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HomeMy WebLinkAboutNCC242922_FRO Submitted_20240920 FINANCIAL RESPONSIBILITY/OWNERSHIP FORM pxPE.s SEDIMENTATION POLLUTION CONTROL ACT • 1�'� • WATER RESOURCES Ol i 105-B Upchurch Street '� Town of Apex, North Carolina 27502 NIY p,Fi Contact: James Misciagno Phone: (919)372-7470 E-Mail: 'ames.misciagno@apexnc.org. No person may initiate any land-disturbing activity on twenty(20)thousand square feet or more before this form has been completed and filed with the Town of Apex Water Resources Department. PART A Name of Project:The Depot a'.North Salem Location of Land-Disturbing Activity:2200 Candun Dr.(PIN 0753016629),2215 Candun Dr.(PIN 0753025086),2520 Laura Duncan Rd.(PIN 0753019933) Approximate Date Land-Disturbing Activity will Commence: 1'9'2°24 Acreage of Land to be Disturbed:7 28 Latitude: 3'76"92 Longitude: -78.828894 Land Owner(s) of Record (use blank page to list additional owners): Name:Old Apex Associates,LP Name: Current Mailing Address: Current Mailing Address 100 10th ST NE STE 300 City, State,Zip:C'rarlottesville,VA 22902 City, State,Zip PART B Person or firm financially responsible (developer)for this land disturbing activity. Financial responsibility includes, but may not be limited to: payment of civil fines and criminal penalties and any other costs associated with bringing the project into compliance with the Town of Apex Soil Erosion and Sedimentation Control Ordinance. Name of Person or Firm:Old Apex Associates,LP Telephone:434-531-6301 E-mail:ishifflett@castledp.com Current Mailing Address: Street Address(if different from mailing address) 100 10th ST NE STE 300 City,State,Zip:Charlottesville,VA 22902 City,State,Zip Revised 9/19/2019 Page 1 If the financially responsible party is not a resident of Wake County, complete the following for an appointed agent, in Wake County, to receive any notice, process, pleading in any action or legal proceeding arising from a violation of the Town of Apex Soil Erosion and Sedimentation Control Ordinance. By signing below,it is agreed that any notice, process, or pleading against the person or firm who is financially responsible for this land-disturbing activity may be served on the undersigned and shall be of the same force and effect as if served on the financially responsible person or firm. The intent of this provision is to establish the presumption that the constructive notice from the Town of Apex will be addressed through the undersigned agent. Name: Thomas H. Johnson, Jr. Telephone: 919-981-4006 Current Mailing Address: Street Address (if different from mailing address) 301 Fayetteville Street, Suite 1700 City, state,zip:Raleigh, NC 27601 City, State,Zip Signature: /iZbl�1lZQ- 7 • If the financially responsible party is a partnership or other person engaging in business under an assumed name,complete Page 4 of this form, or attach a copy of the Certificate of Assumed Name or Partnership as recorded in the Register of Deeds. If the financially responsible party is a corporation, complete the information on Page 5 of this form and submit a current copy of the Annual Report as filed with the Secretary of State. The information contained in this form is true and correct to the best of my knowledge and belief and was provided by me while under oath. (This form must be signed by the financially responsible person if an individual or by an officer, director, partner, or registered agent with authority to execute instruments for a corporation or partnership if it is the financially responsible party). I agree to provide corrected information should there be any change in the information provided herein. Name: 4A] 'Y M G& J1 Y Date: %/eV.°L/ Title or Authority: HC(9'f / el' 4EA A-6 Signature: (� 5-tti0 6 C/"y a Notary Public of the County of 141!jcnk./ , State of Ne h-earolina hereby certify that personally appeared before me this day and under oath acknowledged that the above form was executed by him/her. Witness my hand,and,5,eal this day of 2 0? 7 Q 3(T//� co NOTARYAL � uBLIC REG.#783567O6 Notary My Commission Expires E N . ccMY cOMMISS EXPIRES 2 03131/2027 4 Financial responsibility encompasses personal liability by the person signing this disclosufb,Q 'ifT'aa� Orrt�r in a ' . �•`` partnership or if an officer or director of a corporation which is either:(a)dissolved lawfully under. A IVtcth, aroliNa statutes: (b) suspended from transacting business in North Carolina by the North Carolina Secretary of State; (c) insolvent; (d) in bankruptcy; (e) undercapitalized to the extent it is unable to comply with the Soil Erosion and Sedimentation Control Ordinance; or(f) a "shell" corporation. Revised 9/19/2019 Page 2 PART C Contractors and/or subcontractors (person(s) or firm(s)engaging in the land-disturbing activity): Name Person or Firm: Name of Person or Firm: Weaver Cooke Construction,LLC Weaver Cooke Construction,LLC Telephone:336-378-7900 Telephone:336-378-7900 Email: Email: