NCC250598_FRO Submitted_20250226

® City of Charlotte Soil Erosion and
Sedimentation Control
charlottenc.gov Financial Responsibility/Ownership Form
No person shall initiate any land-disturbing activity covered by Article 28 of the Charlotte Unified Development
Ordinance (UDO) before this form and an acceptable erosion and sedimentation control plan have been completed
and approved by the City of Charlotte. The financially responsible patty will be on record as the party to accept any
Notices of Violation or related documents for any non-compliance with the UDO.
The following form must be filled out in its entirety,place N/A on any field intentionally left blank.
Part A.
1. Project Name:Westview
2. Address or parcel number of all parcels where land-disturbing activity is proposed:
Little Rock Road, Charlotte NC, 28214
3. Approximate date land-disturbing activity will commence: March 01 , 2025
4. Purpose of development(Residential, Commercial, Industrial, etc.): Residential
5. Acreage of land to be disturbed or uncovered: 14 AC
6. Total site acreage: 16.73 AC
7. Landowners of record(use blank pages to list additional owners if necessary):
Owner#1 Name:Developer's Capital Fund, LLC
Address:405 Western Lane Irmo, SC 29063
Telephone: Fax:
Owner#2 Name:
Address:
Telephone: Fax:
8. Include with this form a copy of the most recent deed for all parcels upon which land-disturbing activity is
proposed. Indicate Book and Page where the deed or instrument is filed(use blank pages to list additional deeds
or instruments as necessary):
Book:39381 Page:80-85 Book: Page:
Book: Page: Book: Page:
Revised January 2025 Page 2 of 2

Continue — Financial Responsibility/Ownership Form
Part B.
1. Person(s)or firm(s)financially responsible for this land-disturbing activity:
Person or firm:Clayton Properties Group dba Mungo Homes
Street Address: 8008 Corporate Center Drive, Suite 201, Charlotte, NC 28226
Telephone:[phone] Fax:
Email Address: [e-mail]
NOTE: If the financially responsible party or firm is not the owner of the land to be disturbed,include with this
form the landowner's signed and dated written consent for the applicant to submit a draft erosion and
sedimentation control plan and to conduct the anticipated land-disturbing activities.
2. North Carolina agent for the person or firm who is financially responsible(all companies doing business in
North Carolina must be registered with the NC Secretary of State):
Person or firm: CT Corporation System
Street Address: 160 Mine Lake Court, Suite 200
Raleigh, NC 27615
Telephone: [phone] Fay:
Name of contact(if registered agent is a company): Matt Kearns
Email Address: mkearnsmungo.com
3. The above information and all pages included with this form are true and correct to the best of my knowledge
and belief and was provided by me while under oath (this form must be signed by the financially responsible
person if an individual or by an officer,director,partner,attorney-in-fact,or other person with authority to
execute instruments for the financially responsible company or individual).
Matt Kearns Assistant Secretary
PRINTED NAME TITLE
�-- Z/13/LS
SIGNAT RE DATE
1, , 1�.(rYlIl1..1Q- , a Notary Public of the County
of,: ( f f/ot-/ , State of /JDtt 1 antiD h'xia_
JUMANA KAYED •
herebycerti that 3 4- 'S appeared before Notary Public North Carolina
.�' I�- � �l� f1i11, PP .f Union County
me this day and under oath acknowledged that this form was executed by him/her.
My Commission Expires Jun 8, 2028
Witness my hand and notarial seal this, /3_ day of re,h1fi -
20 eq5--
Notary Signature: /1"efl
My Commission expires: J/irt d20.7cz' Seal
Revised January 2025 Page 2 of 2