NCC223930_FRO Submitted_20221123

City of Charlotte Soil Erosion and
Sedimentation
Control Ordinance
Financial Responsibility/Ownership Form
No person shall initiate any land -disturbing activity on one or more acres as covered by Chapter 17 of the Charlotte
City Code of Ordinances before this form and an acceptable erosion and sedimentation control plan have been completed
and approved by the City of Charlotte. The financially responsible 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 party is out of State, a North Carolina agent must be assigned. All relevant
items on this form must be filled out accurately and completely
Please Type or Print
PART A
1. Project name: University City Embrey (AKA Tryon Park EPL)
2. Address of land —disturbing activity: 8830 IKEA BLVD, Charlotte, NC 28262
3. Approximate date land -disturbing activity will commence: November 1, 2022
Month Day Year
4. Purpose of Development (Residential, Commercial, Industrial, etc.):. Residential
S. Total acreage of land to be disturbed or uncovered: 6.92 AC
6. List total site acreage: 5.88 AC
7. Landowners of Record (attach accompanied page to list additional owners). If the landowner of record is not
the person(s) or firm(s) financially responsible as listed in Part B, item 1, a separate letter of consent signed
by the landowner of record or their authorized agent is required:
Name: UCED-1 LLC
Address: PO BOX 21284
WINSTON SALEM. NC 27120
Telephone: [phone]
r Fax:
((Area Code)
Email Address: JJPOCAM)BRIDGEPROP.COM
Name:
Address:
Telephone:
(Area Code)
Email Address:
Fax:
(Area Code)
(Area Code)
8. Indicate Book and Page where deed or instrument is filed (Use blank page to list additional deeds or
instruments) Book 32585 Page 216 Book Page
Book Page Book Page
Page l

Continue - Financial Responsibility/Ownership Form
PART B
1. Person(s) or firm(s) financially responsible for this land -disturbing activity(Note: If the financially responsible
person(s) or firms) has an out-of-state address, a North Carolina agent must be designated in item 2 below):
Person or Firm: EMBREY PARTNERS, LLC
Address:1020 NE LOOP 410, SUITE 700
SAN ANTONIO, TX 78209
Telephone: [phone] Fax:
(Area Code) (Area Code)
Email Address: [e-mail]
2. If the Financially Responsible Party is not a resident of North Carolina, give name and street address of the
designated North Carolina agent:
Person or Firm: LAND DESIGN
Address:223 N GRAHAM STREET
CHARLOTTE, NC 28202
Telephone: [phone] Fax:
(Area Code) (Area Code)
Email Address: [e-mail]
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.)
JOEL ALBEA
Printed Name
VICE PRESIDENT
Title
7/22/2022
Date
I, r Y G.- a Notary Public of the County
of 61c0' State of �� hereby
certify that }personally
appeared before me this day and under oath acknowledge that this form was executed by him/her.
Witness my hand
of 2 Lx . 20
Notary Signatur
My Commission expires: 1;3
Tara naz
My Commission Expires
• 31291rr2026
8 35898D
charlottenc.gov
Storm Water Services Land Development
600 East Fourth Street, Charlotte, North Carolina 28202-2844
Telephone: [phone]
bttp:..".."cbarlottenc.gov/developmentcenter
Rev. 09/2021 Page 2

Date. 07/21 /2022
RE: UNIVERSITY CITY EMBREY
To whom in may concern:
This letter provides permission to JOEL ALBEA AND EMBREY PARTNERS, LLC
to seek and obtain plan approval to perform grading and/or sitework associated with the above
referenced project. By signing below, the undersigned parties agree to the following:
-TRYON PARK EPL IS A MULTI -FAMILY PROJECT LOCATED IN NORTHEAST CHARLOTTE, NC.
-MECKLENBURG COUTNY PARCEL ID: 04723120
-ADDRESS: 88301KEA BLVD
CHARLOTTE, NC 28262
SITE ACREAGE: 5.59 ACRES
-DISTURBED ACREAGE: 6.43 ACRES
-THIS PROJECT INCLUDES THE DESIGN OF 4 APARTMENT BUILDINGS, 1 PARKING DECK AND ASSOCIATED
INFRASTRUCTURE.
Signature of property owner or authorized representative
Printed name of property owner, company, group corporation or individual, and authorized representative
Mailing address of owner or party represented above