NCC215913_FRO Submitted_20211026

City of Charlotte & Mecklenburg County
Soil Erosion and Sedimentation
Control Ordinance
Financial Responsibility/Ownership Form
No person shall initiate any land -disturbing activity covered by Chapter 17, Article 2 of the Charlotte City Code or
Section 6 of the Mecklenburg County Sedimentation and Erosion Control Ordinance prior to completing and filing this
form with the City of Charlotte Engineering and Property Management Department, Land Development Services Division
or Mecklenburg County Land Development Services. The financial responsibility 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.
Please Type or Print
PART A
1. Project where land -disturbing activity is to be undertaken: Elan University City Apartments
2. Address of land —disturbing activity: 6598 University City Boulevard Charlotte, 28262
0
Approximate date land -disturbing activity will commence: 7 29
Month Day
Purpose of Development (Residential, Commercial, Industrial, etc.): Residential
5. Approximate acreage of land to be disturbed or uncovered: 18.25
6. List total site acreage: 71.94 AC
7. Landowners of Record (Use blank page to list additional owners):
Name: International Business Machines Corporation
Address: 1 North Castle Drive, Armonk, NY 10504
Telephone: [phone]
(Area Code)
Email Address: sehmidt6us.ibm.eom
Name:
Address:
Fax:
(Area Code)
Telephone: Fax:
(Area Code) (Area Code)
Email Address:
Signature:
8. Indicate Book and Page where deed or instrument is filed (Use blank page to list additional deeds or
instruments) Book 4147 Page 378
05159 Page 133
Book Page
Book Page
2021
Year
Page 1

Continue - Financial Responsibility/Ownership Form
PART B
1. Person(s) or firm(s) financially responsible for this land -disturbing activity:
Person or Finn: Greystar GP II, L LC
Address: 521 E . Morehead Street Suite 400 Charlotte North Carolina 2 8? 02
Telephone: [phone]
(Area Code)
Email Address: zach . s encerA a star.cotn
Fax:
(Area Code)
2. North Carolina agent, for the person or firm who is financially responsible:
Person or
Firm:
Greystar GP
I1, LLC
Address:
10521
E. Morehead
Street Suite 400
Charlotte
North Carolina
28202
Telephone: [phone] Fax:
(Area Code) (Area Code)
Entail Address: zach.soencer mg[eystarxom
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)
Josh Glover Vice President
Printed Name Title
3/18/21
Si . re Date
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appeared before me this clay and under oath ackl7owle dge that this form was ex[. cured by hire her.
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Witness my hand and t tc�tarla f j s eul, this dcry aI fMAorCll
Mor-
Notary Signature:
My ('omntission expires:
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(MARLOTTE
ENGINEER W i P iOPEK Y
MANAGEMI hIT
Land Development Division
600 East Fourth Street, Charlotte, North Carolina 28202-2844
Telephone: [phone] Fax: [phone]
http.-/Aandpermits.charmeck.org
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