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HomeMy WebLinkAboutNCC242039_FRO Submitted_20240708 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 address or phone number is unavailable, place N/A in the blank.) Part A. 1. Project Name Beaman Borrow Pit 2. Location of land-disturbing activity: County Greene City or Township Snow Hill Highway/StreetBEAMAN OLD CREEK RDLatitude(decimal degrees)77.672647 Longitude(decimaidegrees) 35.466572 3. Approximate date land-disturbing activity will commence: 08-05-2024 4. Purpose of development(residential, commercial, industrial, institutional, etc.): Borrow Pit 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$100.00 per acre (rounded up to the next acre) is assessed without a ceiling amount. In addition,the Express Permitting supplement is$250 per acre up to eight acres,after which the Express Permitting supplemental fee is a fixed$2,000.00 (Example:8.10-acre application fee is$2,900). Checks should be addressed to NCDEQ. 7. Has an erosion and sediment control plan been filed? Yes ❑ Enclosed U No ^' 8. Person to contact should erosion and sediment control issues arise during land-disturbing activity: Name Justin Barbour E-mail Address justin( barbourbrothers.com Phone: Office# 919 242 1267 Mobile# 919 921 1313 9. Landowner(s)of Record (attach accompanied page to list additional owners): John Milton Beaman n/a 252 916 0420 Name Phone: Office# Mobile# 871 HWY 91 871 HWY 91 Current Mailing Address Current Street Address Snow Hill NC 28580 Snow Hill NC 28580 City State Zip City State Zip 10. Deed Book No. 0602 Page No. 0043 Provide a copy of the most current deed. Part B. 1. Company(ies)who are financially responsible for the land-disturbing activity(Provide a comprehensive list of all responsible parties on accompanied page.) if the company is a sole proprietorship or if the landowner(s)is an individual(s), the name(s) of the owner(s)may be listed as the financially responsible party(res). Barbour Brothers Construction Inc justin@barbourbrothers.com Company Name E-mail Address PO Box 95 2496 NC HWY 581 N Current Mailing Address Current Street Address Pikeville NC 27863 Pikeville NC 27863 City State Zip City State Zip Phone: Office# 919 242 1267 Mobile# 919 921 1313 Note: If the Financially Responsible Party is not the owner of the land to be disturbed, include with this form the landowner's signed and dated written consent for the applicant to submit a draft erosion and sedimentation control plan and to conduct the anticipated land disturbing activity. 2. (a) If the Financially Responsible Party is a domestic company registered on the NC Secretary of State business registry, 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 Phone: Office# Mobile# Name of Individual to Contact(if Registered Agent is a company) (b) If the Financially Responsible Party is not a resident of North Carolina, give name and street address of the designated North Carolina agent who is registered on the NC Secretary of State business registry: Name of Registered Agent E-mail Address Current Mailing Address Current Street Address City State Zip City State Zip Phone. Office# Mobile# Name of Individual to Contact(if Registered Agent is a company) (c) If the Financially Responsible Party is engaging in business under an assumed name, give name under which the company is Doing Business As. If the Financially Responsible Party is an individual, General Partnership, or other company not registered and doing business under an assumed name, attach a copy of the Certificate of Assumed Name. Company DBA Name (d) If 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) Phone: Office# Mobile# 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(s) 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 Party). I agree to provide corrected information should there be any change in the information provided herein. QQ pp i�5}ir pC•��ov✓ Rex elcsi t+ Type or print name Title or Authority D`1t2/Za14 Si t e Date 1,Sinsiet 003-0id Aoa , a Notary Public of the County of ' rl 63. State of North Carolina, hereby certify thatat 1aa(J ,cr appeared personally before me this day and being duly sworn acknowledged that the above form was executed by him/her. Witness my hand and notarial seal, this day of( )Uff., , 20 62q Feaez-1- 44.00,4tv Notary My commission expires OI;3'.2S/ `' P N ED. tee" p-C A R y, i_ z ' � z • , • Pu - 2 0. VS TON G°,,,,, Continued from Items 9 & 10 in Part A of the Financial Responsibility/Ownership Form for multiple owners. Attach copies of this page as needed to list all landowners. Landowner 2 of Record: Name Phone: Office# Mobile# Current Mailing Address Current Street Address City State Zip City State Zip Deed Book No. Page No. Provide a copy