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HomeMy WebLinkAboutNCC242845_FRO Submitted_20240917 DURHAM JCN COUNTY Durham City/County (Office Use Only) i =:,r, Sedimentation and Erosion Control iI FFt ` �7 FINANCIAL RESPONSIBILITY/OWNERSHIP FORM ` = .4,,,, WITH LANDOWNER CONSENT FORM No person may initiate any land-disturbing activity covered by the Durham City-County Unified Development Ordinance before a Land Disturbing Permit is issued by the Sedimentation and Erosion Control Office.Issuance of a Land Disturbing Permit does not relieve the permittee of the obligation to obtain any other licenses, permits and approvals as may be required by Federal, State, County or Municipal governments. This office must be notified in writing of any change to the information on this form. PLEASE TYPE OR PRINT 1. Project name: Junction and Ferrell Private Access Road Extension: Yes or n 2. Road location of land-disturbing activity: Northern Durham Parkway, Junction Road and Ferrell Road Tax Map-Block-Parcel: 236862 PIN: 0842759387 3. Square footage of land to be disturbed or uncovered: 279,557 SF 4. List below the landowner of record. Each landowner must complete Item 8. (If there are multiple owners,please list on a separate page): Scannell Properties#736, LLC Name 8801 River Crossing Blvd.. Suite 300 Address Indianapolis Indiana 46240 City State Zip 908-655-5632 317-842-5957 andys@scannellproperties.com Telephone Fax Email 5. List the person or entity financially responsible for this land-disturbing activity:The financially responsible party shall be (1)the developer or other person who has or holds themselves as having financial or operational control over the land-disturbing activity and/or(2)the land owner or person in possession or control of the land when they have directly or indirectly allowed the land-disturbing activity or have benefited from it and(3)the named party on the Land Disturbing Permit. Scannell Properties#736, LLC Name 8801 River Crossing Blvd., Suite 300 Street Address Indianapolis Indiana 46240 City State Zip 908-655-5632 317-842-5957 andys@scannellproperties.com Telephone Fax Email x As the Financially Responsible Party,I consent to receiving notifications regarding this project via electronic (Initials) communication at _ andys@scannellproperties.com (Email Address) I agree to provide any updated email addresses as necessary to ensure consistent communication is maintained between myself and Durham County Sedimentation and Erosion Control. Electronic notifications may include Plans Review Comments,Approvals,Disapprovals,and/or enforcement actions including Notices of Violation,Stop-Work Orders,and/or Civil Penalties. 201 E.Main St,5th Floor,Durham,N.C.27701•(919)560-0735•Fax(919)560-0740 www.co.durham.nc.usieeng 6. For business applicants,list below the North Carolina registered agent for the financially responsible entity: _Cogency Global Inc. Name 2810 Coliseum Centre Drive,Suite 120 Street Address Charlotte NC 28217 City State Zip 866-775-0114 kbeckner@cogencyglobal.com Telephone Fax Email 7. The above information is true and correct to the best of my knowledge and belief and was provided by me while under oath. I understand that the person or entity listed on Line 5 above will be: (1)the owner of the Land Disturbing Permit when issued; (2)responsible for ensuring compliance with the Act and Ordinance;and,(3)will be the only person or entity with standing to appeal any action taken or decision made by the Sedimentation and Erosion Control Office. 7/24 S/ ,1 t c' t(V,r/. Date Type orint N e �! 3/?— S/3- ///,E',/ Cr Telephone Fax Title or A th ty /!?cri-c �Sea/k'ri�Y9 'rS.44.t Email j Signature Business Applicant(Provide corporate resolution on signatory authority) I, �j/ 64(1 /7 .a Notary Public of the County of /0A2/��,4 State of—/X✓&/7at hereby certify that ,Qrc a0ji/0 personally came before me this day and acknowledged that he is /�g� Jr / oftAC/IMPA% -.4QS .f' 4�C' and acknowledged,on behalf of ..17 .7600/7 J'O� ?4./// ,the due execution of the fore oin instrument. g g Witness my hand and official seal,this 27 day of (4/i ,20 1C ,, /! Public ,� PutKt store of "ane My commission expires Al irr ,20 iT . ' 1 t,, Commission �+Cann.91848 4 1 ca MsafomnErx �,wa�'�`"w blovembar 23,2021 Individual Applicant I, ,a Notary Public of the County of State of ,hereby certify that personally appeared before me this date and under oath acknowledged that the above form was executed by them. Witness my hand and official seal,this day of ,20 Notary Public My commission expires 20 Provide a Notarized Item 8 for each landowner listed in Item 4. 8. Land Owner Consent. As a landowner, I provide my consent for land-disturbing activities to occur on the property listed in Item 2 by the person or entity listed in Item 5. 7/205, 7e,v& Date Type • Print am 573-7 • Telephone Fax Title or Aut y Email Signature Business Landowne (Provide corporate resolution on signatory authority) // I, l4//r C <74.Ss4/1 .a Notary Public of the County of , il�i! State of_ 72A' , .hereby certify that ,'//!V ' jQ" , ' personally came before me this day and acknowledged that he is i�% .Der(J ot�_.l 4*//35,,Gr/;74,5 jJb '4, and acknowledged,on behalf of_ (///)142ercW;,2'S�f/ Z?"4,z,,/ the due execution of the foregoing instrument. Witness my hand and official seal,this 2✓7 .74 day of Cie/ ,20 Ll' �f Publ / , R. Jackson /�J�4:4 !/� ,2(� 1 ry' e" Notary isso ICou not y91848 1 My commission expires ! I SEAL Commisabn Number 1848 Commission ,.Mr 4 Individual Landowner I, ,a Notary Public of the County of State of ,hereby certify that personally appeared before me this date and under oath acknowledged that the above form was executed by them. Witness my hand and official seal,this day of ,20 Notary Public My commission expires 20 The Sedimentation and Pollution Control Act(Act)and the Durham City-County Unified Development Ordinance(Ordinance) includes,but is not limited to,the following legal obligations of the financially responsible party: • Maintain a set of approved sedimentation and erosion control plans,if required,on site. • Display permit on site. • Understand and implement any required plan,including the construction sequence and details. • Inspect,maintain and repair sedimentation and erosion control measures,especially after rainfall events. • Provided adequate ground cover or otherwise stabilize all areas that have not been actively graded within 21 calendar days. • Plan and conduct all land-disturbing activity so as to prevent off-site sedimentation. SE-03 Rev.07/06