NCC243800_FRO Submitted_20241211

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 Land Quality Section, N.C. Department of Environmental Quality. Submit the completed form to the
appropriate Regional Office. (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. Wends Chapel Hill
1. Project Name y p
2. Location of land-disturbing activity: CountyOrange City or TownshipChapel Hill
Highway/StreetCarraway Crossing Latitude35.9700 Longitude-79'0640
3. Approximate date land-disturbing activity will commence:12/9/2024
4. Purpose of development(residential, commercial, industrial, institutional, etc.):Commercial
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): 1 '03
6. Amount of fee enclosed: $ 200'00 . The application fee of $100.00 per acre
(rounded up to the next acre) is assessed without a ceiling amount (Example: 8.10 ac= $900.00).
7. Has an erosion and sediment control plan been filed? YesX No EnclosedX
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Patrick Burnett E-mail Address [e-mail]
Telephone [phone] Cell # 740-464-2047 Fax# [phone]
9. Landowner(s)of Record (attach accompanied page to list additional owners):
NR Edge Property Owner LLC 919-354-3686
Name Telephone Fax Number
3015 Carrington Mill Blvd. Suite 460 3015 Carrington Mill Blvd. Suite 460
Current Mailing Address Current Street Address
Morrisville, NC 27560 Morrisville, NC 27560
City State Zip City State Zip
10. Deed Book No.Lease attatched Page No. Provide a cop
y py of the most current deed.
Part B.
1. Company(ies) or firm(s) who are financially responsible for the land-disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet.) if the company or firm is a sole proprietorship,
the name of the owner or manager may be listed as the financially responsible party.
Wendschmidt NC LLC [e-mail]
Name E-mail Address
1735 Waller St 1735 Waller St
Current Mailing Address Current Street Address
Portsmouth, OH 45662 Portsmouth, OH 45662
City State Zip City State Zip
Telephone[phone] Fax Number740-353-1576

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:
Justin Schmidt [e-mail]
Name E-mail Address
109 Trellingwood Drive 109 Trellingwood Drive
Current Mailing Address Current Street Address
Morrisville, NC 27560 Morrisville, NC 27560
City State Zip City State Zip
Telephone [phone] Fax Number 740-353-1576
(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:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
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 th re be any change in the information provided herein.
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Title or Authority
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nature Date
/2/0'q2--41-
I, Josf,ph N1,1lt r , a Notary Public of the County of nqt.
State of North Carolina, hereby certify that 3v5 r) S��,n,,d.- 1 appeared
personally before me this day and being duly sworn acknowledged that the above form was
executed by him.
Witness my hand and notarial seal, this 1-1*` day of ")c c_t rv,l c r , 20 2y
ARat
raily
Seal _
JOSEPH MILLER My commission expires Novtm10 r '11' , 2O27
NOTARY PUBLIC
Orange County
North Carolina
My Commission Expires 11/27/2027 i