NCC220962_FRO Submitted_20220307

Town of Huntersville
t� Soil Erosion & Sedimentation Control Ordinance
01,1" 1.A1i01 IN Financial Responsibility/Ownership Form
No person shall initiate any land -disturbing activity as defined in the Town of Huntersville Soil
Erosion and Sedimentation Control Ordinance prior to completing and filing this form with the Town
of Huntersville. The financially responsible party will be on record as the party to receive any
Notices of Violation or related documents related to non-compliance issues with the above
Ordinance. By filing this form, the parties are not relieved from any other permits that may be
required for the Project. If the financially responsible party is out of State, a North Carolina agent
must be assigned.
PART A
1
Please Type or Print
Project where land -disturbing activity is to be undertaken: Mirabella (lots 159-161,
198, 199, 204, 205, 212-253)
2. Address of land -disturbing activity: 17008 Monocacy Blvd, Huntersville, NC 28078
3. Approximate date land -disturbing activity will commence. 04
Month
4. Purpose of development (Residential, Commercial, Industrial, etc.):
5. Approximate acreage of land to be disturbed or uncovered: 16.850
6. Total site acreage: 46.936
05 2021
Day Year
Residential
7. Landowners of record (use blank pages to list additional owners as necessary)
Owner #1 Name: MMB Development Eleven, LP
Address: 5881 Glenridge Drive, Suite 250, Atlanta, GA 30328
Telephone:
Email Address:
Owner #2 Name: McCar Homes
Fax:
Address: 10150 Mallard Creek Road, Suite 106, Charlotte, NC 28262
Telephone:
704-509-5742
Email Address:
Fax:
8. Indicate Book and Page where the deed or instrument is filed (use blank pages to list
additional deeds or instruments as necessary)
Book 21985 Page 328 Book Page
Book Page Book Page

Financial Responsibility/Ownership Form - Continued
PART B
1. Person(s) or firm(s) financially responsible for this land -disturbing activity:
Persons or Firm: Eastwood Construction, LLC (Eastwood Construction Partners, LLC)
Address: 2857 Westport Road, Charlotte, NC 28208
Telephone. [phone]
Email Address: [e-mail]
Fax:
2. North Carolina agent for the person or firm who is financially responsible:
Person or Firm. Joseph Stewart
Address: 2857 Westport Road, Charlotte, NC 28208-3647
Telephone:
Email Address: [e-mail]
Fax:
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 is 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)
Mark Battiste VP of Construction
Printed Name Title
Signatu
Date
a Notary
Public of the County of State of Ni,.tkl,. ('a,_[, s hereby
certify that LqartJ personally appeared
before me on this day and under oath acknowledged that this form was executed by him/her.
Witness my hand and notarial seal, this. 30t' day�20Q_ k.
Notary Signature:
My Commission Expires: 7— - t iaa
MARK DAVID KRAWCZYK
Town of Huntersville NOTARY PUBLIC
LINCOLN COUNTY, NC
Po Box 664 fuly Commlaaibn Expires 74-2021
105 Gilead Rd., Ste 300
Huntersville, NC 28070