NCC222331_FRO Submitted_20220624

N94k
- Mecklenburg County Soil Erosion and
f Sedimentation Control Ordinance
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: Oak Creek
2. Address of land -disturbing activity: 14250 Cabarrus Road
3. Approximate date land -disturbing activity will commence: 02
4.
5
E0
Month
Purpose of development (Residential, Commercial, Industrial, etC.): Residential
Approximate acreage of land to be disturbed or uncovered: 74 acres
Total site acreage: 90 acres
01 2022
Day Year
7. Landowners of record (use blank pages to list additional owners as necessary):
Owner #1 Name: Alma Properties
Address: 4608 Carriker Road, Monroe, NC 28110
Telephone: [phone]
Email Address: [e-mail]
Owner #2 Name:
Address:
Telephone:
Email Address:
Fax:
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 13677 page 158 Book Page
Book Page Book Page
(continue on back or separate pages as necessary)
Form Revised 12-2016

Continue - Financial Responsibility/Ownership Form
PART B
1. Person(s) or firm(s) financially responsible for this land -disturbing activity:
Person or Firm: EHC Homes LP
Address: 8008 Corporate Center Drive, Ste 300
Charlotte, NC 28226
Telephone: [phone] Fax: [phone]
Email Address: [e-mail]
2. North Carolina agent for the person or firm who is financially responsible:
Person or Firm: Corporation Service Company
Address: 2626 Glenwood Ave, Ste 550
Raleigh, NC 27608
Telephone:
800-927-9800
Email Address: [e-mail]
Fax: Not applicable
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.)
Dwight Coots
,lgnaiure
I, / "
County of
`z° "ra j I " i `e vi -E V-
11
uteos
certify that
<00t-S
State of
Vice President
08/20/2021
Date
a Notary Public of the
hereby
personally appeared
before me this day and under oath acknowledged that this form was executed by him/her.
Witness my hand and notarial seal, thi day of / LI y 20�-�
MERRY L WIENER
Notary Signature: Notary Public &ate of New YOH(
My Commission expires:
No. 01 WI4756750
Qualified nY
Certificate filed in New York County
My Commission Expires July 31, 2022
Mecklenburg County Land Use and Environmental Services Agency
2145 Suttle Ave.
Charlotte, NC 28208-5237
Phone [phone]