NCC240427_FRO Submitted_20240215

PLAN REVIEW/FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
CATAWBA COUNTY CODE OF ORDINANCES, CHAPTER 16 ARTICLE V
SOIL EROSION AND SEDIMENTATION CONTROL
No person may initiate any land-disturbing activity on one or more acres as covered by the Ordinance before this form
and an acceptable erosion and sedimentation control plan have been completed and approved by the Catawba County
Utilities and Engineering Department. (Please type or print, and if question is not applicable,please NM in the blank)
PART A
1. Job Name ICLT04-DATA CENTER
2. PIN or 911 Address 11723 N NC 16 HWY CONOVER,NC 28613
3. Purpose of development(residential, commercial, industrial, institutional,etc.)IINDUSTRIAL
4. Approximate soil disturbance date 12/19/2024
5. Total acreage disturbed or uncovered(including off-site borrow and waste areas) p149.7 acres
6. Has an erosion and sedimentation control been filed? r Yes E No I— Attached
7. If you have an Erosion Control billing account, would you like this to be billed? r Yes Ix No
Account Number I
PEOPLE
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity
Name !Shad Walters E-mail address [e-mail]
Telephone [phone] Cell# I Fax# IN/A
9. Landowner(s) of Record(attach accompanied page to list additional owners)
Name'MICROSOFT CORPORATION Telephone I Fax# I
Current Mailing Address IONE MICROSOFT WAY
City IREDMOND State IWA Zip 198052
Current Street Address IONE MICROSOFT WAY
City IREDMOND State IwA Zip 198052
10. Deed Book No. 13790 Page No. 10699 PB85/42, 85/41, AND DB 3785 PAGE 1270
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 attached sheet):
Name [MICROSOFT CORPORATION E-mail address I
Current Mailing Address IONE MICROSOFT WAY
City IREDMOND State Zip 198052

Current Street Address IONE MICROSOFT WAY
City REDMOND State WA Zip r98052
Telephone I Fax#
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 kTC0rp0ratm0n System E-mail address INA
Current Mailing Address J15O Fayetteville St, Box 1011
City jRaleigh State NC Zip 27601
Current Street Address I
City Raleigh State INC Zip I27601
Telephone I Fax#
2. (b) If the financially responsible party is a Partnership or other person engaging in business under 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 I E-mail address
Current Mailing Address I
City I State I Zip
Current Street Address I
City I State I Zip
Telephone I Fax# I
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.
A--k- cT 14 Th n'CAI,A CA?
Type or Print Name Title of Authority
2/ ►3 / ,202j
Signature Date
I, -..p iz k 1 D.RpANot T , a Notary Public of the County of a k,)Cr State of North
Carolina,hereby certify that appeared personally before me this day and being duly
sworn acknowledge that the above form was executed by him.
Witness my hand and notary seal, this day of , 20_.
Seal
Notary
My Commission expires

STATE OF WASHINGTON
COUNTY OF KING
This record is acknowledged before me on February I3, 2024 by Aditya Dalmia as
0, of Microsoft Corporation.
-KA-rzrLi Ee.- -NOTARY PUBLIC
My commission expires: 11 / +8 120 -.-
KAREN R O'BRYON
NOTARY PUBLIC#22002526
STATE OF WASHINGTON
COMMISSION EXPIRES
NOVEMBER 18, 2025