NCC243496_FRO Submitted_20241113

SOIL EROSION and SEDIMENTATION CONTROL
Lincoln County Natural Resources Department
115 West Main Street, Lincolnton, NC 28092 704-736-8501 Fax [phone]
FINANCIAL RESPONSIBILITY i OWNERSHIP FORM
No person may initiate any land-disturbing activity on one or more acres as covered by the Act before this form and an acceptable
erosion and sedimentation control plan has been completed and approved by the Lincoln County Natural Resources Department.
(Please type or print. If the question is not applicable or the e-mail and/or fax information unavailable, place N/A in the blank.)
Part A
1. Project Name Hornet Solar Phase 2
2. Location of land-disturbing activity: Latitude35.4169 Longitude-81.0197
Parcel Identification Number(PIN)88482 Watershed Area Not Protected Area(Per Lincoln Cot
Highway/Street Address215 Drew Road Stanley,NC 28164
3. Approximate date land-disturbing activity will commence:11/18/2024
4. Purpose of development(residential,commercial, industrial, institutional,etc.):Solar Energy
5. Total acreage disturbed or uncovered(including off-site borrow and waste areas):310
6. Amount of fee enclosed: $62,000 .The Standard Permitting application fee of$200.00 per acre
(rounded up to the next acre)is assessed without a ceiling amount(Example: 9 acres total$1,800).The Express
Permitting application fee is a dual charge. The normal fee of$200.00 per acre(rounded up to the next acre)is
assessed without a ceiling amount. In addition,the Express Permitting supplement is$250.00 per acre up to eight
acres, after which the Express Permitting supplemental fee is a fixed$2,000.00 (Example:9 acres total$3,800.00).
7. Has an erosion and sediment control plan been filed? Yes No EnclosedX
8. Local appointed person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Emily Brown E-mail [e-mail]
Telephone Cell# Fax#
9. Landowner(s)of Record (attach accompanied page to list additional owners):
Wemald LLC
Name Telephone Fax Number
3758 HIGHWAY 16 NORTH MCINTOSH RS
Current Mailing Address Current Street Address
DENVER NC 28037 CATAWBA SPRINGS TOE NC 28164
City State Zip City State Zip
10. Deed Book No.1990 Page No.277 most recently filed in Lincoln County Register of Deeds.
11. Future Landowner(s) if applicable: (attach accompanied page to list additional owners):
Name Telephone Fax Number
Current Mailing Address Current Street Address
City State Zip City State Zip

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( / 11 ASOIL EROSION and SEDIMENTATION CONTROL
Lincoln County Natural Resources Department
115 West Main Street, Lincolnton, NC 28092 704-736-8501 Fax: [phone]
FINANCIAL RESPONSIBILITY / OWNERSHIP FORM
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):
Hornet Solar LLC (c/o Capital Power) [e-mail]
Name E-mail Address
155 Federal St Suite 1200 155 Feberal St Suite 1200
Current Mailing Address Current Street Address
Boston MA 02110 Boston MA 02110
City State Zip City State Zip
Telephone[phone] Fax Number617-274-7701
2. (a) If the Financially Responsible Party is not a resident of North Carolina,give name and street address of the
designated North Carolina Agent:
CT Corporation System
Name E-mail Address
160 Mine Lake Court STE 200
Current Mailing Address Current Street Address
Raleigh NC 27615
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:
CT Corporation System
Name of Registered Agent E-mail Address
10423-101 Street NW
Current Mailing Address Current Street Address
Edmonton Alberta T5H Oi
City State Zip City State Zip
Telephone Fax Number
(c) In order to facilitate Permitting, it is necessary to be able to contact the Engineer or other consultant who can
assist in providing any necessary information regarding the plan and its preparation:
Kimley-Horn and Associates, INC [e-mail]
Engineering Firm or other consultant E-mail Address
421 Fayetteville St Raleigh NC 27601
Current Mailing Address City State Zip
Luke Lukas 984-900-2008
Individual contact person(type or print) Telephone Fax Number

ov •, <,„,
SOIL EROSION and SEDIMENTATION CONTROL
Lincoln County Natural Resources Department
115 West Main Street, Lincolnton, NC 28092 704-736-8501 Fax: [phone]
FINANCIAL RESPONSIBILITY / OWNERSHIP FORM
(d) Contractors and/or Subcontractors(person(s)or firm(s)engaging in the land-disturbing activity:
Name of Person or Firm Name of Person or Firm
Current Mailing Address Current Street Address
City State Zip City State Zip
Individual contact person(type or print) Individual contact person(type or print)
Telephone Telephone
Fax Number 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 by any change in the information provided
herein and any other associated documents. I understand that all documents that are associated with this project and
project number are parts of the complete project document.
Permission to Enter on Land
I certify that I am authorized to grant and do in fact grant permission to the Natural Resources Erosion Control Inspector
and his agents to enter on the land in question in connection and/or related to this permit.
Emily Brown �,�
Type or print name Title or Authority
- ' 7
Signature \\� Date
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I, L-GY t V ,a Notary Public of the County of (''V e c k L ft.e��5
State of North Carolina, hereby certify that �[ ^. (N r��D `^ appeared personally before
me this day and being duly sworn acknowledged tha the above form was executed by him.
Witness my hand and notarial seal,this day of NOV- ,20 ZL4
Notary
t�= LEVI FORTNER
Notary Public My commission expires�Q'V Z o �C7-
r' ti: ., MAeckl enburg County, NC
G,mmission Expires Nov.20,2027

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:
Beattystar, LLC
Name Phone: Office# Mobile#
6632 ALEXANDER HALL DR
Current Mailing Address Current Street Address
CHARLOTTE NC 28270
City State Zip City State Zip
Deed Book No.3357 Page No.205 Provide a copy of the most current deed.
Landowner 3 of Record:
TMSMJ PROPERTIES LLC
Name Phone: Office# Mobile#
1418 NATURES PRESERVE TR
Current Mailing Address Current Street Address
DENVER NC 28037
City State Zip City State Zip
Deed Book No. 1885 Page No.518 Provide a copy of the most current deed.
Landowner 4 of Record:
LTJ PROPERTIES LLC
Name Phone: Office# Mobile#
1418 NATURE PRESERVE TRAIL
Current Mailing Address Current Street Address
DENVER NC 28037
City State Zip City State Zip
Deed Book No. 1885 Page No. 514 Provide a copy of the most current deed.
2363 672
2831 485
Landowner 5 of Record:
Annie Moore
Name Phone: Office# Mobile#
7604 OLD PLANK RD
Current Mailing Address Current Street Address
STANLEY NC 28164
City State Zip City State Zip
Deed Book No. 2558 Page No.326 Provide a copy of the most current deed.