NCC232890_FRO Submitted_20230926

DURHAM JCN
COUNTY Durham City/County (Office Use Only)
Sedimentation and Erosion Control
BE0 FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
O WITH LANDOWNER CONSENT FORM
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No person may initiate any land-disturbing activity covered by the Durham City-County Unified Development Ordinance before a
Land Disturbing Permit is issued by the Sedimentation and Erosion Control Office. Issuance of a Land Disturbing Permit does not
relieve the permittee of the obligation to obtain any other licenses, permits and approvals as may be required by Federal, State,
County or Municipal governments. This office must be notified in writing of any change to the information on this form.
PLEASE TYPE OR PRINT
1. Project name: Farrington Townes- Lot 1-25
2. Road location of land-disturbing activity: Intersection of Old Chapel Hill Rd & Farrington Rd
Tax Map-Block-Parcel: 140620, 140619 pIN: 0709-01-48-5055,0709-01-48-6223
3. Square footage of land to be disturbed or uncovered: 71,446 sf(1.64 ac)
4. List below the landowner of record. Each landowner must complete Item 8.
(If there are multiple owners,please list on a separate page):
Fuller-Farrington, LLC _
Name
8801 Fast Park Dr, Ste 301
Address
Raleigh NC 27617
City State Zip
919-417-0057
Telephone Fax Email
5. List the person or entity financially responsible for this land-disturbing activity: The financially responsible party shall
be (1) the developer or other person who has or holds themselves as having financial or operational control over the land-
disturbing activity and/or (2) the land owner or person in possession or control of the land when they have directly or
indirectly allowed the land-disturbing activity or have benefited from it and (3) the named party on the Land Disturbing
Permit.
Weekley Homes, LLC
Name
1901 N. Harrison Avenue, Suite 200
Street Address
Cary NC 27513
City State Zip
919-659-1514 [e-mail]
Telephone Fax Email
The Sedimentation and Pollution Control Act (Act) and the Durham City-County Unified Development Ordinance
(Ordinance)includes,but is not limited to,the following legal obligations of the financially responsible party:
• Maintain a set of approved sedimentation and erosion control plans, if required,on site.
• Display permit on site.
• Understand and implement any required plan, including the construction sequence and details.
• Inspect,maintain and repair sedimentation and erosion control measures,especially after rainfall events.
• Provided adequate ground cover or otherwise stabilize all areas that have not been actively graded within 21 calendar
days.
201 E.Main St,5th Floor,Durham,N.C.27701• [phone]•Fax[phone]
www.co.durham.nc.uskeng

• Plan and conduct all land-disturbing activity so as to prevent off-site sedimentation.
6. For business applicants,list below the North Carolina registered agent for the financially responsible entity:
Corporation Service Company
Name
2626 Glenwood Ave, Suite 550
Street Address
Raleigh NC 27608
City State Zip
866-403-5272
Telephone Fax Email
7. The above information is true and correct to the best of my knowledge and belief and was provided by me while under oath. I
understand that the person or entity listed on Line 5 above will be: (1) the owner of the Land Disturbing Permit when issued;
(2)responsible for ensuring compliance with the Act and Ordinance;and, (3)will be the only person or entity with standing to
appeal any action taken or decision made by the Sedimentation and Erosion Control Office.
08/08/23 Joel Stinson
Date Type or Print Name
919-795-7207 Division President
Telephone Fax Title or u orit}
[e-mail]
Email Sign re
***********************************************************************************************************************************
Business Applicant(Provide corporate resolution on signatory authority)
I, Tracy Crosby ,a Notary Public of the County of Durham
State of North Carolina ,hereby certify that Joel Stinson
personally came before me this day and acknowledged that he is Division President
``�%"►UiI',,,,
of Weekley Homes T.T.C. and acknowledged,on behalf of .I ek{ oret ,I.fb�i
,the due execution of the foregoZg instrun pittss/0, A�
� Vo F� �
Witness my hand and official seal,this gtb day of �Au�� � taij ,20 =3
Notary'gblic �o
My commission expires August 30 ,20 73 . �i ~� °8-30.V
***********************************************************************************1jr* “* attrA'* e*********************
Individual Applicant
�,l,,I4,e11ut'
I, ,a Notary Public of the County of
State of ,hereby certify that
personally appeared before me this date and under oath acknowledged that the above form was executed by them.
Witness my hand and official seal,this day of ,20
Notary Public
My commission expires 20
LAND DISTURBING PERMITS ARE NON-TRANSFERABLE

Provide a Notarized Item 8 for each landowner listed in Item 4.
8. Land Owner Consent. As a landowner,I provide my consent for land-disturbing activities to occur on the property listed in
Item 2 by the person or entity listed in Item 5.
8/10/2023 James Anderson
Date Type or Print Name
919-417-0057 Member
Telephone Fax Title or Autfority
[e-mail]
Email Signature
Business Landowner(Provide corporate resolution on signatory authority)
(a►1-t 1 s?Yk‘h) ,a Notary Public of the County of \/\JQtV-Q,
State of ND y'VY\ CtnV0)Mfi ,hereby certify that 'So'cr e S Ayvdi)Ysov,
personally came before me this day and acknowledged that he is Me
of I"J«&Vt.—Fart i rg fti'► LLL and acknowledged,on behalf of Fuji-eY ' r a yr iv j V) LLCJ
,the due execution of the foregoing instrument.Witness my hand and official seal,this ` rN day of Avcyv S r ,20 2 `n
,
VA
Notary Publiti
My commission expires TebY OO.Y y ,20 210 .
Individual Landowner •
I, ,a Notary Public of the County of
State of ,hereby certify that
personally appeared before me this date and under oath acknowledged that the above form was executed by them.
Witness my hand and official seal,this day of ,20
Notary Public
My commission expires 20
SE-03 Rev.07/06
BAILEY SPRING
NOTARY PUBLIC
Wake County
North Carolina
My Commission Expires Feb.22,2026
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