clee@weavercooke.corn clee@weavercooke.com Current Mailing Address: Current Mailing Address 8401 Key Boulevard 8401 Key Boulevard City,State,Zip:Greensboro,NC 27409 City,State,Zip Greensboro,NC 27409 The information contained in this form is true and correct to the best of my knowledge and belief was provided by me while under oath. (This form must be signed by the person or firm engaging in the land-disturbing activity of an individual or by an officer, director, general partner, attorney-in-fact, or other person with authority to execute instruments for the entity engaging in the land-disturbing activity if not an individual. I agree to provide corrected information should there be any change in the information provided herein. Name: Chris Lee Date:09/09/2024 Title or Authority:Senior Vice President of Preconstruction Signature: - I, lV 4�t•N _� � a Notary Public of the County of G _ ,State of North Carolina hereby certify that` personally appeared before me this day and under oath acknowledged that the above form was executed by him/her. Witness my hand and seal this ```,���rrrrrriri�i day of Je�. , Ioz4- • N. \p SEAL M 94/ �'. 23— O TA,Q FN Notary My Commission Expires f,7 _U l,� AU B Lac' � R0 C 0\) .%`, Revised 9/19/2019 Page 3 CERTIFICATE OF ASSUMED NAME OR PARTNERSHIP (SEDIMENTATION POLLUTION CONTROL ACT) The undersigned,proposing to engage in business in Wake County,North Carolina, under an assumed name or partnership name, do hereby certify that: The name under which the business is to be conducted is (insert assumed or partnership name): Old Apex Associates,LP The names and residences and mailing addresses of all the owners of the business are (Insert name and address of each owner): Andy Mcginty, 100 10th ST NE STE 300, Charlottesville,VA 22902 IN WITNESS WHEREOF,this certificate is signed by each of the owners of said business, this day of Owner's from above belo • State of North acelic,a- County of Wake A\�{.w. I, 4-6eL"- Cc"/ a Notary Public, do hereby certify that on this � t day of 202`( , personally appeared before me A44/ t C G•.J7' who are all signers of the foregoing instrument, and each acknowledges the due execution thereof. IN WITNESS n // 20 2"„00 'p'N F day of 4 WHEREOF, I have hereunto set my hand and official seal this �Pp Notar My Commission Expires I O REG. 835 O Com 676 . M�SSi • 03 3,�?Fs GN 02 #1, -4 Revised 9/19/2019 �TH..OF'J'Page 4 Name of Corporation:Old Apex Associates,LP Name of registered agent,street address,mailing address of registered office in Wake County: Name: Corporation Service Company Street Address: 2626 Glenwood Avenue, Suite 550 city,state,zip: Raleigh, NC 27608 Current Mailing Address: 2626 Glenwood Aveune, Suite 550 city,State,Zip: Raleigh, NC 27608 Enter first, middle,and last name of principal officers. Enter title and street address of principal officers. Name and Title: Name and Title: Andy E.Mcginty,Manager Street Address: Street Address: 100 10th ST NE STE 300 City, State,Zip: City,State,Zip: Charlottesville,Va 22902 Name and Title: Name and Title: Street Address: Street Address: City,State, Zip: City, State,Zip: Enter first, middle,and last name of directors. Enter title and street address of directors. Attach pages as necessary. Name and Title: Name and Title: Street Address: Street Address: City,State,Zip: City,State,Zip: Name and Title: Name and Title: Street Address: Street Address: City, State,Zip: City,State,Zip: Revised 9/19/2019 Page 5 --cirmuiie,y NORTH CAROLINA r ..tt .. ' A., _ f . 97 Department of the Secretary of State To all whom these presents shall come, Greetings: I, ELAINE F. MARSHALL, Secretary of State of the State of North Carolina, do hereby certify the following and hereto attached to be a true copy of CERTIFICATE OF FOREIGN LIMITED PARTNERSHIP OF OLD APEX ASSOCIATES, LP the original of which was filed in this office on the 10th day of November, 2021. "'dE' '• 6y`. IN WITNESS WHEREOF, I have hereunto set my CI 4 w'`iii_}' hand and affixed my official seal at the City of :�t'_--/ ',j J Raleigh, this 10th day of November, 2021. #laiite./ ...0 104041e -• � it"'b Scan to verify online. Certification#C202130800843-1 Reference#C202130800843-1 Page: 1 of 4 Secretary of State Verify this certificate online at https://www.sosnc.gov/verification SOSID: 2303592 Date Filed: 11/10/2021 2:01:00 PM Elaine F. Marshall North Carolina Secretary of State "--"-.;.;;-; ', ,, State of North Carolina C2021 308.008.43 Department of the Secretary of State •' i� ,\y,- APPLICATION FOR REGISTRATION `, S• Wll " o AS A FOREIGN LIMITED PARTNERSHIP Pursuant to §59-902 of the General Statutes of North Carolina, the undersigned hereby submits this application for Registration as a Foreign Limited Partnership for the purpose of obtaining a Certificate of Authority to transact business in this State. 