NCC242246_FRO Submitted (2)_20240729

Rowan County
Financial Responsibility/Ownership Form Sedimentation Pollution Control Ordinance
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
Rowan County Environmental Management Department.
Part A Parcel ID Number
Lot 50: 201 A050
Lot 51: 201A051
Lot 52: 201 A052
Lot 53: 201 A053
Lot 54: 201 A054
Lot 55: 201 A055
Lot 56: 201 A056
Lot 57: 201 A057
1. Project Name*
Yorkshire(Lots 50-57)
2. Location of land-disturbing activity(Highway/Street)*
Coppergate Drive
3. Latitude Longitude
Lot 50: 35.647470 Lot 50: -80.616348
Lot 51: 35.647488 Lot 51: -80.615998
Lot 52: 35.647496 Lot 52: -80.615670
Lot 53: 35.647476 Lot 53: -80.615248
Lot 54: 35.647478 Lot 54: -80.614861
Lot 55: 35.647449 Lot 55: -80.614539
Lot 56: 35.647437 Lot 56: -80.614126
Lot 57: 35.647484 Lot 57: -80.613761
4. Approximate date land-disturbing activity will be commenced
06/07/2024
5. Purpose of development(residential, commercial, industrial, etc.)
Residential Homebuilding
6. Approximate acreage of land to be disturbed or uncovered*
4.13 Acres
*this information will be made available on the Rowan County Planning&Development website.
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Rowan County
7. Person to contact should sediment control issues arise during land-disturbing Cell Phone Number*
activities*
Henry Kirchner 704-754-5460
Email Address
[e-mail]
8. Landowner of Record Landowner of Record
Century Communities Southeast, LLC
Name Name
Current Mailing Address Current Mailing Address
7401 Carmel Executive Park Drive
Charlotte, NC 28226
9. Recorded in Deed Book Number Page Number
1282 104
1. Person or Firm who are financially responsible for Person or Firm who are financially responsible for this
this land-disturbing activity land-disturbing activity
Century Communities Southeast, LLC
Name of Person(s) or Firm(s) Name of Person(s)or Firm(s)
Current Mailing Address Current Mailing Address
7401 Carmel Executive Park Drive
Charlotte, NC 28226
Phone Number Phone Number
704-754-5460
*this information will be made available on the Rowan County Planning&Development website.
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Rowan County
a. If the Financially Responsible Party is not a resident of North Carolina, give name and street address of a North
Carolina Agent.
Name of Agent Name of Agent
Current Mailing Address Current Mailing Address
Phone Number Phone Number
b. If the Financially Responsible Party is a Partnership or other person engaging in business under an assumed
name, attach a copy of the certificate of assumed name. If the Financially Responsible Party is a Corporation,
give the name and street address of the Registered Agent.
Name of Agent Name of Agent
National Registered Agents, Inc.
Current Mailing Address Current Mailing Address
160 Mine Lake Ct. Ste.200
Raleigh, NC 27615
Phone Number Phone Number
*this information will be made available on the Rowan County Planning&Development website:
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Rowan County
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 authority to execute instrument s for the
Financially Responsible Person). I agree to provide correctional information should there be any change in the
information provided herein.
Name Title or Authority
Andrew Rouzer Division President
Signature Date
6/12/2024
I, El , a Notary Public of the County of 1 ` 1eEki-Q-(\kUrG:)
State of North Carolina, hereby certify that a ndreu- ) (Ze a- appeared personally before me this
day and being duly sworn acknowledged that the above form was executed by him/her. Witness my hand and seal of
Notary, this `' day of\une.. ,2t 4 .
Notary My commission expires
Date
Seal
Notar
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Checklist
Download a copy of the Erosion and Sedimentation
Control Plan Checklist(PDF)
*this information will be made available on the Rowan County Planning&Development website
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