HomeMy WebLinkAboutNCC230461_FRO Submitted_20230216FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
EROSION & SEDIMENTATION CONTROL
No person may initiate any land -disturbing activity on one or more acres, % acre or more inside a
watershed, as covered by the Sedimentation Pollution Control Act and the Iredell County Land
Development Code, before an acceptable erosion and sedimentation control plan has been submitted
and approved by the Iredell County Planning & Development, Erosion Control Section.
(Please type or print.)
Part A.
Hoover Farms
1. Project Name
2. Location of land -disturbing activity: County Iredell City or Township Troutman
Highwaylstreet Hoover Rd Latitude 35.70346 Longitude -80.87142
3. Approximate date land -disturbing activity will commence: 2/20/2023
4. Purpose of development (residential, commercial, industrial, institutional, etc.):
Residential
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas):
2
8. Amount of fee enclosed: $ 350 . An application fee of $175.00 per acre (rounded up to the next acre) is
assessed without a ceiling amount (Example: a 8.10-acre application fee is $1575). For projects > than 0.5 acres but no
greater than 0.99 acres in a water supply watershed, a flat fee of $100.00 is assessed.
7. Has an erosion and sediment control plan been filed? Yes No Enclosed X
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Juan M Plasencia E-mail Address juanmplasencia@thestratxgroup.com
Telephone Cell # 9542541883 Fax #
9. Landowner(s) of Record (attach accompanied page to list additional owners):
StratX Properties, LLC
Name
5011 Colebrook Ln
Current Mailing Address
Bessemer City, Nc, 28016
CRY State Zip
Telephone
Current Street Address
Fax Number
City state Zip
10. Deed Book No. 2972 page No. 268-270 Provide a copy of the most current deed.
Part B.
i. Person(s) or firm(s) who are financially responsible for the land -disturbing activity (Provide a comprehensive list of all
responsible parties on an attached sheet):
StratX Properties, LLC
Name E-mail Address
5011 Colebrook Ln
Current Mailing Address
Bessemer City, Nc, 28016
City State Zip
Telephone 9542541883
Current Street Address
city
Fax Number
State
Zip
Page 11 of 2
(a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address of the designated
North Carolina Agent:
Name E-mail Address
Current Mailing Address Current Street Address
CRY State Zip City State Zip
Telephone Fax Number
(b) If the Financially Responsible 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:
Austin R Vollmar austinvollmar@thestratxgroup.com
Name of Registered Agent E-mail Address
16006 Henry Ln
Current Mailing Address Current Street Address
Huntersville, NC, 28078
City State Zip City State Zip
Telephone 2488218398 Fax Number
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 attomey-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 Person)_ I agree to
provide corrected information should there by any change in the information provided herein.
Juan RA President
asencia
Type or print na
ML—a
Signature
Title or Authority
2-3-2-Dz
Date
v
I, c ' a Notary Public of the County of LIDu
State of North Carolina, hereby certify that r)IwA5 M A f & U I appeared personally before me this day
and being duly sworn acknowledged that the ibove form was executed by him.
Witness my hand and notarial seal, this day of ' , 20
lrl
Seal Notary
RICHARG��,r:NER
NOTARY PUr3LiC x
Gaston County, North Carolina
My Commission Expires 09-28-2023
My commission expires M-p ye�- 14,
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