NCC216964_MODIFICATION Supporting Documents_20220209

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: Eastside Flats
2. Address of land —disturbing activity: 6601 Executive Circle
Charlotte, NC 28212
3. Approximate date land -disturbing activity will commence: 11 01 2021
Month Day Year
4. Purpose of Development (Residential, Commercial, Industrial, etc.): Residential
5. Approximate acreage of land to be disturbed or uncovered: 6.82 ac
6. List total site acreage: 7.35 ac
7. Landowners of Record (Use blank page to list additional owners):
Name: WCO East Side, LP
"aFlett@ nir 28977 Nasl,rlllc, TN SIWI
Telephone: Fax:
(Area Code) (Area Code)
Email Address:
Signature:
Name:
Address:
Telephone: Fax:
(Area Code) (Area Code)
Email Addre
Signature:
8. Indicate Bo
where deed or instrument is filed (Use blank page to list additional deeds or
instruments) Book 23479 page 31
Book Page
Book Page
Book Page
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Continue - Financial Responsibility/Ownership Form
PART B
1. Person(s) or firm(s) financially responsible for this land -disturbing activity:
Person or Firm: Elmington Capital Group (C. Hunter Nelson)
Address: 118 16th Ave South, Ste 200
Nashville, TN 37203
Telephone: [phone] Fax:
(Area Code) (Area Code)
Email Address: hunter(@_elmingtoncapital.com
2. North Carolina agent, for the person or firm who is financially responsible:
Person or Firm: Pease Law LLC (Paige Pease
Address: 16151 Lancaster Highway, Suite B
Charlotte, NC 28277
Telephone: 0:704-900-0202 M:704-774-9727 Fax: [phone]
(Area Code) (Area Code)
Email Address: paige(peaselawoffice.com
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.)
C. Hunter Nelson Partner
tOlYI7,021
Date
iy Public of the County
ofbavidrold
State of Te vl n 5
e 5e e hereby
certify that _ C . H U In I fy e 1 G�0 N personally
appeared before me this day and under oath acknowledge that this form was executed by hi777/17er.
bTritness nzy hand and nohafial seal, this day of 0 CAV k W 20 2 �
Notary Signature:
My Commission expires.
•
MUOTTE.
ENGINEERING & PROPERTY
MANAGEMENT
Land Development Division
600 East Fourth Street, Charlotte, North Carolina 28202-2844
Telephone: [phone] Fax: [phone]
http://Iandpermits.charmeck.org
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