20060002 Ver 4_Ownership Change_20120117

1)6- ©00Q. 04
SUBURBAN ASSET MANAGEMENT
January 12, 2011
North Carolina Department of Environment and Natural Resources
1639 Mail Service Center
Raleigh, NC 27699 -1639
Re: State Stormwater Permit Ownership Change
Dear Ladies /Gentlemen:
SAM Holly Springs, LLC purchased the Shoppes at Holly Springs from Holly Springs Retail
Investment, LLC on November 30, 2011. A copy of the deed, along with our Ownership Change
Form is enclosed for your records.
If there is any additional information you might need, I can be reach at 757- 671 -1700, extension
303, or via email at ann(@samvirginia.com.
Sincerely,
SUBURBAN ASSET MANAGEMENT
Ann G. Gurnee
Property Manager
Enclosures
j2@gflvqjq
1 7 2012
nANGDENR • WATER QUALITY
SAND STI'MWATER 9RANDH
999 Waterside Drive, Suite 2220, Norfolk, VA 23510 Phone [phone] Fax [phone]

M
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
STATE STORMWATER PERMIT NAME /OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION
1. Stormwater Management Permit Number: DW Q Ap M- Ooo2vq-
2. Project Name: V4ckkA STiti_gls ��;►L SrJVt°STM4*1 LL-C-
3. Current Permit Holder's Company Name/Organization: uo \1T STS s 24A'It S "uer1n0LT lac
4. Signing Official's Name: Sihe jA e►.a '-�)Ai cg- Title: MAC, s owaek-
(person legally responsible for permit)
5. Mailing Address: 3cxr, wPST
City: MA "MePSA,,Xr State: Sr- Zip: 29 41.4
6. Phone: (84 S) Fax: ( 84_) $ S I -X35 4
II. PROPOSED PERMITTEE / OWNER / PROJECT / ADDRESS INFORMATION
This request is for: (please check all that apply)
❑ Name change of the owner (Please complete Items 1, 2 and 3 below)
❑ 1�ame change of project (Please complete Item 5 below)
[jithange in ownership of the property /company (Please complete Items 1,
❑ Mailing address / phone number change. (Please complete Item 4 below)
❑ Other (please explain):
1. Proposed permittee's company name /organization: SAM t- ol1� L L_ C
2. Proposed permittee's signing official's name:
2, 3, and 4 below)
3. Proposed permittee's Title:
4. Mailing Address: L1 a So- 6 Li- /eba n A
City: Y10ei 0I k
haq,,ment, q1 f b-)c f,-ZS,de b eve, S, k ZZZo
State:' VA Zip
Phone: (I5il) 0 1- 1 -2Oo, K 3b-!� Fax:
5. New Project Name to be placed on permit: SAM ��02S, LL C
Please check the appropriate box. The proposed permittee listed above is:
❑ HOA or POA (Attach a copy of the deed transferring ownership of all common areas. Print Name
HOA or POA in #1 above and provide name of HOA(POA) president in #2 above).
he property owner.
❑ Lessee (Attach a copy of the lease agreement and complete Property Owner Information on
page 4)
❑ Purchaser (Attach a copy of the pending sales agreement and complete Pro g Owner
Information on page 4) 0 j�
❑ Developer (Complete Property Owner Information on page 4)
,lad
SSW N/0 Change Rev16Nov2009 Page 1 of 4 DENR.WA�
�'fT(q/yDS
AND STORMWA EBRANCH
o, / o

