NCC222798_FRO Submitted_20220805

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 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 Holder Road Subdivision
2. Location of land -disturbing activity: County Harnett City or TownshipLlllington
Holder Rd 35.3740 g (decimal Lon itude-78.8737
Highway/Street Latltude(decimal degrees) degrees)
3. Approximate date land -disturbing activity will commence:4/1 /2022
4. Purpose of development (residential, commercial, industrial, institutional, etc.): residential
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas):9.36
6. Amount of fee enclosed: $1 ,000 . 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 ❑ No ❑
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
NameBo Bridgers E-mail Address bo@brad leybuiltnC.corn
Phone: Office # 9196392073 Mobile # [phone]
9. Landowner(s) of Record (attach accompanied page to list additional owners):
BS Land 9196392073
Name Phone: Office # Mobile #
466 Stancil Rd
Current Mailing Address
Angier NC 27501
Current Street Address
City State Zip City
10. Deed Book No.4081 Page No.944
State
Zip
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).
BS Land LLC [e-mail]
Company Name E-mail Address
466 Stancil Rd
Current Mailing Address
Angier, NC 27501
Current Street Address
City
State
Zip
City
State Zip
Phone:
Office # 919-639-2073
Mobile
# 919-538-5845
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:
BS Land, LLC
Name of Registered Agent
466 Stancil Rd
Current Mailing Address
Angier, NC 27501
City State
Phone: Office # 919-639-2073
Bradley Stancil
[e-mail]
E-mail Address
Current Street Address
Zip City
Mobile # [phone]
Name of Individual to Contact (if Registered Agent is a company)
State Zip
(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
Current Mailing Address
City
Phone: Office #
E-mail Address
Current Street Address
State Zip City State Zip
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.
Bradley Stancil
Type or print name
Sig a ure
Managing Member
Title or Authority
6/22/22
Date
I a Notary Public of the County of L)A-k--
State of North Carolina, hereby certify that 7E Q lam) L "A —et 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 as day of J L�-V<F , 20
Notary
My commission expires

Continued from Items 9 & 10 in Part A of the Financial Responsibility/Ownership Form for multiple
owners. Attach copies of this page as needed to list all landowners.
Name
Phone: Office # Mobile #
Current Mailing Address
Current Street Address
City State
Zip
City State Zip
Deed Book No.
Page No.
Provide a copy of the most current deed.
Landowner 3 of Record:
Name
Phone: Office # Mobile #
Current Mailing Address
Current Street Address
City State
Zip
City State Zip
Deed Book No.
Page No.
Provide a copy of the most current deed.
Landowner 4 of Record:
Name
Phone: Office # Mobile #
Current Mailing Address
Current Street Address
City State
Zip
City State Zip
Deed Book No.
Page No.
Provide a copy of the most current deed.
Landowner 5 of Record:
Name
Phone: Office # Mobile #
Current Mailing Address
Current Street Address
City State
Zip
City State Zip
Deed Book No.
Page No.
Provide a copy of the most current deed.

Continued from Item 1 in Part 8 of the Financial Responsibility/Ownership Form for multiple parties.
Attach copies of this page as needed to list all financially responsible parties.
Company 2 Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office # Mobile #
Company 3 Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office # Mobile #
Company 4 Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office # Mobile #
Company 5 Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office # Mobile #

