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HomeMy WebLinkAboutNCC222781_FRO Submitted_20220804City 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 forth must be filled out accurately and completely PART A 1. Project name: Please Type or Print ELAN PROSPERITY APARTMENTS 2. Address of land —disturbing activity: 4505 JOHNSTON OEHLER ROAD, CHARLOTTE, NC 28269 3. Approximate date land -disturbing activity will commence: AUGUST 01 2022 Month Day Year 4. Purpose of Development (Residential, Commercial, Industrial, etc.): RESIDENTIAL (MULTI-FAMIY) 5. Total acreage of land to be disturbed or uncovered: 18.6 6. List total site acreage:15.73 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: ELAN PROSPERITY OWNER LLC Address: 465 MEETING STREET, SUITE 500, CHARELSTON, SC, 29403 Telephone: (704) 840-7394 Fax: (Area Code Email Address. JGLOVER GREYSTAR.COM Name: Address: Telephone: (Area Code) Email Address: ax: (Area Code) (Area Code) 8. Indicate Book and Page where deed or instrument is filed (Use blank page to list additional deeds or instruments) Book 37377 Page 245 Book 36754 Page 721 Book Page Book Page Page l Continue - Financial Responsibility/Ownership Form PART B 1. Person(s) or firm(s) financially responsible for this land -disturbing activity (Note: If thefinancially responsible person(,) or firms) has an out-of-state address, a North Carolina agent must be designated in item 2 below): Person or Firm: ELAN PROSPERITY OWNER LLC Address:160 MINE LAKE COURT, SUITE 200, RALEIGH, NC 27615 Telephone: (704) 840-7394 Fax: (Area Code) (Area Code) Email Address: JGLOVER ct GREYSTAR.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 F1 Address: Telephone: (Area Code) Email Address: Fax: (Area Code) 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.) JOSH GLOVER Printed Name VICE PRESIDENT Title 7/6/2022 Date I, AVZc1 C C,--3 d'�`-�-t� a Notary Public of the County of State of N 0 rh' C-o-c ai hereby certify that t) c h 61l 0'j;- r personally appeared before me this day and under oath acknowledge that this form was executed by him/her. Witness my hand and notarial seal, this 0 day of 20 ?-'2- Notary Signature: My Commission expires: I ZO / ZOZ(,e Andrew Phelan NOTARY PUBLIC Mecklenburg County, NC My Commission Expires October 20, 2026 charlottenc.gov Storm Water Services — Land Development 600 East Fourth Street, Charlotte, North Carolina 28202-2844 Telephone: 704/3 3 6-6692 http://charlottenc.gov/developmentcenter Rev. 09/2021 Page 2