NCC220371_FRO Submitted_20220126

FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
No person may initiate any land -disturbing activity on one or more contiguous acres as covered by
the Soil Erosion and Sedimentation Control Ordinance of the City of Greenville (Title 9, Chapter 8) before
this form and an acceptable erosion and sedimentation control plan have been completed and approved by
the City of Greenville, Engineering Department. (Please type or print and, if question is not applicable,
please place N/A in the blank)
I. Project Name Greenville Plaza
2. Location of land -disturbing activity: Township Greenville Township
3. Approximate date land -disturbing activity will be commenced: 1/15/2022
4. Purpose of development (residential, commercial, industrial, etc.)
Commercial
5. Approximate acreage of land to be disturbed or uncovered: 3.3 Acres
6. Has an erosion and sedimentation control plan been filed? Yes X No
7. Person to contact should sediment control issues arise during land -disturbing
activities. Ken Mal ass
S. Landowner (s) of Record (Use blank page to list additional owners)
Front Porch Management, LLC _
Name(s)
1003 Red Banks Road
Current Mailing Address Current Street Address
Greenville, NC 27858
City State Zip
4109
9. Recorded in Deed Book No. 4159
City state - Zip
819
Page No. 193
PART B.
L(a) Person (s) or firm (s) who are financially responsible for this land -disturbing activity
(Use blank page to list additional persons or firms)
Front Porch Mana ement, LLC c/o Robert D. Parrott
Name(s) —
1003 Red Banks Road
Current Mailing Address
Greenville NC 27858
City state Zip
Current Street Address
City State Zip
Telephone [phone] Telephone

2.(a) If the Financially Responsible Party is a Corporation give name and street address of
the registered agent.
(Name
Mailing Address
City State Zip
Telephone
Street Address
City State Zip
Telephone
The above information is true and correct to the best of my knowledge and belief and
was provided by the 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 responsible person). l agree to pauthori#y to execute instruments for the financiallyrovide corrected information should there be any
change in the information provided. herein.
RWignature
bDParrott
in ame
Title or uthority
Date
G-Q��-s _ , a Notary Public of the County of �f
Mate of North Carolina, hereby certify that o
appeared personally before me this day and being duly swum acknow edged that the
above form was executed by him.
Witness my hand and notarial seal, this the I S day of Oaj �, - , 2021
qEa:`. ' _ Y � No#aryl •� "'
$i My commission expires