NCC243123_FRO Submitted_20241009

112.1.1 WAKE COUNTY 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 Wake
7WAKE County Unified Development Ordinance before this form and an acceptable erosion and
sedimentation control plan have been completed and approved by Wake County Department of
Environmental Services. Water Quality Division. (Please type or print and, if the question is not
applicable, place N/A in the blank.)
Part A.
1. Project Name Tranquil Cove
2. Location of land-disturbingactivity: Jurisdiction Wake Co
Y (Wake Co. or Municipality)
Highway/Street Tranquil Cove Latitude 35.980259 Longitude-78-44586
3. Approximate date land-disturbing activity will commence: 10/5/24
4. Type of development (residential. commercial, industrial. institutional. etc.): Residential
5. Total acreage disturbed or uncovered (including off-site utilities and borrow/waste
areas): 1.629
6. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Joseph D Procopio Jr E-mail Address Genesis Building Company INC
Telephone [phone] Cell # Fax#
7. Landowner(s) of Record (attach accompanied page to list additional owners):
Pro Holdings LLC 919-263-3000 [e-mail]
Name(s) Telephone Fax or E-mail address
1600 Heritage Commerce Court#109
Current Mailing Address Current Street Address
Wake Forest NC 27587
City State Zip City State Zip
8. Deed Book No. 19459 Page No. 2104 Provide a copy of the most current deed.
Part B.
1. Person(s) or firm(s) who are financially responsible for the land-disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet. Include requested information):
Genesis Building Company INC [e-mail]
Name E-mail Address
1600 Heritage Commerce Court #109
Current Mailing Address Current Street Address
Wake Forest NC 27587
City State Zip City State Zip
Telephone [phone] Fax Number

2. (a) If the Financially Responsible Party is not a resident of Wake County, identify a designated agent in
Wake County to receive any notice. process, pleading in any action or legal proceeding arising out of any
matter relating to the Wake County Erosion and Sedimentation Control Ordinance and/or Land
Disturbance Permit:
Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone Fax Number
(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:
Joseph D Procopio Jr Genesisbuildingnc angmail.com
Name of Registered Agent E-mail Address
6021 Prescott Pond
Current Mailing Address Current Street Address
Wake Forest NC 27587
City State Zip City State Zip
919-899-5151
Telephone Fax Number
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.
Joseph D Procopio Jr President
Type or rint name Title or Authority
' 1yas� � y
Sigma re Date
I. l Q Jj a 716 ij SYl 1-1-/ . a Notary Public of the County of \Ja f.
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State of North Carolina. hereby certify that ';jQS-( l) 0. `�( DVIU appeared
personally before me this day and being duly sworn acknowle ged that theem above orm was executed by him.
Witness my ham: 4nd notarial seal, this cday of Sv, 20 2�
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Notary Public Not ' 4
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