NCC241900_FRO Submitted_20240620

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 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 NC Education Campus
2. Location of land-disturbing activity: County Wake City or Township Raleigh
Highway/Street West Jones Street Latitude 35.783218 Longitude-78.640844
3. Approximate date land-disturbing activity will commence:January 2024
4. Purpose of development(residential, commercial, industrial, institutional, etc.):Institutional
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas):6.0 acres
6. Amount of fee enclosed: $ 600.00 The application fee of$100.00 per acre
(rounded up to the next acre) is assessed without a ceiling amount(Example: 8.10 ac=$900.00).
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 Tim Hiltbrunner E-mail [e-mail]
Telephone n/a Cell# [phone] Fax# n/a
9 Landowner(s)of Record (attach accompanied page to list additional owners)
State of North Carolina
Name Telephone Fax Number
Current Mailing Address Current Street Address
City State Zip City State Zip
10. Deed Book No. 1712 Page No.243 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.
Legislative Services Commission [e-mail]
Name E-mail Address
16 W. Jones Street, Room 2129 16 W. Jones Street, Room 2129
Current Mailing Address Current Street Address
Raleigh, NC 27601 Raleigh, NC 27601
City State Zip City State Zip
Telephone[phone] Fax Number n/a

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:
n/a
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:
n/a
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
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.
Paul Coble Legislative Services Officer
Type or print name (� Title or Authority
lam' I / e l 7''-1
Signature Date
I, `5 t)5 a h I-I . 1 V t l + I'1 e-ct cl , a Notary Public
+of the County of \, cU
State of North Carolina, hereby certify that Li 'L ( I.. C G l) I appeared
personally before me this day and being duly sworn acknowledged that the above form was
executed by him.
Witness my jlandan.O. notarial seal, this 7, day of d anua.rt,i , 20 2
� : ,,o Tq� : �' A.tc/,Cc v1 4 (,,(�f'-1 -Pti _
�- o` Notary
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My commission expires
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Addendum To Financial Responsibility/Ownership Form
Sedimentation Pollution Control Act
Pursuant to Session Law 2023-134 § 40.1(x), which is attached hereto,
notwithstanding any law to the contrary, the General Assembly has final authority
over any activity related to project planning, contracting, and construction of the
North Carolina Education Campus (the "Project"). The Legislative Services Office is
overseeing the design and construction of the North Carolina Education Campus.
The Legislative Services Office has designated Safran Law Offices as its owners
representative for the Project. All questions regarding the Project can be directed via
email to Tim Hiltbrunner at [e-mail] or Perry Safran at
p s afran@s afranlaw.co m.

(6) Vendor and contractor evaluation.
(7) Identification of the potential for collaboration with industry, other academic
institutions, and State and federal entities.
SECTION 40.1.(w) Of the funds received by the State and deposited to the ARPA
Temporary Savings Fund, established in Section 1.3(a) of S.L. 2023-7, it is the intent of the
General Assembly to use a portion of those funds in future fiscal years for project codes
UNC/B0G23-1 and UNC/B0G23-3.
SECTION 40.1.(x) For project codes NCGA23-1 and NCGA23-2, the General
Assembly shall be considered the funded agency, pursuant to G.S. 143-135.26(1), and,
notwithstanding G.S. 143-341 or any other provision of law to the contrary, shall initiate and
have final authority over any activity related to project planning, contracting, and construction.
SECTION 40.1.(y) For project codes DOA23-4 and DOA23-5, the Department of
Administration shall be considered the funded agency pursuant to G.S. 143-135.26(1) and,
notwithstanding G.S. 143-341 or any other provision of law to the contrary, shall consult with
the Legislative Services Office for any activity related to project planning, contracting, and
construction.
SECTION 40.1.(z) Subsection (p) of this section is effective June 30, 2023. The
remainder of this section is effective July 1, 2023.
SIX-YEAR INTENDED PROJECT ALLOCATION SCHEDULE
SECTION 40.2. It is the intent of the General Assembly to fund capital improvement
projects on a cash flow basis and to plan for future project funding based upon projected
availability in the State Capital and Infrastructure Fund.Nothing in this section shall be construed
(i)to appropriate funds or(ii) as an obligation by the General Assembly to appropriate funds for
the projects listed in future years. The following schedule lists capital improvement projects that
will begin or be completed in fiscal years outside of the 2023-2025 fiscal biennium and estimated
amounts(in thousands)needed for completion of those projects:
Project Code FY23-24 FY24-25 FY25-26 FY26-27 FY27-28 FY28-29
UNC/R&R21 280,503 250,000 200,000 200,000 200,000 200,000
R&R21 200,000 200,000 200,000 200,000 200,000 200,000
DACS21-2 N/A 2,000 1,500 N/A N/A N/A
DACS21-4 750 1,850 1,500 N/A N/A N/A
DACS23-3 N/A 3,000 2,000 4,000 4,000 N/A
DACS23-7 N/A N/A 4,000 N/A N/A N/A
DACS23-8 N/A N/A 2,000 1,000 1,000 1,000
DACS23-9 N/A N/A 750 N/A N/A N/A
DACS23-10 N/A N/A 2,000 2,000 2,200 N/A
DACS23-11 N/A N/A N/A 1,500 1,500 N/A
DACS23-12 N/A N/A N/A 4,000 N/A N/A
DACS23-13 N/A N/A N/A 5,000 N/A N/A
DEQ21-1 3,325 28,650 17,075 N/A N/A N/A
DNCR21-13 15,000 24,250 86,800 30,950 N/A N/A
DNCR23-1 3,000 3,000 30,000 24,000 N/A N/A
DNCR23-7 2,000 7,721.24 7,000 N/A N/A N/A
D0A22-1 N/A N/A 8,800 22,000 35,200 22,000
DOA22-3 N/A N/A N/A N/A 21,000 N/A
DOA23-1 500 N/A N/A N/A 1,000 20,244
DOA23-2 2,900 800 800 N/A N/A N/A
DOA23-3 N/A N/A N/A N/A N/A 11,000
Page 594 Session Law 2023-134 House Bill 259