III. REQUIRED ITEMS
This application package will not be accepted by the Division of Water Quality unless all of the
applicable required items listed below are included with the submittal.
1. This completed and signed form.
2. Legal documentation of the transfer of ownership. (For Permit Transfers Complete Current Permittee
and Proposed Permittee Sections)
3. A copy of the recorded deed restrictions, if required by the permit.
4. The designer's certification, if required by the permit and if not already submitted to DWQ.
5. If the Proposed Permittee is a corporation, LLC or General Partnership, provide documentation from
the Secretary of State office, which supports the named president, vice president, member, manager
or General Partner.
6. The $40.00 processing fee. If this is an initial transfer from the original permittee to the property owner
or other responsible party such as an HOA, the processing fee is not required. Subsequent ownership
transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements:
❑ Check here if the Current Owner is only changing the owner name, company name or project
name, or the mailing address, and will retain ownership of the permit.
1, , the current owner, hereby notify the Division of
Water Quality that I am changing my name or company name and /or I am changing my mailing
address and /or I am changing the name of the permitted project. I further attest that this application
for a name /ownership change is accurate and complete to the best of my knowledge. I understand
that if all required parts of this application are not completed and that if all required supporting
information and attachments as outlined above are not included, this application package will be
returned as incomplete.
Check here if Current Owner is transferring (selling) the property to a new owner and will not
retain ownership of the permit.
I, s7ee�e,✓ lSAiidPi2 , the current owner, am submitting this application for a transfer of
ownership for permit # OG -o002 d 4 . I hereby notify DWQ of the sale or other legal transfer
of the stormwater system associated with this permit. I further acknowledge and attest that I have
transmitted a copy of the most recent permit, a copy of the Designers Certification, a copy of the
DWQ approved plans and /or approved as -built plans, a copy of the approved Operation and
Maintenance agreement and copies of past maintenance records to the Proposed Permittee named
in Sections II and V of this form at the mailing address listed in Section II of this form. I further attest
that I assign all rights and obligations as permittee to the Proposed Permittee named in Section V of
this form. I understand that this transfer of ownership cannot be approved by the Division of Water
Quality unless and until the facility is in compliance with the permit and the Proposed Permittee signs
this form. I understand that in the event the facility is not in compliance or the Proposed Permittee
does n,ot sign this form, the responsibility to bring the facility into compliance and to comply with the
terms and conditions of the permit remains with me until such time as the Proposed Permittee signs
this form and the Division approves it.
Signature: �— Date: Alp I7 2011
a Notary Public for the State of
pl)l� County of el-4 ,- k �--7,_J , do hereby certify that
o�P,f,;vE,e personally appeared before me this the
/7-w day of Allcvem G , 20/ / , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
tary Signature
SSW N/0 Change Rev16Nov2009 Page 2 of 4
_ "(Notary Seal),,

V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the
Proposed Permittee for all transfers of ownership)
I, PC�4,1,jt , hereby notify the Division of Water Quality that I have
acquired through sale, lease or legal transfer, the responsibility for constructing and /or operating and
maintaining, the permitted stormwater management system. I have examined the permit and
inspected the permitted facility, and agree to assume the rights and liabilities contained in the permit
and to comply with the terms and conditions of the permit.
I attest that I have reviewed this application for an ownership change and it is accurate and complete
to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information and attachments are not included, this
application package will be returned as incomplete.
I further acknowledge and attest that in the event the required facility inspection reveals that the
project is not in compliance with the permit, I understand this transfer of ownership will not be
approved until the project is brought into compliance. I acknowledge and attest that I have received a
copy of the most recent permit, a copy of the Designer's Certification, a copy of the DWQ approved
plans and /or approved as -built plans, a copy of the approved Operation and Maintenance agreement
and copies of past maintenance records from the previous permittee. I further acknowledge and
agree that I will cons t and /or operate and maintain the system per the requirements listed in the
permit and in the perati n and Maintnance agreement.
Signature: Date: 12-23-11
I, J , a Notary Public for the State of
VAtAtwk , County of Mtft"X- , do hereby certify that
f tsmoo- PVC / personally appeared before me this the
23RD day of DLL "15C - , 20 It , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
JUDEE E. T,1A��MZZ0Ng�-�. CLAMOR
REG SOTRAtPb'W`d'1 p2 Rl�
Nota igna re COMMONWEALTH OF VIRGINIA
MY COMMISSION EXPIRES
FEBRUARY 28, 2013
Additional copies of the original permit and the approved Operation and Maintenance plan can be
obtained from the appropriate Regional Office of the Division of Water Quality.
This completed form, including all supporting documents and processing fee, should be sent to the
appropriate Regional Office of the North Carolina Department of Environment and Natural
Resources, Division of Water Quality, as shown on the attached map.
Please note that if the Proposed Permittee listed above is not the property owner, the property owner
must complete and sign page 4 of this document. Both the lessee /developer and the property
owner will appear on the permit as permittees.
SSW N/0 Change Revl Mov2009 Page 3 of 4

VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION
If the Proposed Permittee listed in Sections 11 and V of this form is not the Property Owner, the
Property Owner must provide his /her Contact Information below and sign this form:
Printed Name:
Organization:
Title within the Organization:
Street Address:
City:
Mailing Address:
City:
Phone:
Email:
State:
(if different from street address)
State:
Fax:
Zip:
Zip:
I certify that I own the property identified in this permit transfer document and have given permission
to the Proposed Permittee listed in Sections II and V to develop, lease or purchase the property. A
copy of the lease agreement or pending property sales contract has been provided with the
submittal, which indicates the party responsible for the construction and /or operation and
maintenance of the stormwater system.
As the legal property owner I acknowledge, understand, and agree by my signature below, that I will
appear as a permittee along with the lessee /developer and that if the designated Proposed
Permittee dissolves their company and /or cancels or defaults on their lease agreement or pending
sales contract, responsibility for compliance with the DWQ Stormwater permit reverts back to me,
the property owner. As the property owner, it is my responsibility to notify DWQ by submitting a
completed Name /Ownership Change Form within 30 days of procuring a developer, lessee or
purchaser for the property. I understand that failure to operate and maintain the stormwater
treatment facility in accordance with the permit is a violation of NC General Statue 143 - 215.1, and
may result in appropriate enforcement action including the assessment of civil penalties of up to
$25,000 per day, pursuant to NCGS 143 - 215.6.
Signature of the property owner
County of
day of
Date:
a Notary Public for the State of
, do hereby certify that
personally appeared before me this the
, 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
(Notary Seal)
Notary Signature
SSW N/0 Change Rev16Nov2009 Page 4 of 4

X126111 ,
Prepared By:
Hiredder Fleischer
P.O. Box 600
Richmond, VA 2321 8-0600
Tax Pare! #/GP1N 1477.36.3753.4000
MOM C -If M
P,K4720pG 1004
MA�.
Consideration: $15.443,000.00
T ;13j6q
THIS DEED OF ASSUMPTION is made as of this .AQ_ day of June, 2002,
by and betweenINIA BEACH ASS LTD. d/b /a Virginia Beach
Associates of Alabama, L.P., an Alabama limited partnership ("Grantor "); and
FMWROK3,QEaffLP ARK L P_ a Virginia limited partnership ("Grantee')
whose mailing address is 2 Eaton Street, Suite 1100, Hampton, Virginia 23669,
Attention: Mr. Aubrey L. Layne, Jr.
��.
In consideration of Ten Dollars ($10.00) cash in hand paid by Grantee to
Grantor and other good and valuable consideration, the receipt and sufficiency of
which are acknowledged, Grantor grants and conveys to Grantee, with General
Warranty and, cxcept as hereinafter set forth, English 'Covenants of Title, the
property described on Exhibit A attached hereto and by this reference made a part
hereof.
This conveyance is subject to current ad valorem taxes, leases, all applicable
easements, covenants, restrictions and agreements of record, including, without
limitation, the instruments described below, and such matters as would be revealed
by an ALTA survey and inspection of the land and improvements conveyed hereby.
Grantee, as evidenced by its joinder herein, covenants and agrees to assume
and be bound by all the covenants, agreements, terms, provisions, obligations and
conditions set forth in (i) the Deed of Trust, Assignment of Leases and Security
Agreement dated May 1, 1998 granted to Allan B. Goldstein, Trustee, recorded in
the C'lerk's Office of the Circuit Court of the City of Virginia Beach, Virginia, in
Deed Book 3884, page 287, the Assignment of Leases and Rents dated May 1, 1998
and recorded in the foregoing Clerk's Office in Deed Book 3884, page 316, and the
note secured thereby, dated May 1;1998, in the original principal amount of
$8,600.000.00 plus interest, for the benefit of Allied Capital Corporation, and (ii) the
Deed of Trust, Assignment of Leases and Security Agreement dated May 1, 1998
granted to Allan B. Goldstein, Trustee, recorded in the foregoing Clerk's Office in
Deed Book 3889, page 323, the Assignment of Leases and Rents dated May 1, 1998
and recorded in the foregoing Clerk's Office in Deed Book 3884, page 353, and the
note secured thereby, dated May 1, 1998, in the original principal amount of
(6/17/02)

994720PG 1005
$3,900,000.00, plus interest, for the benefit of Allied Capital Corporation, As of the
dato hereof, the unpaid principal balance of the obligation described in (i) above is
$8,265,025.24 and the unpaid principal balance of the obligation described in (ii)
above is $3,749,503.83.
WITNESS the following signatures:
GRANTOR: VIRGINU BEACH ASSOCIATES, LTD.,
d/b/a/ Vagina Beach Associates of Alabama, L.P.,
an Alabama limited partnership
By; Guilford Development Corporation,
an Alabama corporation, its general partner
By:
AL—
William W. Jord
Executive Vice - President
COMMONWEALTH OF VIRGINIA
CITY /COUNTYOF MrklI , to.wit:
The foregoing instrument was acknowledged before me this � day of June,
2002, by William W. Jordan, the Executive Vice- President of Guilford Development
Corporation, an Alabama corporation, in its capacity as general partner of
VIRGINIA BEACH ASSOCIATES, LTD., d/b /a Virginia Beach Associates of
Alabama, L.P., an Alabama limited partnership, on behalf of the limited
partnership.
My commission expires:
tl- 3o -0�1
-- 04W A&A -
Notary Public
2

