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HomeMy WebLinkAboutNCC242038_FRO Submitted_20240710 WAKE COUNTY 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 Wake County Un Development co boib COUNTY sedimentation ified controlev plan haveOrdinan been completedef re and th s approvedform byand an Wake Countyaccepta le Department erosion ofand NOWT cnaoi iNn Environmental Services, Water Quality Division. (Please type or print and, if the question is not applicable, place N/A in the blank.) Part A. 1. Project Name Barrington Subdivision - Phase 3D 2. Location of land-disturbing activity: Jurisdiction Town of Zebulon (Wake Co. or Municipality) Highway/Street Parks Village Rd. Latitude 35.8398* Longitude -78.2942* 3. Approximate date land-disturbing activity will commence: 07-15-2024 4. Type of development(residential, commercial, industrial, institutional, etc.): Commercial Non-Residential 5. Total acreage disturbed or uncovered (including off-site utilities and borrow/waste areas): 10.00 AC 6. Person to contact should erosion and sediment control issues arise during land-disturbing activity: raleighlandswppp@dreamfindershomes.com Name James Woofter E-mail Address Telephone Cell# 703-930-3069 Fax# 7. Landowner(s) of Record (attach accompanied page to list additional owners): DFC Barrington, LLC chris.butler dfcapitalmanagement.com Christopher Butler 908-418-6601 Name(s) Telephone Fax or E-mail address 13000 Sawgrass Village, Building 5, Suite 24 13000 Sawgrass Village, Building 5, Suite 24 Current Mailing Address Current Street Address Ponte Vedra Beach FL 32082 Ponte Vedra Beach FL 32082 City State Zip City State Zip 8. Deed Book No. 018542 Page No. 01854 Provide a copy of the most current deed. Part B. 1. Person(s) or firm(s) who are financially responsible for the land-disturbing activity (Provide a comprehensive list of all responsible parties on an attached sheet. Include requested information): Dream Finders Homes, LLC Patrick O. Zalupski Name E-mail Address 14701 Philips Hwy, Suite 300 14701 Philips Hwy, Suite 300 Current Mailing Address Current Street Address Jacksonville FL 32256 Jacksonville FL 32256 City State Zip City State Zip Telephone Fax Number 2. (a) If the Financially Responsible Party is not a resident of Wake County, identify a designated agent in Wake County to receive any notice, process, pleading in any action or legal proceeding arising out of any matter relating to the Wake County Erosion and Sedimentation Control Ordinance and/or Land Disturbance Permit: Jon McReynolds raleighlandswppp@dreamfindershomes.com Name E-mail Address 7200 Falls of Neuse, Suite 202 7200 Falls of Neuse, Suite 202 Current Mailing Address Current Street Address Raleigh NC 27615 Raleigh NC 27615 City State Zip City State Zip Telephone 919-374-3473 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: Corporate Creations Network Inc. Name of Registered Agent E-mail Address 15720 Brixham Hill Avenue #300 15720 Brixham Hill Avenue #300 Current Mailing Address Current Street Address Charlotte NC 28277 Charlotte NC 28277 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. Jon McReynolds Division President Type or print name Title or Authority Signatur 1 Date I, /)lam b�r 24G1r> a Notary Public of the County of 4J046_ II State of North Carolina, hereby certify that J Dn N'i-)e,^ At?dam appeared personally before me this day and being duly sworn acknowledged th the above form was executed by him. Witness my hand and notarial seal, this d day of • , 20v�V %%%%%%%%%%%%%!,!% </i,111 /144-1j,/ �~e••$' %� A/>' ••�'y Notary Seas s •`• •` My Comm.Exp.I My commission expires ///o)-3/ oo2V % 11/23/2024 C n ins %