NCC241991_FRO Submitted_20240701

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 Highest Power Solar
2. Location of land-disturbing activity: County Franklin City or Township Unincorporated
Highway/Street Ronald Tharrington Road Latitude 36.116457 N Longitude-78.242129 W
3. Approximate date land-disturbing activity will commence:February 2021
4. Purpose of development(residential, commercial, industrial, institutional, etc.):Solar Energy
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas):
6. Amount of fee enclosed: $ . The application fee of $65.00 per acre (rounded
up to the next acre)is assessed without a ceiling amount (Example: a 9-acre application fee is$585).
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 Tripp McSwain E-mail Address [e-mail]
Telephone Cell# [phone] Fax#
9. Landowner(s)of Record (attach accompanied page to list additional owners):
Edward F. Yarborough Family Trust
Name Telephone Fax Number
324 Cloudes Mill Drive
Current Mailing Address Current Street Address
Alexandra VA 22304
City State Zip City State Zip
10. Deed Book No. 1084 _page No. 112 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.
Pine Gate Renewables [e-mail] _
Name E-mail Address
130 Roberts Street 130 Roberts Street
Current Mailing Address Current Street Address
Asheville NC 28801 Asheville NC 28801
City State Zip City State Zip
Telephone [phone] Fax Number

CONTINUATION OF LANDOWNER(S) OF RECORD
Landowner(s)of Record (attach accompanied page to list additional owners):
The Highest Power, LLC
Name Telephone Fax Number
P.O. Box 10141 1418 Ronald Tharnngton Road
Current Mailing Address Current Street Address
Wilmington 28412 Louisburg C
City State Zip City State Zip
PIN
2826-31-6722 Deed Book No. 2182 Page No. 1111 _ Provide a copy of the most current deed.
PIN
2826-40-0918 Deed Book No. 1591 Page No. 619 Provide a copy of the most current deed.
Landowner(s)of Record(attach accompanied page to list additional owners):
Davis Clyde McKinley, Ji
Name Telephone Fax Number
3933 Setonhurst Road
Current Mailing Address Current Street Address
MD 21208
City State Zip City State Zip
10. Deed Book No. _ Page No. 666 Provide a copy of the most current deed.

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:
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.
Ben Catt CEO
Type or print name Title or Authority
( _ 1173/2o2o
Signature Date
I, 4A)o --, , a Notary Public of the County of gvrt Cor)-►,(•e.
State of North Carolina, hereby certify that I ('A-ff 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 o23r`{day of nt, , 20 OZ0_
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tary
Seal \,off AR r '= My commission expires Tay S 0o��
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