NCC240042_FRO Submitted_20240108

FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
EROSION & SEDIMENTATION CONTROL
IR E D E L L No person may initiate any land-disturbing activity on one or more acres, 1/2 acre or more inside a
COUNTY NC 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 Windgate Subdivision
2. Location of land-disturbing activity: County Iredell City or Township Mooresville
Highway/Street Shinnville Road Latitude 35.6261 N Longitude 80.82W
3. Approximate date land-disturbing activity will commence: 1/1/24
4. Purpose of development(residential, commercial, industrial, institutional,etc.): residential
5. Total acreage disturbed or uncovered(including off-site borrow and waste areas): 16.2
6. Amount of fee enclosed: $ 2,975.00 . An application fee of$175.00 per acre(rounded up to the next acre) is
assessed without a ceiling amount (Example: a 8.10-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$100.00 is assessed.
7. Has an erosion and sediment control plan been filed? Yes X No Enclosed on file
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Mark Altman E-mail Address [e-mail]
Telephone [phone] Cell# same Fax#
9. Landowner(s)of Record(attach accompanied page to list additional owners):
DRP NC 2 LLC 212-751-5949
Name Telephone Fax Number
590 Madison Avenue 13th Floor same
Current Mailing Address Current Street Address
New York NY 10022
City State Zip City State Zip
10. Deed Book No. 3033 Page No. 109-113 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):
Davidson Homes LLC ATT: Mark Altman maltman andavidsonhomesllc.corn
Name E-mail Address
1903 N Harrison Avenue Suite 200 same
Current Mailing Address Current Street Address
Cary NC 27529
City State Zip City State Zip
Telephone [phone] Fax Number
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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 information provided herein.
Mark Altman Vice President Land Development
Type or print name Title or Authority
1 -I4Y _ 2 3
Signature Date
I, (ya'1p rl (1. �" 1 ii)t 1. a Notary Public of the County of (^
State of North Carolina, hereby certify that 1`i\ci'ct< 1 t Vv\.P f'\ appeared personally before me this day
and being duly sworn acknowledged that the above form was executed by him.
✓`i ln.
Witness my hand and notarial seal,this I Z5" day of . 4y ,20 t) 3
CIS QtAi
Notary
Seal ol
My commission expires peC7— a yf r kt e.p
Celinda Howell
NOTARY PUBLIC
Wake County
North Carolina
My Commission Expires December 27,2.026
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