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HomeMy WebLinkAboutNCC220858_FRO Submitted_20220223City 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: WILKINSON CATALYST 2. Address of land —disturbing activity: 2401 WILKINSON BLVD , CHARLOTTE, NC 28208 3. Approximate date land -disturbing activity will commence: NOVEMBER 01 2021 Month Day Year 4. Purpose of Development (Residential, Commercial, Industrial, etc.): MULTIFAMILY 5. Approximate acreage of land to be disturbed or uncovered: 5.75 ACRES 6. List total site acreage: 7.03 ACRES 7. Landowners of Record (Use blank page to list additional owners): Name: SEE NEXT PAGE FOR ALL LISTED OWNERS Address: Telephone: Fax: (Area Code) (Area Code) Email Address: Signature: Name: Address: 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 09744 Page Book 26596 Page 910 794 Book 29806 Page Book Page 629 Page 1 Continue - Financial Responsibility/Ownership Form PART B 1. Person(s) or firms) financially responsible for this land -disturbing activity: Person or Firm: WILKINSON EXCHANGE QOZE Address: 1600 CAMDEN ROAD, SUITE 200 CHARLOTTE, NC 28203 Telephone: (7 0 4) 8 7 7- 5 6 81 (Area Code) Email Address: BEAU@CATALYSTCP . COM LLC Fax: (Area Code) 2. North Carolina agent, for the person or firm who is financially responsible: Person or Firm: Address: Telephone: Fax: (Area Code) (Area Code) Email Address: 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.) I Vr� l'�b �r� %k . i4�y' rt��S l • 1ck, je_ Printed Name ') Title Signature I, yEyl�I of E CIC Lt-7 w oV ?-G FrNSitN Date . a Notary Public of the County State of N a1LTVl CAMO LI hereby certify that 4iLfrT e "J'rd personally appeared before me this day and under oath acknowledge that this form was executed by him/her. Witness my hand and notarial seal, this Z day of 20 QZ Notary Signature: My Commission expires:. Ali Z QHLR.OM ENGINEERING & PROPERTY MANAGEMENT Land Development Division 600 East Fourth Street, Charlotte, North Carolina 28202-2844 Telephone: 704/336-6692 Fax: 704/336-6586 http://Iandpermits.charmeck.org Page 2 7. Landowners of Record (Use blank page to list additional owners): Name: SP-CHARLOTTE LLC Address: 8632 WILKINSON BLVD CHARLOTTE, NC 28208 Telephone: 704-391-2960 (Area Code) Email Address: 45 Signature: Name: EKASH HOLDI Address: 2 910 PROVID� LLC VIEW LANE CHARLOTTE, NC 28270 Fax: (Area Code) Baldev@mays-hotels.com Baldev Thakor, Member Telephone: Fax: (Area Code) (Area Code) Email Address: Signature: Name: GRIFFITH E C CO Address: 1944 BRUNSWICK AVENUE CHARLOTTE, NC 28207 Telephone: Fax: (Area Code) (Area Code) Email Address: Signature: 7. Landowners of Record (Use blank page to list additional owners): Name: Sp —CHARLOTTE LLC Address: 8632 WILKINSON BLVD CHARLOTTE, NC 28208 Telephone: Fax. - (Area Code) Email Address: Signature: Name: VEKASH HOLDINGS LLC Address: 2910 PROVIDENCE VIEW LANE CHARLOTTE, NC 28270 Telephone: o ,4 - % Z-,/- — O Fax: (Area Code) Email Address: S aw (e Signature: `7 Z- — 2 7 Name: GRIFFITH E C CO Address: 1944 BRUNSWICK AVENUE CHARLOTTE, NC 28207 Telephone: Fax: (Area Code) (Area Code) Email Address: (Area Code) (Area Code) Signature: 7. Landowners of Record (Use blank page to list additional owners): Name: SP—CHARLOTTE LLC Address: 8632 WILKINSON BLVD CHARLOTTE, NC 28208 Telephone: Email Add: Signature: Name: Address: (Area Code) VEKASH HOLDINGS LLC 2910 PROVIDENCE VIEW LANE CHARLOTTE, NC 28270 Telephone:_ Email Address: Signature: (Area Code) Name: GRIFFITH E C CO Fax: Fax: (Area Code) (Area Code) Address: 1944 BRUNSWICK AVENUE CHARLOTTE, NC 28207 Telephone: "7 0 k 33 Z- —1 l ^1 3 Fax: -704 . 3 3 Z - -7l -7 G� (Area Code) � (Area Code) Email Address: bv,,o o V-5 Signature: ,C1,