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Click ‘Get Form’ to open the nc Mecklenburg Financial Responsibility form in the editor.
Begin with Part A. Fill in the project name where land-disturbing activity will occur, followed by the address of the site.
Indicate the approximate date when the land-disturbing activity will commence by selecting the month, day, and year.
Specify the purpose of development (e.g., Residential, Commercial, Industrial) and provide both approximate acreage of disturbed land and total site acreage.
List all landowners of record. Use a blank page if necessary for additional owners, including their names, addresses, fax numbers, telephone numbers, and email addresses.
In Part B, enter details for the person or firm financially responsible for this activity along with their North Carolina agent's information.
Ensure that all provided information is accurate. The form must be signed by the financially responsible individual or an authorized representative.
Complete any notary requirements as specified at the end of the form before submission.
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