMENTS LLC
The confirmation letter will be mailed to the applicant. This letter will be the applicant's official IRS notice and will
contain important information regarding the EIN.Allow up to 4 weeks for the letter to arrive by mail.
We strongly recommend you print this page for your records.
Click"Continue"to get additional information about using the new EIN.
fa IRv
EIN Assistant
Your Progress; 1.Idhntity • 2,Authenticate • 3,Arid,- sna 4.Detaitc. 5.EIN Confirmation
Summary of your information Help Topics
Please review the information you are about to submit.If any of the information below is incorrect,you will
need to start a new application. L.N. What is Form 1128?
Click the"Submit"button at the bottom of the page to receive your EIN.
Organization Type:LLC
LLC Information
Legal name: IDLEWILD APARTMENTS LLC
County: UNION
State/Territory: NC
Start date: JUNE 2020
Closing month of accounting year: DECEMBER{The closing month of the
accounting year is defaulted to December due
to your organization type.To change your
closing month of accounting year,complete
Form 1128.)
State/Territory where articles of organization NC
are(or will be)filed:
Addresses
Physical Location: 309 POST OFFICE DR
INDIAN TRAIL NC 28079
Phone Number: 704-684.0034
TPD Name: WESLEY S HINSON
TPD Address: 403 GILEAD RD STE J
HUNTERSVILLE NC 28078
TPD Phone Number: 704-2745578
Responsible Party
Name: MICHEL SCOTT MBR
SSN/ITIN: XXX-XX.4417
Principal Business Activity
What your business/organization does: OTHER
Principal products/services: REAL ESTATE HOLDING MANAGEMENT
AND INVESTMENT
Additional LLC Information
Owns a 55,000 pounds or greater
highway motor vehicle: NO
Involves gambling/wagering: NO
Involves alcohol,tobacco or firearms: NO
Files Form 720{Quarterly
Federal Excise Tax Return): NO
Has employees who receive Forms W-2: NO
Reason for Applying: STARTED A NEW BUSINESS
We strongly recommend you print this summary page for your records as this will be your only
copy of the application.You will not be able to return to this page after you click the"Submit"
button.
Click"Submit"to send your request and receive your EIN. Submit Once you submit,
please wait while your
application is being
processed.It can take
up to two minutes for
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processed.
' AR ° , NORTH CAROLINA
' �5, ram,
4� J'' Department of the Secretary of State
To all whom these presents shall come, Greetings:
I, Elaine F. Marshall, Secretary of State of the State of North Carolina, do hereby certify
the following and hereto attached to be a true copy of
ARTICLES OF ORGANIZATION
OF
IDLEWILD APARTMENTS, LLC
the original of which was filed in this office on the 29th day of June, 2020.
F` o p' T'!?�1ij,c, El •r IN WITNESS WHEREOF, I have hereunto set my
f,�o` 'AA +� �, -. 'F hand and affixed my official seal at the City of
0IthP
•a. Raleigh this 29th day of June 2020� Scan to verify online.
w �
Certification#C202018101353-1 Reference#C202018101353-1 Page: 1 of 3 Secretary of State
Verify this certificate online at https://www.sosnc.gov/verification
SOSID: 2003271
Date Filed: 6/29/2020 3:52:00 PM
Elaine F.Marshall
State of North Carolina North Carolina Secretary of State
Department of the Secretary of State C2020 181 01353
Limited Liability Company
ARTICLES OF ORGANIZATION
Pursuant to §57D-2-20 of the General Statutes of North Carolina,the undersigned does hereby submit these Articles
of Organization for the purpose of forming a limited liability company.
. The name of the limited liability company is: Idlewild Apartments, LLC
(See Item 1 of the Instructions for appropriate entity designation)
2. The name and address of each person executing these articles of organization is as follows: (State whether each
person is executing these articles of organization in the capacity of a member,organizer or both by checking
all applicable boxes.)Note: This document must be signed by all persons listed.
