NCC241369_FRO Submitted_20240506

City of Charlotte & Mecklenburg County
Soil Erosion and Sedimentation
Control Ordinance
Financial Responsibility/Ownership Form
No person shall initiate any land-disturbing activity covered by Chapter 17, Article 2 of the Charlotte City Code or
Section ¢ of the Mecklenburg County Sedimentation and Erosion Control Ordinance prior to completing and filing this
form with the City of Charlotte Engineering and Property Management Department,Land Development Services Division
or Mecklenburg County Land Development Services. The financial responsibility 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.
Please Type or Print
PART A
1. Project where land-disturbing activity is to be undertaken: Villages at Creedmore
2. Address of land—disturbing activity: Elgin Drive, Charlotte, NC 28214
3. Approximate date land-disturbing activity will commence: 06 01 2021
Month Day Year
4. Purpose of Development(Residential, Commercial, Industrial,etc.): Residential
5. Approximate acreage of land to be disturbed or uncovered: 15.56 ac
6. List total site acreage: 29.16 ac
7. Landowners of Record(Use blank page to list additional owners):
Name: LGI Homes - NC, LLC
Address: 3037 Sherman Dr
Lancaster, SC 29720
Telephone: [phone] Fax: N/A
(Area Code) (Area Code)
Email Address: Chris.Pereira@ LGIHomes.com
Signature:
Name: N/A
Address: N/A
Telephone: N/A Fax: N/A
(Area Code) (Area Code)
Email Address: N/A
Signature: N/A
8. Indicate Book and Page where deed or instrument is filed(Use blank page to list additional deeds or
instruments) Book 34144 page 986 Book Page
Book Page Book Page
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Continue - Financial Responsibility/Ownership Form
PART B
1. Person(s)or firm(s)financially responsible for this land-disturbing activity:
Person or Firm: LGI Homes - NC, LLC
Address: 3037 Sherman Dr
Lancaster, SC 29720
Telephone: [phone] Fax:
(Area Code) (Area Code)
Email Address: [e-mail]
2. North Carolina agent, for the person or firm who is financially responsible:
Person or Firm: CSC Global
Address: 2626 Glenwood Avenue, Suite 550
Raleigh, NC 27608
Telephone: Fax:
(Area Code) (Area Code)
Email Address:
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.)
Jeff Webb VP of Land Acquisitions and Development
Printed Name Title
4-30-2020
Signature I Date
I, V Q,-) , a Notary Public of the County
of /��P.IL(4-4 L..r7 , State of / C416 loll- , hereby
certify that L( = (i.k6h personally
appeared before me this day and under oath acknowledge that this form was executed by him/her.
,1 ieni
Witness my hand and notarialseal, this 1111 day of �' " 20 07/D
Notary Signature: " 1-tyY1
My Commission expires:
•
Iris efferson
Public
Notary Public
Mecklenburg COW*
North Carolina
CHARLOTTE- M Commission Ex res 1 2021
ENGINEERING&PROPERTY
MANAGEMENT
Land Development Division
600 East Fourth Street,Charlotte,North Carolina 28202-2844
Telephone:[phone] Fax:[phone]
http://landpermits.charmeck.org
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