NCC232553_ESC Approval Submitted_20230823

FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
EROSION & SEDIMENTATION CONTROL
IIZ L D E L L No person may initiate any land-disturbing activity on one or more acres, '/2 acre or more inside a
watershed, as covered by the Sedimentation Pollution Control Act and the Iredell County Land
Development Code, before an acceptable erosion and sedimentation control plan has been submitted
and approved by the Iredell County Planning& Development, Erosion Control Section.
(Please type or print.)
Part A.
1. Project Name R06705 'VO' 4.
2. Location of land-disturbing� activity: County .�`-« City or Township
Vg Highway/Street e` ((5kr 1(• Latitude .779gi(°1J Longitude C90• 91(2G&1°1/4
3. Approximate date land-disturbing activity will commence: ASA�p
4. Purpose of development(residential, commercial, industrial, institutional, etc.): Zt5:dCrft- .
g.BS
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): --_ AZ✓L-3
6. Amount of fee enclosed: $_ Szs . An application fee of$175.00 per acre(rounded up to the next acre)is
assessed without a ceiling amount (Example: a 9-acre application fee is $1575). For projects > than 0.5 acres but no
greater than 0.99 acres in a water supply watershed, a flat fee of$135.00 is assessed.
7. Has an erosion and sediment control plan been filed? Yes No Enclosed
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name a4doz? J E-mail Address
Telephone ?pc -363- . -i c Cell# Fax# A.VA
9. Landowner(s)of Record(attach accompanied page to list additional owners):
TiuA10/1 . f nEs LLc. 70,1-363-ZSKS /b/4—
Name Telephone Fax Number
63/- &r4c.l<y Sc404 eJ . S�'k <-1,H6—
Current Mailing Ad ress VI Current Street Address
Ain e.caL Ai( 28/17
City State Zip City State Zip
10. Deed Book No. � 24,81 Page No. So3 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):
r„11)0(44. 11DA4E5 1-L(. n34fri ►@`1-19.,n)or+�.lq escam
Name E- Address
{
&3/- grad"'le sC Lad �� 5pole zl-,
Current Mailing Addrels Current Street Address
1 .esv.1‘ /SIG 2.017
ity State Zip City State Zip
Telephone 70`(- G3-2-0.6 Fax Number /Q// ,Q J
Page 1 of 2

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 E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone Fax Number
(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 E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone 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 informatio provided herein.
C '�7
Type of r print e Title or A hority
'-.23/, 23
• ure Date
I, /„ �(/�,( �/V lc , a Notary Public of the County of
State of North Carolina, hereby certify that C 'V'V 161411 /0" AA appeared personally before me this day
and being duly sworn acknowledged that the above form was executed by him.
Witness my hand and notarial seal, this '1day of 41 A ,20 A3
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„„„imm,„,,„„,.N G.tat;i,,�� Notary ri��sa ti�
_ �GTAR}� - My commiss .n expires
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Page 2 of 2

EMIIIII
Rood Hazard Area Certificate Zoning Docla: teaa2asI rya,CRP
a lag
Recorded:11f22/2022 et 12:fi:02 Pei
Aec«b o to mapping prodded by the Federal Emergency Management Agency and &CYVN.R-20(Mel.faulty) Fee MR:
County,Page
1 of 1
shown on Me OlgBd Flood Insurance Rote Mop(DRAM)Paned 4724,oredell County, ENSairg Setback. rrurnn P.Purcell Register of tend,
North Carolina effective dote O3/18/reaQ the properly shorn hereon/s not Front-35' �3 aI.
