NCC240871_FRO Submitted_20240326

Pitt County
S� Planning Department
Development Services Building
164 1 1717 W. 5th Street
411-cnSoti Greenville, North Carolina 27834-1696 James F.Rhodes,AICP
Telephone: [phone] Director
Fax: [phone]
Financial Responsibility/Ownership Form
Soil Erosion and Sedimentation Control Ordinance
No person may initiate any land-disturbing activity on one or more contiguous acres as
covered by the Act before this form and an acceptable erosion and sedimentation control plan
have been completed and approved by the Pitt County Planning Department. (Please type or
print and, if question is not applicable, place N/A in the blank.)
Part A.
1. Project Name Luke's Landing
2. Location of land-disturbing activity: County Pitt
City or Township Grimesland , and Highway/Street NC Hwy 33
3. Approximate date land-disturbing activity will be commenced: May 1st, 2021
4. Purpose of development(residential, commercial, industrial, etc.): Residential
5. Approximate acreage of land to be disturbed or uncovered: 36.37 ac
6. Has an erosion and sedimentation control plan been filed? Yes X No
7. Person to contact should sedimentation control issues arise during land-disturbing activity:
Name Landon Weaver Telephone [phone]
8. Landowner(s) of Record (Use blank page to list additional owners):
Bill Clark Homes of Greenville, LLC
Name(s) Name(s)
200 E.Arlington Blvd 200 E.Arlington Blvd
Current mailing address Street address
Greenville NC 27858 Greenville NC 27858
City State Zip City State Zip
9. Recorded in Deed Book No._3710 Page No. 739-742
Part B.
1. Person(s) or firm(s) who are financially responsible for this land-disturbing activity (Use
the blank page to list additional persons or firms):
Landon Weaver
Name of person(s)or Firm(s) Name(s)
200 E. Arlington Blvd
Current mailing address Street Address
Greenville NC 27858 Greenville NC 27858
City State Zip City State Zip
252-814-1481
Telephone Telephone

2. (a) If the Financially Responsible Party is a Corporation, give name and street address of
the Registered Agent.
Name(s)
Current mailing address Street Address
City State Zip City State Zip
Telephone Telephone
(b) If the Financially Responsible Party is a Partnership give the name and street address
of each General Partner (Use blank page to list additional partners):
Name(s) r Names)
Current mailing ad ess Current mailing address
1
City S to •,,,,, Zip .„„.„A CityState Zip
ilinskua Wit
•
Telephone - ► 4w*• • >—• *^Telephone
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/her attorney-in-fact or if not an individual by an officer, director, partner, or
registered agent with 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.
Landon Weaver Land Development Manager
Type r pri me Title or Authority
3 —8-21
Signature Date
I, 17€8oRR•N T_Zo`(,c.''TM. , a Notary Public of the County of uswo‘R State
of North Carolina, hereby certify that LA nfOoN 1n1�4v
appeared personally before me this day and being duly sworn acknowledged that the above fouii
was executed by him.
Witness my hand and notarial seal this S day of ("\ArRCN . 20 2I
f 1
``�,j%IU111j�li Notary
`��O ....14 T.gOr� ., My commission expires q-?f-22 .
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