NCC220095_FRO Submitted_20220106

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: Woodford Green Townhomes
2. Address of land --disturbing activity: 1480 Toddville Rd., Lots I —13, 43 — 48 and 82 —123 (Bldgs 1001,
1002, 1008 & 1015 -1022)
3. Approximate date land -disturbing activity will commence:
Jan. 2022
Month Day Year
4. Purpose of Development (Residential, Commercial, Industrial, etc.): Townhome Construction
5. Approximate acreage of land to be disturbed or uncovered: 2.15 ae.
6. List total site acreage: .10.35 ac.
7. Landowners of Record (Use blank page to list additional owners):
Name (1) : Toddville Townhome Lots LLC
Address: 136 Main
Pineville, NC 28134
Telephone: [phone] Fax: N/A
(Area Code) (Area Code)
Email Address: susan a-vestcapital.com (Susan Rosenblatt)
Signature: See Authorization Letter Lrom Owner
Name (2):
Address:
Telephone: Fax:
(Area Code)
Email Address:
Signature:
(Area Code)
8. Indicate Book and Page where deed or instrument is filed (Use blank page to list additional deeds or
instruments) Book 34971 Page 140 Book Page
Book Page Book Page
Page 1

Continue - Financial Responsibility/Ownership Form
PART S
1. Person(s) or firm(s) financially responsible for this land -disturbing activity:
Person or Firm: NVR. Inc. /Ryan Homes
Address: 13924 Professional Center Drive Suite 100
Huntersville NC 28078
Telephone: [phone] Fax: [phone]
(Area Code) (Area Code)
Email Address: mealdwel(aovrine.com (Mike Caldwell) _
2. North Carolina agent, for the person or firm who is financially responsible:
Person or Firm: Corporation Service Compan
Address: 2626 Glenwood Avenue Suite 550
Raleigh, NC 27608
Telephone: [phone] Fax: NIA
(Area Code) (Area Code)
Email Address: NIA
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.)
nLtz_r ��
Printed NAe� Title
Date
a Notary Public of the County
Of
ce;
appeared before me this day and under oath acknowledge that this form was executed by him/her.
Witness my hand and n to ial seal, this day of 20
Notary Signature.
My Commission expires:
t
S:12021122140 - CREEKSIDE PH 11DOCSTR0 REVI.DOCX
•
win
rrrrr�rr�
ENMNaMMGa Q PROPERTY
. MANAGEMENT
Land Development Division
600 East Fourth Street, Charlotte, North Carolina 28202-2844
Telephone: [phone] Fax: [phone]
http://Iandperynits.charrneck.org
At
ooQ 01� Pu C0001V
�yealcleribu�9 Cp
Z v'
,/ 0n T N C
irrrrrr r r � i��s�ti��
?reby
Page 2