Name Business Address Capacity
Wesley S. Hinson 309 Post Office Drive,Indian Trail,NC 28079 EMember*Organizer
EMember('Organizer
OMember*Organizer
3. The name of the initial registered agent is: Wesley S. Hinson
4. The street address and county of the initial registered agent office of the limited liability company is:
Number and Street 309 Post Office Drive
City Indian Trail State:NC Zip Code: 28079 County: Union
5. The mailing address, if different from the street address, of the initial registered agent office is:
Number and Street
City State: NC Zip Code: County:
6. Principal office information: (Select either a or b.)
a. X The limited liability company has a principal office.
The principal office telephone number: (704) 684-0034
The street address and county of the principal office of the limited liability company is:
Number and Street: 309 Post Office Drive
City: Indian Trail State: NC Zip Code: 28079 County: Union
BUSINESS REGISTRATION DIVISION P.O. BOX 29622 Raleigh,NC 27626-0622
(Revised August. 2017) Form L-01
C'nrtifirotinntt C 111701R1011G2-1 RPfornnrnfL C'111 111R1012G'1-P€rru• 7 of 1
The mailing address,
d ess,if different from the street address, of the principal office of the company is:
Number and Street:
City: State: Zip Code: County:
b. The limited liability company does not have a principal office.
7. Any other provisions which the limited liability company elects to include(e.g.,the purpose of the entity)are
attached.
8. (Optional): Listing of Company Officials (See instructions on the importance of listing the company officials in the
creation document.
Name Title Business Address
9. (Optional): Please provide a business e-mail address:
The Secretary of State's Office will e-mail the business automatically at the address provided above at no cost when a
document is filed. The e-mail provided will not be viewable on the website. For more information on why this service is
offered,please see the instructions for this document.
10. These articles will be effective upon filing,unless a future date is specified:
This is the 29th day of June ,2020
ignature
Wesley S.Hinson,Organizer
Type or Print Name and Title
The below space to be used if more than one organizer or member is listed in Item#2 above.
Signature Signature
Type and Print Name and Title Type and Print Name and Title
NOTE:
1. Filing fee is$125. This document must be filed with the Secretary of State.
BUSINESS REGISTRATION DIVISION P.O.BOX 29622 Raleigh,NC 27626-0622
(Revised August. 2017) Form L-01
rartifioatinnff (`/0'01R1011G2-1 Rafaranraif f lMO1R1(11 c1-Pane• 2 inf.'2
FINANCIAL RESPONSIBILITY/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, if the question is not applicable or the e-mail and/or fax
information unavailable, place N/A in the blank.)
Part A.
1. Project Name
2. Location of land-disturbing activity: County City or Township
Highway/Street Latitude Longitude
3. Approximate date land-disturbing activity will commence:
4. Purpose of development(residential, commercial, industrial, institutional, etc.):
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas):
6. Amount of fee enclosed: $ . The Express Permitting application fee is a dual
charge. The normal fee of$65.00 per acre (rounded up to the next acre) is assessed without a ceiling
amount. In addition, the Express Permitting supplement is $250.00 per acre up to eight acres, after
which the Express Permitting supplemental fee is a fixed $2,000.00 (Example: 9 acres total is $2,585).
7. Has an erosion and sediment control plan been filed? Yes No Enclosed
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name E-mail Address
Telephone Cell# Fax#
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Name Telephone Fax Number
Current Mailing Address Current Street Address
City State Zip City State Zip
10. Deed Book No. Page No. Provide a copy of the most current deed.
Part B.
1. Company (ies) or firm(s) who are financially responsible for the land-disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet.) If the company or firm is a sole
proprietorship, the name of the owner or manager may be listed as the financially responsible party.
Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone Fax Number
2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina Agent:
Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone 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:
WC c S ‘4,1%.) SW.) w o (9 f4 N so (-to
Name of Registered Agent E-mail Address
3oc �o S� ocF:mot, b r
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephonk tk—N' tp gy — UU3 4 Fax Numbe(10v1)c„, V1 — V U3
(c) In 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:
Engineering Firm or other consultant E-mail Address
Individual contact person (type or print) Telephone 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.
Type or print name Title or Authority
Signature Date
, a Notary Public of the County of
State of North Carolina, hereby certify that 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 day of , 20
Notary
Seal
My commission expires