NCC231593_FRO Submitted_20230606

PLAN REVIEW/FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
CATAWBA COUNTY CODE OF ORDINANCES, CHAPTER 16 ARTICLE V
SOIL EROSION AND SEDIMENTATION CONTROL
No person may initiate any land-disturbing activity on one or more acres as covered by the Ordinance before this form
and an acceptable erosion and sedimentation control plan have been completed and approved by the Catawba County
Utilities and Engineering Department. (Please type or print, and if question is not applicable,please N/A in the blank)
PART A
1. Job Name !Spencer Road Subdivision
2. PIN or 911 Address 13723-15-63-5314
3. Purpose of development(residential, commercial, industrial, institutional,etc.)lResidential
4. Approximate soil disturbance date 16/1/2023
5. Total acreage disturbed or uncovered(including off-site borrow and waste areas) 143 acres
6. Has an erosion and sedimentation control been filed? Yes r No f Attached
7. If you have an Erosion Control billing account, would you like this to be billed? I Yes r No
Account Number
PEOPLE
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity
Name !Taylor Brower E-mail address [e-mail]
Telephone I Cell # 1704-201-4495 Fax#
9. Landowner(s) of Record(attach accompanied page to list additional owners)
Name Meritage Homes of the Carolinas, Inc. Telephone I855-588-6374 Fax#
Current Mailing Address 113925 Ballantyne Corporate PI
City !Charlotte State INC Zip 128277
Current Street Address 113925 Ballantyne Corporate PI
City 'Charlotte State NC Zip 128277
10. Deed Book No. [ Page No. I
PART B
1. Person(s)or firm(s)who are financially responsible for the land-disturbing activity(Provide a comprehensive list
of all responsible parties on attached sheet):
Name (Tim Sheehy(Meritage Homes of the Carolinas,Inc.) E-mail address [e-mail]
Current Mailing Address 113925 Ballantyne Corporate PI
City Charlotte State INC Zip 128277

Current Street Address 113925 Ballantyne Corporate PI
City 'Charlotte State NC Zip 128277
Telephone p704-944-8900 Fax#
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 I
Current Mailing Address I
City ' State Zip '
Current Street Address I
City State ' Zip '
Telephone ' Fax# I
2. (b) If the financially responsible party is a Partnership or other person engaging in business under 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 'Corporation Service Company E-mail address I
Current Mailing Address 2626 Glenwood Avenue,Suite 550
City !Raleigh State NC Zip 127608
Current Street Address 2626 Glenwood Avenue,Suite 550
City 'Raleigh State NC Zip 127608
Telephone [phone] Fax# I
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 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 person). I agree to
provide corrected information should there be any change in the information provided herein.
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Type or ' t Name ( Title o,f.Authprity
Signature Date
I, } � —� ,a Notary Public of the County of l {r(! ( State of North
Carolina,hereby certify that_ appeared personally before me this day and being duly
sworn acknowledge that the above form was executed him.
11N1111111fN/y
Wit yitang eko tary seal,this ISCL7 day of _ N ,20Z7
WIDTARY
Not r}
=,L UBL,G v My Commission expires 2- Z.
'e4-� Print Form
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