The URL can be used to link to this page

Home My WebLink AboutNCC230021_FRO Submitted_20230104FINANCIAL 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 address or phone number is unavailable, place N/A in the blank.) Part A. 1. Project Name I� n I BS Wolfspeed 2. Location of land -disturbing activity: CountyChatham City or Township Siler City ETJ (Unincorporated) U S 64 W 35.74239-79.53566 Highway/Street Latltude(decimal degrees) Longltude(decimal degrees) 3. Approximate date land -disturbing activity will commence: December 2022 4. Purpose of development (residential, commercial, industrial, institutional, etc.). Industrial 5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 21 8.67 6. Amount of fee enclosed: $ 3,300 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 ❑x No ❑ 8. Person to contact should erosion and sediment control issues arise during land -disturbing activity: Name Wes Feinman E-mail Addresswes.feinman@whiting-turner.com Phone: Office # 919-256-6460 Mobile # 919-337-2385 9. Landowner(s) of Record (attach accompanied page to list additional owners): TIMS FARM & FORESTRY LLC 336-362-2026 336-362-2026 Name Phone: Office # Mobile # 7157 BOBBY JEAN RD OFF US 64 W Current Mailing Address Current Street Address JULIAN NC 27283 CHATHAM CO. NC 27344 City State Zip City State Zip 10. Deed Book No. 1 547 Page No. 0865 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 tho landowner(s) is an individual(s), the name(s) of the owner(s) may be listed as the financially responsible party(ies). The Whiting -Turner Contracting Company Company Name 8529 Six Forks Road Forum IV, Suite 150 Current Mailing Address Raleigh North Carolina 27615 City State Zip Phone: Office # 91 9-256-6471 Sean. Noonan0whitina-turner.com L-1I IQII /1%UUIG00 8529 Six Forks Road Forum IV, Suite 150 Current Street Address Raleigh North Carolina City State Mobile # 919-930-1032 27615 Zip 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 Partv is a domestic company reqistered on the NC Secretary of State business registry, give name and street address of the Registered Agent: Name of Registered Agent Current Mailing Address City State Phone: Office # Zip E-mail Address Current Street Address City State Zip Mobile # Name of Individual to Contact (if Registered Agent is a company) (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 E-mail Address Current Mailing Address Current Street Address City State Zip City State Zip Phone: Office # Mobile # Name of Individual to Contact (if Registered Agent is a company) (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. Wes Feinman Type or print e Signature Sr. Project Manger Title or Authority 11/15/22 Date a Notary Public of the County of Wake State of North Carolina, hereby certify that Wes Felnman appeared personally before me this day and being duly sworn acknowledged that the above form was executed by him/her. Witness my hand and notarial seal, this 1 5th day of November 2022 Nota I My commission expires Jennifer Kelly NOTARY PUBLIC Franklin County, NC My 6®fltffll§@I@fl EXpires 49osl 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. Landuwiel 2 of Recurd: TIMS FARM &FORESTRY LLC Name 7157 BOBBY JEAN RD Current Mailing Address JULIAN NC 27283 336-362-2026 Phone: Office # OFF US 64 W Current Street Address CHATHAM CO. NC City State Zip City Deed Book No. 1729 Page No. 1027 336-362-2026 Mobile # 27344 State Zip Parcel ID: 72513 Provide a copy of the most current deed. Landowner 3 of Record: TIMS FARM &FORESTRY LLC 336-362-2026 Name Phone: Office # 7157 BOBBY JEAN RD OFF US 64 W Current Mailing Address JULIAN NC City State Deed Book No. 1659 336-362-2026 Mobile # Current Street Address 27283 CHATHAM CO. NC 27344 Zip City State Zip 0443 Parcel ID: 61119 Page No. Provide a copy of the most current deed. Landowner 4 of Record: T1R en r n nR w e r�nrnTn�i I l n I IIwo r-AhivI &FORCJ I R i LLC% Name 7157 BOBBY JEAN RD Current Mailing Address JULIAN NC City State Deed Book No. 1729 27283 nnr_ nr_ n nnnr_ JJV-JUG-GVGU Phone: Office # OFF US 64 W 00l2 nrn nnnr_ JJV-JUG-GVGu IP/ICJ �Ll3:7 Current Street Address CHATHAM CO. NC 27344 ZIP Clty Page No. 1027 Landowner 5 of Record: TIMS FARM &FORESTRY LLC Name 7157 BOBBY JEAN RD State Zip Parcel ID: 12580 Provide a copy of the most current deed. 336-362-2026 336-362-2026 Phone: Office # Mobile # OFF BENJIE WILLIAMS RD Current Mailing Address Current Street Address JULIAN NC 27283 CHATHAM CO. NC 27344 City State Zip City State Zip Parcel ID: 12547 Deed Book No. 1664 Page No. �515 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: TIMS FARM &FORESTRY LLC Name Current Mailing Address 336-362-2026 Phone: Office # OFF US 64 W 336-362-2026 Mobile # Current Street Address JULIAN NC 27283 City State Zip City State Zip Parcel ID: 82157 Deed Book No. 1729 Page No. 1 O27 Provide a copy of the most current deed. Landowner 7 of Record: TIMS FARM &FORESTRY LLC 336-362-2026 Name Phone: Office # 7157 BOBBY JEAN RD Current Mailing Address Current Street Address CHATHAM CO. NC 27344 City State Deed Book No.1704 336-362-2026 Mobile # Zip City State Zip 0053 Parcel ID: 76879 Page No. Provide a copy of the most current deed. Landowner8 of Record: Richard Devane and Diane Kirkman Name Current Mailing Address Phone: Office # Mobile # 20416 US 64 W Current Street Address Siler City NC 27344 City State Zip City Deed Book No. 63p Page No. 0720 Landowner 9 of Record Mary Pricilla Grass State Zip Parcel ID: 63971 Provide a copy of the most current deed. Name Phone: Office # Mobile # 20266 US 64 W Current Mailing Address Current Street Address Siler City NC 27344 City State Zip City State Zip Deed Book No. 1043 0721 Parcel ID: 78171 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 2 of Record: Russell Kathie L Trustee - Name Phone: Office # Mobile # 727 W Hargett St St. 209 558 Ben'ie Williams Rd Current Mailing Address Current Street Address Raleigh NC 27603 Staley NC 27355 City State Zip City G State Zip Deed Book No.- 1713 Page No. 0161 Provide a copy of the most current deed. Landowner 3 of Record. - Name Current Mailing Address City Deed Book No. Landowner 4 of Record: Phone: Office # Current Street Address State Zip City Page No. Mobile # State Zip Provide a copy of the most current deed. Name 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 5 of Record: Name Current Mailing Address City State Deed Book No. Phone: Office # Current Street Address Mobile # Zip City State Zip Page No. Provide a copy of the most current deed.