NCC243555_FRO Submitted_20241118

JOHNSTON 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 Act before this
form and an acceptable erosion and sedimentation control plan have been completed and approved by the
Johnston County Department of Public Utilities. (Please type or print and, 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 NameCharlotte's Ridge Subdivision (fka Antioch Rd Subdivision) - Lots 1-16, 18, 19, 21
2. Location of land-disturbing activity: City or Township O'Neals
Highway/Street Antioch Church Rd Latitude 35.69067' N Longitude -78.25952' W
3. Approximate date land-disturbing activity will commence: 9/1/2024
4. Purpose of development(residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): 5.7
6. Amount of fee enclosed: $ 1,900 . The application fee of$450.00 per acre (rounded
up to the next acre) is assessed for the first 10 acres and an additional $225 per acre for each
additional acre (rounded up to the next acre). Individual residential lots plans are$100 per lot.
7. Has an erosion and sediment control plan been filed? Yes X No Enclosed X
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Bryan Stanley E-mail Address bstanley©hhhunthomes.com
Telephone [phone] Cell# N/A Fax# N/A
9. Landowner(s) of Record (attach accompanied page to list additional owners):
HHHunt Homes Raleigh-Durham, LLC N/A N/A
Name Telephone Fax Number
1 Fenton Main St suite 280 Same
Current Mailing Address Current Street Address
cary nc 27511 Same
City State Zip City State Zip
10. Deed Book No. 6715 Page No. 316-325
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):
HH Hunt Homes [e-mail]
Name E-mail Address
1 Fenton Main St. Same
Current Mailing Address Current Street Address
Cary NC 27511 Same
City State Zip City State Zip
Telephone [phone] Fax Number N/A

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:
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:
Bryan Stanley [e-mail]
Name of Registered Agent E-mail Address
1 Fenton Main St. Same
Current Mailing Address Current Street Address
Cary NC 27511
City State Zip City
State Zip
Telephone Fax Number
4
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.
William Sutphin Vice President
Type or print na Title or Authority
S gnature Date1® p2-f
, a Notary Public of the County of j ,4��_
State of North Carolina, hereby certify thatj. C
personally before me this day and being dulysworn acknowledgbd
ed ��that appeared
executed by him. owledgd the above form was
Witness my hand and notarial seal, this'ia -'day of � .,�- =l}'" , 20 ;�4--
Seal Notary
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Johnson
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