NCC242426_FRO Submitted_20240808

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 Lot 9 Roymac Industrial Park, M2 Maxi Laydown Yard
2. Location of land-disturbing activity: County New Hanover City or Township Wilmington
Highway/Street Metro Circle Latitude 34.2889 Longitude-77.9769
3. Approximate date land-disturbing activity will commence:07/22/24
4. Purpose of development(residential, commercial, industrial, institutional, etc.):Commercial
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): 1.81
6. Amount of fee enclosed: $ 200.00 . 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 Yes No Enclosed
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Christian Rodrigue E-mail Address [e-mail]
Telephone NA Cell# 2078319006 Fax# NA
9. Landowner(s) of Record (attach accompanied page to list additional owners):
M2 Maxi Partners LLC NA NA
Name Telephone Fax Number
351 E. Conestoga Rd Suite 207 351 E. Conestoga Rd Suite 207
Current Mailing Address Current Street Address
Wayne PA 19087 Wayne PA 19087
City State Zip City State Zip
10. Deed Book No.6656 Page No.2660 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.
M2 Maxi Partners, LLC [e-mail]
Name E-mail Address
351 E. Conestoga Rd Suite 207 351 E. Conestoga Rd Suite 207
Current Mailing Address Current Street Address
Wayne PA 19087 Wayne PA 19087
City State Zip City State Zip
Telephone[phone] Fax Number NA

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:
Registered Agent Solutions, Inc. NA
Name E-mail Address
176 Mine Lake Court, Suite100 176 Mine Lake Court, Suite100
Current Mailing Address Current Street Address
Raleigh NC 27615 Raleigh NC 27615
City State Zip City State Zip
Telephone [phone] Fax Number NA
(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:
NA NA
Name of Registered Agent E-mail Address
NA NA
Current Mailing Address Current Street Address
NA NA
City State Zip City State Zip
Telephone NA Fax Number NA
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.
Thomas Dunkel Chief Investment Officer
Type or print name Title or Authority
8/2/2024
Signature Date
I, Cnri5\-OQt•tbr 0 170r1 y , a^Notary Public of the County of JeccersGA
State of I t�eftea�,hereby certify that 1 11001 GS D of v I.ci 1)V ri k e I appeared
personally before me this day and being duly sworn acknowledged that the above form was
executed by him. /n
Witness my hand and notarial seal, this 7 day of 1A vO u 5 4- , 20 2 LI
CHRISTOPHER D BRADY Notary
NOTARY PUBLIC ry
SegITATE OF COLORADO Marc 1 2 a�
NOTARY ID 20234009149 My commission expires n 01
MY COMMISSION EXPIRgg MARQH B9 2027