NCC230189_FRO Submitted_20230123

FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
No person may initiate any land -disturbing activity on one or more 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 Division. (Please type or print and, if the question is not applicable or the e-mail
and/or fax information unavailable, place N/A in the blank.)
Part A.
1. Project Name Townes at Laurel Ridge - Building Construction
2. Location of land -disturbing activity: County Pitt City or Township Greenville
Highway/Street Laurel Ridge Dr. Latitude 35.580493 Longitude-77.435885
3. Approximate date land -disturbing activity will commence: October 2022
4. Purpose of development (residential, commercial, industrial, institutional, etc.): residential
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 2.5 Acres
6. Amount of fee enclosed: $ 300.00 . The application fee of $100.00 per acre (rounded
to the tenth of acre) is assessed without a ceiling amount (Example: a 9-acre application fee is $900).
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 Chris Ahlers E-mail Address cahlers drhorton.com
Telephone [phone] Cell # 336-312-6567 Fax # N/A
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Aahan Homes, LLC 919-271-5830 N/A
Name Telephone Fax Number
2729 Willow Rock Lane 2729 Willow Rock Lane
Current Mailing Address Current Street Address
Apex NC _ _ 27523 A,, -ex NC 27523
City State Zip City State Zip
10. Deed Book No. 4026 Page No. 304 _ 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. tmdavis1(d)drhorton.com
Name E-mail Address
7208 Falls of Neuse Rd., Ste 201 7208 Falls of Neuse Rd., Ste 201
Current Mailing Address Current Street Address
Raleigh NC 27615 Raleigh NC 27615
City State Zip City State Zip
Telephone [phone] Fax Number NIA

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
Current Mailing Address
City
Telephone
E-mail Address
Current Street Address
State Zip City
Fax Number
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 of Registered Agent
Current Mailing Address
City
Telephone
State
E-mail Address
Current Street Address
Zip City State Zip
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.
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S a Notary Public of the County of
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personally before me this day and being duly swo acknowledged that the above form was
executed by him.
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