NCC230063_FRO Submitted_20230117

Pitt County
������ Planning Department
Development Services Building
1717 W. 5th Street
o
caszoti Greenville, North Carolina 27834-1696
Telephone: [phone] James F. Rhodes, AICP
Fax: [phone] Director
Financial Responsibility / Ownership Form
Soil Erosion and Sedimentation Control Ordinance
No person may initiate any land -disturbing activity on one or more contiguous acres as
covered by the Act before this form and an acceptable erosion and sedimentation control plan
have been completed and approved by the Pitt County Planning Department. (Please type or
print and, if question is not applicable, place N/A in the blank.)
Part A.
1. Project Name Southerland Estates
2. Location of land -disturbing activity: County Pitt
City or Township Greenville , and Highway/Street NC 4 3
3. Approximate date land -disturbing activity will be commenced: July 2022
4. Purpose of development (residential, commercial, industrial, etc.): Residential
5. Approximate acreage of land to be disturbed or uncovered: 12 Ac
6. Has an erosion and sedimentation control plan been filed? Yes_ No x
7. Person to contact should sedimentation control issues arise during land -di sturbing_activity:
Name Dewitt Newkirk Telephone 252 - 814 - 9105
8. Landowner(s) of Record (Use blank page to list additional owners):
Mitchell Christopher Cash James Edwin Hice
Name(s) Name(s)
1910 Quail Ridge Dr. Apt 3900 Harlando Ave.
Current mailing address Street address
Greenville, NC 27858 Sebring, FL 33872
City State Zip City State Zip
9. Recorded in Deed Book No. 3 9 4 4 Page No. 7 5- 7 8
Part B.
1. Person(s) or firm(s) who are financially responsible for this land -disturbing activity (Use
the blank page to list additional persons or firms):
Dewitt Newkirk
Name of person(s) or Firm(s) Name(s)
1750 N. Greene St.
Current mailing address Street Address
Greenville, NC 27834
City State Zip City State Zip
252-814-9105
Telephone Telephone

2. (a) If the Financially Responsible Party is a Corporation, give name and street address of
the Registered Agent.
au;■ Mu
Name(s)
Current mailing address
Street Address
City State Zip
City State Zip
Telephone
Telephone
(b) If the Financially Responsible Parry is a Partnership give the name and street address
of each General Partner (Use blank page to list additional partners):
Name(s)
Name(s)
Current mailing address
Current mailing address
City State Zip
City State Zip
Telephone
Telephone
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
an individual or his/her attorney- in -fact or if not an individual by an officer, director, partner, or
registered agent with authority to execute instruments for the financially responsible person). I
agree to provide corrected information should there be any change in the information provided
herein.
Dewitt Newkirk
T
i e
Owner
Title or Authority
Da(e
I, N c'rrr, E• , a Notary Public of the County of FP- -- State
of North Carolina, hereby certify that 0 C W , -n- N evri V,r L
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 12- day of N P • t t 20 zZ
Notary
My commission expires L 9 - ZS
NETRA E. BOYKIN