of the most current deed. Landowner 3 of Record: Name Phone: Office# Mobile# Current Mailing Address Current Street Address City State Zip City State Zip Deed Book No. Page No. Provide a copy of the most current deed. Landowner 4 of Record: Name Phone: Office# Mobile# Current Mailing Address Current Street Address City State Zip City State Zip Deed Book No. Page No. Provide a copy of the most current deed. Landowner 5 of Record: Name Phone: Office# Mobile# Current Mailing Address Current Street Address City State Zip City State Zip Deed Book No. Page No. Provide a copy of the most current deed. Continued from Item 1 in Part B of the Financial Responsibility/Ownership Form for multiple parties. Attach copies of this page as needed to list all financially responsible parties. Company 2 Name E-mail Address Current Mailing Address Current Street Address City State Zip City State Zip Phone: Office# Mobile# Company 3 Name E-mail Address Current Mailing Address Current Street Address City State Zip City State Zip Phone: Office# Mobile# Company 4 Name E-mail Address Current Mailing Address Current Street Address City State Zip City State Zip Phone: Office# Mobile# Company 5 Name E-mail Address Current Mailing Address Current Street Address City State Zip City State Zip Phone: Office# Mobile# From:John Milton Beaman 871 HWY 91 Snow Hill NC 28580 June 10, 2024 Barbour Brothers Construction, Inc. (Justin Barbour) PO Box 95, Pikeville NC 27863 RE: Beaman Borrow Pit Greene County, NC To Whom It May Concern, This letter gives Barbour Brothers Construction, Inc(Justin Barbour) authority to pursue land approvals for erosion and sediment control plans for the Beaman Borrow Pit, located at Beaman Old Creek Road, Snow Hill NC 28580. I also give permission for Barbour Brothers Construction, Inc(Justin Barbour)to perform excavation on this property. Thank you for your consideration, Landowner John Milton Beaman Financially Responsible Party cps TAn/I'I , oV/1212oz4 =`z O TA Rifs stin Barbour, Vice President AVBLIC' Barbour Brothers Construction, Inc. o .414,iii)8214.-11/606/N ,,,,,,,,,,,,,,, ' L,,�iC5 6 J-36o2 Page 1 of 1 0 1"U Cp/r1/hi.�Sid r! (�I f't ROY COOPER �, + _- 1 r," Governor ' W ELIZABETH S.BISER `. 1 4m,„.,76 Secretary Q WILLIAM E.TOBY VINSON,JR NORTH CAROLINA Interim Director Environmental Quality 05-23-2024 LETTER OF APPROVAL Greene County Board of Education ATTN: Frank Creech, Superintendent 301 Kingold Boulevard Snow Hill, North Carolina 28580 RE: Project Name: Greene Central High School Project ID: GREEN-2024-0101 Acres Approved: 20 County: Greene City: Snow Hill Address: NC Hwy 91 River Basin: Neuse Stream Classification: C: Aquatic Life, Secondary Contact Recreation, Fresh water; SW: Swamp Waters; NSW: Nutrient Sensitive Waters Submitted By: Timmons Group Plan Type: New Plan Dear Mr. Creech, This office has reviewed the subject erosion and sedimentation control plan. We hereby issue this Letter of Approval. Any modifications required for approval are listed in the body of the email that accompanied this attached letter. The enclosed Certificate of Approval must be posted at the job site. This plan approval shall expire three (3) years following the date of approval, if no land- disturbing activity has been undertaken, as is required by Title 15A NCAC 4B .0129. As of April 1, 2019, all new construction activities not explicitly exempt are required to complete and submit an electronic Notice of Intent (eNOI) form requesting a Certificate of Coverage (COC) under the NCG010000 Construction General Permit. After the form is reviewed and found to be complete,you will receive a link with payment instructions for the annual permit fee. After the fee is processed,you will receive the COC. As the Financially Responsible Party shown on the FRO form submitted for this project,you MUST obtain the COC prior to commencement of any land disturbing activity. The eNOI form may be accessed at deq.nc.gov/NCG01. Q North Carolina Department of Environmental Quality I Division of Energy,Mineral and Land Resources 512 North Salisbury Street 1 1612 Mail Service Center I Raleigh,North Carolina 27699-1612 o�mrore.�me�iaai� /� 919.707.9200 Letter of Approval Greene County Board of Education 05-23-2024 Page 2 of 2 Please direct questions about the eNOI form to the Stormwater Program staff in the Raleigh central office. If the owner/operator of this project changes in the future, the new responsible party must obtain a new COC. Title 15A NCAC 4B .0118(a) and the NCG01 permit require that the following documentation be kept on file at the job site: 1. The approved E&SC plan as well as any approved deviation. 2. The NCG01 permit and the COC, once it is received. 