NCC240874_FRO Submitted_20240327

City 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 form must be filled out accurately and completely
Please Type or Print
PART A
1. Project name: The Villages at Mallard Creek
2. Address of land—disturbing activity: 10701 Mallard Creek Road Charlotte, NC
3. Approximate date land-disturbing activity will commence: 11 01 2022
Month Day Year
4. Purpose of Development(Residential, Commercial, Industrial, etc.): Residential
5. Total acreage of land to be disturbed or uncovered: 3.95 acres
6. List total site acreage: 3.702 acres
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: Dhanesh Kumar
Address: 215 North Pine Unit 3026, Charlotte NC 28202
Telephone: [phone] Fax: N/A
(Area Code) (Area Code)
Email Address: [e-mail]
Name:
Address:
Telephone: Fax:
(Area Code) (Area Code)
Email Address:
8. Indicate Book and Page where deed or instrument is filed(Use blank page to list additional deeds or
instruments) Book 20917 Page 331-333 Book Page
Book Page Book Page
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Continue - Financial Responsibility/OwnershipForm
PART B
1 . Person(s) or tirm(s) financially responsible for this land-disturbing activity:
Person or Firm: Kinger Homes LLC
Address: 215 N . Pine Street Unit 3206 , Charlotte , NC 28210
Telephone: (704) 550- 1652 Fax:
(Area Code) (Area Code)
Email Address: dhanesh@kingerhomes. com
2. North Carolina agent, for the person or firm who is financially responsible:
Person or Firm:
Address:
Telephone: Fax:
(Area Code) (Area Code)
Email Address:
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.)
Dhanesh Kumar Managing Director
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ENGINEERING &PROPERTY
MANAGEMENT
Land Development Division
600 East Fourth Street, Charlotte, North Carolina 28202-2844
Telephone: [phone] Fax: [phone]
http://landpermits.channeck.org
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