NCC240306_FRO Submitted_20240205

Financial Responsibility/Ownership Form Sedimentation Pollution Control Ordinance
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 Rowan County
Environmental Management Department.
Part A Parcel ID Number
628-159
1.Project Name*
Scotland Ln Subdivision
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2.Location of land-disturbing activity(Highway/Street)*
Scotland Lane Salisbury, NC 28146 Rowan County
Latitude Longitude
35.595437 -80.420548
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3.Approximate date land-disturbing activity will be commenced
11/3/2024 I
4.Purpose of development(residential,commercial,industrial,etc.)
Residential
5.Approximate acreage of land to be disturbed or uncovered*
6.28
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6.Person to contact should sediment control issues arise during land-disturbing Cell Phone Number*
activity* 980-721-6086
John Erickson
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*this information will be made available on the Rowan County Planning&Development website.
Email Address
�[e-mail]

7.Landowner of Record Landowner of Record
Mega Grading LLC Mega Grading LLC
Name Name
Current Mailing Address Current Mailing Address
r18605 STARCREEK DR STE 102 [18605 STARCREEK DR STE 102
'CORNELIUS, NC 28031-9435 CORNELIUS, NC 28031-9435
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8.Recorded in Deed Book Number Page Number
Part B
1.Person or Firm who are financially responsible for this Person or Firm who are financially responsible for this►and-
land-disturbing activity disturbing activity
Mega Grading LLC I Mega Grading LLC
Name of Person(s) or Firm(s) Name of Person(s) or Firm(s)
Current Mailing Address Current Mailing Address
118605 STARCREEK DR STE 102 18605 STARCREEK DR STE 102
ICORNELIUS, NC 28031-9435 CORNELIUS, NC 28031-9435
Phone Number Phone Number
980-686-2388 980-686-2388
a. If the Financially Responsible Party is not a resident of North Carolina,give name and street address of a North Carolina
Agent.
Name of Agent Name of Agent
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Current Mailing Address Current Mailing Address
Phone Number Phone 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 the name and street
address of the Registered Agent.
Name of Registered Agent
Marvin Edgardo Garcia Alfaro
Current Mailing Address Current Street Address
1707 Bondale PI 1707 Bondale PI
Charlotte, NC 28216 Charlotte, NC 28216
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Telephone Number Telephone Number
1980-686-2388 980-686-2388
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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 authority to execute instruments for the Financially Responsible Person).
I agree to provide correctional information should there be any change in the information provided herein.
Name Title or Authority
'John Erickson Managing Member
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Signature Date
12/04//2023
I,J (((l✓PiPedA vfat%5 ,a Notary Public of the County of f 1eciderh_i-r,q State of North Carolina,
hereby certify that JOhr �j- cx..5 Y' appeared personally before me this ay and being duly sworn acknowledged
that the above form was executed by him/her.Witness my hand and seal of Notary,this 4 day of Utrentee ,2092.
Notary My commission expires
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Checklist YQ' ,G�yO I'1d J tic\
Download a copy of the Erosion and Sedimentation _ H c'
Control Plan Checklist(PDF) AVSLIG C.r.
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