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arpo ° Mecklenburg County Soil Erosion and
M4i1 Sedimentation Control Ordinance
Financial Responsibility/Ownership Form
No person shall initiate any land-disturbing activity covered by Section 6 of the Mecklenburg
County, Mint Hill or Davidson Sedimentation and Erosion Control Ordinances prior to
completing and filing this form with Mecklenburg County Land Use and Environmental
Services. The financially responsible party will be on record as the party to accept any Notices
of Violation or related documents for any non-compliance with the above Ordinances. 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:Stephens Farm RTAP-2
2. Address of land-disturbing activity: Stephens Rd (Parcels 013 091 04)
3. Approximate date land-disturbing activity will commence: July 1 2024
Month Day Year
4. Purpose of development(Residential, Commercial, Industrial, etc.): Residential
5. Approximate acreage of land to be disturbed or uncovered: 13.03
45.42
6. Total site acreage:
7. Landowners of record (use blank pages to list additional owners as necessary):
Owner#1 Name: PDG-Stephens Farms, LLC
Address: 6719-C Fairview Rd, Charlotte, NC 28078
Telephone: 704-365-1208 Fax:
Email Address: dfaulkner@pacedevelop.com
Owner#2 Name:
Address:
Telephone: Fax:
Email Address:
8. Indicate Book and Page where the deed or instrument is filed(use blank pages to list
additional deeds or instruments as necessary):
Book 38299 Page 752 Book Page
Book Page Book Page
(continue on back or separate pages as necessary)
Form Revised 12-2016
Continue - Financial Responsibility/Ownership Form
PART B
1. Person(s) or firm(s) financially responsible for this land-disturbing activity:
Person or Firm: Classica Homes, LLC
Address: 2215 Arysley Town Blvd. Suite G Charlotte, NC 28273
Telephone: 704-940-0273 Fax:
Email Address: LBurton@ClassicaHomes.com
2. North Carolina agent for the person or firm who is financially responsible:
Person or Firm: Larry Burton
Address: 2215 Arysley Town Blvd. Suite G Charlotte, NC 28273
Telephone: 704-940-0273 Fax:
Email Address: LBurton@ClassicaHomes.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.)
Brian Hall Vice President
Printed Name Lik Title
6/18/24
Signature Date
I, C N1 VD-( \rn I,LtOn , a Notary Public of the
County of T r (' ( j , State of NOY 01 CEL b t 1 fC( , hereby
certify that 'Y(J h \ personally appeared
before me this day and under oath acknowledged that this form was executed by him/her.
Witness my hand and notarial seal, this 1 B tin day of j U n-( , 20 2�— .
Notary Signature: CtILLLL
ur-26.1,u___
My Commission expires: l(T J4/ i
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M
,s Mecklenburg County Land Use and Environmental Services Agency
Notary Public Z`s
2145 Suttle Ave.
Iredell - Charlotte,NC 28208-5237
County = Phone(980)314-3234
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