HomeMy WebLinkAboutNCC220995_FRO Submitted_20220309City of Charlotte & Mecklenburg County
Soil Erosion and Sedimentation
Control Ordinance
Financial Responsibility/Ownership Form
No person shall initiate any land -disturbing activity covered by Chapter 17, Article 2 of the Charlotte City Code or
Section 6 of the Mecklenburg County Sedimentation and Erosion Control Ordinance prior to completing and filing this
form with the City of Charlotte Engineering and Property Management Department, Land Development Services Division
or Mecklenburg County Land Development Services. The financial responsibility party will be on record as the party to
accept any Notices of Violation or related documents for any non-compliance of the City of Charlotte Soil Erosion and
Sedimentation Ordinance. If the financially responsible parry is out of State, a North Carolina agent must be assigned.
Please Type or Print
PART A
1. Project where land -disturbing activity is to be undertaken: Seven Oaks Townhomes
2. Address ofland—disturbing activity: 3033, 3119 & 3210 Sharon View Rd.
3. Approximate date land -disturbing activity will commence: Dec. 01, 2021
Month Day Year
4. Purpose of Development (Residential, Commercial, Industrial, etc.): Residential
5. Approximate acreage of land to be disturbed or uncovered: 4.2 acres
6. List total site acreage: 4.70 acres
7_ Landowners of Record (Use blank page to list additional owners):
Name: Blue Azalea -Seven Oaks, LLC
Address: 6420 Rea Rd, Suite Al-362
Charlotte, NC 28277
Telephone: 704-578-8698
(Area Code)
Email Addr!�: j dizazzo@blueazalea . net
A. n
Signature:
Name:
Address:
Telephone:
(Area Code)
Email Address:
Fax: N/A
Fax:
(Area Code)
(Area Code)
Signature:
S. Indicate Book and Page where deed or instrument is filed (Use blank page to list additional deeds or
instruments) Book 3 6 0 6 4 Page 179 Book 36064 Page 170
Boole 36064 Page 18 8 Book Page
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Continue - Financial Responsibility/Ownership Form
PART B
1. Person(s) or firm(s) financially responsible for this land -disturbing activity:
Person or Firm: Blue Azalea -Seven Oaks, LLC
Address: 6420 Rea Rd, Suite Al-362
Charlotte, NC 28277
Telephone: 7 04 - 5 7 8- 8 6 9 8 Fax: N/A
(Area Code) (Area Code)
Email Address: Jdizazzo@blueazalea.net
2. North Carolina agent, for the person or firm who is financially responsible:
Person or Firm: Joseph R. Di Zazzo
Address: 6420 Rea Rd, Suite Al-362
Charlotte, NC 28277
Telephone: 7 0 4- 5 7 8- 8 6 9 8 Fax: N/A
(Area Code) (Area Code)
Email Address: idizazzo@blueazalea. net
3. The above information is true and correct to the best of my knowledge and belief and was provided by me
while under oath. (This form must be signed by the financially responsible person if an individual or by an
officer, director, partner, attorney -in -fact, or other person with authority to execute instruments for the
financially responsible company or entity, if not an individual.)
Joseph R. Di Zazzo
M A%,;A6-i_Q
Printed ame Title
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Signatur Date
I, I a Notary Public of the County
Of State of M i (A hereby
certify that Z personally
appeared before me this day and under oath_ acknowledge that this f was executed by him/her.
Witness my hand and ar l this can of 20
Notary Signature: `,����t ill fe
it
My Commission expires:
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CHOU)TTE.
ENGINEERING & PROPERTY
MANAGEMENT
Land Development Division
600 East Fourth Street, Charlotte, North Carolina 28202-2844
Telepphone:704/336-6692 Fax: 704/336-6586
bttp://IandpeiTnits.charineck.org
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