NCC231386_FRO Submitted_20230510

DocuSign Envelope ID:DDF6B3DD-23178.4ACF-A702-D7BCF31146F7
PLAN REVIEW/FINANCIAL RESPONSIBILITY/OWNERSHIP 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)
PART A
I, Job Name Bear Park
2.PIN or 911 Address .1371412970462,37.1412960319.and 371412866394. ..
3.Purpose of development(residential,commercial,industrial,institutional,etc.)[ Residential(Townhomes) -^
4.Approximate soil disturbance date May 2023
5.Total acreage disturbed or uncovered(including off-site borrow and waste areas)[v.26
6. Has an erosion and sedimentation control been filed? 1x'l Yes Cl No [] Attached
7.If you have an Erosion Control billing account,would you like this to be billed? l yes El No
Account Number N/A -.--___-
PEOPT.F,
8.Person to contact should erosion and sediment control issues arise during land-disturbing activity
Name Brian Toye E-mail address Jbtoye@nvncom
Telephone [phone] Cell# [phone] i Fax# I N/A
9.Landowner(s)of Record(attach accompanied page to list additional owners)
Name I BCDG-Bear Park,LLC Telephone [phone] Fax# I N/A
Current Mailing Address I 2401 Hobart Ct.
City I. Charlotte 1 State INC.............. _ 1 Zip 128209
Current Street Address I 2401 Hobart Ct.
City I Charlotte State INC Zip I 28209
10.Deed Book No. I 3762 Page No. I 1941
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 I NVR,Inc.(dba Ryan Homes) --_.I E-mail address [ [e-mail](Brian Toye)
Current Mailing Address I 13924 Professional Center Dr.,Suite 100
City HuntersviHe State LW I Zip j28078

DocuSign Envelope ID:DDF6B3DD-23D8-4ACF-A702-D7BCF31146F7
Current Street Address L13924 Professional Center Dr.,Suite 100
City [Huntersville __ ---- State INC —_.J Zip L28078
Telephone I (704)875-9B87 I Fax# N/A •
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 Corporation Service Company __ ---j E-mail address I N/A
Current Mailing Address I 2626 Glenwood Avenue,Suite 550
City JRalelgh. Y
j
State NC Zip27608 :
•
Current Street Address [2626 Glenwood Avenue,Suite 550 _ --
City Raleigh J State LNC Zip 27608
Telephone [84o35272 -�� I Fax# N/A 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 L—_ —__--
Current Mailing Address
City I
jstate I Zip
Current Street Address
City I j- ...._.._...... .. State I
- i Zip 1. - - - i
Telephone I I Fax# 1
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 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), 1 agree to
provide corrected information should there be any change in the information provided herein,
Se--4k FotA- r.° -Ds U1s1.01.1 00-0 ef-"
Du�08i cA,by
e,,ppr rI}l Name Title of Authority (1
t,{. d 3/31/2023
[�34754FC... Date
4
I, A 3 t e Q.,I 1 t t.y> ,a Notary Public of the County of L.l VI e.01 V State of North
Carolina,hereby certify that J .1-{,4. Jj e{" appeared personally before me this day and being duly
sworn acknowledge that the above form was executed by him.
Witness my hand and notary seal,this 3 t 54-- day of 0-t- ,20?3
Seal aal,..__di 4 J�-4211.44
ANNETTE N GALLUP Notary f
Notary Public, North Carolina J
Lincoln county My Commission expires (2i j aUa
My Commission Expires
February 29,2024 s�", '
_ t