IJ-FWU 1 - r 17•r-r
HARNETT COUNTY TAX ID#
100539 0004
100539 0005
11-30-2021 BY ED
For Registration Matthew S. Willis
Register of Deeds
Harnett County, NC
Electronically Recorded
2021 Nov 30 10:21 AM NC Rev Stamp: $ 2448.00
Book: 4081 Page:944 - 947 Fee: $ 26.00
Instrument Number: 2021028048
Submitted electronically by Adams Howell Sizemore & Adams P.A. iu compliance with North Carolina statutes governing
recordable documents and the terms of the submitter agreement with the Harnett County Register of Deeds.
Prepared by and Return to:
Reginald B. Kelly, Attorney at Law, P.O. Box 1118, Lillington, NC 27546
The attorney preparing this instrument has made no record search or title examination of the property
described herein, and expresses no opinions as to title or tax consequences, unless contained in a
separate written certificate.
PID#: 100539 0004 and 100539 0005
REVENUE STAMPS: $2,448.00
STATE OF NORTH CAROLINA
COUNTY OF HARNETT
WARRANTY
DEED
This WARRANTY DEED is made the 17th day of November, 2021, by and between
Stephen Alexander Salmon and spouse, Elisa June Salmon, of 1661 Peach Farm Road,
Lillington, NC 27546 (hereinafter referred to in the neuter singular as "the Grantor") and BS
Land, LLC, a North Carolina limited liability company of 1415 Jackson King Road, Willow
Spring, NC, 27592 (hereinafter referred to in the neuter singular as "the Grantee");
WITNESSETH:
THAT said Grantor, for valuable consideration, receipt of which is hereby acknowledged,
has given, granted, bargained, sold and conveyed, and by these presents does hereby give, grant,
bargain, sell and convey unto said Grantee, its heirs, successors, administrators and assigns, all
of that certain piece, parcel or tract of land situate, lying and being in Upper Little River Township
of said County and State, and more particularly described as follows:
TRACT I: PID: 100539 0004
ALL THAT CERTAIN TRACT OR PARCEL OF LAND CONTAINING
FORTY-EIGHT AND THIRTY FOUR ONE HUNDREDTHS (48.34) ACRES,
MORE OR LESS, IN UPPER LITTLE RIVER TOWNSHIP, HARNETT
COUNTY, NORTH CAROLINA, LOCATED ON THE NORTH SIDE OF THE
JOHNSONVILLE ROAD BETWEEN PINEVIEW AND LILLINGTON, ABOUT
FOUR MILES SOUTHWEST FROM LILLINGTON, BOUNDED NOW OR
FORMERLY, ON THE NORTH BY THE LANDS OF W. J. ALLEN, ON THE

Li-twY 1 - r ♦7YJ
EAST BY THE LANDS OF FRANK TENGIN, FORMERLY STEVENS, W. A.
PARKER AND THE MT. ARREL CHURCH LOT, ON THE SOUTH BY THE
LANDS OF LEANDER LEE ESTATE, SAID ROAD BEING THE LINE, AND
ON THE WEST BY THE LANDS OF MOLLIE STEPHENS AND DENNIS
MCLEAN, A PUBLIC ROAD BEING THE LINE, SAID TRACT OF LAND
BEING MORE PARTICULARLY DESCRIBED ACCORDING TO A PLAT
MADE BY O. A. WAKEFIELD, LEE COUNTY SURVEYOR, FROM A SURV
EY MADE IN MARCH 1945, AS REVISED BY W. L. JOHNSON ON APRIL 1,
1946, AS FOLLOWS:
BEGINNING AT A POINT ON SAID JOHNSONVILLE ROAD WHERE IT IS
INTERSECTED BY ANOTHER PUBLIC ROAD, AT OR NEAR THE STEVENS
CORNER, AND RUNNINNG THENCE ALONG SAID ROAD WHICH INTE
RSECTS SAID JOHNSONVILLE ROAD NORTH 14 DEGREES WEST 4.4
CHAINS TO AN IRON STAKE; THENCE NORTH 39 DEGREES 02 MINUTES
WEST 11.98 CHAINS TO A CORNER OF W. J. ALLEN; THENCE ALONG
THE LINE OF SAID W. J. ALLEN NORTH 11 DEGREES 15 MINUTES EAST
4.45 CHAINS; NORTH 70 DEGREES EAST 7.48 CHAINS, AND NORTH 5
DEGREES 30 MINUTES WEST 9.99 CHAINS TO A WILD CHERRY AND
POST OAK AND RED OAK POINTERS IN THE OLD MCLEAN LINE, NOW
THE ALLEN LINE; THENCE ALONG ANOTHER LINE OF SAID W. J.
ALLEN SOUTH 70 DEGREES EAST 5.42 CHAINS TO A POINT KNOT,
HICKORY POINTERS. THENCE SOUTH 82 DEGREES EAST 5.5 CHAINS TO
A STAKE; THENCE SOUTH 10 DEGREES EAST 20.44 CHAINS TO A
STAKE; THENCE SOUTH 55 DEGREES EAST 2.5 CHAINS TO A STAKE;
THENCE SOUTH 70 DEGREES 30 MINUTES EAST 2.41 CHAINS TO A
STAKE; THENCE SOUTH 15 DEGREES 45 MINUTES EAST 7.16 CHAINS;
THENCE SOUTH 9 DEGREES 30 MINUTES WEST 2.2 CHAINS TO A STAKE
ON SAID JOHNSONVILLE ROAD, A CORNER; THENCE ALONG SAID
ROAD NORTH 79 DEGREES WEST 19.1 CHAINS TO THE POINT OF
BEGINNING AND BEING THAT CERTAIN 68.02 ACRE TRACT SHOWN
AND DELINEATED AN A PLAT MADE BY O. A. WAKEFIELD, LEE
COUNTY SURVEYOR, MADE FROM A SURVEY IN MARCH 1945, WHICH
IS RECORDED IN PLAT BOOK 5, PAGE 42, REGISTRY OF HARNETT
COUNTY, SAVING AND EXCEPTING THEREFROM that certain 19.68 acre
tract conveyed to W.J. Allen by C.B. Horton and wife, Melissa Horton, by deed
dated April 1, 1946, recorded in Book 298, Page 446, Registry of Harnett County.
LESS AND EXCEPT FROM THE ABOVE DESCRIBED TRACT II IS THE
FOLLOWING:
1. ALL OF THAT 0.255 ACRE PARCEL PREVIOUSLY CONVEYED AS
DESCRIBED IN DEED BOOK 2626, PAGE 284 AND MAP NO. 2008-994,
HARNETT COUNTY REGISTRY.
SUBJECT TO EASEMENT TO CAROLINA POWER & LIGHT COMPANY,
RECORDED IN BOOK 303, PAGE 31 AND EASEMENT TO DUKE ENERGY

