NCC243275_FRO Submitted_20241024

10/21/24,3:11 PM Rowan County
Financial Responsibility/Ownership Form Sedimentation Pollution Control Ordinance
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 Rowan County
Environmental Management Department.
Parcel ID Number
230 046
I. Project Name"
G2 Structures Site Improvements
2. Location of land-disturbing,activity I Highwa), Street)*
8955 W NC 152 Hwy Mooresville, NC 28115
Latitude Longitude
35°34'53"N 80°44'10"W
3. tpproximate date land-disturbing actisity will be commenced
•10/1/2024
3. Purpose of development{residential.commercial,industrial,etc.)
Industrial
5. 1pproximate acreage of land to be disturbed or uncovered"
2.55
b. Person to contact should sediment control issues arise during land-disturbing Cell Phone Number'
actin ;316-655-4935
Clifton Ward
'this information will be made available on the Rowan County Planning b Development website
https://www.rowancountync.gov/FormCenter/Print?formlD=96&Preview=YES&Save=False&savedProgresslD= • 1/4

10/21/24,3:11 PM Rowan County
;,it `•elttr
[e-mail]
•
t Anthill!! .'of 1tvenr•1 1.audn1%ner of Record
New Covenant Partners VIII, LLC
Name Name
Current Mullin!! \ddres' ( urrent \Ittilin;; Wdress
8955 W NC 152 Hwy Mooresville, NC 28115
`i Reenrde+l in Devi Runl.',turning- Pa,,,e\uttihei
1312 .369
P:nt B
E. Person or F it•tn ha arc financially responsible for this Person or Firm nhn are financial) responsible for this land-
1:mnA-distort/ioe alai)it' distnrhim,actit it%
G2 Structures, LLC
Name of Person(s)or Firm(s) Name of Person(s)or Firm(s)
( torrent \latline, 1dulress Current \laitine \ddress
8955 W NC 152 Hwy Mooresville, NC 28115
I'houc \mother Phone Number
.t. if the Financially Responsible Parts Is nol a resident of North( .u-o€ilia.f.T.iVe name and street address of a North t arotina
t,ctit.
Name of%gent Name of \gent
James Brammer
t of rent 'Wolin', \titlress current Manilla \ddress
8955 W NC 152 Hwy Mooresville,NC 28115
https://www.rowancountync.gov/FormCenter/Print?formlD=96&Preview=YES&Save=False&savedProgress1D= 2/4

10/21/24,3:11 PM Rowan County
Phone\umber I'hone lumber
[phone]
b. lithe Financially Responsible Parts is a Partnership ut other person emming in business under an assumed name.attach .1
copy id the certificate of assumed name. If the I inauciallx Responsible ['nth_ is a ( orporation.give the name:and street
address of the Registered %gent.
\ante of Registered keen(
James Grammer
( urrent flailing address ( orrcut 1Irect Xddress
8955 W NC 152 Hwy Mooresville, NC 28115 166 High Hills Drive Mooresville, NC 28117
Ielephone Aumber telephone Number
[phone]
the abuxe information is true and correct to the hest of my I.ituvvledge and belief and it as'winkled h% me under oath.r l his
form must he signed by the Financially Responsible Person if an indi%idu,rl or his attorney-in-fact or if nut an individual by an
officer,director,partner.or registered agent vvittr authority to execute instruments for the Fin.uielall% Responsible Personl. 1
agree to provide correctional information should there he am change in the information prusided herein.
Name I isle or tutliority
Clifton Ward Member
tiignature (late
mm/ddlyyyy
10/22/24
•ead Raid, �� �' , ' e L ufihe( onnty all // 1GHc ufi lurch lherd,; .��„ , tree j 11.,, fk appeared persau.:. , �,....,;Diu nd tieing du s u•n acknewiiedgeq
that the alone form i - cotes+ my handandseal of\otar%.: 0121/4_tla% of . !Half
Notary tih commission expires
mm/ddlyyyyI
ifittt rrt,,, & /'o101oX
2- _ ' o
•
AT 0TARy%�
U
PUBL`G •
•
https://wwW.1- untypc.goWt kpr ip/Print?formID=96&Preview=YES&Save=False&savedProgresslD= 3/4
= �1 r i-s rl3 s,•s,