HomeMy WebLinkAboutNCC222211_FRO Submitted_20220706City of Charlotte Soil Erosion and
Sedimentation
Control Ordinance
Financial Responsibility/Ownership Form
No person shall initiate any land -disturbing activity on one or more acres as covered by Chapter 17 of the Charlotte
City Code of Ordinances before this form and an acceptable erosion and sedimentation control plan have been completed
and approved by the City of Charlotte. The financially responsible 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. All relevant
items on this form must be filled out accurately and completely
Please Type or Print
PART A
1. Project name: Miranda Village Phase 1 (Parcel 03741127
2. Address of land disturbing activity: Miranda Road, Charlotte, NC 28216
3. Approximate date land -disturbing activity will commence: 06 05 2022
Month Day Year
4. Purpose of Development (Residential, Commercial, Industrial, etc.): Residential
5. Total acreage of land to be disturbed or uncovered: 13.15
6. List total site acreage: 13.62
7. Landowners of Record (attach accompanied page to list additional owners). If the landowner of record is not
the person(s) or firm(s) financially responsible as listed in Part B, item 1, a separate letter of consent signed
by the landowner of record or their authorized agent is required:
Name: Net Zero Miranda LLC, a Delaware Limited Liability Company
Address: 4001 Kennett Pike, Suite 302
Wilmington. DE 19807
Telephone: 980-321-7564 Fax: _.
(Area Code) (Area Code)
Email Address: david.weiss@man.com
Name:
Address:
Telephone: Fax:
(Area Code)
Email Address:
(Area Code)
8. Indicate Book and Page where deed or instrument is filed (Use blank page to list additional deeds or
instruments) Book 37116 Page 660 Book Page
Book 37116 Page 663 Book Page
Page 1
Continue - Financial Responsibility/Ownership Form
PART B
I. Person(s) or firm(s) financially responsible for this land -disturbing activity (Note: If the financially responsible
person(s) or firms) has an out-of-state address, a North Carolina agent must be designated in item 2 belaw):
Person or Firm: Net Zero Miranda LLC, a Delaware Limited Liability Company
Address: 4001 Kennett Pike, Suite 302
Wilmington. -DE 19607
Telephone:_ 980-321-7564 Fax:
(Area Code) (Area Code)
Email Address:_ david-weiiss@man.com
2. If the Financially Responsible Party is not a resident of North Carolina, give name and street address of the
designated North Carolina agent:
Person or Firm: Man Global Private Markets (USA). Inc as investment Manaaer
Address: 6836 Carnegie Blvd., Suite 430
Charlotte. NC 28211
Telephone: 980-321-7564 Fax
(Area Code) (Area Code)
Email Address: david.weissOman.com
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.)
See following page
Printed Name
Title
Signature Date
a Notary Public of the County
Of_ - _. , State of , hereby
certify that personally
appeared before me this da), and under oath acknowledge that thisform was executed by him -her:
Witness my hand and notarial seal, this day of 120.
Notary Signature:
My Commission expires:
charloitenc.gov
Storm Water Services - Land Development
600 East Fourth Street, Charlotte, North Carolina 28202-2844
Telephone: 704336-6692
htta.: eharlottene.eov-devcloamentcentcr
Rev. 09.2021 Page 2
Net Zero Miranda LLC
By: Man Global Private Markets (USA), Inc. its Investment Manager
By:
Nam : Audrey N son
Title. uthorize Signatory
By:
Name: Catherine Yang
Title: Authorized Signatory
:'T�WVlPJA AY11.rr/OEM=
a Notary Public of the County
he►•eby
certify that Audrey Nelson and Catherine Yang personally
appeared before me this day and under oath acknowledge that thisform
u,as executed by him/het:
Witness nay hand a r r ah �maA, 1 day of I A / /t Q _, 20�_
Notary Signature:
My Commission e,
NANCY ELLEN LYNCH
NOTARY PUBLIC -STATE OF NEW YORK
No.02LY6310407
Qualified in New York County
My Commission Expires 08-25-2022