3. Records of inspections made during the previous 12 months. Also, this letter gives the notice required by G.S. 113A-61.1(a) of our right of periodic inspection to ensure compliance with the approved plan. North Carolina's Sedimentation Pollution Control Act is performance-oriented,requiring protection of existing natural resources and adjoining properties. If, following the commencement of this project, the erosion and sedimentation control plan is inadequate to meet the requirements of the Sedimentation Pollution Control Act of 1973 (North Carolina General Statute 113A-51 through 66), this office may require revisions to the plan and implementation of the revisions to ensure compliance with the Act. Acceptance and approval of this plan is conditioned upon your compliance with Federal and State water quality laws, regulations, and rules. In addition, local city or county ordinances or rules may also apply to this land-disturbing activity. This approval does not supersede any other permit or approval. Please note that this approval is based in part on the accuracy of the information provided in the Financial Responsibility Form and on the plan, which you provided. You are requested to file an amended form if there is any change in the information included on the form. Your cooperation is appreciated. Sincerely, Land Quality Section Page 1 of 3 Book page O q 0602 0043 fiaa fee*Info an ea 911-` day ofI 3 Co ode / m GREENE COUNTY NC 06/09/2006 k BookNO p o . Page #3 $40.00 dl/ancy<544utpr s''"iTH pLINA �F' Real Estate �g �of Deeds,Greene unty NC Excise Tax WARRANTY DEED NO TITLE EXAMINATION PERFORMED BY DRAFTING ATTORNEY Prepared by: Richard J. Archie WHITE & ALLEN, P.A. NORTH CAROLINA GREENE COUNTY C0 THIS DEED, made this day of June, 2006, by JESSE MARION BEAMAN, Unmarried and JOSEPH STEVEN GIORDANO, Unmarried, Grantors; to JOHN MILTON BEAMAN, Grantee; WITNESSET H: That Grantors, for a valuable consideration paid by Grantee, the receipt of which is hereby acknowledged, have sold, and by these presents, do grant, bargain, sell and convey unto Grantee, his heirs and assigns, in fee simple, that parcel of land lying and being in Snow Hill Township, Greene County, North Carolina, and more particularly described as follows. BEING all of that tract or parcel of land containing 1.53 acres, including right of way, by computer, as shown on that map entitled "RECOMBINATION MAP FOR RECORD FOR JOHN MILTON BEAMAN" dated 04/24/06 and prepared by Barrow & Barrow, P.A. , which map is duly of record in Map Book 28, at Page 38 in the office of the Greene County Registry and is incorporated herein by reference for a more accurate description. Book:602 Page:43 Seq: 1 Page 2 of 3 Book Page 0602 0044. TO HAVE AND TO HOLD the aforesaid parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee simple. And the Grantors covenant with the Grantee that Grantors are seized of said premises in fee, have the right to convey the same in fee simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the claims of all persons whomsoever, subject to valid and enforceable utility easements, rights-of-way and restrictions of record, if any, and a pro rata share of the current year's ad valorem property taxes and such additional exceptions as may be hereinafter stated. Title to the property hereinabove described is subject to the following restrictions: None. The designation Grantors and Grantee as used herein shall include said parties, their heirs, successors and assigns, and shall include singular, plural, masculine, feminine or neuter as required by context. IN WITNESS WHEREOF, the Grantors have hereunto set their hands and seals the day and year first above written. ESSE MARION BEAMAN J� E• STEVEN GIORDANO I 2 Book:602 Page:43 Seq:2 Page 3 of 3 Book Page 0602 0045 STATE OF'A•1rl le.,-,O COUNTY OF 4.1-14, Personally appeared before me this day JESSE MARION BEAMAN, Unmarried, being personally known to me or identified by satisfactory evidence and acknowledged to me his due voluntary execution of the foregoing instrument for the terms and purposes therein set forth. Witness my hand and notarial seal, this day of June, 2006. Signatu� � -'— Printed Name: �-eqa V A: r,,.,p,,/„ Notary Public uuu,rU4. tl.. Y ; My commission expires: 1. 67 Ls O d • STATE OF �.. COUNTY OF Qj Personally appeared before me this day JOSEPH STEVEN GIORDANO, Unmarried, being personally known to me or identified by satisfactory evidence and acknowledged to me his due voluntary execution of the foregoing instrument for the terms and purposes therein set forth. Witness my hand and notarial seal, this 2 day of June, 2006. • Printed Name: Y•.Q111 1,1,1/Aht4 „, Notary Public J<� ai ► -r My commission expires: ' Oer • afc #2 n 091024-00002 �� ` e 3 'r4inr{iyn9d�"- Book:602 Page:43 Seq:3