NCC221725_FRO Submitted_20220506

A77lV'NCDBQFayetteville Regional Office
Energy, Mineral and Land Resources
Project Narrative/Contact |nformation-3.2D.3OZ2
Sediment and Erosion Control Plan Submittal for Small Residential Lots
Homes byDickerson INC
Kelly O'Rourke — Director ofPlanning
/919'885'S9O3
Homes by Dickerson will be building (6) single family homes on in Hollycrest Subdivision in the Village of
Pinehurst.
These lots have previously been developed by Bass Design and Development, who have anactive
erosion permit on the subdivision. The purpose of this erosion application is to cover Homes by
Dickerson's disturbance when building single family homes. The homesites are relatively flat, previously
developed, and donot require any mass grading.
The lots included inthis submitted are lots l-4, 6, and 8.These are already owned by Homes by
Dickerson, and deeds are attached (GIS is not yet updated).
The total acreage is 2.41 acres, and 2.41 acres of total disturbance across the 6 homesites. Silt fence will
be installed at the low points of the homesites, and construction entrances at the front of each lot.
Construction on all 6 lots will begin within 60-90 days of each other and the NCGO1 permit is expected
to close out within 1'2 years.

FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
EXPRESS PERMITTING OPTION
No person may initiate any land -disturbing activity on one or more acres as covered by the Act before this form
and an acceptable erosion and sedimentation control plan have been completed and approved by the Land
Quality Section, N.C. Department of Environmental Quality. Submit the completed form to the appropriate
Regional Office. (Please type or print and, if the question is not applicable or the e-mail address or phone
number is unavailable, place N/A in the blank.)
Part A.
1. Project Name !� 011y C V'ZS t' Ut U YJ
2. Location of land -disturbing activity: County M City or Township i k1ck ; t Of hv St
Highway/Street ��' -W ZC LW 1 Latltude(decimal degrees)v�` I �b�J] Longltude(decimal degrees) 79.5011
3. Approximate date land -disturbing activity will commence: �2-
4. Purpose of development (residential, commercial, industrial, institutional, etc.):t1il
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): Z < (ACrzS
6. Amount of fee enclosed � �00 � 00 . The Express Permitting application fee is a dual charge
The normal fee of $100.00 per acre (rounded up to the next acre) is assessed without a ceiling amount.
In addition, the Express Permitting supplement is $250 per acre up to eight acres, afterwhich the Express
Permitting supplemental fee is a fixed $2,000.00 (Example: 8.10-acre application fee is $2,900). Checks
should be addressed to NCDEQ.
7. Has an erosion and sediment control plan been filed? Yes ❑ Enclosed K No ❑
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Cm lr ) tt.g E-mail Address
Phone: Office # fl y _ 3 ' 7"104- Mobile # (9 �4 3��o _ 19 U)q
9. Landowner(s) of Record (attach accompanied page to list additional owners):
I�Ovv"s g'k 11 � q 4-1- 444J `'j i l - � 05-- 5g04
Name Phone: Office # Mobile #
z `t, hP c(k lo.. place✓ Sec 2(0 -7101 (reeJimuvti' �c1 4,1(5
Current Mailing Address Current Street Address
City State Zip City State Zip
10. Deed Book No. �
Page No. �10\
(I i vo
1;1)0k �- PC\
r,l q `6 P� 6 cy -1 G
7
Provide a copy of the most current deed.

Part B.
1. Company(ies) who are financially responsible for the land -disturbing activity (Provide a comprehensive list
of all responsible parties on accompanied page.) if the company is a sole proprietorship orif the landowner(s) is
an individual(s), the name(s) of the owner(s) may be listed as the financially responsible party(ies).
1^IoMkS (3d p (c.ur5 0 n i N C, Ion ho z sbq c1i l x S 3n Go►'1'1
Company Name -mail Address
2.&41 Pick z,c\� C CVQ_ 41 f 0 CVUjJKnwr kct
Current Mailing Address Current Street Address
Kc,l f [ J b.\ N L. 2-7 (.02 ki-c ob M 2-1(P 3
City State Zip City State Zip
Phone: Office # 9 �� '`'� 4`7'` 4� Mobile #
Note: If the Financially Responsible Party 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 activity.
2. (a) If the Financially Responsible Party is a domestic company registered on the NC Secretary of State
business registry, 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
Phone: Office # Mobile #
Name of Individual to Contact (if Registered Agent is a company)
(b) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina agent who is registered on the NC Secretary of State business registry:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office # Mobile #
Name of Individual to Contact (if Registered Agent is a company)
(c) If the Financially Responsible Party is engaging in business under an assumed name, give name under
which the company is Doing Business As. If the Financially Responsible Party is an individual, General

