NCC233089_FRO Submitted_20231013

TOWN OF KNIGHTDALE FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
. No person may initiate any land-disturbing activity on one or more acres as covered by the Town
of Knightdale Unified Development Ordinance before this form and an acceptable
erosion and sedimentation control plan have been completed and approved by Town of
Knightdale, Public Works Department, Stormwater Division. (Please type or print and, if the
question is not applicable, place N/A in the blank.)
Part A.
1. Project Name 1000 Whispering Creek Ct. Knightdale NC 27545
2. Location of land-disturbing activity: Knightdale _(Town Limits or ETJ)
Highway/Street Whispering Creek CT Latitude 35.763515 Longitude 78.505990
3. Approximate date land-disturbing activity will commence: 1 1/10/2023
4. Type of development(residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off-site utilities and borrow/waste
areas):0.2509
6. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Jonathon Haper E-mail Address [e-mail]
Phone# [phone] Cell# 919-868-8467
7. Landowner(s)of Record (attach accompanied page to list additional owners):
Catherine Brown and Toron Brown 919-624-1203 [e-mail]
Name(s) Telephone E-mail address
1000 Whispering Creek CT Same as mailing
Current Mailing Address Current Street Address
Knightdale NC 27545 Same as mailing
City State Zip City State Zip
8. Deed Book No.0 19195 Page No.01 889 Provide a copy of the most current deed.
Part B.
1. Person(s) or firm(s) who are financially responsible for the land-disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet. Include requested information):
The Drees Homes Company [e-mail]
Name E-mail Address
8521 Six Forks Rd. Suite 500 same as mailing
Current Mailing Address Current Street Address
Raleigh NC 27615 Same as mailing
City State Zip City State Zip
Phone# [phone]

2. (a) If the Financially Responsible Party is not a resident of Wake County, identify a designated agent in
Wake County to receive any notice, process, pleading in any action or legal proceeding arising out of any
matter relating to the Town of Knightdale Erosion and Sedimentation Control Ordinance and/or
Land Disturbance Permit:
Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone#
(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:
Reginald B. Gillespie Jr. [e-mail]
Name of Registered Agent E-mail Address
4600 Marriot Drive Suite 400 4600 Marriot Drive Suite 400
Current Mailing Address Current Street Address
Raleigh NC 27612 Raleigh NC 27612
City State Zip City State Zip
Phone# [phone]
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
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.
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Type or print name Title or Authority
Signs ur Date
I, NCX.V(YVAka:(YkM011.C1-- , a Notary Public of the County of WGL
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State of North Carolina, hereby certify that 3)C\O t ,0,--\ \N A - -c appeared
personally before me this day and being duly sworn acknowledged that the above form was executed by him.
Witness my hand and notarial seal, this 21 day of SQe.M- 2.0 , 20 2 j
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