NCC241966_FRO Submitted_20240628

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;5 t Durham City/County (Office Use Only)
Sedimentation and Erosion Control
3 FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
WITH LANDOWNER CONSENT FORM
No person may initiate any land-disturbing activity covered by the Durham City-County Unified Development Ordinance before a
Land Disturbing Permit is issued by the Sedimentation and Erosion Control Office.Issuance of a Land Disturbing Permit does not
relieve the permittee of the obligation to obtain any other licenses, permits and approvals as may be required by Federal, State,
County or Municipal governments. This office must be notified in writing of any change to the information on this form.
PLEASE TYPE OR PRINT
1. Project name: Oakridge Residential—Phase A Extension: Yes or No
2. Road location of land-disturbing activity: 4950 Durham-Chapel Hill Blvd.
Tax Map-Block-Parcel: 236586 etc. PIN: 0800344498 etc.
3. Square footage of land to be disturbed or uncovered:. 1,002,500
4. List below the landowner of record. Each landowner must complete Item 8.
(If there are multiple owners,please list on a separate page): See attached page.
Name
See attached page.
Address
City State Zip
Telephone Fax Email
5. List the person or entity financially responsible for this land-disturbing activity: The financially responsible party shall be
(1)the developer or other person who has or holds themselves as having financial or operational control over the land-disturbing
activity and/or(2)the land owner or person in possession or control of the land when they have directly or indirectly allowed
the land-disturbing activity or have benefited from it and(3)the named party on the Land Disturbing Permit.
Avalon Oakridge LP
Name
555 South mangum St. Suite 100
Street Address
Durham NC 27701
City State Zip
475-766-7321 N/A liz smith(a,avalonbay.com
Telephone Fax Email
As the Financially Responsible Party,I consent to receiving notifications regarding this project via electronic
(Initials) communication at_liz smith(a,avalonbay.com_.
(Email Address)
I agree to provide any updated email addresses as necessary to ensure consistent communication is maintained between myself
and Durham County Sedimentation and Erosion Control.
Electronic notifications may include Plans Review Comments,Approvals,Disapprovals, and/or enforcement actions including
Notices of Violation, Stop-Work Orders,and/or Civil Penalties.
201 E. Main St,5'Floor,Durham,N.C.27701 •[phone]•Fax[phone]
www.co.durham.nc.us/ceng

6. For business applicants,list below the North Carolina registered agent for the financially responsible entity:
Elizabeth A.Smith
Name
555 South Mangum St. Suite 100
Street Address
Durham NC 27701
City State Zip
475-766-7321 N/A liz smithnu,avalonbay.com
Telephone Fax Email
7. The above information is true and correct to the best of my knowledge and belief and was provided by me while under oath. I
understand that the person or entity listed on Line 5 above will be: (1)the owner of the Land Disturbing Permit when issued;
(2)responsible for ensuring compliance with the Act and Ordinance;and,(3)will be the only person or entity with standing to
appeal any action taken or decision made by the Sedimentation and Erosion Control Office.
L/. 6, L( J
ate Type or 1 t Name
Ser h 0/2- C. • ) -AeitePeaky
Telephone Fax " Tit or A on
J f �_ rug av -i ha .:Cy
Email Signa re
Business Applicant(Provide corporate resolution on signatory authority)
l , a Notary Public of the County of
State of ,hereby certify that
personally came before me this day and acknowledged that he is
of and acknowledged,on behalf of
,the due execution of the foregoing instrument.
Witness my hand and official seal,this day of ,20
Notary Public
My commission expires ,20
*********************************************************************************************************************************
Individual Applicant
I,Ate „,ct J 2, ,a Notary Public of the County of 0
r
State of, — C ,hereby certify that -e �v, S aiv-y
personally appeared before me this date and under oath acknowledged that the above form was executed by them.
Witness my hand and official seal,this day of Aa- 20 "2-...4/
Notary Public
.. ®`ii ma/iota/®8®
My commission expires 0 s t 20 :3 ®�°'�+QA ®l�+r,
®® •,tee aea a
My Comm. Exp,
Provide a Notarized Item 8 for each landowner ' t� d .
4,,®s C 0 U '
4futilliiil to'?

