NCC243177_FRO Submitted_20241015

CITY OF GREENSBORO
FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
No person may initiate any land-disturbing activity covered by the Sedimentation Pollution Control Act before this form
has been completed and filed with the Sediment and Erosion Control Section of the City of Greensboro. (Please type
or print and, if questions are not applicable, place N/A in the blank).
Part A:
1. Project Name: REEDY FORK RANCH MIDDLETON PHASE 4 LOT EROSION CONTROL
2. Location of land-disturbing activity: 3157 HIGHLANDER POINT
3. Approximate date land disturbing activity will be commenced: SUMMER 2024
4. Development type: Commercial Industrial Institutional MF residential SF residential ✓
5. Approximate acreage of land to be disturbed: 6.96
6. Has an erosion and sediment control plan been filed? Yes ✓ No
7. Landowner(s) of Record (attach pages to list additional owners):
TRUE HOMES,LLC 704.507.0295 BMCWHIRTER@TRUEHOMESUSA,COM
Name Telephone Email
121 SHIELDS PARK DRIVE,SUITE G 121 SHIELDS PARK DRIVE,SUITE G
Current Mailing Address Current Physical Street Address
KERNERSVILLE NC 27284 KERNERSVILLE NC 27284
City State Zip City State Zip
8. Deed County: GUILFORD Book: 8765 Page: 108
9. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name: DREW FULCHER Telephone: [phone]
E-mail: [e-mail] Other:
Part B:
1. Company(ies) or firm(s) who are financially responsible for the land-disturbing activity (Provide a comprehensive
list of all responsible parties on an attached sheet.) If the company or firm is a sole proprietorship the name of the owner
or manager may be listed as the financially responsible party.
TRUE HOMES,LLC 704-507-0295 [e-mail]
Name Telephone Email
121 SHIELDS PARK DRIVE,SUITE G 121 SHIELDS PARK DRIVE,SUITE G
Current Mailing Address Current Physical Street Address
KERNERSVILLE NC 27284 KERNERSVILLE NC 27284
City State Zip City State Zip

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:
1ME,SLS t S.M�NSonl,}{,rysoN Fiavuc, (1!a (7o4-)l®94-0 1
Name Telephone Email
g001 POET oFFIcE. ®Wv6 3005 PoCT oFPICC OtztvC
Current Mailing Address Current Physical Street Address
1NDIarn1 ill. NC. Z9o7q IN DIA r-1 MAIL Mt- 290'7 i
City State Zip City State Zip
(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:
Name Telephone Email
Current Mailing Address Current Physical Street Address
City State Zip City State Zip
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
be any change in the information provided herein,
BRIAN MCWHIRTER MARKET PARTNER
Type or print name Title or Authority
Signature Date
I, S'het1eti e- , a Notary Public of the County of lJli� k-
rTh
State of Nt` 1 Cam i y' cx, , hereby certify that 1 c\x— J\ Nhi yk,e,y
Personally accepted before me this day and under oath acknowledged that the above form was
executed by owner(s).
Witness my hand and notarial seal, this'1 O iay of 3-0Y'e, , 20 ELA
My Commission expires 12.
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IViy 12121/2027