NCC223344_FRO Submitted_20220926

PLAN REVIEW/FINANCIAL RESPONSIBILITYIOWNERSHIP FORM
CATAWBA COUNTY CODE OF ORDINANCES, CHAPTER 16 ARTICLE V
SOIL EROSION AND SEDIMENTATION CONTROL
No person may initiate any land -disturbing activity on one or more acres as covered by the Ordinance before this form
and an acceptable erosion and sedimentation control plan have been completed and approved by the Catawba County
Utilities and Engineering Department. (Please type or print, and if question is not applicable, please N/A in the blank)
1. Job Name IShannon Woods- Phase 1
2. PIN or 911 Address 1368611661830,368611669952,368602770808,368612872371,368704800340,368602783188
3. Purpose of development (residential, commercial, industrial, institutional, ete.)lRes idential
4. Approximate soil disturbance date August 15, 2022
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas) 142.0
6. Has an erosion and sedimentation control been filed? r yes F No r Attached
7. If you have an Erosion Control billing account, would you like this to be billed? r yes rx' No
Account Number IN/A
PEOPLE
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity
Name iMarkHenninger E-mail address Mark. [e-mail]
Telephone [phone] Cell # ' Fax #
9. Landowner(s) of Record (attach accompanied page to list additional owners)
Name Shannon Woods Partners, LLC Telephone l Fax #
Current Mailing Address 13840WInd.ermere Parkway, Suite 402
City Cumming State
Current Street Address
City State
10. Deed Book No. Page No.
IGA Zip P0041-7025
Zip
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 attached sheet):
Name Lennar (Contact: Mark Henninger) E-mail address [e-mail]
Current Mailing Address 6701 Carmel Road, Suite 425
City Charlotte State INC Zip 128226

Current Street Address [6701 Carmel Road, Suite 425
City Charlotte State NC Zip F28226
Telephone [phone] Fax # I -
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
Current Mailing Address
City I State Zip
Current Street Address
City I StateI � Zip
Telephone Fax #
2. (b) If the financially responsible party is a Partnership or other person engaging in business under 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 E-mail address
Current Mailing Address
City State Zip
Current Street Address
City State Zip
Telephone Fax #
The above infonnation 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 be any change in the information provided herein.
D' Mi"Ciyi P(e; ►d VH-
Type or P ' t e Title of Authority
Signature Date
I, �% J �� �-S , a Notary Public of the County of 1 State of North
Carolina, hereby certify that MdLljl(, appeared personally before me this day and being duly
sworn acknowledge that the above form was executed by hftn.
Witness my hand and notary seal, this ��_ day of , 2
Seal KATHLEEN G. JONES
NOTARY PUBLIC Nota
Union County ry
North Carolina My Commission expires J a-7
My Commission Expires May 4, 2027
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