Loading...
HomeMy WebLinkAboutNCC221684_FRO Submitted_20220502Sul? Mecklenburg County Soil Erosion and ' Sedimentation Control Ordinance ry GARO T Financial Responsibility/Ownership Form No person shall initiate any land -disturbing activity covered by Section 6 of the Mecklenburg County, Mint Hill or Davidson Sedimentation and Erosion Control Ordinances prior to completing and filing this form with Mecklenburg County Land Use and Environmental Services. The financially responsible party will be on record as the party to accept any Notices of Violation or related documents for any non-compliance with the above Ordinances. If the financially responsible party is out of State, a North Carolina agent must be assigned. Please Type or Print PART A l . Project where land -disturbing activity is to be undertaken: Lot #9 - Davidson Farms Subdivision 2. Address of land -disturbing activity: 19527 KISTLER FARM RD, Davidson, NC 28036 3. Approximate date land -disturbing activity will commence: April 29 2022 Month Day Year 4. Purpose of development (Residential, Commercial, Industrial, etc.): Residential 5. Approximate acreage of land to be disturbed or uncovered: 0.54 6. Total site acreage: 0.725 7. Landowners of record (use blank pages to list additional owners as necessary): Owner #1 Name: MATTHEW SHAHADY Address: 8224 BRAMFIELD DR HUNTERSVILLE NC 28078 Telephone: 704-807-0797 Fax: Email Address: RConstable@arhomes.com Owner #2 Name: Address: Telephone: Fax: Email Address: 8. Indicate Book and Page where the deed or instrument is filed (use blank pages to list additional deeds or instruments as necessary): Book 36825 page 710 Book Page Book Page Book Page (continue on back or separate pages as necessary) Form Revised 8-2014 Continue - Financial Responsibility/Owners,hip Form PART B 1. Person(s) or firms) financially responsible for this land -disturbing activity: Person or Firm: Monterey Bay- Charlotte, LLC Address: 200 J. Pomona Dr. Greensboro, NC 27407 Telephone: 704-902-4030 Fax: Email Address: RConstable@arhomes.com 2. North Carolina agent for the person or firm who is financially responsible: Person or Firm: Address: Telephone: Email Address: 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 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.) Rick Constable Printed Name President Title 4-7-22 Date �n f ^ II,n, ,,� n /� , a Notary Public of the County of / V, GC l �l� r ltk VA , State of / kV4!q (A. tDI Ilia , hereby certify that 9"k dk C-0n �10Le --� personally appeared before me this day and under oath acknowledged that this form was executed by him/her. Witness my hand and notarial seal, this day of l'1 , 20 22 Notary Signature: e My Commission `cS- 5— 2-D2 q s n Mecklenburg County Land Use and Environmental Services o 700 N. Tryon Street Charlotte, NC 28202-2236 a `'. (704) 432-2520 C; n ,r`�ero FAX (704) 432-2523 aUo