NCC222146_FRO Submitted_20220609

FINANCIAL RESPONSIBILITYIOWNERSHIP DORM
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 lredell County Land
19' Development Code, before an acceptable erosion and sedimentation control plan has been submitted
and approved by the lredell County Planning & Development, Erosion Control Section.
(Please type or print )
Part A.
i. Project Name Winecoff Village
2. Location of land -disturbing activity, County lredell City or Township Troutman
HighwaY/StreeL Winecoff Street Latitude 35.70492 Longitude-80.879402
3. Approximate date land -disturbing activity will commence. 6/1/2022
4. Purpose of development (residential, commercial, industrial, institutional, etc.):
Residential
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 29.0
6 Amount of fee enclosed. $ $5,075.00 An application fee of $175.00 per acre (rounded up to the next acre) is
assessed without .a ceiling amount (Example- a .9-8cre 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 $1.35.00 is assessed.
7. Has an erosion and sediment control plan been filed? Yes No Enclosed x
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity.
Name dim McComiskey
Telephone .[phone] Cell #
E-mail Address [e-mail]
Fax #
9. Landowner(s) of Record (attach accompanied page to list additional owners),
TruNorth Homes, LLC 704-953 2810
Name Telephone
831-300 Brawley School. Rd. PMB 217
Current Mailing Address
Mooresville NC 28117
City State Zip
152 Ragsdale Trail
Current Street Address
Fax Number
Mooresville NC 28117
City State Zp
10. Deed Book No. 2887 Page No. 360 �_ Provide a copy of the most current deed.
Part S.
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):
Nest Communities, LLC
Name
PO Box 3966
Current Mailing Address
Mooresville NC 28117
City State Zip
Telephone [phone]
[e-mail]
E-mail Address
236 Raceway Chive, Suite 7
Current Street Address
Mooresville NC 28117
City State Zip
Fax Number
Page i of 2

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 E-mail Address
i
Current Mailing 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
Current Mailing Address
City State Zip
Telepho
E-mail Address
i
Current Street Address
City I State Zip
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 nape Title or Authority
Signature Date
�QQ,V-R (�>c-J�S'i'w , a Notary Public of the County of 1"� ` b� rq
i
State of North Carolina, hereby certify that Dn"il�fC1 -I'( U Q Le S appeared personally before me this day
and being duly sworn acknowledged that the above form was executed by him.
Witness my hand and notarial seal, this o- day of J i`Q- , 20-
Notary
Seal
Sharlene Batista
Notary Public - North Carolina
Mecklenburg county­
COMMission Expiration:May 2Q24
My commission expires & A
Page 2 of 2