NCC231870_FRO Submitted_20230628

Check if this project is ARPA-funded •
FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
No person may initiate any land-disturbing activity on one or more acres as covered by the Act, including any
activity under a common plan of development of this size as covered by the NCGO1 permit, 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 North Regional WWTP Expansion
*If this project involves American Rescue Plan Act (ARPA) funds, list the Project Name below
under which you applied for funding through the Division of Water Infrastructure(DWI).
Harnett Regional Water North Regional WWTP Expansion
2. Location of land-disturbing activity: County Harnett City or Township Lillington
615 Edwards Brothers Dr. 35.395170 -78.803637
Highway/Street Latitude(decimal degrees) Longitude(decme,degrees)
3. Approximate date land-disturbing activity will commence:June 1, 2023
4. Purpose of development(residential, commercial, industrial, institutional, etc.): Utility
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas):32.8
6. Amount of fee enclosed: $3300 . The application fee of$100.00 per acre (rounded
up to the next acre) is assessed without a ceiling amount (Example: 8.10-acre application fee is$900).
Checks should be addressed to NCDEQ.
7. Has an erosion and sediment control plan been filed? Yes❑ Enclosed x❑ No El
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Steve Ward E-mail Address [e-mail]
Phone: Office# 910-893-7575 Mobile# [phone]
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Harnett County 910-814-3042 910-890-0394
Name Phone: Office# Mobile#
PO Box 759 700 McKinney Pkwy
Current Mailing Address Current Street Address
Lillington NC 27546 Lillington NC 27546
City State Zip City State Zip
10. Deed Book No. 1474 Page No.228-231 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 or if the landowner(s)is
an individual(s), the name(s)of the owner(s)may be listed as the financially responsible party(ies).
Harnett County [e-mail]
Company Name E-mail Address
PO Box 759 700 McKinney Pkwy
Current Mailing Address Current Street Address
Lillington NC 27546 Lillington NC 27546
City State Zip City State Zip
Phone: Office# 910-893-7575 Mobile# [phone]
Note: If the Financially Responsible Party is not the owner of the land to be disturbed, include with this form
the landowners 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
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.
Steve Ward HRW Director
Type or nt na Title or Authority
2/23/23
Signature Date
\ \A,I, � � e���l� li^�_ � u14-k,: �1 , a Notary Public of the County of V4.6),.t•S
State of North Carolina, hereby certify that _ , , W - appeared personally
before me this day and being duly sworn acknowledgedtthhatt the above form was executed by him/her
_lb
Witness my hand and notarial seal, this `
day of `c UW°-�%, , 20
Notary
e-I- -%. OFFICIAL SEAL My commission expiresu ���'�
r Notary Public. North Carolina
* S County of Harnett
Carolyn K. Murayama

