NCC221952_FRO Submitted_20220524

VR
Mecklenburg County Soil Erosion and
J itSedimentation Control Ordinance
°4rM CAa 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
1. Project where land -disturbing activity is to be undertaken: Alexander Farms
2. Address of land -disturbing activity: 8315 Westmoreland Rd, Cornelius, NC 28031
3. Approximate date land -disturbing activity will commence: April 15 2022
0
Month
Purpose of development (Residential, Commercial, Industrial, etc.): Mixed -use
5. Approximate acreage of land to be disturbed or uncovered: 46.58
6. Total site acreage: 54.71
Day Year
7. Landowners of record (use blank pages to list additional owners as necessary):
Owner #1 Name: ALEXANDER FARMS MU LLC
Address: 2165 Louisa Drive, Belleair Beach, FL 33768
Telephone: [phone]
Email Address: [e-mail]
Fax:
Owner #2 Name: RRCAP-SFR ALEXANDER FARMS, LLC
Address: 517 Alcove Rd, Ste 301, Mooresville, NC 28117
Telephone: [phone]
Email Address: [e-mail]
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 36910 Page 671 Book 36910
Book Page
:se
Page 664
Page
(continue on back or separate pages as necessary)

Continue - Financial Responsibility/Ownership Form
PART B
1
Person(s) or firm(s) financially responsible for this land -disturbing activity:
Person or Firm: Alexander Farms MU, LLC
Address: 2165 Louisa Drive, Belleair Beach, FL 33786
Telephone:
727-742-9798
Fax:
Email Address: [e-mail]
2. North Carolina agent for the person or firm who is financially responsible:
Person or Firm: Susan Irvin
Address: 19726 Zion Avenue, Cornelius, NC 28031
Telephone: [phone] Fax:
Email Address: [e-mail]
704-896-0875
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.)
Owen Ewing
Printe a e
Signature
I,
Title
IIoI'�-
Date
a Notary Public of the
,b
County of �, , State of t—k or, cSLQ , hereby
certify that Q 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 I D day of Etf n , 20�"�.
Notary Signature:
My Commission e
Mecklenburg County Land Use and Environmental Services Agency
2145 Suttle Ave.
,.��•nYF` CFYSTALSTEELE Charlotte, NC 28208-5237
•"'•`�•-:
MY COMMISSION # HH 115719 Phone [phone]
"F6' o Bonded Thru1 Notary
6, 2025
Public Underwriters

Additional Owners Sheet
Owner #3 Name: RRCAP-MF ALEXANDER FARMS, LLC
Address: 517 Alcove Rd, Ste 301, Mooresville, NC 28117
Telephone: [phone]
Email Address: [e-mail]