8. Land Owner Consent. As a landowner,I provide my consent for land-disturbing activities to occur on the property listed in
Item 2 by the person or entity listed in Item 5.
�l (S) , A -,.544 -�
Dalto Ty e or Pr nt N e p
�3 �� 544/01Z. � " �°� `S 1� . i/°01 �' .Telephone l ' Fax '/� Trt e o ;,utrority
Email / Signature
***********************************************************************************************************************************
Business Landowner(Provide corporate resolution on signatory authority)
I, L, Re) ,a Notary Public of the County of 0 ��.. e� .
State of Ai,,,— AA-, 0 (k-.--, ;, , ae hereby certify that E. ; -e_ A
personally came before me this day and acknowledged that is 0,
of !f a ` and acknowledged,on behalf of Avalon Bay
the due execution of the foregoing instrument.
Witness my hand and official seal,this ( day of �'°_➢ ,20 .4
7 c
Notary Public
My commission expires a Cp ( j ,20 9—
octi lliii//+i,,
*******************************************************************************************************xx* '1,"$®r *s` ®�
i****
�,,Individual Landowner . ;'° �;
I i = 4
a Notary Public of the County of = t3 a
State of ,hereby certify that 04,,\,e,c 1
personally appeared before me this date and under oath acknowledged that the above form was execute1644Z '°®®®
Witness my hand and official seal,this day of ,20
Notary Public
My commission expires 20
The Sedimentation and Pollution Control Act(Act)and the Durham City-County Unified Development Ordinance(Ordinance)
includes,but is not limited to,the following legal obligations of the financially responsible party:
■ Maintain a set of approved sedimentation and erosion control plans,if required,on site.
■ Display permit on site.
• Understand and implement any required plan,including the construction sequence and details.
• Inspect,maintain and repair sedimentation and erosion control measures,especially after rainfall events.
• Provided adequate ground cover or otherwise stabilize all areas that have not been actively graded within 21 calendar days.
• Plan and conduct all land-disturbing activity so as to prevent off-site sedimentation.
SE-03 Rev.07/06

9. Land Owner Consent. As a landowner,I provide my consent for land-disturbing activities to occur on the property listed in
Item 2 by the person or entity listed in Item 5.
` /il-/L (4 L p,•-ilin41 L€i.ii- co./ .3CI'1i'LP cp. O.OrtiHlu�K I�L-�
Date I Type or Print Name
t`l y q ( I 6 .� 3
1-4.t+.r .ark asttwt DI,."►t Lr_c
Telephone Fax Title or Authority
Email Signature
***********************************************************************************************************************************
Business Landow r(Provide corporate resolution on signatory authority)
I, r,i �� 1�� 11 6 S ,a Notary Public of the County of `.� Q.
State of KiC9&h CG1o[t1Q ,hereby certify that F.D..44,,-LO Crt el-t1•ru04-1P1- Lri-r—tMR-N
personally came before me this day and acknowledged that he is a'^A."�r're, Inr G >n r"''a7 4.0"1
OJ tI4Ia..L rt. Oval-i.iLL t LLC .,./a
of *''4.s % l e".....".1.. ^ G is xi---and acknowledged,on behalf of Durhill(Durhill II)
t e due execution of the foregoing instrument.
Witness my hand and official seal,this p(i,1
,day 20 Q914
I tl Not Public S°,-.,—.> ?i 4 ,+1 L 5 1
My commission expires IV IQ CI A S I ,20 aNOTARY PUE LIC
1
INNiE
************************************************************************************************** ********1,94.13w1 **wow,044*
.,
Individual Landowner
I, ,a Notary Public of the County of
State of ,hereby certify that
personally appeared before me this date and under oath acknowledged that the above form was executed by them.
Witness my hand and official seal,this day of ,20
Notary Public
My commission expires 20
The Sedimentation and Pollution Control Act (Act) and the Durham City-County Unified Development Ordinance
(Ordinance)includes,but is not limited to,the following legal obligations of the financially responsible party:
• Maintain a set of approved sedimentation and erosion control plans,if required,on site.
• Display permit on site.
• Understand and implement any required plan,including the construction sequence and details.
• Inspect,maintain and repair sedimentation and erosion control measures,especially after rainfall events.
• Provided adequate ground cover or otherwise stabilize all areas that have not been actively graded within 21 calendar
days.
• Plan and conduct all land-disturbing activity so as to prevent off-site sedimentation.

4. Landowners of Record
Durhill LLC
Durhill III LLC
Avalon Oakridge LP