NCC242410_FRO Submitted_20240807

FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
No person may initiate any land-disturbing activity on one or more acres as covered by the Act before this form
and an acceptable erosion and sedimentation control plan have been completed and approved by the Land
Quality Section, N.C. Department of Environmental Quality. Submit the completed form to the appropriate
Regional Office. (Please type or print and, if the question is not applicable or the e-mail address or phone
number is unavailable, place N/A in the blank.)
Part A.
1. Project Name Willowbrook
2 Location of land-disturbing activity: County Cleveland City or Township Shelby
Kings Road 35.274660 -81.500390
Highway/Street 9 _ Latitude(decimal degrees) Longitude(decimal degrees)
3. Approximate date land-disturbing activity will commence:05/01/2024
4. Purpose of development(residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): 50
6. Amount of fee enclosed: $5000 The application fee of$100.00 per acre (rounded
up to the next acre) is assessed without a ceiling amount (Example: 8.10-acre application fee is$900).
Checks should be addressed to NCDEQ.
7. Has an erosion and sediment control plan been filed? Yes 11 Enclosed ❑x No ❑
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Matt Kearns E-mail Address [e-mail]
Phone: Office# 843-258-1372 Mobile# [phone]
9. Landowner(s)of Record (attach accompanied page to list additional owners):
KINGS ROAD SHELBY LLC
Name Phone: Office# Mobile#
231 POST OFFICE DRIVE S
Current Mailing Address Current Street Address
INDIAN TRAIL, NC 28079
City State Zip City State Zip
10. Deed Book No. 1883 Page No. 2159 Provide a copy of the most current deed.

Part B.
1 Company(ies)who are financially responsible for the land-disturbing activity(Provide a comprehensive list
of all responsible parties on accompanied page.) If the company is a sole proprietorship or if the landowner(s)is
an individual(s), the name(s)of the owner(s)may be listed as the financially responsible party(ies).
Clayton Properties Group Inc dba Mungo Homes [e-mail]
Company Name E-mail Address
8008 Corporate Center Drive, Suite 201 8008 Corporate Center Drive, Suite 201
Current Mailing Address Current Street Address
Charlotte, NC 28226 Charlotte, NC 28226
City State Zip City State Zip
Phone: Office# 843-258-1372 Mobile# [phone]
Note: If the Financially Responsible Party is not the owner of the land to be disturbed, include with this form
the landowner's signed and dated written consent for the applicant to submit a draft erosion and sedimentation
control plan and to conduct the anticipated land disturbing activity.
2. (a) If the Financially Responsible Party is a domestic company registered on the NC Secretary of State
business registry, give name and street address of the Registered Agent:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# Mobile#
Name of Individual to Contact(if Registered Agent is a company)
(b) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina agent who is registered on the NC Secretary of State business registry:
CT Corporation System mkearnsc mungo.com
Name of Registered Agent E-mail Address
160 Mine Lake Ct Ste 200 160 Mine Lake Ct Ste 200
Current Mailing Address Current Street Address
Raleigh, NC 27615 Raleigh, NC 27615
City State Zip City State Zip
Phone: Office# Mobile#
Matt Kearns
Name of Individual to Contact(if Registered Agent is a company)

(c) If the Financially Responsible Party is engaging in business under an assumed name, give name under
which the company is Doing Business As. If the Financially Responsible Party is an individual, General
Partnership, or other company not registered and doing business under an assumed name, attach a copy
of the Certificate of Assumed Name.
/ 1Ce vngo Homer -
Company IAA Name
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(s)
or his attorney-in-fact, or if not an individual, by an officer, director, partner, or registered agent with
the authority to execute instruments for the Financially Responsible Party). I agree to provide
corrected information should there be any change in the information
information provided herein.
ti/
Type or printz na e
Title or Authority
lam- 7 / Z6, / "1
Signature Date
I, -c-fl.:kl<\n , a Notary Public of the County of G-b-
State of North Carolina, hereby certify that %•2J 3 k- _r2 .vk ' appeared personally
before me this day and being duly sworn acknowledged that the above form was executed by him/her
Witness my hand and notarial seal, this ','t- day of ---( fI3G,.rv\ , 20 g.k4
0 gi,..
FAITH SU Notary
NOTARY PUBLIC
GASTON COUNTY,NC My commission expires fj'A-A—a0-d-2
My Commission Expired 3-17-2027

DocuSign Envelope ID:888AC3C2-DAA8-4D98-8FB9-FB48108194E8
Clayton.
properties group
ACTIO NBY WRITTEN CO MENT 0 FTH EBO ARD 0 F
DIRECTO RS 0 FCLAYTO NPRO IERTIES G Im IP,INC.
Novem her 8,2023
The undersigned,being all of the m an hers of the Board of Directors(the"Board")of Clayton Properties Group,Inc.,a
Tennessee corporation(the"Corn',any"),acting by written consent as perm ited by Section 48-18-202 of the Tennessee Business
Corporation Act and Section 3.6 of the Bylaws of the Corn piny, hereby consent to the adoption of the following resolutions
without a m a;ting and agree that such actions are taken with like effect and validity as though duly taken by the affirm live vote
of the Board at a meeting duly called and legally held as of the date first written above:
APPO NTMENT 0 FO IFICERS
WHEREAS,the Board believes it to be advisable and in the best interests of the Com piny and its shareholders for the
Corn piny to appoint certain individuals as officers of the Corn piny.
NO W,TH EREFO IE, BE IT RESO LVED, that the Board hereby appoints the following individual to serve as an
officer of the Company until such individual's successor is duly appointed or until such individual's earlier death,resignation,
retirem sit,disqualification or rem oval:
M att Kearns—Assistant Secretary
G INERAL RESO IUTIO 1s5
RESO LVED, that the Board hereby authorizes and em rowers each of the authorized officers of the Corn piny (the
"Authorized Officers"), on behalf and in the nam eof the Company to prepare or cause to be prepared and to execute, deliver,
verify,acknowledge,file or record any docum nits,instrum acts,certificates,statem sits,papers,or any am aidm sits thereto,that
such Authorized Officer deem snecessary, appropriate or desirable in order to effectuate the actions approved in this Action by
Written Consent, and to take such further steps and do all such further acts or things as such Authorized Officer deem s
necessary, appropriate or desirable to carry out the intent of the resolutions set forth in this Action by Written Consent;
FURTH ER RESO LVED, that the authority and power given pursuant to this Action by Written Consent be deem al
retroactive and that the Board hereby ratifies, approves and adopts all acts authorized by this Action by Written Consent
perform al prior to the execution of this Action by Written Consent; and
FURTH ER RESO LVED,that the Board hereby directs the Secretary of the Corn piny to place this Action by Written
Consent in appropriate order in the books and records of the Com'any.
The m embers of the Board are perm ited to execute this Action by Written Consent in counterparts, all of which taken
together constitute but a single instrum an.
[Signature Page Follows]

DocuSign Envelope ID:888AC3C2-DAA8-4D98-8FB9-FB48108194E8
Each of the undersigned has executed this Action by Written Consent as of the date first written above
for the purpose of evidencing (i) such undersigned's consent to the taking of the foregoing actions without a
m eeting and (ii) such undersigned's affirm dive vote in favor of taking the foregoing actions.
DocuSigned by:
i M AR c�ael utherford
DocuSigned by:
CoU Vas
\---2BA8A2D2BF3B42A...
C olt Davis
DocuSigned by:
I_ �2G inaa'I'once
[Signature Page to Action by Written Consent of
the Board of Directors of Clayton Properties G pup, Inc.]