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HomeMy WebLinkAboutNCC243438_FRO Submitted_20241106 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 Soil Erosion and Sedimentation Control Ordinance of the City of Greenville(Title 9,Chapter 8)before this form and an acceptable erosion and sedimentation control plan have been completed and approved by the City of Greenville, Engineering Department. (Please type or print and, if the question is not applicable or the e-mail address or phone number is unavailable, place N/A in the blank.) Part A. 1. Project Name Boviet Solar: Cell Manufacturing Building Expansion 2. Location of land-disturbing activity: County Pitt City or Township Greenville Highway/Street Sugg Parkway Latitude(decimal degree35.657958Longitude(decimal degrees) -77.343517 3. Approximate date land-disturbing activity will commence: October 25, 2024 4. Purpose of development(residential, commercial, industrial, institutional, etc.): Industrial 5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): 41 acres 6. Amount of fee enclosed: $ 4,100 . The application fee of$100.00 per acre or portion thereof (rounded up to the next acre) is assessed without a ceiling amount (Example: 8.10-acre application fee is$900). 7. Has an erosion and sediment control plan been filed? Yes ❑ Enclosed 14 No ❑ 8. Person to contact should erosion and sediment control issues arise during land-disturbing activity: Name Steve Lane E-mail Address slave@arcomurray.com Phone: Office# Mobile# 847-544-9511 9. Landowner(s)of Record (attach accompanied page to list additional owners): Boviet USA Property, LLC 864-517-6162 Name Phone: Office# Mobile# 1125 Sugg Pkwy 1125 Sugg Pkwy Current Mailing Address Current Street Address Greenville NC 27834 Greenville NC 27834 City State Zip City State Zip 10. Deed Book No. 4539 Page No. 497 Provide a copy of the most current deed. 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.) If the company is a sole proprietorship or if the landowner(s)is an individual(s), the name(s)of the owner(s)maybe listed as the financially responsible party(ies). Boviet USA Property, LLC xzc@boviet.com Company Name E-mail Address 1125 Sugg Pkwy 1125 Sugg Pkwy Current Mailing Address Current Street Address Greenville NC 27834 Greenville NC 27834 City State Zip City State Zip Phone: Office# Mobile# 864-517-6162 Note: If the Financially Responsible Party is not the owner of the land to be disturbed, include with this form the landowner's 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: VCorp Agent Services, Inc. cosherovitz@vcorpservices.com Name of Registered Agent E-mail Address 160 Mine Lake Court Suite 200 160 Mine Lake Court Suite 200 Current Mailing Address Current Street Address Raleigh NC 27615 Raleigh NC 27615 City State Zip City State Zip Phone: Office# 845.425.0077 Mobile# Charles Osherovitz 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 N/A Name of Registered Agent E-mail Address N/A N/A Current Mailing Address Current Street Address N/A N/A City State Zip City State Zip Phone: Office# N/A Mobile# N/A N/A 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 Partnership, or other company not registered and doing business under an assumed name, attach a copy of the Certificate of Assumed Name. Company DBA Name 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(s) 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 Party). I agree to provide corrected information should there be any change in the information provided herein. Type or print name Title or Authority �11ctr. ( ✓.t /0/2 / ?.a74 Signature f Date h� G✓oov'e✓ r , a Notary Public,�n of the County of State of North Carolina, hereby certify that MO\L•Y 1 r 1Ai' appeared personally before me this day and being duly sworn acknowledged that the above form was executed by him/her Witness my hand and notarial seal, this day of O( -v h,./A-- , 20 ail ottli•Itr,i, G7 `/ x`.)✓Wt� � � G RQ /* Nota e eal L(% My commission expires (ti1,/•1 t/ 2,0Lc M � AUBL\r' 4„'�r 0 u ��• �:t �,/IIIN1 N/A Continued from Items 9 & 10 in Part A of the Financial Responsibility/Ownership Form for multiple owners. Attach copies of this page as needed to list all landowners. Landowner 2 of Record: Name Phone: Office# Mobile# Current Mailing Address Current Street Address City State Zip City State Zip Deed Book No. Page No. Provide a copy of the most current deed. Landowner 3 of Record: Name Phone: Office# Mobile# Current Mailing Address Current Street Address City State Zip City State Zip Deed Book No. Page No. Provide a copy of the most current deed. Landowner 4 of Record: Name Phone: Office# Mobile# Current Mailing Address Current Street Address City State Zip City State Zip Deed Book No. Page No. Provide a copy of the most current deed. Landowner 5 of Record: Name Phone: Office# Mobile# Current Mailing Address Current Street Address City State Zip City State Zip Deed Book No. Page No. Provide a copy of the most current deed. N/A Continued from Item 1 in Part B of the Financial Responsibility/Ownership Form for multiple parties. Attach copies of this page as needed to list all financially responsible parties. Company 2 Name E-mail Address Current Mailing Address Current Street Address City State Zip City State Zip Phone: Office# Mobile# Company 3 Name E-mail Address Current Mailing Address Current Street Address City State Zip City State Zip Phone: Office# Mobile# Company 4 Name E-mail Address Current Mailing Address Current Street Address City State Zip City State Zip Phone: Office# Mobile# Company 5 Name E-mail Address Current Mailing Address Current Street Address City State Zip City State Zip Phone: Office# Mobile#