NCC223682_FRO Submitted_20221028

City 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 tiling 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: BrightWater Subdivision Phase 2
2. Address of land -disturbing activity: 15105 Grand Palisades Parkway
3. Approximate date land -disturbing activity will commence:; August 01 2021
Month Day Year
4. Purpose of Development (Residential, Commercial, Industrial, etc.): Residential -Single Family
5. Approximate -acreage -of- land to -be -disturbed -or -uncovered: ,
6. List total site acreage: 35.06
7. Landowners of Record (Use blank page to list additional owners):
Name: Lennar Carolinas, LLC
Address: 11230 Carmel Commons, Charlotte, NC 28226
Telephone: [phone] Fax:
(Area Code) (Area Code)
Email Address: Christian.JonesCcDlennar.com
Signature:
Name: N/A
Address: N/A
Telephone: N/A Fax: N/A
(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 35136 page 116 Book Page
Book 35135 page 1262 Book Page
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Continue - Financial Responsibility/Ownership Form
PART B
1. Person(s) or firm(s) financially responsible for this land -disturbing activity:
Person or Firm: Lennar Carolinas, LLC
Address: 6701 Carmel Road, Suite 425, Charlotte, NC 28226
Telephone:[phone] Fax:
(Area Code)
Email Address:', [e-mail]
(Area Code)
2, North Carolina agent, for the person or firm who is financially responsible:
Person or Firm: Same as above
Address:
Telephone: Fax:
(Area Code) (Area Code)
Email Address:
3. The above information is true and correct to the best of my lmowledge 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
fmancially responsible company or entity, if not au individual-) V/
ct
Mark Henninger resident
Printed Name
Signature
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Notary Signature:
My Commission expi s:
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State of
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ENGINEERING & PROPERTY
MANAGEMENT
Land Development Division
600 East Fourth Street, Charlotte, North Carolina 28202-2844
Telephone: [phone] Fax: [phone]
http://landpeirnits. charinect,c,org
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