L7YVV 1 - f 17&tV
PROGRESS, LLC RECORDED IN BOOK 3582, PAGE 920, REGISTRY OF
HARNETT COUNTY.
TRACT II: PID: 100539 0005
BEING THE SAME LANDS DESCRIBED IN A DEED OF MALCOLM BLACK
AND WIFE, BETTY BLACK, TO JOSEPH S. STEPHENS, DATED
DECEMBER 7, 1903, AND RECORDED IN THE OFFICE OF THE REGISTER
OF DEEDS FOR HARNETT COUNTY IN BOOK 161, PAGE 501:
BEGINNING AT A STAKE AND GUM POINTERS ON THE LILLINGTON
AND JOHNSONVILLE ROAD, ON THE EAST SIDE OF DUNCAN'S CREEK,
AND RUNS AS THE SAID ROAD AND CROSSING THE SAID CREEK 31
CHAINS TO A STAKE AND POINTERS ON THE SIDE OF THE ROAD;
THENCE NORTH 35 DEGREES WEST 3 CHAINS TO A STAKE AND
POINTERS; THENCE NORTH 12-1/2 DEGREES WEST 20 CHAINS TO A
STAKE AND POINTERS IN NEILL MCLEAN'S LINE; THENCE AS HIS LINE
SOUTH 87 DEGREES EAST CROSSING SAID CREEK 21 CHAINS AND 11
LINKS TO A ROCK CORNER WITH POINTERS; ASA BISHOP'S
(DECEASED) CORNER; THENCE AS HIS LINE SOUTH 3 DEGREES WEST
1 CHAIN AND 30 LINKS TO HIS CORNER ON SAID CREEK, A GUM;
THENCE DIRECT TO THE BEGINNING, CONTAINING SIXTY (60) ACRES,
MORE OR LESS.
The tracts hereinabove described being a portion of the same property acquired by
Grantors in Deed Book 3719, Page 641, Harnett County Registry.
"The property herein described is () or is not ( X ) the primary residence of the Grantor
(NCGS 105-317.2)
TO HAVE AND TO HOLD the above -described lands and premises, together with all
appurtenances thereunto belonging, or in anywise appertaining, unto the Grantee, its heirs,
successors, administrators and assigns forever, but subject always, however, to the limitations set
out above.
AND the said Grantor covenants to and with said Grantee, its heirs, successors,
administrators and assigns that it is lawfully seized in fee simple of said lands and premises,
and has full right and power to convey the same to the Grantee in fee simple (but subject,
however, to the limitations set out above) and that said lands and premises are free from any
and all encumbrances, except as set forth above, and that it will, and its heirs, successors,
administrators and assigns shall forever warrant and defend the title to the same lands and
premises, together with the appurtenances thereunto appertaining, unto the Grantee, its heirs,
successors, administrators and assigns against the lawful claims of all persons whomsoever.

u-rvu I - v a&ri
IN WITNESS WHEREOF, the Grantor has hereunto set its hand and seal and does adopt
the printed word "SEAL" beside its name as its lawful seal.
(SEAL)
Stephe lexander Salmon
a
(SEAL)
Elis J e Salmon
STATE OF NORTH CAR LINA
COUNTY OF W rrG
I, a Notary Public of the County and State aforesaid, certify that Stephen Alexander
Salmon and Elisa June Salmon personally appeared before me this day and acknowledged the
due execution of the foregoing instrument.
Witness my hand and official seal, this 2a
4`tA I t 191), 1/
. "C�GI�I T. yo''� ,
J
x("ertw*r� �gdthere)
My
COMMISSION EXPIRES
�y p J B 1�
My Comini§siion Expires: 2, 1 Z5
day of NOV , 2021.
Notary Public