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Home My WebLink AboutNCC220667_FRO Submitted_20220208Financial Responsibility Ownership .; ENGINEERING (Sedimentation Pollution Control Act) `""W SERVICES One Exchange Plaza, Suite 304 Raleigh, NC 27601 This section to be completed by City of Raleigh staff Submittal Date Effective Date Transaction Number Permit Number LD- The remaininq sections to be completed by the Applicant SECTION 1: GENERAL INFORMATION & INSTRUCTIONS This form is required to be completed, notarized and submitted with all Land Disturbing Permit applications. The information provided herein becomes an enforceable part of the approved Erosion and Sediment Control Plan and the Land Disturbing Permit listed above. Non-compliance may result in the assessment of civil penalties and could potentially affect all permits, inspections and/or Certificates of Occupancy for this Project. Should any of the information on this form change, a revised, executed form shall be submitted within thirty (30) days, said submission shall include a copy of any documents recorded with the Register of Deeds. The effective date of this form shall be the effective date as designated above by the City of Raleigh. No rights and liabilities associated with any designation shall incur until the effective date, or the effective date of transfer to any subsequent Party. Upon any delegation of an Applicant/Permittee or Financially Responsible Party, the Owner shall continue to receive notice at the address provided. A permit may not be transferred to a residential Home Owner's Association as the Applicant/Permittee or Financially Responsible Party, until the issued Land Disturbing Permit for this project is administratively closed by the Stormwater Management Division. Raleigh City Code §14-1011 sets forth that it shall be unlawful and a violation of this code for any person to give false information or misrepresentations in any application or permit required by this code. Failure to provide full disclosure of the requested information may be grounds for denial or revocation of a Land Disturbing Permit. Please complete all sections below. Type or print and, if information on the form is not applicable, place N/A in the blank. All pages of this form must be completed and submitted or the form will be rejected and returned. The property owner must initial each page of the form prior to submittal. SECTION 2: PROJECT INFORMATION PROJECT NAME Milburnie Ridge Lots 1-38 PERMITTED PHASE(S) PROJECT ADDRESS Refer to sheet 6 of this document WAKE NUMBER(S) TYPARCELID Refer to page 6 of this document DATE PRO EICTINIITATIONOF Winter 2022 EXPECTED DURATION OF PROJECT 1 year ACREAGE OF LAND TO BE DISTURBED (.`� 91 ac V PROPERTY OWNER'S INITIALS: �^I Stormwater Inspections Form 112 08.01.16 Page I of 5 SECTION 3: PROPERTY OWNER INFORMATION Lennar Carolinas LLC PROPERTY OWNER OF RECORD 1100 Perimeter Park Dr, Ste 112 919-465-5935 MAILING ADDRESS (NO P.O. BOX) TELEPHONE NUMBER FAX NUMBER Morrisville, NC 27560 troy.george@lennar.com CITY, STATE, ZIP E-MAIL ADDRESS The undersigned acknowledges that he is the Owner, or holds the Owner's power of attorney, of the property which is the subject of this application, and further states that the permitted land -disturbing activities are authorized to be conducted on the subject property with the full knowledge, permission and consent of the Owner. The undersigned acknowledges that he is the Property Owner for permit implementation, compliance and enforcement resulting under this Land Disturbing Permit and Unified Development Ordinance, Article 9.4. The Owner of the property upon which the land -disturbing activity is to be undertaken states and affirms that he has read and understands the statements and disclosures made in this form and that the information disclosed herein is true and correct to the best of his knowledge and belief. This form must be signed by the Owner of the property or by a person with authority to execute instruments, if the Owner is not an individual. This, the day of �E�.b,« E,e 20 •2 If . 7—RO—PERTY RE TITLE IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this day of e/ne, 202_1. 6 v6m +�Ene o Notary Public (print name) My Commission Expires: 'f-0 -71�7_S� Notary Public Sit�Aure U) -c a(.i Notary Public Title / Positi �(°��N H' R�°��'�� ate` `' •''•.•.....y�� I��I NOTARY = PUBLIC 1 (Si UN,�po`�� PROPERTY OWNER'S INITIALS: Stormwater Inspections Form 112 08.23.16 Page 2 of 5 SECTION 4: OWNER'S APPOINTED AGENT INFORMATION The Owner of the property upon which land -disturbing activities will be undertaken is required to either reside in or appoint an agent for service with business and residence addresses within Wake County, North Carolina. Section 4 must be completed if the Property Owner listed in Section 3 does not reside in Wake County, North Carolina and is optional for all others. The Owner of the subject property hereby appoints the following person as an agent to receive service of any notice, process, or pleading in any action or legal proceeding arising out of any matter relating to Unified Development Ordinance, Article 9.4. The Owner agrees that any notice, process, or pleading may be served by and through the undersigned appointed agent and such service shall have the same force and effect as if service was accomplished upon the Owner. NAME COMPANY, IF APPLICABLE STREET ADDRESS (NO P.O. BOX) CITY, STATE, ZIP TITLE TELEPHONE NUMBER FAX NUMBER E-MAIL ADDRESS The undersigned acknowledges that