located within a special flood hazard area.inn Property is O.GrelY within on area Side- T5' ..78
designated'Zone X-other oreoe..Aro.determined to be outride the 0.2X Rao•- 35'
annual Mance Poo...areas amide future conditions IX annual chance
flood... Glenn Ronny Pox _
and tat I
Jerry my-coy m
Trudy Duncan Pox
Si
D.4 1645,Pg. 1446 ' --I
PRO.4724-34-8905 g
MIS L'l 1
Errsr tkg Stone
5 88-1524•E 643.50' S l'A
Notice 7/8-Er
- Vicinity Map (NTS)
11
•Property subject to any easements and rfDlet of way an neea4 Legend 'S Certificate of Ownership & Dedication
and all NOOOT sasements and rights o1 ray CAPS Oil mavuir Ins SEr COWAN THE
SURVEYORS NAME AND LlC3l5E NUMBER I nereby certify that I am the owner of the property shown and
•This suety/s subject to any facts Mot may be disclosed byem. CI ... I I described
crlbed harp ,which b located the 0 pl this
f'riaefct/an of
full and accurate title sea IRS 1/2'IRON ROD SET M TH 0ELLOW CAP 28'RCP the Canty of Ir..and that I hereby adopt this plan of
•ORP crams IRON PIPE AS SHOWN at subdnbion with my free consent,establish minimum budding
•This survey plot does not shoe any unrecorded written arxfbocl�Isr.a> tad.
nwritten easements,dedications«other encumbrances.such •cp_......_Eo ypu-I IRON ROD AS SfIOR'11'X CP_........_CVAIPtlTED PO1.YTburdens could exist on this property and not appear on thin plat )1(5gg SURVEY SPIKE SETa awe ale Fla dead reehr'ctions uhiM NI Oe mated Dy the
Accordingly,users of this plot are warned to remain alert Iar the repeatedwbiWfan;existence of such unrecorded burdens not Mown hereon. ' ""'-•"'' N4IL SE'T n Meeoreno goeJwmeetal regukelau of any kind ther than
•This plat wan drown for Me exclusive use of Me party named _.-._-_.Slaty SIGNIMax far wN,ia a ce Ms lawn 00.00 by under Ne lraddl
r.. •thanhereon.Said certificates do not extend fo any unnamed person _UT1U7Y POLE SCanty.00.6la a1 Ordinance regulations,whkh wed be elated by
riMout an expms recertification DY the suns namng acid ....._..T^. rWum_-__-_TELEPHONE PEDESTALare deed aubo'eirirvh;and
c 1 undontand Mot en/oeerlert of deed rwrictiona and any
•The Glaba Narigatkn Satepite Sysram(GLASS)has uw0 fo b' "-_' other contraetua agreements is not the responsibMty of Redd,
nRE NrDRANTsperform landers tlor eospgeodahc positioning accuraey rrotwMte of tin 95X stonnda s.part 2 ' Canty,wMinoot De undw'folen by IrtMN Utaryia of sofa deed and Le Me salassifactloo(95X confidence)using reof tine kinemotk.mea nu antis/! I the rtfn ofkated D frictions and contractual agreements.
following inhumation was used: (,•DmfAc Open Spore �./ J/0.75 Acre I zt-z,,•-Ztrod&Mow cerRly shot this mop was drown under mysuper.tan 0film.4,an aawal oPte,corny made urger my sorer.eion32,543 Sq Ft own.: Datcand the following nformation woo used rp preform the suety Oduabw 20,432 Sq R In R/W f Notary
Clan.of SLreage CLASS A EDI et Nord Corona being County
Positional AY 0.06' g w'ufa• 5 tlbt wTjpe of GP5 Fuld Procedure RTX Alle
I c' a Notary PnMk fo-AlaDates of Surma 12-6-2021 Tpical 20'wide Z -r{u>� A
Doblm/Ep0Mr NA083(2011) D'nwway - i I y" pretty and stet.do hereby certify that art.
Published/Reed-Control Use Nt5 ]// �w!