aRUMe&
hK4720% 1006
PEMBRABE OFFICE PARE, L.P.,
a Virginia finited partnership
By: Pembroke Subsidiary'GP, LLC, a Virginia
limited liability company, as General Partner
By: GA Non-Ma r, Inc., a
Virginia co on, as Manager
COMMONWEALTH OF VIRGINIA
CITY/COUNTYOF ri10r bIl . to -wit:
The regoin tv strument Wits ac�tu Iedged before me this _ day of June,
2002, by 1 Mt. . the V, if ksidi P of GA Non - Member
Manager, Inc., a irginia corporation, in its capacity as the Manager of Pembroke
Subsidiary GP, LLC, a Virginia limited liability company, in its capacity as the
General Partner of; 0, NITMOKE OFFICE PARK, L.P., a Virginia limited
partnership, on behalf of the limited partnership.
My commission expires: it- `
1.
3

OK472OPG 1007
ALL THAT certain tract of land, together with the improvements thereon and the
appurtenances thereunto belonging, lying, situate and being in the Bayside Borough, City
Of Virginia Beach, Virginia, and being bounded and described as follows:
Beginning at a point where the westerly line of First Street is intersected by the northerly
line of Cambridge Street, and from said point running along the said westerly line of First
Street S 04 65'03" W 237.18 feet to a pin in the northerly line of Virginia Beach Boulevard;
thence along said line of Virginia Beach Boulevard N 85 03' 30" W 150 feet to a pin; thence
Ieaving the line of Virginia Beach Boulevard and running thence N 04 55'03" E 245.74 feet
to a drill hole; thence N 86 58' IT W 186.33 feet to a point in the easterly line of Kellam
Road; thence along add line of Kellam Road N 14 20' 05" W 44.27 feet to a pin; thence
continuing along said line of Kellam Road N 14 20'05" W 169.47 feet to a pin; thence along
a curve to the right having a radius of 10.00 feet an arc distance of 19.10 feet to a pin in the
southerly Hue of Broad Street, thence along said line of Broad Street S 84 54'2W E 65.41
feet to it pin; thence continuing along said line of Broad Street and along a curve to the left
having a radius of 600.00 feet an an distance of 258.82 feet to a pin; thence
N 70 22 34" E 72.50 feet to a pin; thence N 70 22' 34" E 313.5$ feet to a pin; thence along a
curve to the right having a radius of 890.00 feet an arc, distance of 106.78 feet to a pin;
thence along a curve to the right having a radius of 890.00 feet an are distance of 274.43
feet to a pin; thence S 85 04' 57" E 384.90 feet to a point; thence continuing along said
course 15b.uu feet to a point; thence leaving the line of Broad Street and running along a
curve to the right having a radius of 10.00 feet an arc distance of 15.71 feet to a point in the
westerly line of Independence Boulevard; thence along said line of Independence Boulevard
S 04 55' 03" W 58.81 feet to a pin; thence continuing along said line of Independence
Boulevard and along a curve to the left having 's radius of 11441.90 feet an are distance of
301.21 feet to a point; thence leaving the line of Independence Boulevard and running
N 58 51' 13" W 11.29 feet to a point; thence N 85 04'27"W 533.84 feet to a pin; thence
S 04 55' Or W 147.35 feet to a pin in the northerly line of Cambridge Street; thence along
said line N 85 04' 57" W 650.00 feet to a pin at the point of beginning; said property
continuing 13.964 acres.
LESS AND EXCEPT:
• Conveyance of 1.331 Acres more or less conveyed in Deed Book 2695 at page 542.
e Conveyance of 32 square feet taken by the City of Virginia Beach in Deed Book 2447
at page 1638.
e Conveyance of 0.204 Acres ($884 square feet) property to the City of Virginia Beach
for Independence Boulevard recorded in Deed Book 2939 at page 1291.
BEING part of the same property conveyed to Virginia Beach Associates, Ltd. by deed from
Pembroke Associates dated September 28,1984, recorded in the Clerk's Office, Circuit
Court, City of Virginia Beach, Virginia in Deed Book 2364, page 443.
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