NCC232337_FRO Submitted_20230804

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GUILFORD COUNTY FINANCIAL RESPONSIBILITY/
PLANNING ING AND DEVELOPMENT OWNERSHIP FORM
CAR
A Grading Permit must be obtained before initiating any land-disturbing activity over one(1)acre(43,560 square feet).A
Grading Permit Application, this Financial Form, a Grading/Erosion Control Plan, a surety, good for one (I) year, and a
permit fee should be submitted 30 days prior to the planned commencement of the land-disturbing activity.
The above information should be submitted to: Earl E.Davis II-Inspections Division
Guilford County Planning and Development
Post Office Box 3427
Greensboro,N.C.27402(336)641-3334
Please type or print answers to the following:
Date: 7/24/2023
Name of Project: Brightwood Farm 6A
Location of Project: whitsetl NC
Acreage of Land to be Disturbed: 18.44
LATITUDE 36°04'30.0°N (In Degrees)LONGITUDE 79°36'10.3°w (In Degrees)
Purpose of Activity(street construction,commercial building,parking lot,etc.): MUltl-fam'lylnwnhnma development
Landowner(s)of record:
Name: Forestar(USA)Real Estate Group,Inc. Name:
Address: 8041 Arco Corporate Drive,#110 Address:
Raleigh,NC 27617
Telephone: (Home) Telephone: (Home)
(Office) 7/24/2023 (Office)
(Fax) (Fax)
(E-Mail) mlmuellerAjorestaccom (E-Mail)
Indicate County,Book,and Page where deed or instrument is filed.
Guilford 8744 2424
County Book Page
The information provided on this form 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 property owner if an individual. If owned by a company or
corporation, this form must be signed by an officer, director, partner, attorney-in-fact, or other person with authority to
execute instruments for the corporation. If the person financially responsible is not a resident of North Carolina, a North
Carolina agent must be designed. If someone other than the owner is financially responsible, their signature is required
below also.
Megan L.Mueller 1 6
Print or Type Name of Individual N.C.Agent's Signature(if applicable)
Foreslar(USA)Real Estate Group,Inc.
Tr an of Company Additional Financially Responsible Party (if applicable)
Owner's i re
No,E2 Grading Permit&Appl. Page 3 of 6
Rev.December 2017

PLEASE READ THE FOLLOWING INFORMATION.•
If a Grading Permit is issued it is valid for up to one(1)year from the date it is issued. If circumstances warrant it, it may
be extended for six(6) months after the one (1)year period. Upon written notice the Grading Permit may be revoked for
failure to install devices as shown on the plan in a prompt fashion, or for failure to maintain the devices once they have
been installed. If a Grading Permit is revoked, all other development permits and approvals are withheld until the property
is once again in compliance with Guilford County regulations. Also, upon written notice a Civil Penalty (fine) can be
instigated against the property owner and/or additional Financially Responsible Party (if any) for violations of Guilford
County's Soil Erosion and Sedimentation Control Ordinance. This penalty is up to$5000.00 per day and is assessed daily
for every day the property is in violation. (Interfering with or hampering an inspection can result in a civil penalty without
written notice).
STATE OF G _ O is SLGNATURE)
COUNTY OFG#
1,a Notar Public of said County and State,do hereby certify that 5 , �ram ;
V $ �� personally appeared before me this day andnder oa h acknowledged reading t
information above an8 acknowledged that the above form was executed by him or her.
Witness my hand and official seal,this the b 1 day of O ,20 O"1111°1a 1111,,
Ne
NotaryPubli4 PulBo
My Commission Expires:
(SEAL)
(ADDITIONAL FINANCIALLY RESPONSIBLE PARTY SIGNATURE)
STATE OF
COUNTY OF
I,a Notary Public of said County and State,do hereby certify that
personally appeared before me this day and under oath acknowledged reading the information above and
acknowledged that the above form was executed by him or her.
Witness my hand and official seal,this the day of 20
Notary Public
My Commission Expires:
(SEAL)
No.E2 Grading Permit&Appl. Page 4 of 6
Rev.December 2017