NCC240268_FRO Submitted_20240131

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: Bask Steele Creek
2. Address of land—disturbing activity: 9111 Steele Creek Avenue
3. Approximate date land-disturbing activity will commence: December 1 2023
Month Day Year
4. Purpose of Development(Residential, Commercial, Industrial, etc.): Residential and Commercial
5. Total acreage of land to be disturbed or uncovered: 2 3 . 5 4
6. List total site acreage: 2 8 . 3 0
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: RRPVI Steele Creek Charlotte MF LP and RRPVI Steele Creek COMM LLC
Address: 4801 PGA Blvd.
Palm Beach Gardens, FL 33418
Telephone: 5 61 . 63 0 . 6110 Fax:
(Area Code) (Area Code)
Email Address: DKlepser@ramrealestate . com
Name:
Address:
Telephone: Fax:
(Area Code) (Area Code)
Email Address:
8. Indicate Book and Page where deed or instrument is filed (Use blank page to list additional deeds or
instruments) Book 0 3 9 0 3 Page 0 91 Book Page
Book Page Book Page
Page I

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 must be designated in item 2 below):
Person or Firm:RRPVI Steele Creek Charlotte MF LP and RRPVI Steele Creek COMM LL(
Address: 4801 PGA Blvd.
Palm Beach Gardens, SL 33418
Telephone: 5 61 . 6 3 0 . 6110 Fax:
(Area Code) (Area Code)
Email Address: kgeller@ramrealestate . corn
2. If the Financially Responsible Party is not a resident of North Carolina, give name and street address of the
designated North Carolina agent:
Person or Firm: David Klepser
Address: 2100 S . Tryon Street, Suite 203
Charlotte, NC 28203
Telephone: 571 . 214 . 9 3 2 5 Fax:
(Area Code) (Area Code)
Email Address: dklepser@ramrealestate . com
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.)
RRPVI Steele Creek Ch rlotte MF LP, By: RRPVI Steele Creek Charlotte MF GP LLC, as General Partner, By: Ram Realty Associates VI LLC, as Manager
RRPVI Steele Creek Charlotte COMM LLC, By: Ram Realty Associates VI LLC, as Manager �.naS ./
Printed Nam J Title
1l11126s-i
Signature 4 ' p. �1 Date
I, lam` �u i -Sa C,�,�-�vo,L- , a Notary Public of the County
PCtVr'
,,of p/ ►�-ti,., -Q-� �r� � , State of RDY; &Q�. , hereby
cert that I1-'k L-l rY\y' \1 hqs personally
appeared before me this d , d under oath acknowledge that this form was executed by him/her.
Witness my hand and no., s seal i I1' day of J CLYLaXIA , 20214
Notary Signature: 1 U v` ""
My Commission expires: 0-1 CAA ICI CUL—)
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(CO) el` Pue(/ LISAJ.SANDOVAL
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* t A4 * Commission#HH 398205
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li'OF Flop Expires May 19,2027
charlottenc.gov
Storm Water Services—Land Development
600 East Fourth Street,Charlotte,North Carolina 28202-2844
Telephone: [phone]
http://charlottenc.eov/developmentcenter
Rev.09/2021 Page 2