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�►/ , FOa RECI ION Imam OF DEEDS
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V NORTH CAROLINA, K} COUNTY al:NO sw+
14
S1:111tMENr iSti ibis.N
HARNETT COUNTY. DEED -
THIS DEED, Made and entered into this eday of February, 2001, by and between TOWN OF
LILLINGTON of Post Office Box 296, Lillington, North Carolina 27546 (Grantors); and COUNTY OF
HARNETT of Post Office Box 759,Li hiagton,North Carolina 27546 (Grantee);
WITNESSEIH:
That the Grantors,for and in consideration of the sum of ONE HUNDRED DOLLARS and other good and
valuable consideration to them paid by the Grantee,the receipt of which is hereby acknowledged,have bargained and
sold and by these presents do hereby give,grant,bargain,sell and convey unto the Grantee,its heirs and assigns,all
that certain tracts or parcels of land situate and being in Lillington Township,Harnett County,North Carolina,and
more particularly described as follows:
Parcel#:
CT ONE:
I
BEGINNING at point C as shown on the map of the disposal plant site as recorded in Map Book 9,at i
Page 29,Harnett County registry,and runs thence South 79 degrees 39 minutes East 1589.80 feet to an
iron stake; thence South 10 degrees 21 minutes West 1200 feet to another stake;thence North 791
degrees 39 minutes West 2,250 feet to a stake In the EF Property line as shown on the plat recorded in
Map Book 9;thence North 10 degrees 21 minutes East along the EF property line as shown on said
map,a distance of 600 feet to point E as shown on said map;thence with the ED property line as
shown on said map South 79 degrees 39 minutes East 660 feet to point D on said map;thence with the
DC property line as shown on said map North 10 degrees 21 minutes East 600.1 feet to point C on said
recorded map,the point of beginning and containing 52.89 acres,more or less,according to an actual'
survey by Moore,Gunder and Associates,Inc.,Town Engineers.
This being the same property conveyed to the Town of Lillington,by deed from Frances R.Ross,dated
July 20,1962,and appearing of record in Deed Book 412,Page 461,Harnett County Registry.
TRACT TWO:
BEGINNING at an iron pipe corner in the northern margin of the right-of-way of the Prison Camp
Road,the dividing corner between the W.R.Cranford—Mrs.Frances IL Rom property,the same
being designated as Point"A"on the map of the Town of Lillington Sewage Treatment Plant site
prepared by Moore,Gardner and Associates,Inc,In January 1960,and runs thence North 10 degrees
21 minutes East 2664.68 feet to an iron pipe,another corner with Cranford,the same being designated
as Point"B"on said map;thence South 79 degrees 39 minutes East 710.20 feet to an iron pipe,another
corner with Cranford,the same being designated as Point"C"on said map;thence a new dividing line
South 10 degrees 21 minutes West 600.10 feet to an iron pipe,a new corner with Ross,the same being
designated as Point"D"on said map;thence another new dividing line North 79 degrees 39 minutes
West 660 feet to an iron pipe,another new corner with Ross,the same being designated as Point"E"
on said map;thence another new dividing line South 10 degrees 21 minutes West 2064.10 feet to an
iron pipe in the northern margin of the right-of-way of said Prison Camp Road,another new corner
with Ross,the same being designated as Point"F"on said map;thence with the northern margin of
the right-of-way of the Prison Camp Road North So degrees 19 minutes West 50 feet to the point of
beginning and containing 12.15 acres,more or less,according to a survey and map made by Moore,
Gardner and Associates,Inc.,in January,1960. Said map is recorded in Map Book 9,at Page 29,
Harnett County Registry,and reference is here made to said map for a full and complete description
of said lands. The above described tract of land is a portion of the lands conveyed to Charles R.Ross
(now deceased)and wife,Frances IL Ross,by C.Reid Ross and wife,et al,by deed dated October 1,
1942,and recorded in Book 290,at Page 11,Harnett County Registry.
This being the same property conveyed to The Town of Lillington,by deed from Frances R.Ross,
widow,dated January 8,1960,and appearing of record in Deed Book 389,Pate 568,Harnett County
Registry.
Prepared by: David F.McRae,Attorney at Law,Post Office . _ ' .' • ,. • + -.
. •11C NTVT_ I ' .JD
M �. •

