NCC221527_FRO Submitted_20220510

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v •..y.., Mecklenburg County Soil Erosion and
Sedimentation Control Ordinance
°gr�y�a Financial Responsibility/Ownership Form
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No person shall initiate any land -disturbing activity covered by Section 6 of the Mecklenburg
County, Mint Hill or Davidson Sedimentation and Erosion Control Ordinances prior to
completing and filing this form with Mecklenburg County Land Use and Environmental
Services. The financially responsible party will be on record as the party to accept any Notices
of Violation or related documents for any non-compliance with the above Ordinances. 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: Abberly Commons Apartments
2. Address of land -disturbing activity:
Charlotte, NC 28215
10623 Harrisburg Road
3. Approximate date land -disturbing activity will commence: 11 10 2021
5
Month Day Year
Purpose of development (Residential, Commercial, Industrial, etc.): Muti-Family Development
Approximate acreage of land to be disturbed or uncovered: 20
Total site acreage: 23
7. Landowners of record (use blank pages to list additional owners as necessary):
Owner #1 Name: Abberly Commons, LLC
Address: 1401 Sunday Drive, Suite 109A
Raleigh, NC 27607
Telephone: [phone] Fax:
Email Address: [e-mail]
Owner #2 Name:
Address:
Telephone:
Email Address:
Fax:
8. Indicate Boole and Page where the deed or instrument is filed (use blank pages to list
additional deeds or instruments as necessary):
Boole 69 Page 583 Book Page
Book Page Book Page
(continue on back or separate pages as necessary)
Form Revised 12-2016

Continue - Financial Responsibility/Ownership Form
PART B
1. Person(s) or firm(s) financially responsible for this land -disturbing activity:
Person or Firm: HHHunt Of NC, INC.
Address: 1401 SUNDAY DR STE 109
RALEIGH, NC 27607
Telephone. [phone]
Email Address:
Fax:
2. North Carolina agent for the person or firm who is financially responsible:
Person or Firm:
vt L4-
Address: 1401 SUNDAY DR STE 109
RALEIGH, NC 27607
Telephone: [phone] Fax:
Email Address: (7-4c-.P,A-f1 87ZL11 14 M u � � •
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.)
Printed Name
Signature
I, U074 Gea.. ,- - =Se CL
County of (Air, ju
certify that a -a � 0
Title
RHONDA K SEAGROVES j jj/ , / Z J
WAKE COUNTY, NO
My Commission Expires 3-31-2023
a Notary Public of the
State of �Ij C, , hereby
personally appeared
before me this day and under oath acknowledged that this form was executed by him/her.
Witness my hand and otarial seal, this day of _jyAm,&A , 20
Notary Signature: OWN 1� •tzz& 0_
My Commission expires: d 3 — ZD 23
Mecklenburg County Land Use and Environmental Services Agency
2145 Suttle Ave.
Charlotte, NC 28208-5237
Phone [phone]
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