NCC242873_FRO Submitted (2)_20240923

Part B.
1. Company(ies)who are financially responsible for the land-disturbing activity(Provide a comprehensive list
of all responsible parties on accompanied page.)II tho company is a solo proprietorship or it the landownar(s)is
an individual(s),the name(s)of the owner(s)may bo listed as the financially responsible party(ies).
Correia Construction Company LLC [e-mail]
Company Name E-mail Address l;
130 Timberwood Ln (same)
Current Mailing Address Current Street Address
Clinton, NC 28328 •
City State Zip City State Zip
Phone: Office# 91 Q-590-9362 Mobile# [phone]
Note: If the Financially Responsible Party Is not the owner of the land to be disturbed, include with this form
the landowners signed and dated written consent for the applicant to submit a draft erosion and sedimentation
control plan and to conduct the anticipated land disturbing activity.
2. (a)If the Financially Responsible Party is a domestic company registered on the NC Secretary of State
business registry, give name and street address of the Registered Agent:
Kevin Correia [e-mail]
Name of Registered Agent E-mail Address
130 Timberwood Ln •
Current Mailing Address Current Street Address
Clinton, Nc 28328
City State Zip City State Zip
Phone: Office#910-590-9362 Mobile# [phone]
Name of Individual to Contact(if Registered Agent is a company)
(b) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina agent who is registered on the NC Secretary of State business registry.
N/A
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# Mobile#
Name of Individual to Contact(if Registered Agent is a company)
(c) if the Financially Responsible Party is engaging in business under an assumed name,give name under
which the company is Doing Business As. If the Financially Responsible Party is an individual, General