NCC232720_FRO Submitted_20230911

City of Greensboro, NC
Grading Permit Application
GREENSBORO
Owner Information: Permit#:
Company ZAS Ventures LLC Contact Zahid Chaudhary -
Address 2001 W Vandalia Road Phone No.
Greensboro,NC 27407 Email zahidc336©gmat.com
Project Information:
Project Name Mavis-W Gate City Blvd
Address 5701 W Gate City Blvd Latitude 36.015847 Longitude •79.895348
Greensboro,NC 27407 Tax Map 7832554706
Area Graded 1.30 Acres and/or 56,628 _sq.ft. Site Area 1•59 Acres and/or 69,322 sq.ft.
Proposed Use of Property Auto service station(tire change) Zoning CD-C-M
Brief Description of Project Location Project is located at 5701 W Gate City Blvd,approximately 700 LF southwest of the intersection of West Gate City Blvd and High Paint Rd.
Brief Description of Development Plan Construction of a 6,136 SF auto service station and related paving,grading,utility,stormwater,landscaping,and lighting Improvements.
If this application is approved by the properly designated authorities and a grading permit issued,the undersigned does hereby agree to
comply with all applicable City regulations under the Greensboro Soil Erosion and Sedimentation Control Ordinance as described in
Chapter 30-12-6 of the Greensboro Land Development Ordinance.
Before beginning any grading operation, call for an on-site prg- +•-i+. a'on meeting, and when area has been protected,call for final
inspection.
Signature of owner,developer,or agent: Date: 0S4
FOR OFFICE USE
Approved by Date
Permit No. Date
Tracking No. Date Approved Tracking Type: TRC Grading
Surety Amount Surety Type: LOC SCB HOD Check
Surety Number Surety Expiration Date
Temporary Measures Approved Date
Final Inspection Approved Date
-1

1
CITY OF GREENSBORO
FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
No person may initiate any land-disturbing activity covered by the Sedimentation Pollution Control Act before this form
has been completed and filed with the Sediment and Erosion Control Section of the City of Greensboro. (Please type
ur print and, if questions are not applicable, place N/A in the blank).
Part A:
1. Project Name: Mavis-W Gate City Blvd
2 Location of land--disturbing activity: 5701 W Gate City Blvd_
3. Approximate date land disturbing activity will be commenced: February 2023
4 Development type: Commercial ✓ Industrial_Institutional MF residential_ SF residential
,,. Appruxin etc: uureucyc of land to be disturbed:,d_SU --
v. I iaa ail ulusion uu,d seUiincr;t cuntrui plan been iiied`1 Yes v No
7 L.cnbtowner(s)of Record (attach pages to list additional owners):
ZAS Ventures LLC _ [e-mail]
Name Telephone Email
2001 W Vandalia Road _ 2001 W Vandalia Road
Current Mailing Address Current Physical Street Address
Greensboro NC 27407 Greensboro NC 27407
City State Zip City State Zip
8. Deed County: Guilford Book: 8162 - - Page: 2626
9. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name: Joey Gechijian Telephone: [phone]
L riiail: [e-mail] Othei:
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.
Mavis Southeast LLC 919-984-2500
Name Telephone Email
358 Saw Mill River Road _ 358 Saw Mill River Road
Current Mailing Address Current Physical Street Address
Millwood NY 10546 Millwood NY 10546
City State Zip City State Zip

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:
Name Telephone Email
Current Mailing Address Current Physical Street Address
City State Zip City State Zip
(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 Telephone Email
(_;ui I el ii Iviailiriy Address Current 1-'hysical Street Address
City State Zip City State Zip
Thu above ii tformation is [rue and correct to the best of my knowledge and belief and was provided by me
,[rider 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 there
be any change in the information provided herein.
Type or pri name Title or uthority 1`
Sig dture Date
1, bap ihe_ W • Ske-tt , a Notary Public of the County of UgeS l'►«s�e+�
State of KleAti �� , hereby certify that ki-t Ivey S&A-5'35
Personally accepted before me this day and under oath acknowledged that the above form was
executed by owner(s).
Witness my hand and notarial seal, this ib day of Sep kYrihe r , 20 IL
My Commission expires 12-123'202 5
DANINE M SKELLY
Notary Public,State of New York
NO.01SK6401980
Qualified in Westchester County
Commission Expires 12/23/2023

