NCC230607_FRO Submitted_20230308

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 Charlotte
City Code of Ordinances before this form and an acceptable erosion and sedimentation control plan have been completed
and approved by the City of Charlotte. The financially responsible 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. All relevant
items on this form must be filled out accurately and completely
Please Type or Print
PART A
1. Project name: Ovata at Reedy Creek
2
3
4
5
6
Address of land —disturbing activity: 9729 NEWELL-HICKORY GROVE RD
CHARLOTTE NC 28213
Approximate date land -disturbing activity will commence: July
Month
Purpose of Development (Residential, Commercial, Industrial, etC.): Residential
Total acreage of land to be disturbed or uncovered: 3.60
List total site acreage: 3.58
01
Day
2022
Year
7. Landowners of Record (attach accompanied page to list additional owners). If the landowner of record is not
the person(s) or firm(s) financially responsible as listed in Part B, item 1, a separate letter of consent signed
by the landowner of record or their authorized agent is required:
Name: FAMILY LTD PARTNERSHIP GRIER JOSEPH W JR
Address: 521 E MOREHEAD ST STE 440 CHARLOTTE NC 28202
Telephone:_
Email Address:
Name:
Address:
Telephone:_
Email Address:
(Area Code)
(Area Code)
Fax:
Fax:
(Area Code)
(Area Code)
8. Indicate Book and Page where deed or instrument is filed (Use blank page to list additional deeds or
instruments) Book 5936 page 676 Book Page
Book 5936 page 676
Book Page
Page 1

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 firm(s) has an out-of-state address, a North Carolina agent mast be designated in item 2 below):
Person or Firm: Ovata Reedy Creek GP, LLC
Address: 325 Rocky Slope Road, Suite 101 Greenville, SC 29607
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 the
designated North Carolina agent:
Person or Firm: Todd C. Brockmann
Address: 17250 Lancaster Highway, Suite 608 Charlotte, NC 28277
Telephone: [phone] Fax:
(Area Code)
Email Address: [e-mail]
(Area Code)
3. The above information is true and correct to the best of my knowledge 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
financially responsible company or entity, if not an individual.)
Taylor Davis
Printed N
Managing Member
Title
;2 1: z L-�oaa
Date
j n A �l a rt,,. �G�J � 6 r a Notary Public of the County
of 01YIR-Lk) Vl L State of _S&Oyn opi-b Oka, hereby
certify that Ly b6w 5 personally
appeared before me this day and under oath acknowledge that this form was executed by him/her.
Witness my hand and notarial seal, this 7 day of 1F, r Ut a 1r20 a- a.
Notary Signature:
My Commission expires:
Ashana Taylor
r Notary Public
South Carolina
My Commission Expires 09.23.29
SM
charlottenc.gov
Storm Water Services — Land Development
600 East Fourth Street, Charlotte, North Carolina 28202-2844
Telephone: [phone]
http://charlottenc.gov/developmenteenter
Rev. 09/2021 Page 2