1. The name of the foreign limited partnership is:Old Apex Associates, LP 2. If the name of the foreign limited partnership is unavailable for use in the State of North Carolina, the name the limited partnership wishes to use is: (The name must contain the words"Limited Partnership,"or the abbreviation"L.P."or"LP,"or the combination "Ltd. Partnership") 3. The jurisdiction in which the limited partnership was formed is A, United States and the date of formation was 11/04/2021 . The limited partnership's period of duration is 4. The street address of the principal office is: Number and Street:230 Court Square City:Charlottesville State:VA _ Zip Code:22902-5158 County:Albemarle The mailing address, if different from the street address, of the principal office: Telephone: Number and Street: City: State:VA ZipCode:22902-5158 County: 5. Name of Registered Agent: Corporation Service Company 6, Address of Registered Agent's Office: Number and Street: 2626 Glenwood Ave Ste 550 City:Raleigh State: NC Zip Code:27608 County: Wake The mailing address,if different from the street address,of the registered office: Number and Street 2626 Glenwood Ave Ste 550 City:Raleigh State: NC Zip Code:27608 County: Wake NOTES: Filing fee is 550. This document must be tiled with the Secretary of State. BUSINESS REGISTRATION DIVISION P.O.BOX 29622 RALEIGH,NC 27626-06222 (Revised August,2017) Page 1 Form LP-04 7. In consideration of the issuance of a Certificate of Authority to transact business in North Carolina, the limited partnership appoints the Secretary of State of North Carolina as the agent to receive service of process,notice or demand,whenever the foreign limited partnership fails to appoint or maintain a registered agent in this State,or whenever such registered agent cannot with reasonable diligence be found at the registered office. 8. (Optional): Please provide a business e-mail address: Privacy Redaction The Secretary of State's Office will e-mail the business automatically at the address provided at no charge when a document is filed. The e-mail provided will not be viewable on the website. For more information on why this service is being offered,please see the instructions for this document. 9. Enter the name and address of each general partner: (attach additional sheets if necessary) Name CDP Apex, LLC Name Street/No.230 Court Square Street/No, City_Charlottesville City State/Zip VA 22902-5158 United States State/Zip _ 10. Limited Partners (select 1 or 2, as appropriate) ❑ Attached is a list of the names and addresses of all limited partners (include full name/street address/city/state/zip code/county); or The location of the office where list of the names and addresses of the limited partners and their capital contributions will be kept as long as the limited partnership transacts business in North Carolina is: Number and Street: 230 Court Square City:Charlottesville State:VA _ Zip Code:22902 County: Albemarle 11. (Select one) ❑ The foreign limited partnership is a foreign limited liability limited partnership. ❑The foreign limited partnership is not a foreign limited liability limited partnership. 12. This registration will be effective upon filing, unless a future date and/or time is specified: Old Apex Associates, LP Typed or printed name CDP Apex, LLC Signature Andy McGinty, Mn -- 6.7c e ik I Pe-r I Title NO'ITS. Filing fee is S50. 'Fills document must be filed with the Secretary of State. BUSINESS REGISTRATION DIVISION P.O.BOX 29622 RALETGH.NC 27626-06222 (Revised August, 2017) Page 2 Form LP-04 f are" rj r A jtixüls $fafi C or or fion Olrrx misstin "wit, CERTIFICATE OF FACT I Certify the Following from the Records of the Commission: A certificate of limited partnership was filed with the Commission on behalf of Old Apex Associates, LP, a limited partnership formed under the law of VIRGINIA, effective as of f November 4, 2021. As of the date set forth below, a certificate of cancellation canceling the existence of Old Apex Associates, LP, a Virginia limited partnership, has not been filed in the Office of the Clerk of the Commission. Nothing more is hereby certified. �.. Signed and Sealed at Richmond on this Date: Qop aloh P o -� �',v? ,\ '.IN, 44.'16 November 9,2021 w • N1.14-12'A; h 12 79:" 1903 Bernardi. Logan,Clerk of the Commission CERTIFICATE NUMBER : 2021110916543976 NORTH CAROLINA Department of the Secretary of State CERTIFICATE OF AUTHORITY I, ELAINE F. MARSHALL, Secretary of State of the State of North Carolina, do hereby certify that OLD APEX ASSOCIATES, LP having filed on this date an application conforming to the requirements of the General Statutes of North Carolina, a copy of which is hereto attached, is hereby granted authority to transact business in the State ofNorth Carolina. oMp^mFi',T:s` 0 :do •- IN WITNESS WHEREOF, I have hereunto set El • y � r.. �}�_� my hand and affixed my official seal at the City of Raleigh, this 10th day of November, 2021. #4.1;*e." ti'V{ aft"-12-‘;16 Scan to verify online. - 000. Document Id:C202130800843 Secretary of State Verify this certificate online at https://www.sosnc.gov/verification