Partnership, or other company not registered and doing business under an assumed name, attach a copy
of the Certificate of Assumed Name.
Company DBA Name
(d) If order to facilitate Express Permitting, it is necessary to be able to contact the engineer or other
consultant who can assist in providing any necessary information regarding the plan and its preparation:
Engineering firm or other consultant E-mail Address
Individual contact person (type or print) Phone: Office #
Mobile #
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(s)
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 Party). I agree to provide
corrected information should there be any change in the information provided herein.
Type or print name
i ature
V10 / C. 00
Title or Authority
,,;: z-1, z"-
Date
I, K, ll, el PP, J a Notary Public of the County of
State of North Carolina, hereby certify that `✓ (1nC i,-1-k1 /4 6 kc i VIy >�V" appeared personally
before me this day and being duly sworn acknowledged that the above form was executed by him/her.
Witness my hand and notarial seal, this day of %` ` �� 20 Z- Z
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My commission expires

THIS INSTRUMENT PREPARED BY:
Margaret A. Lorenz, Esq.
Lorenz & Creed Law Firm, PLLC
230 N. Bennett Street
Southern Pines, NC 28387
Excise Tax: $720.00
THIS DEED made this Z day
GRANTOR
BASS DESIGN AND DEVELOPMENT, LLC,
a North Carolina limited liability company
For Registration Register of Deeds
Judy D. Martin
Moore County, NC
Electronically Recorded
February 3 2022 4.3Z53 PM
Book: 5792 Page: 83 - 84 #Pages: 2
Fee: $26.00 NC Rev Stamp: $720.00
Instrument# 2022002150
TO BE RECORDED IN THE
DEED RECORDS OF
MOORE COUNTY, NC
2022, by and between:
GRANTEE
HOMES BY DICKERSON, INC., a North
Carolina Corporation
Tax Address:
7101 Creedmoor Road, suite 115
Raleigh, NC 27613
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and
assigns, and shall. include singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH, the Grantor, for valuable consideration paid by the Grantee, the receipt of which is hereby
acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee
simple, all that certain lot or parcel of land situated in Mineral Springs Township, Moore County, North
Carolina, and more particularly described as follows:
Being all of Lots 1, 2, and 3, Hollycrest, as shown on map entitled "Hollycrest,
Village of Pinehurst, Hollycrest Properties, Inc." recorded in the Office of the
Register of Deeds for Moore County North Carolina in Plat Cabinet 3, Slide 379 and
380.
submitted electronically by "Nelson Mullins LLP"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Moore county Register of Deeds.

The property herein described does not include the primary residence of the
Grantor.
Being a portion of the same property conveyed to Grantor in instrument recorded in Book 5753, Page 476,
in the Moore County, North Carolina, Register of Deeds. The attorney preparing this instrument has not
searched the title to the real property hereby conveyed and makes no opinion relative to the status of the
title to the real property hereby conveyed.
This conveyance is made subject to (i) the lien of the County of Moore for taxes and other assessments for
the current year, which taxes or other assessments shall be pro -rated as of the date of closing and which
Grantee by acceptance of this deed expressly agrees to pay; (ii) utility easements of record; and (iii)
unviolated restrictive covenants of record that do not materially affect the value of the property.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto
belonging to the Grantee in fee simple.
And Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right
to convey the same in fee simple; that title is marketable and free and clear of all encumbrances, and that
Grantor will warrant and defend the title against the lawful claims of all persons whomsoever except for the
exceptions noted herein.
IN WITNESS WHEREOF, the said Grantor has hereunto set his hand and seal the day and year first above
written.
BASS DESIGN AND DEVELOPMENT, LLC,
a North Carolina Limited Liability Company
BY: Cam'- (SEAL)
KENNETH H. BASS, MANAGER
STATE OF NORTH CAROLINA
COUNTY OF MOORE
I, of the County and State aforesaid, certify that KENNETH H. BASS (either
being p onally known to e or proven by satisfactory evidence (said evidence being
}, pers e before me this day and acknowledged that he is a Manager of BASS DESIGN
AND DEVELOPMENT, LLC, a North Carolina limited liability company, and that he, as
Member/Manager being authorized to do so, voluntarily executed the foregoing on behalf of said limited
liability company for the purposes stated therein.
WITNESS my hand and official stamp or sea day , 2022.
0 N'D q
oter ��Notary Public
Cyn m
00,U bl- Z
7-My CooUntk
[SEAL] 06 0'
�O
Rhonda O'Brien
Printed or typed name of Notary Public
My commission expires; h 1
2