Combined DidGEM Model:2Fiactr 099987994 Todd E Bonfield \1 r aen�)personally appeared before me Mr day an4Ntll4B414 And
Units-Us Screwy Feet D.B.2035, Pg. 1982 e - �7+' Me due execution of the foregoing instrument. �IpM g
/� PIN:4724-34-4349 i ncr..my hand and oKren/Cleo. ,L4,‘� l ee�
•Area determined by coordinate computoftons '✓/[�GG••
•Loins)to be served by n&lidual well and individual septic arefiC+I M' the 22 coy of dw•6°' T'Wt •'
system. /'- - --.—. o '°fel tG i _
•There in a 10'drainage and utility easement Bang all lot/net/- ' : L J -ie -! NaIrY P b/kr.
"
rf.4'r1 " '' ° di
Remainder o/ �}u �r e 202 (rl0.D••jj"�f'°`.{•As of the date of this remg Me lots hone not been 1 R-L uy ®: Theodore M. BenDow My aaamnriaa een' �w L• 1•IINtt.....nrpected byth the Irnoeq County Health Deding er Unfd N� 0• ............- .1 I D.B. 4724, P44. 018 Certificate of Approval for Recording:
141
inspected Mae is no assurance that building permits will be f'.{l�� ^ PIN:s724-d4-Z078
•issued
number of late 8 LY_`51944•61.074.141111111. aM4r.. _•• �11����tt U4 `5.1r ��SUDy8Ais0nn Ordnance al ,for ,NNorrtth�olnaa exception to
•Total area divide&6.63 Acres ry.. ® lil
¢ t / 0
• y(°„ 11•n ra dL
That this plot was plotsprepared a accordance with of s.47 as ; f 4 I D .. Aden sbabr Otte
amended Mat Mrs plot,meet the requirement of as.I]-30 ' : N 6005
i further certiO,Mot this survey creates a subdi».ion or land g'
Y or munkfpa y _ _ alter Supply Watershed Certificate:
wit.,the area of a cant foe that Rea ordinance 'e/ SC) PP Y
if
that regular.paeels of fond - 'l • in To the best of my Imowkdge M0 plot does not tie within o ter
git
supply watershed designated by the North Carolina Ohbfon f'aNiMen Nan my origlnd signofvra registrotlon number and I K� Endronmenta Management as ppears en the Matersrted Protection
swot th�22th day of Naeember 2022 AO •.y sin of Iredw'I County.North Cardona
/ �1�3 5 Lean Mmlama �1`4,• / F� gjC e�M . Da-?Or)
® and sparse. I E eh19rr AdnnMbotor Data
Ted Al.Benbor NC PCS L-3175 Nancy Williams t '`1•- i u ti Review Officer Certificate
rum License re C-1588 D.B.2649,Pg.2386 . ,
J!F PIN:4724-33-4845 r`'r 3 State of North Carolina
y�1 I / yDaw�tr�f,edal
' :`; � $ lJ'�4�" I JbM.Peden
. Rosier Officer,Dodd
if lelSFAI, :'� I /County:totted map ar Wolper.ehkh thin urtMeoUon is
fnhed too/etatut0ey rrpreen te Ion reaading
I' L-3175 a Ai 4 e.a ,(
-i:.jt r1 .4. r. 1 , a J Lot 1 '/tr .1I.7)-7011
' ►ems . :,: jr.,,,_,....z, yin I 129 Aem eef °f w e.
S . ..e.w•. 56,133 Sq Ft
a a>% %. kW quip 1E163 Sq R et R/W costae Bearing Distance
A� T I
-P�'la.��\ I i,-:+, L7 S 8753'15" E 9.24'
p -,E i <L' 1 ( Lot 2 L2 S 0354'24"W 261.22'
�4' 1'eih ©re ,�. �'` -�`-- L t a84 Ace L3 S 06,3'28"W 192.86'
,\ �rr yT-' 27,967 Sq ft L4 S 0673'28"W 238.00'
g 0 \ ,'9 ,_ - t Weimer;7.635 Sq R"R� L5 S 06'13'213"W 124.00'
• L6 S 0613'28"W 20.91'
Unless otherwise indiab4 all distances Mown as g ` '�«�. tg r Lot 3 L7 S 06'19'18"W 83.59'
h Yonea ground drahnees.To careen to grid 4T t► \`` - L8 S 0619'18"W 92.00'
Arlan...multiply the ground&Ora ce by Me 0.67 Acre
combined Nebr. 0rO �\�• •.� I.
