HomeMy WebLinkAboutNCC221056_FRO Submitted_20220317City 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 party is out of State, a North Carolina agent must be assigned.
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PART A
1. Project where land -disturbing activity is to be undertaken:
CITISIDE PLAZA WALK TOWNHOMES
2. Address of land —disturbing activity: 1137 PLAZA WALK DR., CHARLOTTE NC 28215
PARCELS: 099-021-21, 099-021-45, 099-021-44
3. Approximate date land -disturbing activity will commence:
Month Day Year
4. Purpose of Development (Residential, Commercial, Industrial, etc.): RESIDENTIAI
5. Approximate acreage of land to be disturbed or uncovered: 1.75 AC.
6. List total site acreage: 2.24 AC.
7. Landowners of Record (Use blank page to list additional owners):
Name: TRUE HOMES, LLC. (SHAUN GASPARINI)
Address: 2649 BREKONRIDGE CENTER DR., CHARLOTTE NC 28110
Telephone: 704-271-1 l 91
Fax:
(Area Code) (Area Code)
Email Address: sgasyarini@truehomesusa.com T_
Signature: AA- Pp., '
Name: SIZOY/V (y AS�A/11�1
Address: 2 l<
Telephone: Nyy) 77%-y�� 6 fax:
(Area Code)
Email Address:
Signature:
(Area Code)
8. Indicate Book and Page where deed or instrument is filed (Use blank page to list additional deeds or
instruments) Book 18186 Page 864
Book Page
Book Page
Book Page
Page I
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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: TRUE HOMES, LLC. (SHAUN GASPARINI)
Address: 2642 BRE KON DGE CENTER DR,,, CHARLOTTE. NC 28110
Telephone: _ _ Fax:
(Area Code) (Area Code)
Email Address: sgasparini@truehomesusa.com
2. North Carolina agent, for the person or firm who is financially responsible:
Person or Firm:
Telephone: Fax:
(Area Code)
Email Address:
(Area Code)
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.)
Printed Name Title
CN
J1/\ -2
Signature Date
1. 7L 4awl Lwve a Notary Public of the County
of V14C4ddWW Ue` State of l v►a hereby
certify that hay^ l -sG S&C. A"
..personally
appeared before me this day and under oath acknom,ledge that this form tivas executed by him/her.
Witness my hand and notarial soul, this 22 of 77o I 2 p
Notary Signature:
My Commission expires: -"Ur4it I S 2n2.6
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Lund Development Division
600 East Fourth Sverl, Charlotte, North Carolina 28202-2844
Telephone:70,11336-6692 Fnx:70,11336-6586
htlp1dandperm its.charmeck.org
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