HomeMy WebLinkAboutNCC221720_FRO Submitted_20220524City 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.
Please Type or Print
PART A
1. Project where land -disturbing activity is to be undertaken: University Volvo Polestar
g y on Street, Charlotte, NC 28262 7720 N. Tr 2. Address of land —disturbing activ�t : Y
3. Approximate date land -disturbing activity will commence: 06 01 2022
Month Day Year
4. Purpose of Development (Residential, Commercial, Industrial, etc.): Commercial
5. Approximate acreage of land to be disturbed or uncovered: 1.25 ac
6. List total site acreage: 1.55 ac
7. Landowners of Record (Use blank page to list additional owners):
Name: University Investments, Inc
Address: 7716 North Tryon St
Charlotte, NC 28262
Telephone: 704-547-1095 Fax:
(Area Code)
Email Address: sgmvoiyo@hotmail.com
Signature: ��
Name:
'77i6 AJ
ddafI—2S 'Z_
Telephone:701�2 /0�2 Fax:
(Area Code) T _—, e / F o
Email Address:
Signature:
(Area Code)
(Area Code)
S. Indicate Book and Page where deed or instrument is filed (Use blank page to list additional deeds or
instruments) Book 25973 page
Book
Page
115
Book Page
Book Page
Page 1
Continue - Financial Responsibility/Ownership Form
PART B
1. Person(s) or firms) financially responsible for this land -disturbing activity:
Person or Firm: University Investments, Inc
Address: 7716 N. Tryon St.
Charlotte, NC 28262
Telephone: 704-547-1095 _ Fax:
(Area Code) (Area Code)
Email Address: sgmvolvo@hotmail.com
2. North Carolina agent, for the person or firm who is financially responsible:
Person or Firm:
Address:
Telephone: T _Fax:
(.Area Code) (Area Code)
Email Address:
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.)
Steve Magowan
Printed Name -1/
Signature
I,
President
Title
f b 9 bo;
Date
a Notary Public of the County
of Me C c State of 4�— hereby
certify that �C.(�a personally
appeared before me this day and under oath acknowledge that this form was executed by him/her.
Witness my hand and notarial seal, jis / / day of �,Or ' 20 1070--
Notary Signature:
My Commission expires:
l L GREGORY COLE JR
i NOTARY PUBLIC
1 MECKLENBURG COUNTY, NC
MY COMMIS5i0N E7(PIRE5 AUGU5T 5, 2023
CHARUff rM,:
ENGINEERING &PROPERTY
MANAGEMENT
Land Development Division
600 East Fourth Street, Charlotte, North Carolina 28202-2844
Telephone: 704/336-6692 Fax: 704/336-6586
http://IandpernT its. charmeck,oTg
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