NCC223941_FRO Submitted_20221214

City of Charlotte Soil Erosion and
Sedimentation
Control Ordinance
Financial Responsibility/Ownership Form
No person shall initiate any land -disturbing activity on one or more acres as covered by Chapter 17 of the Charlotte
City Code of Ordinances before this form and an acceptable erosion and sedimentation control plan have been completed
and approved by the City of Charlotte. The financially responsible party will be on record as the party to accept any Notices
of Violation or related documents for any non-compliance of the City of Charlotte Soil Erosion and Sedimentation
Ordinance. If the financially responsible party is out of State, a North Carolina agent must be assigned. All relevant
items on this form must be filled out accurately and completely
Please Type or Print
PART A
1. Project name: Skyway Industrial Park
2. Address of land —disturbing activity: Shopton Rd (no address currently assigned)
north of Shopton Road at Pinecrest Drive (private) (tax parcel IDs 14125114, 14107120, 14107126, and 14107125)
3. Approximate date land -disturbing activity will commence: November 28, 2022
Month Day Year
4. Purpose of Development (Residential, Commercial, Industrial, etc.): Industrial
5. Total acreage of land to be disturbed or uncovered: 41.0 acres
6. List total site acreage: +/- 157.33 acres
7. Landowners of Record (attach accompanied page to list additional owners). If the landowner of record is not
the person(s) or firm(s) financially responsible as listed in Part B, item 1, a separate letter of consent signed
by the landowner of record or their authorized agent is required:
Name: EastGroup Properties LP
Address: 3495 Piedmont Road, Building 11, Suite 350, Atlanta, GA 30305
Telephone: [phone] Fax:
(Area Code) (Area Code)
Email Address: [e-mail]
Name:
Address:
Telephone: Fax:
(Area Code)
Email Address:
(Area Code)
8. Indicate BooIc and Page where deed or instrument is filed (Use blank page to list additional deeds or -
instruments) Book 36640 Page 344, 347
Boot{ 36641
Page
484
Book Page
Boole Page
Page l

Continue - Financial Responsibility/Ownership Form
PART B
1. Person(s) or firm(s) financially responsible for this land -disturbing activity (Note: If the financially responsible
person(v) or frrw(s) has an out -of --state address, a North Carolina agent rnrrst be designated in item 2 below):
Person or Firm: EastGrou Pro erties LP
Address: 3495 Piedmont Road, Building 11, Suite 350, Atlanta, GA 30305
Telephone: [phone] Fax:
(Area Code)
Email Address: ron.coffey(d).eastq rou .net
(Area Code)
2. 1f the Financially Responsible Party is not a resident of North Carolina, give name and street address of the
designated North Carolina agent:
Person or Firm: CT Corporation System
Address: 160 Mine Lake CT, Suite 200, Raleigh, NC 27615-6417
Telephone: [phone] Fax:
(Area Code)
Email Address:
(Area Code)
3. The above information is true and correct to the best of my knowledge and belief and was provided by me
while under oath. (This form must be signed by the financially responsible person if an individual or by an
officer, director, partner, attorney -in -fact, or other person with authority to execute instruments for the
financially responsible company or entity, if not an individual.)
Ronald Coffey Construction Manager, EastGroup Properties LP
Printed Name Title
Signature
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11 /21 /2022
Date
a Notary Public of the County
, hereby
appeared before me this day and under oath aclawi-vledge that this form was executed by h.irrr/her.
Wilness my hand and notarMl seal this day of (jj ,� r .......... _.... ____, 20
Notaiy Signature:
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Rev. 09/2021 Page 2