For Registration Register of Deeds
Judy D. Martin
Moore County, NC
Electronically Recorded
February 15, 2022 4:03:52 PM
Book: 5798 Page: 69 - 70 #Pages: 2
Fee: $26.00 NC Rev Stamp: $480.00
Instrument# 2022002806
GENERAL WARRANTY DEED
THIS INSTRUMENT PREPARED BY:
Margaret A. Lorenz, Esq.
Lorenz & Creed Law Firm, PLLC
230 N. Bennett Street
Southern Pines, NC 28387
Excise Tax: $480.00
THIS DEED made this day
UKAN I UK
BASS DESIGN AND DEVELOPMENT, LLC,
a North Carolina limited liability company
2022, by and between:
GRANTEE
HOMES BY DICKERSON, INC., a North
Carolina Corporation
Tax Address:
7101 Creedmoor Road, suite 115
Raleigh, NC 27613
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and
assigns, and shall include singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH, the Grantor, for valuable consideration paid by the Grantee, the receipt of which is hereby
acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee
simple, all that certain lot or parcel of land situated in Mineral Springs Township, Moore County, North
Carolina, and more particularly described as follows:
Being all of Lots 4 and 6, Hollycrest, as shown on map entitled "Hollycrest, Village
of Pinehurst, Hollycrest Properties, Inc." recorded in the Office of the Register of
Deeds for Moore County North Carolina in Plat Cabinet 3, Slide 379 and 380.
The property herein described does not include the primary residence of the
Grantor.
submitted electronically by "Nelson Mullins LL.P"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Moore County Register of Deeds.

Being a portion of the same property conveyed to Grantor in instrument recorded in Book 5753, Page 476,
in the Moore County, North Carolina, Register of Deeds. The attorney preparing this instrument has not
searched the title to the real property hereby conveyed and makes no opinion relative to the status of the
title to the real property hereby conveyed.
This conveyance is made subject to (i) the lien of the County of Moore for taxes and other assessments for
the current year, which taxes or other assessments shall be pro -rated as of the date of closing and which
Grantee by acceptance of this deed expressly agrees to pay; (ii) utility easements of record; and (iii)
unviolated restrictive covenants of record that do not materially affect the value of the property.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto
belonging to the Grantee in fee simple.
And Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right
to convey the same in fee simple; that title is marketable and free and clear of all encumbrances, and that
Grantor will warrant and defend the title against the lawful claims of all persons whomsoever except for the
exceptions noted herein.
IN WITNESS WHEREOF, the said Grantor has hereunto set his hand and seal the day and year first above
written.
BASS DESIGN AND DEVELOPMENT, LLC,
a North Carolina Limited Liability Company
BY: 66.' SEAL
KENNETH H. BASS, MANAGER
STATE OF NORTH CAROLINA
COUNTY OF MOORE
I a of the County and State aforesaid, certify that KENNETH H. BASS (either
bein ers�y�own e or proven by satisfactory evidence (said evidence being
e before me this day and acknowledged that he is a Manager of BASS DESIGN
AND DEVELOPMENT, LLC, a North Carolina limited liability company, and that he, as
Member/Manager being authorized to do so, voluntarily executed the foregoing on behalf of said limited
liability company for the purposes stated therein.
WITNESS my hand and official stamp or seal day )2022.
�\XNotary Pubii �Z� Notary Public
c
Moore
County =_
My Comm. Exp. _
[SEAL] O 06-07-2022 Q
fC A V ,O\_������
Rhonda O'Brien
Printed or typed name of Notary Public
My commission expires: Lod <a-
2

For Registration Register of Deeds
Judy D. Martin
Moore County, NC
Electronically Recorded
February 3, 2022 4:00:09 PM
Book: 5791 Page. 595 - 596 #Pages: 2
Fee. $26.00 INC Rev Stamp: $240.00
Instrument# 2022002138
GENERAL WARRANTY DEED
THIS INSTRUMENT PREPARED BY:
Margaret A. Lorenz, Esq.
Lorenz & Creed Law Firm, PLLC
230 N. Bennett Street
Southern Pines, NC 28387
TO BE RECORDED IN THE
DEED RECORDS OF
MOORS COUNTY, NC
Excise Tax: $240.00
THIS DEED made this c day of��12" 2422, by and between.
GRANTOR GRANTEE
BASS DESIGN AND DEVELOPMENT, LLC, HOMES BY DICKERSON, INC., a North
a North Carolina limited liability company Carolina Corporation
Tax Address
7101 Creedmoor Road, suite 115
Raleigh, NC 27613
The. designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and
assigns, and shall include singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH, the Grantor, for valuable consideration paid by the Grantee, the receipt of which is hereby
acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee
simple, all that certain lot or parcel of land situated in Mineral Springs Township, Moore County, North
Carolina, and more particularly described as follows:
Being all of Lot 8, Hollyerest, as shown on map entitled "Hollyerest, .Village of
Pinehurst, Hollycrest Properties; Inc." recorded in the Office of the Register of
Deeds for Moore County North Carolina in Plat Cabinet 3, Slide 379 and 390.
The property herein described does not include the primary residence of the
Grantor,
submitted electronically by "Nelson Mullins LLP"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Moore county Register of needs.

F)