NCC220440_FRO Submitted_20220124

FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
EROSION & SEDIMENTATION CONTROL
No person may initiate any land -disturbing activity on one or more acres, '/2 acre or more inside a
watershed, as covered by the Sedimentation Pollution Control Act and the Iredell County Land
Development Code, before an acceptable erosion and sedimentation control plan has been submitted
and approved by the Iredell County Planning & Development, Erosion Control Section.
(Please type or print.)
Part A.
1. Project Name Falls Cove at Lake Norman Phases 3-4
2. Location of land -disturbing activity: County Iredell County City or Township Town of Troutman
Highway/Street Hamptons Cove Road Latitude 36.6694 Longitude-80.8888
3. Approximate date land -disturbing activity will commence: 2/1/2021
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 47.41
8,400 (previously paid)
6. Amount of fee enclosed: $ . An application fee of $175.00 per acre (rounded up to the next acre) is
assessed without a ceiling amount (Example: a 9-acre application fee is $1575). For projects > than 0.5 acres but no
greater than 0.99 acres in a water supply watershed, a flat fee of $135.00 is assessed.
7. Has an erosion and sediment control plan been filed? Yes X No Enclosed
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Chelsea Halley E-mail Address [e-mail]
Telephone [phone] Cell # 980-445-8374 Fax #
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Lennar Carolinas, LLC 704-759-6000
Name
Telephone Fax Number
6701 Carmel Road, Suite 425
6701 Carmel Road, Suite 425
Current Mailing Address
Current Street Address
Charlotte NC 28203
Charlotte NC 28203
City State Zip
City State Zip
10. Deed Book No. Page No.
_ 92- Provide a copy of the most current deed.
Part B.
1. Person(s) or firm(s) who are financially responsible for the land -disturbing activity (Provide a comprehensive list of all
responsible parties on an attached sheet):
Lennar Carolinas, LLC
Mark. [e-mail]
Name
E-mail Address
6701 Carmel Road, Suite 425
6701 Carmel Road, Suite 425
Current Mailing Address
Current Street Address
Charlotte NC 28203
Charlotte NC 28203
City State Zip
City State Zip
Telephone [phone]
Fax Number
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2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address of the designated
North Carolina Agent:
Name
Current Mailing Address
E-mail Address
Current Street Address
City State Zip City State Zip
Telephone Fax Number
(b) If the Financially Responsible Party is a Partnership or other person engaging in business under an assumed name, attach
a copy of the Certificate of Assumed Name. If the Financially Responsible Party is a Corporation, give name and street
address of the Registered Agent:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone Fax Number
The above information is true and correct to the best of my knowledge and belief and was provided by me under oath (This form
must be signed by the Financially Responsible Person if an individual or his attorney -in -fact, or if not an individual, by an officer,
director, partner, or registered agent with the authority to execute instruments for the Financially Responsible Person). I agree to
provide corrected information should there by any change in the information provided herein.
Type or print na��w Title or Authority
ignature Date
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C e"
-A b a Notary Public of the County of t Q�►►�.
State of North Carolina, hereby certify that AA 4e—V.'\ - appeared personally before me this day
and being duly sworn acknowledge te for was execut y Min.
Witness my hand and notarial seal, this 1_day of 120 a
N tary
Seal — — — —
DIDA PERDOMO My commission expires
- North Carolina
Union County
r7blic
Commission Expires Nov 18, 2023
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