NCC231038_FRO Submitted_20230414

PLAN REVIEW/FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
CATAWBA COUNTY CODE OF ORDINANCES, CHAPTER 16 ARTICLE V
SOIL EROSION AND SEDIMENTATION CONTROL
No person may initiate any land-disturbing activity on one or more acres as covered by the Ordinance before this form
and an acceptable erosion and sedimentation control plan have been completed and approved by the Catawba County
Utilities and Engineering Department. (Please type or print, and if question is not applicable,please N/A in the blank)
PART A
1. Job Name (Legacy Ridge Lots 2, 17, 196-205
2. PIN or 911 Address 1378110267296;378109158581
3. Purpose of development (residential, commercial, industrial, institutional,etc.) residential
4. Approximate soil disturbance date L2hh/2023
5. Total acreage disturbed or uncovered(including off-site borrow and waste areas) 2.19
6. Has an erosion and sedimentation control been filed? >J Yes ❑ No ❑ Attached
7. If you have an Erosion Control billing account, would you like this to be billed? ❑ Yes I7 No
Account Number IN/A
PEOPLE
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity
Name (Mark Henninger E-mail address [e-mail]
Telephone [phone] Cell# Fax#
9. Landowner(s) of Record(attach accompanied page to list additional owners)
Name VR Farms LLC Telephone I704-516-2344 J Fax#
Current Mailing Address 17271 Long Island Road
City (Catawba State NC Zip 28609
1
Current Street Address 17271 Long Island Road
City Catawba State INC Zip 28609
10. Deed Book No. Page No.
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 attached sheet):
Name ILennar Carolinas,LLC E-mail address [e-mail]
Current Mailing Address 6701 Carmel Road,Suite 425
City Charlotte State INC Zip 28226

Current Street Address 6 01 Carmel Road,Suite 425
City [Charlotte j State LNC Zip 28226
Telephone r7045428300 Fax#
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 L _ E-mail address
Current Mailing Address
City State I - Zip
Current Street Address
City ------- -- State II Zip [
[
Telephone Fax#
2. (b)If the financially responsible party is a Partnership or other person engaging in business under 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 E-mail address I
Current Mailing Address
City State Zip L
Current Street Address [
City ( State Zip
Telephone Fax#
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.
it(a<\A PRAni Q i vis;on Pt ;d evE--
Type or r. e Title of Aut rity
/023
Signature Date
I, /„OLD►leers &-J(mnaS ,a Notary Public of the County of State of North
Carolina,hereby certify that M.a("K. Fi2(1 n in cier' appeared personally before me this day and being duly
sworn acknowledge that the above form was executed by him.
Witness my hand and notary seal,this 1 D day of JGn ..L a ,20 a3
Seal
KATHLEEN G. JONES Notary
NOTARY PUBLIC Union County My Commission expires ,57t4 f I �
.T= 1. r
North Carolina
My Commission Expires May 4,2027 Print Form