fi
CONVEYED APPURTENANT TO AND A PORTION OF SAID ABOVE described tracts of land is
the following 50 foot Sanitary Sewer Easement for the purposes of maintaining an underground sewer
line and is more particularly described as follows:
BEGINNING at a small birch tree on the South bank of the Cape Fear River,a dividing corner
• between the W.R Cranford-Frances R.Ross property,the same being the original northwest corner
of the Frances R Ross 220 acre tract,and runs thence South 10 degrees 21 minutes West 1240.52 feet
to an iron pipe,corner with Cranford in the line of the 12.15 acre tract conveyed to the Town of
Llllngton by Frances R Ross by deed dated January 8,1960;thence with the line of said 12.15 acre
tract South 79 degrees 39 minutes East 50 feet to an Iron pipe,the northeast corner of said 12.15 acre
tract, said corner being designated as Point "C" on the map of the Town of Llington sewage
treatment plant site prepared by Moore,Gardner and Associates,Inc.,in January 1960;thence North
10 degrees 21 minutes East 121930 feet to a point en the South bank of the Cape Fear River;thence
northwesterly along the south bank of said river to the beginning. The above described tract of land is
•
a portion of the lands conveyed to Charles R.Ross(now deceased)sad wife,Frances R Ross,by C.
• Reid Ross and wife,et al,by deed dated October 1,1942,and recorded in Book 290,Page 11,Harnett
County Registry.
Said parcel of land is designated as "50' Sanitary Sewer Easement"on the map of the Town of
Lilllngton sewage treatment plant site prepared by Moore,Gardner and Associates,Inc.,in January
1960,which map is recorded in Map Book 9,at Page 29, Harnett County Registry.
This being the same easement as conveyed to the Town of Lil ington,by Deed of Easement from
Frances R Ras,widow,dated January 8,1960,and appearing of record in Deed Book 389,Page 569,1
Harnett County Registry.
The description within this deed contains the property which is subject to that certain lease appearing
• of record in Deed Book 1086,Page 742-749,Harnett County Registry.
LESS AND EXCEPT from the above described property are the following:
(1) Deed of Easement from The Town of Lid{ngton to the State of Carolina,dated March 27,1962
appearing of record in Deed Book 436,Page 13,Harnett County Registry and more particularly
described as follows:
BEGINNING at a point in the northern right of way line of the Prison Camp Road where the
right of way for the 50 foot access road to the Town's Sewage Treatment Plant is bounded by the
Mrs.Charles Ross property,said point being further described as being approximately 1445 feet
from the corporate limits of the Town of Lillington;thence from said beginning point following
the above described access road on a bearing of North 10 degrees 21 minutes East for a distance of
approximately 1464 feet;thence on a bearing of North 55 degree 21 minutes East for a distance
of approximately 165 fat;thence,on a bearing of North 10 degrees 21 miarta East for a distance
of approximately 420 feet parallel to the Cranford property line and 180 feet perpendicular to
this property line;thence on a bearing of North 55 degrees 21 minutes East for a distance of
approximately 28 feet;thence on a bearing of South 79 degrees 39 minute East to the Influent box
between the Waste Stabilization Ponds as shown by drawing No.700 11 06 762 entitled"Sanitary
Sewer Force Main for Harnett Prison near L llingten,N.C.,dated July 9,1%2.
(2) Right of Way Agreement from the Town of Lillington to North Carolina Department of
Transportation,dated June 6,1968 as appearing of record In Deed Book 506,Page 201,Harnett
County Registry.
(3) Deed of Easement to Carolina Power&Light Company appearing of record in Deed Book 1050,
Page 588,Harnett County Registry.
(4) Any and all roadways,rights-of-way,and easements of records and those visible by inspection of
the premises.
(5) If applicable,deed of railroad right of way easement to Becker County Sand and Gravel as
recorded in Book 480,Page 210,Harnett County.
(6) Other matters of record.
TO HAVE AND TO HOLD die aforesaid parcel or tract of land together with all privileges and
appurtenances thereinto belonging unto the Grantee,its heirs and assigns,to their only use and behoof forever.
And the party Grantors,for themselves,their heirs,executors and administrators,covenant with the Grantee,
its heirs and assigns,that they are seized of said premises in fee and have the right to convey the same;that the same is
free and clear from all encumbrances and that they do hereby forever warrant and will forever defend the title to the
it

's •
same against the claims of all persons whomsoever.
IN WITNESS WHEREOF,the Grantors have hereunto set their hands and seals the day and year first above
•
_ J
•
�• I"` 4�,. TOWN OF LILLINGTON
2s• •
I. st,O - M.Walker,Mayor
•
• / •
• B.Wilder C 1.e4.}4.
NORTH CAROLINA
HARNETT COUNTY ACKNOWLEDGEMENT
1, Y1 t?} 111 NisfrN L'CC►M a Notary Public of the County and State aforesaid,
certify that JAMS M.WALKER,who,being by me duly sworn,says that he is Mayor of the Town of Mington
and that Vidde B.Wilder is Clerk of said Town,that the seal affixed to the foregoing and attested instrument is the
seal of said Town,and that said instrument was signed by him as Mayor of said Town and by the Clerk of said Town,
who affixed the official seal of said Town to said instrument; and that the said James M. Walker, Mayor,
acknowledged said instrument to be the act and deed of the
Town of Lillington.
Witness my hand and notarial seal,this the J+, day of February,2001
Notary Public
My Commission Expires: &3^- 1 1
NOTARY
PUBLIC �
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KIMBERLY S. HARGROVE
REGISTER OF DEEDS, HARNETT
COURTHOUSE
P.O. BOX 279
LILLINGTON, NC 27546
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Filed For Registration: 02128/2001 03:50:18 PM
Book: RE 1474 Page: 228-231
Document No.: 2001003115
DEED 4 PGS $12.00
Recorder. ELMIRA MCLEAN
State of North Carolina,County of Harnett
The foregoing certificate of JANET F. MCLEAN Notary is certified to be correct.This 28TH of February 2001
KIMBERLY S.HARGROVE,REGISTER OF DEEDS By: 6.41.to-)
Deputy/A7(stant Register of Deeds
* 200 003 *
2001003115

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