NCC230035_FRO Submitted (2)_20230109

pert B.
1 Corrmpanyt:esi who are frnarscraally ►espOns+dle for the land-drsturbing acttwty (Provide a OOmprehensive list
of al# responslble parties on accornpanted pag'e.I W fhr cOrFV @nY it' a W.00 p,► m Porsrnp or or me .4n,d'wrrer{s)'s
err ockvldva!{s), the narrx"sJ of rhP pwrrerfs) may be ksMd as Me Nnofw.- Jlv re1PQfWbf9 ParfYfPas)
Lagle Properties, LLC
Company Name
207 Dulin Road
Curren? Mailing Address
Mocksville, NC 27028-7201
C sty
Phone. Office A
State
E-mail Address
Current Str"I 4ddress
Zip City state
Mobilrr # 336-399-3821
Zip
Note_ It the Financially Respomiwe Party Is not the owner of the land to to disturbed, indu[le witf this form
the Wndowner's Signed and date's wrl t n con wnt for the applicant 14 Submit a draft erosion and sedrmentstior:
control plan and to Chifxiuct the anticipated land disturbmg scttrnty
2 +al If the Financially Responsiote Party is a domestic company reg:5tered on the NC Secretary of State
Nosiness registry ove name and street address of the Registered Agent
Name of Registered Agent
Current Mailing Address
E-mafl Address
Current Street Addrm
City State Zip Ctty
Phone pff>Ce # Mot7de #
Name of Indwdual to Contact Of Registered Agent is a company;(
State Zip
{bj If the FrnanGaily Responsibly Party is not a restder'lt of Nartts Carolina. give name aria street address
of tree designated North Caro4na .+gent who is reg,nte:-ad on the NC Secretary of State Wsiness registry
Name of Registered Agent
Current Malang Address
Email Address
Cunem StTeet Adarms
City State Zp City
PtIon►es QfFce 9 K40bile 0
Name of Indtviduad to Contact (if Registered Agent is a company)
State Zip