NCC242574_FRO Submitted_20240823

poUN cr
.T� Gaston County/gi'� ' a Gaston Natural Resources Department
� � � r
1303 Dallas-Cherryville Hwy. Dallas, N.C. 28034 Telephone: [phone]
846
4, Soil Erosion & Sedimentation Control
0 la
�,3' Financial Responsibility/Ownership
No person may initiate any land-disturbing activity on one (1) or more acres of property in all portions of
Gaston County, except for that property within the city limits of the incorporated municipalities of Gaston
County who have not adopted the Gaston County Soil Erosion & Sedimentation Control Ordinance,
before this form and an acceptable Soil Erosion & Sedimentation Control Plan have been completed and
approved by the Gaston County Natural Resources Department's staff.
(Please type or print and, if question is not applicable, place N/A in blank)
PART A:
1. Project Name Baler Mills
2. Location of land-disturbing activity
City Gastonia Highway/Street 1010 Neal Hawkins Road
Latitude 35.22406-North Longitude 81.17920-West
3. Approximate date land-disturbing activity will commence June 2024
4. Purpose of development (residential, commercial, industrial, etc.) Residential
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas) 17.9
6. Amount of fee enclosed $7,200
7. Soil Erosion & Sedimentation Plan Filed? Yes. I Enclosed ✓ No
8. Landowner(s)of Record (Use blank page to list additional owners)
Charles R.Dixon&wife,Gilda P.Dixon Andrew Sean Dixon
Name Name
1029 Nottingham Drive 2911 Dixon Howe Road
Mailing Address Mailing Address
Gastonia NC 28054 Gastonia NC 28056
City State Zip City State Zip
Telephone Number Telephone Number
9. Indicate Deed Book and Page where deed(s)or instrument(s)are recorded
Deed Book 2246 Page 27&35
Deed Book 4732 Page 863-864
10. Tax Map No. 141329, 141587,210366 Block Lot No.
Page 1

PART B,
1. Person(s)or firm(s)who are financially responsible for this land-disturbing activity. NOTE: if FRP is not the
Landowner of Record Part A:8., include with this form the landowner's signed and notarized written consent for the
applicant to submit a draft erosion and sedimentation control plan and to conduct the anticipated land disturbing
activity.
Tri Pointe Homes Holdings, Inc Ben Taylor
Name Contact Name for Inspection Reports
6325 Ardrey Kell Road,Suite 150 [e-mail]
Street and Mailing Address Email Address
Charlotte NC 28277 321-230-9793
City State Zip Telephone Number
321-230-9793
Telephone Number Fax Number
2. If the Financially Responsible Party is not a resident of North Carolina, give the name and street
address of a North Carolina agent.
Name
Street and Mailing Address Email Address
City State Zip Telephone Number
3. 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 the name and street address of the Registered Agent.
Corporation Service Company
Name
2626 Glenwood Ave,Suite 550
Street and Mailing Address Email Address
Raleigh NC 27608 [phone]
City State Zip Telephone Number
4. 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 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 Taylor Director of Land Development
Type or Print Name Title or Authority
ay1-�(49
}„ , n, Date UAftN
1 , Vt , a Notar Public of the County of � ,State of North
y
Car mina, hereby certify that' \ (x appeared personally before me this day
an bein 'duly sworn kno ged that th a ove form s execute by him.
itnes my hand a t I al, this S day of (1? 26. 9.
4 a,0 J-00-
tary SEAL My Commission Ex Tres
Ytftt lV SOAN
Nof,kl I Ul Llc
UIJib'N otoNTY Page 2
N8Fiti bitfdllfla
My Commission(3pif@§ MAY 2,2024

Erosion and Sedimentation Control Permit Submittal Checklist
Document Submittal Requirements
FRO has created a Citizens Self Service (CSS)
Completed, Signed, and Notarized FRO Portal Account and the account has been
I Form (to be signed by person financially verified
responsible for the project and no item
should be left blank, mark N/A if needed) 1® I Copy of most current Deed for the site
✓ Landowner of Record Authorization Letter f 171
l Name and contact information of NC Registered
(if the FRO is not the landowner of record) I I Agent, if applicable
I Copy of Certificate of Assumed Name, if Complete set of Erosion Control Plans and
Calculations (utilize remaining checklists to
applicable
ensure complete submittal)
Plans-Location Information and General Site Features
`/ Project Location I Roads, Streets
I North Arrow I d l Scale
✓ Adjoining lakes, streams, or other major ✓ Property lines
drainage ways
✓ Legend I Existing Contours
I Proposed Contours ✓ Limit and acreage of disturbed area
pi
Planned and existing building(s) location I Planned and existing road(s) location and
and elevations elevations
✓ Lot and/or building numbers f7,1 Land use of surrounding areas
I Rock outcrops I Seeps or springs
✓ Wetland limits I Easements
Streams, lakes, ponds, drainageways,
✓( dams; also, any official wetland, stream, if Boundaries of the total tract
and/or watercourse delineation report(s)
Plans- Borrow and Waste Areas
If the same person conducts the land-disturbing activity and any related borrow or waste activity shall
constitute part of the land-disturbing activity unless the borrow or waste activity is regulated under the
I Mining Act of 1971, or is a landfill regulated by the Division of Solid Waste Management. If the land-
disturbing activity and any related borrow or the same person does not conduct waste activities, they
be considered separate land-disturbing activities.
riStockpiled topsoil or subsoil location(s) I® I Street profiles
Plans Vegetative Stabilization
Planned vegetation with details of plants, seed,
mulch, fertilizer NOTE: Plan should include
I Areas and acreage to be stabilized I provisions for groundcover in accordance with
NPDES Construction Stormwater General
Permit NCG010000
Page 3

W i
I Specifications of permanent and temporary
vegetation ✓ Method of soil preparation
Plans-Site Drainage Features
Existing and planned drainage patterns
di (include offsite areas that drain through ✓ Size of areas to be disturbed (acreage)
project)
nSize and location of culverts and sewers I® Soils information (type, special characteristics)
Design calculations and construction for Design calculations, cross-sections, and method
tie
culverts and storm sewers ✓ of stabilization of existing and planned channels
(include temporary linings)
Design calculations and construction details
of energy dissipaters below culverts and Soil information below culvert and storm sewer
IT/1 storm sewer outlets (for rip-rap aprons, ✓ outlets
include stone sizes(diameters) and apron
dimensions)
Design calculations and construction details Name of receiving watercourse or name of
✓ to control groundwater i.e., seeps, high pi municipal operator(only where stormwater
water table, etc. discharges are to occur)
Plans-Erosion Control Measures
✓ Legend ✓ Location of temporary and permanent measures
✓ Construction drawings and details for [1 Design calculations and construction details for
temporary and permanent measures I�' I sediment basins and other measures
✓ Maintenance requirements during ✓ Person responsible for maintenance during
construction construction
✓ Maintenance requirements and responsible
person(s)for permanent measures
Plans-Other Requirements
✓ Narrative describing construction sequence ✓ Narrative describing the nature and purpose of
(as needed) the construction activity
Construction sequence related to sedimentation
and erosion control (include installation of
critical measures prior to initiation of the land-
®/ Bid specifications regarding erosion control ✓ disturbing activity and removal of measures
after areas they serve have been permanently
stabilized)
Page 4