NCC224063_FRO Submitted_20221229

FIN...IC1AL RESPONSIBILITY/OWNERSH.. FORM
SEDIMENTATION POLLUTION CONTROL ACT
No person may initiate any land disturbing activity on one or more acres as covered by the Act befo e this form
ar --�
and an acceptable erosion and sedimentation control plan have been completed and approved 6 e Land
Quality Section, N.C. Department of Environmental Quality. Submit the completed form to the appra I
Regional Office. (Please type or print and, if the question is not applicable or the e-mail address or phone
number is unavailable, place N/A in the blank.)
Part A.
1
2.
3.
4.
5.
6.
7.
Project Name-11-455 Loweri
16
Location of land -disturbing activity: CountvCabarrus City or Townshipy®nc®rd ,,
Lower Rocky River Rd 35.25-30.61i.�
Highway/Street Latltude(decimal degrees) Longitude(decimal degrees)
Approximate date land -disturbing activity will commence:
03/0/2022
Purpose of development (residential, commercial, industrial, institutional, etc.): Residential
Total acreage disturbed or uncovered (including off -site borrow and waste areas): 3.Aeres
Amount of fee enclosed: $ . . The application fee of $100.00 per acre (rounded
up to the next acre) is assessed without a ceiling amount (Example: 8.10-acre application fee is $900).
Checks should be addressed to NCDEQ.
Has an erosion and sediment control plan been filed? Yes ® Enclosed ® No
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Nameri Nannapaneni E-mail [e-mail]
Phone: Office # Mobile # [phone]
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Sri Nannapaneni
Name Phone: Office #
11455 Lower -Rocky River Rd
Current Street Address
Mobile #
City State Zip City State Zip
10. Deed Book No. 1 4 Page No. 237 Provide a copy of the most current deed.

Part B.
1. Company(ies) who are financially responsible for the land -disturbing activity (Provide a comprehensive list
of all responsible parties on accompanied page.) If the company is a sole proprietorship or if the landowner(s) is
an individual(s), the name(s) of the owner(s) may be listed as the financially responsible party(ies).
Stone Enterprises of Locust, LLC
Company Name
1 396 Meadowcreek Ch road
Current Mailing Address
Locust, NC 28097
City State Zip
Phone: Office # 7045165393
E-mail Address
Current Street Address
City
Mobile #
State
Zip
Note: If the Financially Responsible Party is not the owner of the land to be disturbed, include with this form
the landowner's signed and dated written consent for the applicant to submit a draft erosion and sedimentation
control plan and to conduct the anticipated land disturbing activity.
2. (a) If the Financially Responsible Party is a domestic company registered on the NC Secretary of State
business registry, give name and street address of the Registered Agent:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office # Mobile #
Name of Individual to Contact (if Registered Agent is a company)
(b) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina agent who is registered on the NC Secretary of State business registry:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office # Mobile #
Name of Individual to Contact (if Registered Agent is a company)

(c) If the Financially Responsible Party is engaging in business under an assumed name, give name under
which the company is Doing Business As. If the Financially Responsible Party is an individual, General
Partnership, or other company not registered and doing business under an assumed name, attach a copy
of the Certificate of Assumed Name.
Company DBA Name
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(s)
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 Party). I agree to provide
corrected information should there be any change in the information provided herein.
Type or pri t name
Signature
manager
Title or Authority
S/26/20
Date
I. - I l ) ., a Notary Public of the County of ) ( Pi
State of North Carolina, hereby certify that �rf / . �lil�l` i appeared personally
before me this day and being duly sworn acknowledged that the above form was executed by him/her.
Witness my hand and notarial seal, this 26 day of 4` 20 � �--
ManokBandaru
NOTARY PUBLIC
CA6ZkUS County
North Carolina
My Commission Expires December 7, 2025
Notary
My commission expires ( --
,

Continued from Items 9 & 'W in Part A of the Financial Responsibilay/Ownership Form for multiple
owners. Attach copies of this page as needed
to list all landowners.
Landowner 2 of Record:
Ramesh Nallapaneni
Name
Phone: Office # Mobile #
9047 Cornflower Dr
Current Mailing Address
Current Street Address
Harrisburg, NC 28075
City State
Zip
City State Zip
Deed Book No.
Page No.
Provide a copy of the most current deed.
Landowner 3 of Record:
Goutham Nedunuri
7349051665
Name
Phone: Office # Mobile #
9047 Cornflower Dr
Current Mailing Address
Current Street Address
Harrisburg, NC 28075
City State
Zip
City State Zip
Deed Book No.
Page No.
Provide a copy of the most current deed.
Landowner 4 of Record:
Name
Phone: Office # Mobile #
Current Mailing Address
Current Street Address
City State
Zip
City State Zip
Deed Book No.
Page No.
Provide a copy of the most current deed.
Landowner 5 of Record:
Name
Current Mailing Address
City
Deed Book No.
Phone: Office # Mobile #
Current Street Address
State Zip City
Page No.
State Zip
Provide a copy of the most current deed.