NCC223194_FRO Submitted_20220912

RECEIVED
AUG 0 4 2027
FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
EROSION & SEDIMENTATION CONTROL
No person may Initiate any land -disturbing activity on one or more acres, % acre or mere Inside a watershed, as covered by the
Sedimentation Pollution Control Act and the Iredell County Land Development Code, before this form and an acceptable erosion
and sedimentation control plan have been submitted and approved by the Iredall County Development Services, Planning Division -
Erosion Control Section. (Please type or print.)
Part A.
1. Project Name Villas at Prestwick
2. Location of land -disturbing activity: County iredell City or Township Mooresville
Highway/Street Fais► Rand and shearer Road Latitude 35.542919 .. Longitude-80.806932
3. Approximate date land -disturbing activity will commence- 07/2022
4, Purpose of development (residential, commercial, Industrial, Institutional, etc.), Residential
S. Total acreage disturbed or uncovered (including off site borrow and waste areas): 8'�8
6. Amount of fee enclosed: $ 1,575 An application fee of $175.00 per acre (rounded up to the next acre) Is
assessed without a calling amount (Example: a 9-acre application fee Is $1576). For projects s than .5 acre but < 1.0 acre
In a water supply watershed, a flat fee of $136.00 Is assessed.
7. Has an erasion and Sediment control plan been filed? Yes No Enclosed x
S. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Marc Battiste .-� E-mail Address mbattiste ageastwoodhornes.com
Telephone [phone] Cell #
Fax #
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Prestwick 65, LLC 704-3994553
Name Telephone Fax Number
10880 Wilshire Blvd., Suite 1420
Current Mailing Address Current Street Address
Los Angeles CA 90024
city State Zip City State—"'__.__ Zip
10, Deed Book No. 2793 Page No, 675 Provide a copy of the most current deed,
Part B.
1. Person(s) or firms) who are financially responsible for the land- disturbing activity (Provide a comprehensive list of all
responsible parties on an attached sheet):
Eastwood Construction Partners, LLC
Name
2857 Westport load
Currant Mailing Address
Charlotte NC 28208
City State Zip
Telephone [phone]
[e-mail]
7eastwoodhomes.com
E-mail Address
Current Street Address
City State Zip
Fax Number
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2. (a) If the Financially Respons(t.,.'Parly is not a resident of North Carolina, give .,ame and street address of the designated
North Carolina Agent;
Name
E-mail Address
Current Mailing Address " ^ Current Street Address
City State ZIP City State Zip
Telephone` Fax Number.
(b) If the Financially Responsibfe Party is a Partnership or other person engaging in business under an assumed name, attach
a copy of the Certificate of Assumed Name, If the Financially Responsible Party Is a Corporation, give name and street
address of the Registered Agent:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone�Fax Num
The above Information Is true and correct to the best of my knowledge and belief and was provided by me under oath (This form
must be signed by the Financially Responsible Person if are individual or his attorney -in -fact, or if not an Individual, by an officer,
director, partner, or registered agent with the authority to execute Instruments for the Financially Responsible Iverson), I agree to
provide corrected information should there by any change in the Information provided herein.
Marc Battiste Vice president of Construction
Type or print name — Title or Authority
Signature' tat_
a !`Notary Public of the County of Q GCtA'C ►1 Ua'UY�
State of North Carolina, hereby certify that. M CLVCI - appeared personally before me this day
and being duly sworn acknowledged that the above form was executed by him.
Witness my hand and notarial seal, this 5 day of LA.
1
Nota ry
Seal �7
My commission expires _�1_ 9A
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