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Home My WebLink AboutNCC223702_FRO Submitted_20221031FINANCIAL RESPONSIBILITY/OWNERSHIP FORM NT Project # 22105 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 address or phone number is unavailable, place N/A in the blank.) 9.111K_11 1. Project Name Highlands - Logan Homes - 54 Lots 2 3 4 Location of land -disturbing activity: County BRUNSWICK City orTownship BSL Highway/Street Fifty Lakes Drive Latitude(decimal degrees) 34.0213 Longitude(decimal degrees)-78.0529 Approximate date land -disturbing activity will commence: ASAP Purpose of development (residential, commercial, industrial, institutional, etc.): Residential 5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 13.5 6. Amount of fee enclosed: $ 1,400.00 . The application fee of $100.00 per acre (rounded up to the next acre) is assessed without a ceiling amount (Example: 8.10-acre application fee is $900). Checks should be addressed to NCDEQ. 7. Has an erosion and sediment control plan been filed? Yes ❑ Enclosed ❑ No ❑ Person to contact should erosion and sediment control issues arise during land -disturbing activity: Name J. Phillip Norris, P.E. E-mail Address pnorris@ntengineers.com Phone: Office # 910-287-5900 Mobile # 910-471-9638 9. Landowner(s) of Record (attach accompanied page to list additional owners): Logan Developers, Inc. 910-332-3781 Name 60 Gregory Rd. NE Ste. 1 Current Mailing Address Phone: Office # Mobile # 60 Gregory Rd. NE Ste. 1 Current Street Address Belville NC 28451-9276 Belville NC 28451-9276 City State Zip City State Zip 10. Deed Book No. See Attached Page No. 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) may be listed as the financially responsible party(ies). Logan Developers, Inc. Company Name 60 Gregory Rd. NE Ste. 1 Current Mailing Address Belville NC 28451-9276 City State Zip Phone: Office # 910-332-3781 Djr@logandevelopers.com E-mail Address 60 Gregory Rd. NE Ste. 1 Current Street Address Belville NC 28451-9276 City State Zip Mobile # 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: D.I. Logan Name of Registered Agent 60 Gregory Road Current Mailing Address Belville NC City Djr@logandevelopers.com E-mail Address 60 Gregory Road Current Street Address 28451-9276 Belville NC 28451-9276 State Zip City Phone: Office # 910-332-3781 Mobile # Name of Individual to Contact (if Registered Agent is a company) State Zip (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: Name of Registered Agent Current Mailing Address City State Phone: Office # E-mail Address Current Street Address Zip City Mobile # Name of Individual to Contact (if Registered Agent is a company) State Zip (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. D.I. Logan Type or print name �i� Signature ---------------- - 6 ------------------------------------------ President Title or Authority 1ol�la� Date I,r.nc ��i�nS a Notary Public of the County of State of North Carolina, hereby certify that _� �_ ��G2r1 appeared personally before me this day and being duly sworn acknowledged tha e above form was executed by him/her. Witness my hand and notarial seal, this Seal day of _� r , 20� Y ommission expires 040)pe171 ,�• Jeanette Phillips NOTARY PUBLIC Brunswick County, NC My Commission Expires October 17, 2023 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: BSL LAND HOLDINGS LLC Name P.O. Box 3167 Current Mailing Address Wilmington NC 28406 City State Zip Deed Book No. SEE ATTACHED Page No, Landowner 3 of Record: SECOND ADAM HOLDINGS, LLC Name P.O. Box 3167 Current Mailing Address Wilmington NC 28406 910-791-1196 Phone: Office # Mobile # 2201 Burnett Blvd. Current Street Address Wilmington NC 28401 City State Zip Provide a copy of the most current deed. 910-791-1196 Phone: Office # Mobile # 2201 Burnett Blvd. Current Street Address Wilmington NC 28401 City State Zip City State Zip Deed Book No. SEE ATTACHED Page No. Provide a copy of the most current deed. Landowner 4 of Record: BROTHERLY LAND LLC 910-791-1196 Name Phone: Office # Mobile # P.O. Box 3167 2201 Burnett Blvd. Current Mailing Address Current Street Address Wilmington NC 28406 Wilmington NC 28401 City State Zip City State Zip Deed Book No. SEE ATTACHED Page No. Provide a copy of the most current deed. Landowner 5 of Record: CANAAN HOLDINGS LLC 910-791-1196 Name Phone: Office # Mobile # P.O. Box 3167 2201 Burnett Blvd. Current Mailing Address Current Street Address Wilmington NC 28406 Wilmington NC 28401 City State Zip City State Zip Deed Book No. SEE ATTACHED Page No. Provide a copy of the most current deed. 