he/she is the Owner's appointed agent. This, the day of APPOINTED AGENT SIGNATURE K11 TITLE IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his/her hand and seal, this day of Notary Public (print name) My Commission Expires: PROPERTY OWNER'S INITIALS: /UV 20 Notary Public Signature Notary Public Title / Position (SEAL) Stormwater Inspections Form 112 08.23.16 Page 3 of 5 SECTION 5: FINANCIALLY RESPONSIBLE PARTY INFORMATION The Owner of the subject property authorizes the following person or firm as the Financially Responsible Party for this Land Disturbing Permit. The Financial Responsible Party shall receive service of any notice, process, civil assessment or pleading in any action or legal proceeding arising out of any matter relating to the Land Disturbing Permit issued under this permit application and Unified Development Ordinance, Article 9.4. Troy George Raleigh Division President FINANCIALLY RESPONSIBLE PARTY TITLE Lennar 919-465-5935 COMPANY, IF APPLICABLE TELEPHONE NUMBER 1100 Perimeter Park Dr, Suite 112 STREET ADDRESS (NO P.O. BOX) FAX NUMBER Morrisville, NC 27560 troy.george@lennar.com CITY, STATE, ZIP E-MAIL ADDRESS The undersigned acknowledges that he is the Financially Responsible Party for permit implementation, compliance and enforcement resulting under this Land Disturbing Permit and Unified Development Ordinance, Article 9.4. He has read and understands the statements and disclosures made in this form, that the information disclosed herein is true and correct to the best of his knowledge and belief. This form must be signed by the person or firm financially responsible for the land developing activity or other person with authority to execute instruments for the financially responsible party, if not an individual. This, the ?J y of f EGA �E� 20 a l . FINANCIALLY P SIBL PARTY SIGNATURE TITLE IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this day of b.0 eM 202=4V—cq '4 ekj�' I I No ary Public (print name) t� Notary Public Signature My Commission Expires: I �I ��z S/ (�� a- 06 ,v`uu�RONotary Public Title / Positio Jr : ','t�tt�t pll`fl PROPERTY OWNER'S INITIALS: `J G Stormwa ter Inspections Form 112 08.23.16 Page 4 of 5 SECTION 6: APPLICANT / PERMITTEE The Owner of the subject property authorizes the following person or firm as the Applicant/Permittee to receive service of any notice, process, civil assessment or pleading in any action or legal proceeding arising out of any matter relating to the Land Disturbing Permit issued under this permit application and Raleigh Unified Development Ordinance, Article 9.4. The Applicant/Permittee designated below is the person responsible for implementation of permit conditions and violation under Article 9.4 of the Raleigh Unified Development Ordinance. The Applicant/Permittee may be the landowner or another party who acknowledges that he is the Contractor responsible for completion of the project as approved. Wesley Smith Manager APPLICANT/PERMITTEE TITLE Lennar COMPANY, IF APPLICABLE TELEPHONE NUMBER 1100 Perimeter Park Drive, Suite 112 919-465-5935 STREET ADDRESS (NO P.O. BOX) FAX NUMBER Morrisville, NC 27506 wesley.smith@lennar.com CITY, STATE, ZIP E-MAIL ADDRESS The undersigned acknowledges that he is the Applicant/Permittee for permit implementation, compliance and enforcement resulting under the Land Disturbing Permit listed above and Unified Development Ordinance, Article 9.4. He has read and understands the statements and disclosures made in this form and that the information disclosed herein is true and correct to the best of his knowledge and belief. This form must be signed by the person or firm responsible for the permit or by a person with authority to execute instruments for the Applicant/Permittee, if not an individual. This, the 1 l day of 6e-( , 20 a ( . ev- APPLICANT/PERIVITTEE SIGNATURE TITLE IN WITNESS WHEREOF, the undersigned Notary Public has hereunto set his hand and seal, this I.1 day of 1�x QWt w►*f .20 21 16 v-eii E02,o Notary Public (print name)�C My Commission Expires: T-17`zoy;- PROPERTY OWNER'S INITIALS: ��& —0�eu �( 'Vl otary Public Signature av- Notary Public Title / Position NOTARY s i PUBLIC , Stormwater Inspections Form 112 o8 Page 5 of 5 Single Family Homes Lot Number PIN Address 1 1746610683 2401 Pikes Peak Dr 2 1746611712 2405 Pikes Peak Dr 3 1746611727 2409 Pikes Peak Dr 4 1746611823 2413 Pikes Peak Dr 5 1746611828 2417 Pikes Peak Dr 6 1746611913 2421 Pikes Peak Dr 7 1746611913 2425 Pikes Peak Dr 8 1746621004 2429 Pikes Peak Dr 9 1746612687 2404 Pikes Peak Dr 10 1746613644 4004 Whitney Peak Dr 11 1746614604 4008 Whitney Peak Dr 12 1746615623 4020 Whitney Peak Dr 13 1746615683 4024 Whitney Peak Dr 14 1746616632 4028 Whitney Peak Dr 15 1746616682 4032 Whitney Peak Dr 16 1746617642 4036 Whitney Peak Dr 17 1746617691 4040 Whitney Peak Dr 18 1746618660 4044 Whitney Peak Dr 19 1746619652 4048 Whitney Peak Dr 20 1746617820 4033 Whitney Peak Dr 21 1746616870 4029 Whitney Peak Dr 22 1746616821 4025 Whitney Peak Dr 23 1746615871 4021 Whitney Peak Dr 24 1746615821 4017 Whitney Peak Dr 25 1746614862 4013 Whitney Peak Dr 26 1746614812 4009 Whitney Peak Dr 27 1746613862 4005 Whitney Peak Dr 28 1746613803 4001 Whitney Peak Dr 29 1746613931 2416 Pikes Peak Dr 30 1746613926 2420 Pikes Peak Dr 31 1746623011 2424 Pikes Peak Dr 32 1746623006 2428 Pikes Peak Dr 33 1746622191 2432 Pikes Peak Dr 34 1746622186 2500 Pikes Peak Dr 35 1746622271 2504 Pikes Peak Dr 36 1746622267 2508 Pikes Peak Dr 37 1746622363 2512 Pikes Peak Dr 38 1746622388 2516 Pikes Peak Dr