NCC222003_FRO Submitted_20220526

Fes.
Soil Erosion and Sedimentation Control
a I i." I i f `x XI F, i t '` ; }.
Financial Responsibility/Ownership Form
Ni:)T Rt-'Ql, IRED TO Hh' C0,44PI l:TI'l) FOR RES11)f?W77.4f. /,07`I1I1fdAUTS'.
PLEASE READ THE FOLLOWiNQ INFORMA [ON:
l ) l hi:, section must be: signed in the presence of a Notary
D All t-and-Disturbing permits arc valid for till to (2) years troill the, state of issuance. t]' circurustariccs warrant, fihc: prrmit may b
cxtcaded for (2) years per the conditions of the Chatham CoUllty Soil Erosion arld Sedimentation Control Ordinance. Upon written
notice. the Land -Disturbing permit may be revoked fur failure to comply with the Ordinanei_. if the prrn,it is revoked, all tither
permits and dpprovals are withheld until rite property is once agairl in compliance with Chatham County regulations, Also- llpon
written notice, a civil penalty (fine) can be instigated iigainsr the prope'rtV owner andl, Tr additiooal ti ancially restwonsible party (it ally)
for violations of the Chatham County Moil Erosion and Stdiinent'ation C-ontrol Ordinance, This penalty is ui> to $5000'(W per violation
per day and is assessed daily for every cloy the property is in violation. Interfering with or liartr7erinvr an inspection can result in a civil
penalty witbottt written notice.
z) The information provided oil this form is true alid correct to the best ofniy kno%xledge and hcliet'and was provided by me while
Under oath.
4) This farm must be signed by the, property wwner if an individual. l f owned Ilya company or corporation, this fornl must be signed
by all officer. dirccxor, partner, attorney -in -tint, or other person %vith authority to CXecutcinstrunle virs for the coryunation Gild
accompanied by a ccnlipletc list of all partncrs. m anaging, nic rthcra and rcgistered agents cif tlic company or corporation.
OWNER 0F PROPE WFY:
Nance antt title: Easterling Fine Harries INC.
Company {ii' iplalictiiYle); sterling Fine Homes INC-
ADDITIONAL NAL FINA_'iICIALLY RESPO SIBLE PARTY (if any):
Name and Title:
Company:
Signature:
NORTH CAROLINA AGENT (if an)*):
Nance and Title:
Company:
Sig
naturc:
S �
Notary public of County in the stale
do hereby certify that ' % .Y :•, _- ---personally
appeared before me this clay and tuider oath acknowledged reading the informatiou above and acknowledged that the
above form vas eXecttted bv hint or her.
Witness my liand and oftis:iat seal, this the day of
Notary public, `INDY COCHIE
Notary rubhc Pdogh i, i us!na
My commission expires Chathain Caur(!&?F.Al_,)
3 My Corns iissionn Expires Dv x:t123
Page 3 of 3