NCC220219_FRO Submitted_20220112

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:
Aberdeen II
2. Address of land —disturbing activity: 3007 RIDGE RD CHARLOTTE NC 28269
3. Approximate date land -disturbing activity will commence:
Month Da Year
4. Purpose of Development (Residential, Commercial, Industrial, etc.): Residentiah
5. Approximate acreage of land to be disturbed or uncovered: 17.75 Acres
6. List total site acreage:
26.3 Acres
7. Landowners of Record (Use blank page to list additional owners):
8
Name: Constance J R/T Oehler
Address: 12232 Jimmy Oehler Rd
Charlotte, North Carolina 28269
Telephone:
(Area Code)
Email Address:
Signature:
Fax:
(Area Code)
Name: Charles Ronald Oehler Brenda Goss Oehler
Address: 3025 Ridge Rd Charlotte, North Carolina 28269
[e-mail]
Telephone: [phone]
(Area Code)
Email Address:
Fax:
(Area Code)
Indicate Book and Page where deed or instrument is filed (Use blank page to list additional deeds or
instruments) Book 28357 page 424 Book 26127 Page 657
Book 3385 Pacle 405 Book 9255 Page 264
VA
Page I

City of Charlotte & Mecklenburg County
Soil erosion and Sedimentation
Control Ordinance
Financial Rexponaibility/Ownership Form
No person shall Initiate any la A44turbing activity covered by Chapter 17, Article 2 of the Charlotte City Coda or
Section 6 of the Mecklenburg County Sedimentation and EraRlon Control Ordinance prior to completing and Mini this
force with the City of Charlotte Knginvoring and Property Management Department, Land Development Sarvicta Division
or Mecklenburg County Land DoWoprnenl Servicv5, Thv financial raponsibility p#my will be on record err the party to
accept any Notices; of Violation or rvlatod doommvnts far any non-compliance of the City of Charlotte Soil Erosion and
Sedimentation Ordinance, tf the Rnanoially mspomi'blc party is out of 9tato, a North Carolina agent must be assigned.
Pl@ase Type or Print
DART A
1, Project where land -disturbing activlty is to bo undertaken; Aberdeen 11
2, Addtvss of land —disturbing activity; 3007 RIDGE RD CHARLOTTE NC 28269 — -- _
3, Approximate date lond4l4tnrbing activity will commenew Month
d. Purpose of Development (residential, Con mwelal, Industrial,
, at )_ Rcsidcntlay You
5, Approximate acreage of land to be disturbed or uncovered;17,76 Acrov
6. List total site nervago; 26J Acres
7, l andownem of record (Use blank page to list additional owners);
Name; Constance J Ra Ashlar:
Address; 12232 Jimmy Aehlor Rd
Charlotte, North Carolina 21269
Telophono; — !o i3- .3 SZ.3 pax;
(Area Code) (Area Cede)
Email Address: & er 1956 zz j2 ma . LO rn
Name; Charles
Oahler
Adducts, 3026 Ridge Rd Charlotte, Nosh Carolina 20209
Telephone,, PaK;
(Ares i%0 (Aron Code)
Email Addresis
Signaturvi
i. indlaate Hook and page when deed or instrument Is Mod (Un blank page to list additional deeds or
Inatrumrnts) Back Z�� Pago 424 Book 26127 Page 067
Book 13i� 1 _ hP 405 Book 9255 �.. Palle 264
toe

Continue - Financial Responsibility/Ownership Form
PART B
1. Person(s) or firm(s) financially responsible for this land -disturbing activity:
Person or Firm: NIII Homes
Address: 5350 77 Center Drive Suite 100
Charlotte North Carolia 28217
Telephone: [phone] Fax:
(Area Code) (Area Code)
Email Address: ihorton(amihomes. com
2. North Carolina agent, for the person or firm who is financially responsible:
Person or Firm:
Address:
Telephone: Fax:
(Area Code)
Email Address:
(Area Code)
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.)
Cody Simoneaux
I,
certify that _(
appeared before me t
Witness my hand
Notary Signatt
Ify Commissio zl
VP of Land Development
Title
Date
" a Notary Public of ' the County
Staleof hereby
personally
under oath acknowledge that this firm was executed by himlher.
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ENGINEERING & PROPERTY
MANAGEMENT
Land Development Division
600 East Fourth Street, Charlotte; North Carolina 28202-2844
Telephone:[phone] Fax:[phone]
http:lllandpermits.charmeck.org
Page 2

City of Charlotte
Financial Responsibility Form
Project: Aberdeen tl
Project Location: 3007 Ridge Road, Charlotte, NC 28269
Additional Landowners:
Name: Deborah G Hough
Address: lfli Ridge Road, t�arlotte, N��5269
Signature: ct(
f� - 70 ,/- �5Gc/—��