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 6 of Record: Delightsome Land Holdings LLC Name P.O. Box 3167 Current Mailing Address Wilmington NC 28406 City State Zip Deed Book No. SEE ATTACHED Page No.. 910-791-1196 Phone: Office # Mobile # 2201 Burnett Blvd. Current Street Address Wilmington NC 28401 City State Zip Provide a copy of the most current deed. Landowner 7 of Record: Harvest Holdings LLC 910-791-1196 Name Phone: Office # Mobile # P.O. Box 3167 2201 Burnett Blvd. Current Mailing Address Current Street Address Wilmington NC 28406 Wilmington NC 28401 City State Zip City State Zip Deed Book No. SEE ATTACHED Page No. Provide a copy of the most current deed. Landowner 8 of Record: Great Land LLC Name P.O. Box 3167 Current Mailing Address Wilmington NC 28406 City State Zip Deed Book No. SEE ATTACHED Page No. Landowner 9 of Record: Fruitful Land Holdings LLC Name P.O. Box 3167 Current Mailing Address Wilmington NC 28406 City State Zip Deed Book No. SEE ATTACHED Page No, 910-791-1196 Phone: Office # Mobile # 2201 Burnett Blvd. Current Street Address Wilmington NC 28401 City State Zip Provide a copy of the most current deed. 910-791-1196 Phone: Office # 2201 Burnett Blvd. Current Street Address Wilmington NC Mobile # 28401 City State Zip Provide a copy of the most current deed. 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 10 of Record: Excellent Land LLC 910-791-1196 Name Phone: Office # Mobile # P.O. Box 3167 2201 Burnett Blvd. Current Mailing Address Current Street Address Wilmington NC 28406 Wilmington NC 28401 City State Zip City State Zip Deed Book No. SEE ATTACHED Page No. Provide a copy of the most current deed. Landowner 11 of Record: Name Current Mailing Address City Deed Book No. Landowner 12 of Record: Name Phone: Office # Mobile # Current Street Address State Zip City State Zip Page No. Provide a copy of the most current deed. 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 13 of Record: Name Phone: Office # Current Mailing Address Current Street Address Mobile # City State Zip City State Zip Deed Book No. Page No. Provide a copy of the most current deed. DOWNING ROAD LOT # PARCEL OWNER Deed BK Deed PG 124 157PGO0117 BSL LAND HOLDINGS LLC 4019 1307 125 157P000118 BSL LAND HOLDINGS LLC 4019 1307 126 157PGO0119 BSL LAND HOLDINGS LLC 4019 1307 127 157PGO0120 BSL LAND HOLDINGS LLC 4019 1307 128 157P000121 BSL LAND HOLDINGS LLC 4019 1307 129 157P000122 BSL LAND HOLDINGS LLC 4019 1307 130 157PGO0123 BSL LAND HOLDINGS LLC 4019 1307 131 157P000108 BSL LAND HOLDINGS LLC 4019 1307 132 157PGO0107 SECOND ADAM HOLDINGS LLC 4019 1318 133 157P000105 BROTHERLY LAND LLC 4019 1321 134 157PG0010 CANAAN HOLDINGS LLC 4019 1324 135 157PGO0124 DELIGHTSOME LAND HOLDINGS LLC 4019 1327 DOWNING ROAD 140 157PH001 HARVEST HOLDINGS LLC 4019 1339 143 157PH00201 BSL LAND HOLDINGS LLC 4035 970 144 157PH00104 GREAT LAND LLC 4019 1336 145 157PH00105 FRUITFUL LAND HOLDINGS LLC 4019 1333 149 157PH00106 EXCELLENT LAND LLC 4019 1330 151 157PH00204 BSL LAND HOLDINGS LLC 4128 24 FIFTY LAKES DRIVE LOT # OWNER Deed BK Deed PG 104 173AE00101 LOGAN DEVELOPERS INC 4877 903 105 173AE00103 LOGAN DEVELOPERS INC 4888 229 106 157PF00117 LOGAN DEVELOPERS INC 4888 229 107 157PF00118 LOGAN DEVELOPERS INC 4888 229 136 157P000103 LOGAN DEVELOPERS INC 4888 229 137 157PGO0125 LOGAN DEVELOPERS INC 4888 229 168 157PH00303 LOGAN DEVELOPERS INC 4888 229 PINE NEEDLES LOT # OWNER Deed BK Deed PG 62 173AD003 LOGAN DEVELOPERS INC 4833 546 63 173AD00301 LOGAN DEVELOPERS INC 4833 546 64 173AD00302 LOGAN DEVELOPERS INC 4833 546 PINE NEEDLES 83 173AE00109 LOGAN DEVELOPERS INC 4833 546 84 173AE00110 LOGAN DEVELOPERS INC 4833 546 85 173AE00111 LOGAN DEVELOPERS INC 4833 546 86 173AE001 LOGAN DEVELOPERS INC 4833 546 87 157PF001 LOGAN DEVELOPERS INC 4833 546 WESTWAY ROAD LOT # PARCEL OWNER Deed BK Deed PG 92 157PF00105 BSL LAND HOLDINGS LLC 4019 1307 93 157PF00106 BSL LAND HOLDINGS LLC 4019 1307 94 157PF00107 BSL LAND HOLDINGS LLC 4019 1307 95 157PF00108 BSL LAND HOLDINGS LLC 4019 1307 96 157PF00109 BSL LAND HOLDINGS LLC 4019 1307 97 157PF00110 BSL LAND HOLDINGS LLC 4019 1307 98 157PF00111 BSL LAND HOLDINGS LLC 4019 1307 99 157PF00112 BSL LAND HOLDINGS LLC 4019 1307 100 157PF00113 BSL LAND HOLDINGS LLC 4019 1307 101 157PF00114 SECOND ADAM HOLDINGS LL( 4019 1318 102 157PF00115 BROTHERLY LAND LLC 4019 1321 103 157PF00116 CANAAN HOLDINGS LLC 4019 1324 WESTWAY ROAD 108 157PGO0102 BSL LAND HOLDINGS LLC 4029 912 110 157PG001 DELIGHTSOME LAND HOLDINC 4019 1327 111 157PGO0109 BSL LAND HOLDINGS LLC 4019 1307 112 157P000110 BSL LAND HOLDINGS LLC 4019 1307 113 157P000111 BSL LAND HOLDINGS LLC 4019 1307 114 157PGO0112 BSL LAND HOLDINGS LLC 4019 1307 115 157PGO0113 BSL LAND HOLDINGS LLC 4019 1307 116 157PGO0114 BSL LAND HOLDINGS LLC 4019 1307 119 157PGO0115 BSL LAND HOLDINGS LLC 4019 1307