NCC242883_FRO Submitted_20240923

FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
EROSION & SEDIMENTATION CONTROL
IR L D L L L No person may initiate any land-disturbing activity on one or more acres, '/ acre or more inside a
c c ra watershed, as covered by the Sedimentation Pollution Control Act and the Iredell County Land
Development Code, before an acceptable erosion and sedimentation control plan has been submitted
and approved by the Iredell County Planning&Development, Erosion Control Section.
(Please type or print.)
Part A.
1. Project Name The Townes at Lake Norman —
2. Location of land-disturbing activity: County lredell County City or Township.Mooresville
Highway/Street River Highway Latitude 35-596897 Longitude-80.882275
3. Approximate date land-disturbing activity will commence: October 2024
4. Purpose of development(residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered(including off-site borrow and waste areas): 7.25
6. Amount of fee enclosed: $ 2 200.00 . An application fee of$275.00 per acre(rounded up to the next acre)is
assessed without a ceiling amount (Example: a 8.10-acre application fee is $2475). For projects > than 0.5 acres but no
greater than 0.99 acres in a water supply watershed,a flat fee of$100.00 is assessed.
7. Has an erosion and sediment control plan been filed? Yes _No _ Enclosed X
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Jake Flores E-mail Address [e-mail]
Telephone Cell# 704-577-0308 Fax#
9. Landowner(s)of Record(attach accompanied page to list additional owners):
D.R. Horton, Inc.
Name Telephone Fax Number
8025 Arrowridge Blvd. _ 8025 Arrowridge Blvd.
Current Mailing Address Current Street Address
Charlotte NC 28273 Charlotte NC 28273
City State Zip City State Zip
10. Deed Book No.3084 Page No.711-715 Provide a copy of the most current deed.
Part B.
1. Person(s) or firm(s) who are financially responsible for the land-disturbing activity (Provide a comprehensive list of all
responsible parties on an attached sheet):
D.R. Horton, Inc. [e-mail]
Name E-mail Address
8025 Arrowridge Blvd.
Current Mailing Address Current Street Address
Charlotte NC 28273
City State Zip City State Zip
Telephone [phone] Fax Number
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2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address of the designated
North Carolina Agent:
Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone Fax 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 name and street
address of the Registered Agent:
CT Corporation System [e-mail]
Name of Registered Agent E-mail Address
160 Mine Lake Ct. Suite 200
Current Mailing Address Current Street Address
Raleigh NC 27615
City State Zip City State Zip
Telephone [phone] Fax Number
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 the authority to execute instruments for the Financially Responsible Person). I agree to
provide corrected information should there by any change in the information provided herein.
Jake Flores Division Stormwater Compliance Specialist II
Type or print name Title or Authority
9/9/2024
.Sig i re �� � Date
I, 'C(-C( LI &t.- O L(C S , a Notary Public of the County of 61Ct_S4 Y 1
State of North Carolina, hereby certify that Ta..4 F I or S appeared personally before me this day
and being duly sworn acknowledged that the above form was executed by him.
Witness my hand and notarial seal,this `/I day of Sfi 4C-tevt -V , 20 a
rt
Notary
Seal Aka f 1 a-1 a�a My commission expires '^-"'I ,
0 RACHEL MARTIN HAYES
Notary Public, North Carolina
Gaston County
My Commission Expires
May 27,2025
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