NCC223493_FRO Submitted_20221010

City of Charlotte Soil Erosion and
Sedimentation
Control Ordinance
Financial Responsibility/Ownership Form
No person shall initiate any land -disturbing activity on one or more acres as covered by Chapter 17 of the Charlc
City Code of Ordinances before this form and an acceptable erosion and sedimentation control plan have been comple
and approved by the City of Charlotte. The financially responsible party will be on record as the party to accept any Noti
of Violation or related documents for any non-compliance of the City of Charlotte Soil Erosion and Sedimentat
Ordinance. If the financially responsible party is out of State, a North Carolina agent must be assigned. All relev
items on this form must be filled out accurately and completely
Please Type or Print
PART A
1. Project name: Price Lane Townhomes PHII
2. Address of land -disturbing activity:
4821 Price Lane Tax parcel(s) 143-251-02 & 143-251-07
3. Approximate date land -disturbing activity will commence.
08 01
Month
4. Purpose of Development (Residential, Commercial, Industrial, etc.):
5. Total acreage of land to be disturbed or uncovered: 8.0 ac
6. List total site acreage: 9.3 ac
2022
Day Year
Residential - single family attached
7. Landowners of Record (attach accompanied page to list additional owners). If the landowner of record is t
the person(s) or firm(s) financially responsible as listed in Part B, item 1, a separate letter of consent signe
by the landowner of record or their authorized agent is required:
Name: SEI Land Holdings, LLC
E
Address: 1418 Biltmore Dr.
Charlotte, NC 28207
Telephone: [phone] Fax:
(Area Code) (Area Code)
Email Address: ncurranl23 mail.com
Name:
Address:
Telephone: Fax:
(Area Code) (Area Code)
Email Address:
Indicate Book and Page where deed or instrument is tiled (Use blank page to list additional deeds or
instruments) Book 27942 Page 563 Book Page
Book Page Book Page

Continue - Financial Responsibility/Ownership Form
PART B
1. Person(s) or firm(s) financially responsible for this land -disturbing activity (Note: If the financially responsible
person(s) or frrm(s) has an oast-nf--state address, a North Carolina agent must be designated in item 2 below):
Person or Firm:
Address:
BlueHeel Developme
9606 Bailey Rd.
Cornelius, NC 28031
Telephone. [phone] Fax:
(Area Code)
Email Address: [e-mail]
(Area Code)
2, if the Financially Responsible Parry is not a resident of North Carolina, give name and street address of
designated North Carolina agent:
Person or Firm:
Address:
Telephone:
(Area Code)
Email Address:
Fax:
(Area Code)
3. The above information is true and correct to the best of my knowledge and belief and was provided by r
while under oath. (This form must be signed by the financially responsible person if an individual or by
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.)
Matt Gallagher Devel
Printed,9a,w6 , Title
ignature
= IA J IOTA
°.f- VV1
eerqfy that
Associate
Zl
a Notary Public of the
State oVt m ,look
appeared before ore this day and under oath acknowledge that this form was executed by himlher.
Witness my hand and n ial seal, this V day Uf 20-N
Notary Signature:
A11-
My Commission expire
TAYLGR G SIMMO
NOTARY PUBLIC
Mecklenburg County, North Carolina
My Commission Expires 8131126
charlattenc.gov
Storm Water Services - Land Developmcrit
600 East Fourth Street, Charlotte, North Carolina 28202-2W
Telephone: [phone]
Rev. 0912021 ht#p:llcha rlottenc.govldey elopmenteen ter
ty
�2

SEI Land Holdings, LLC
To Whom It May Concern:
Please accept this letter as my consent for Blue Heel Development to submit
construction drawings and for them to take the financial responsibility for the soil
erosion and sedimentation control ordinance associated with the development of
the property located at 4821 Price Lane, Charlotte. Tax parcel numbers 143-251-
02 and 143-251-07.
Sincerely,
i
Edward Curran
SEI Land Holdings, LLC
1418 Biltmore Drive, Charlotte, North Carolina 28207