,
CITY OF GREENSBORO
WATER RESOURCES DEPARTMENT
SEDIMENT AND EROSION CONTROL SECTION
GREEN$ORO
RESPONSIBILITY: The owner of any property within the City limits of the City of
Greensboro where a land-disturbing activity is taking place, shall be solely responsible for any
off-site damage to adjacent property or to City streets (mud and erosion in street), that may
have been caused by the lack of erosion control measures and poor maintenance. The soil
erosion measures detailed on your plans are the minimum required by the City of Greensboro.
\n(hr,e,t nondition bron.m np grant the owner/de,,,eleper may be required by the City of
CA-clisliloio to l-[Af ihiis/her engineers to design or redesign additional measures/devices to
assure land protection.
I. Fr«,ion Conirr l rn(iasures shall he installed prior to grading and according to plans or as
,; ,. .Lt,u r.y L,e ALy of C,,icc:„i.,e; r'.. L.rusiuii L;unirui kispector.
2. The approval of the Erosion Control plan does not mean that additional measures may
not be r ..qi :red to stop off-site sediment.
7. The Qv : 0i Dokve u e=i• 2,i'iiliil i e quire the Contractor to take every reasonable precaution
throughout construction to prevent erosion of soil and sedimentation of streams, lakes,
reservoirs, other impoundments, ground surfaces or other property, as required by
Chapter 30, Soil Erosion and Sedimentation Control, of the Code of Ordinances, City of
Greensboro, North Carolina.
4. The Own€ riDe velopor is responsible for maintaining the erosion and sediment control
devices for the duration of the construction.
a. Inspect the site after each rain and periodically to ensure workmanship is according
to plan and site is in compliance with the Erosion Control Ordinance.
b. Repair or replace damaged or inoperative devices as directed by the Soil Erosion
Inspector within a reasonable time or time set forth by the inspector.
c. Keep mud off city streets
5. If eroded soil from the site is deposited on adjacent property, public street or into a
waterway, the Owner/Developer shall be responsible for returning the adjacent property,
city street or waterway to its original condition satisfactorily to the City or the owner of
the property.
6. After placement of asphalt binder on newly constructed street the shoulder shall be
seeded within fourteen (14) days according to the Seeding Specifications.

7. Temporary or permanent groundcover shall be provided on all perimeter areas and
slopes 3:1 or greater within 7 calendar days following completion of any phase of
grading. Provide groundcover for all disturbed areas within 14 calendar days following
completion of construction or development.
8. The Owner/Developer must plan site work so stone placement on drive entrance,
driveway and parking lot can start immediately after fine grading.
9. The Owner or Responsible Party is responsible for the long-term maintenance of the
groundcover on the property. Groundcover must be maintained to a degree that
prevents soil erosion and sedimentation at all times. The City of Greensboro has the
authority to require changes in the owner's groundcover maintenance plan in order to
stop soil erosion and sedimentation at any time.
Section 30-5-5.4 (B)—Specific Civil Penalties
Any person who violates any of the provisions of this chapter, or rules or orders adopted or
issued pursuant to this chapter, or who initiates of continues a land-disturbing activity for which
an erosion control plan is required except in accordance with the terms, conditions, and
provisions of an approved plan, shall be subject to a civil penalty of up to five thousand dollars
($5000.00) per day. No penalty shall be assessed until the person alleged to be in violation has
been notified of the violation by registered or certified mail return receipt requested, or other
means. The notice shall describe the violation with reasonable particularity, give the person a
reasonable time period to correct the violation and state that failure to correct the violation will
result in assessment of a civil penalty of up to five thousand ($5000.00) per day or other
enforcement action including criminal penalties. Each day of continuing violation shall constitute
a separate violation. The city council shall determine the amount of the civil penalty to be
assessed under this subsection and shall make written demand for payment upon the person in
violation, and shall set forth in detail a description of the violation for which the penalty has been
imposed. In determining the amount of the penalty the governing body shall consider the
degree and extent of harm caused by the violation and the cost of rectifying the damage. If
payment is not received or equitable settlement reached within thirty (30)days after demand for
payment is made the matter shall be referred to the city attorney for institution of a civil action in
the name of the city in the appropriate division of the general courts of justice for recovery of the
penalty. Any sums recover d shall be used to carry out the purposes and requirements of this
chapter.
Signature: Date: / - V aq
Owner(Print): Zahid Chaudhary Date:
Project Address: 5701 W Gate City Blvd,Greensboro,NC 27407