29,298 Sq Ft L9 S OB19',8"w 90.00'
N �� � * " L10 S OB19'18" W 58.99'
-,{ 759 Ft RA Li S 0541'28"W 31.01'
iiir Lot 4 i 02 S 05'41'28"W 160.50'
Robinson'ty.` ♦ - L13 S 0541'28"W 157.6T
by Rd' ♦ 0.61 Acre L14 S a615'28"W 156.99'
`ti enc Ffobl V, \ �. 14 26,604 Sq Ft L15 N 2515'09" W 31.93'
Legend Us,a 12•P9 4466 ra Iw*ti•9 4,732 Sq R A R/h L16 N 31'00'25" W 266.45'
PIN 9._......PARCEL j0E'NT/nuTION NUMdat ? 0'8'472'L' ���� Lot 5 L18 N 43'15'09"W 122-50'
RCP RDNFORCED CONCRETE P1PE �N. $ 0.57 Acre L19 N 29'51'18"E 24.53'
EP_._--EDGE OF PAVEMENT
R/W-_.-_RIGHT OF WAY - I 25,035 Sq Ft 120 N 23'09.56"E 20.00'
N15.._ NOT TO SCALE 7/B'Er o� /etm•••4819 Sq R In IVW 1.21 N 8753'15"W 51.12'
Nos_._._NamTi cARGLM4 r,1roDFnc sefm2r L22 N 25'15'09" W 154.08'
James A Lacy d
LlN£StaVL2TFD d spouse, 'tye\ - Lot 6 L23 S OB73'43"W 101.74'
Nan Rene Lacy 0�4 0.59 Acre L24 S 8336'43" E 101.74'
11E LME SURVEYED D.B.2593, Pg.228 �' p
____UAfE NOr SUTA£YED RN:4724-33-4175 \ • 5,656 Sq Ft Revision Plot of.'
—0E—OVERHEAD
(Of 184E at, 4 k00e ip tf517 sq FT" Vir Robinson Forest
—aE—OeERHFM UT4ln'LAVE o RobinsonWoods
SETBACKAVE L ssse� Lot 7 Formerly Robi Woods
ROOS 0.61 Acre
too a 10o 200 300 21 B.8 Coordinates 26,674 SqFt
• • . • • e 142375Z8026 I P.B. 78, Pg. 72 P.� 7$ Pg. 38
GRAP•• •••C 9t^AT 1.= too A 7• a ►tebiy 4340 Sq R"RIM' Statesville Township, lredell County, NC
Lot 8 Owners of Record: Theodore M. Benbow
TED 0.91 Acre Deed Reference: D.B. 2888, Pg. 1141
N PiN. 4724-44-2018
N agh�ge 6 7'.' ',.►' 39507 Sq Ft
►ldtiq fop yy R"R/y Job Number: 2112406F5.OWO (2112406.CR0)
'r� F Hydrant ea Field Work: 12-2-2021
sss Plat Dote: 10-13-2022
Proudly Surveying fl.do0County Revised Plot Date: 11-17-2022 to change
snce 1989 Hers 7m 1' 1 s the size of lot 8 and remainder tract
830 96NAL 4Qd DRIVE EXT.STA6ESW.DE NC 28625 um"s and lots to be served byindividual well
PeDhE(704)870-9861 fva"Hcp,•„� Revised Plat Date: 11-22-2022 to change
We`b°"d°'ya°>m°p'°"ta°" subdivision name g
Bock 78 Page.83 Pagel et _.

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