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HomeMy WebLinkAboutNCC240760_FRO Submitted_20240315 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 ICLT17-DATA CENTER 2. PIN or 911 Address 13820 HICKORY LINCOLNTON HWY NEWTON,NC 28658 3. Purpose of development(residential, commercial, industrial, institutional,etc.){INDUSTRIAL 4.Approximate soil disturbance date IJUNE 2024 5. Total acreage disturbed or uncovered(including off-site borrow and waste areas) 1145 6. Has an erosion and sedimentation control been filed? E Yes Nc No r Attached 7. If you have an Erosion Control billing account,would you like this to be billed? r Yes Esc No Account Number PEOPLE 8. Person to contact should erosion and sediment control issues arise during land-disturbing activity Name I5lad Walters E-mail address ISWaIters@WKDICKSON.COM Telephone 706-838-63U Cell# I704-430-8537 Fax# IN/A 9. Landowner(s) of Record(attach accompanied page to list additional owners) Name MICROSOFT CORPORATION Telephone 1 Fax# I Current Mailing Address {ONE MICROSOFT WAY City REDMOND State WA Zip 198052 Current Street Address IONE MICROSOFT WAY City {REDMOND State WA Zip 198052 10. Deed Book No. 13641 Page No. r1642-47 3781/0506-0511, 3781/0535-0544 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 CORPORAT1ON E-mail address { Current Mailing Address {ONE MIRCROSOFT WAY City REDMOND State WA Zip 198052 Current Street Address ONE MICROSOFT WAY City REDMOND State IWA Zip 198052 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 CT Corporation System E-mail address IN/A Current Mailing Address j150 Fayetteville St,Box 1011 City (Raleigh State INC Zip 127601 Current Street Address jNIA City Raleigh State INC Zip 127601 Telephone [N/A Fax# [N/A 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 [N/A E-mail address [N/A Current Mailing Address [N/A City IN/A State IN/A Zip IN/A Current Street Address f N/A City IN/A State IN1e Zip IN/A Telephone Fax Fax# IN/A 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. -I-owa✓!' 1) (iJG// ro l-# 1 (C r yyc&-L L/,r•2 p/s.s•iot1 Type or Print Name Title of Authority V ff/Plod- Signs a Date I, , a Notary Public of the County of 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 Print Form STATE OF WASHINGTON COUNTY OF KING This record is acknowledged before me on of , 2024 by 1- ,mac.✓ c Q_ as CJL) P of Microsoft Corporation. KAREN R O'BRYON Karen O'B on -NOTARY PUBLIC NOTARY PU81.10Z2442525 0' STATE OF WASHINGTON My commission expires: November 18, 2025 COMMISSION Exp1RES NOVEMBER 18, 2026