SW8060901_HISTORICAL FILE_20181011

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 0 u 0 cW t
DOC TYPE
❑ CURRENT PERMIT
❑ APPROVED PLANS
HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
2o1F1 \ok\
YYYYMMDD

V,
ROY COOPER NORTH CAROLINA
Governor Environmental Quality
MICHAEL S REGANI
A cr ctary
WILLIAM E (TOBY) VINSON JR
It t01701 DJYCto
October 11, 2018
Funston 1 and &7 imber, LI C
Attn Allen Jefferson Carp, Manager
7406 Funston Road SE
Wnnabow, NC 28479
Subject Approved Minor Modification
State Stormwater Management Permit No SW8 060901
Brunswick Forest Phase 6 Section 1
High Density Subdivision Project
Brunswick County
Dear Mr Earp
The Wilmington Regional Office received a complete, modified State Stormwater Management Permit
Application for the subject project on September 7, 2018 Staff review of the plans and specifications
has determined that the project, as proposed, will comply with the Stormwater Regulations set forth in
Title 15A NCAC 2H 1000 effective January 1, 2017 We are forwarding modified Permit No SW8
060901 dated October 11, 2018, for the construction, operation and maintenance of the stormwater
control measures (SCMs), built -upon areas, as well as the stormwater collection system and/or
vegetated conveyance system associated with the subject project
I his permit shall be effective from the date of issuance until September 21, 2020 and shall be subject
to the conditions and limitations as specified therein, and does not supersede any other agency permit
that maybe required Please pay special attention to the permit conditions regarding the operation
and maintenance of the SCMs, storinwater collection system, and/or vegetated conveyances, the
limitation of built -upon area, modification of the project, the procedures for changing ownership of
and/or transferring the permit, and the need to renew the permit Please also pay attention to the
permit conditions that requires the recordation of deed restrictions and protective covenants,
easements, and the maintenance agreement, which must all be provided along with certification upon
completion of the project Failure to comply with these requirements will result in future compliance
problems
The following modifications are included and covered by this permit
I Attachment A Impervious area has been reallocated as summarized in Attachment A There are no
changes to the plans
Lots 1-14 Each residential lot was increased by 600sf The future allocation was reduced
accordingly
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right
to request an adjudicatory hearing by filing a written petition with the Office of Administrative
Hearings (OAH) The written petition must conform to Chapter 150B of the North Carolina General
Statutes and must be filed with the OAH within thirty (30) days of receipt of this permit You should
contact the OAH with all questions regarding the filing fee (if a filing fee is required) and/or the details
of the filing process at 6714 Mail Service Center, Raleigh, NC 27699-6714, or via telephone at 919-
431-3000, or visit their website at www NCOAH com Unless such demands are made this permit shall
be final and binding
Nut IhCI olina Depai Iment of Lm n unnxntal Qoahh I Dnision of Lneig) Mmei if and Lend Resawces
Wilo,myton Reyonal 011 ice 1117CnmdmalDmeL%1LLnsion I Wilmington North Carolina 28405
910 7%7215

State Stormwater Permit No SW8 060901
Page 2 of 2
If you have any questions, or need additional information concerning this matter, please contact Kelly
Johnson in the Wilmington Regional Office, at [phone]
FrSincqrely
3x0ylojmsolironine al Engineer
enclosures AttachmentA-ImpennousAllocation
Q
� °6S/kp7 \\\Stormwatcr\Pcemuts 8 Projects\2006\060901 HD\201810 permit minor 060901
cc Mr Adam Grady, PI , Hanover Design
1123 Floral Parkway, Wilmington, NC 28403
NCDOT District Engineer
Brunswick County Engineering
Wilmington Regional Office Stormwater File

State Stormwater Management Systems
Permit No SW8 060901
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL & LAND RESOURCES
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY COMMERCIAL DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of
North Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Funston Land & Timber. LLC
Brunswick Forest Phase 6 — Section 1
Hwy 17, 2 4 miles south of intersection of US 74176 County
Brunswick County
FOR THE
construction, operation and maintenance of two (2) wet detention pond(s) in compliance
with the provisions of 15A NCAC 2H 1000 (hereafter referred to as the "stormwater
rules') and the approved stormwater management plans and specifications and other
supporting data as attached and on file with and approved by the Division of Energy,
Mineral & Land Resources (hereafter referred to as the Division or DEMLR) and
considered a part of this permit
This permit shall be effective from the date of issuance until September 21, 2020, and
shall be subject to the following specified conditions and limitations
I DESIGN STANDARDS
1 This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data
2 This stormwater system has been approved for the management of stormwater
runoff as described in Section 1 5 of this permit The stormwater controls
identified as Pond 9 for the Sales Center and Pond 10 for the Wellness Center
have been designed to handle the runoff from 405 110 square feet and 240,000
square feet of built -upon area, respectively The total impervious area is
645,100 square feet The tract development will be limited to the amount of built -
upon area
3 All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements The final plats for the project
will be recorded showing all such required easements in accordance with the
approved plans
Page 3 of 10

State Stormwater Management Systems
Permit No SW8 060901
The runoff from all built -upon area within the permitted drainage area(s) of this
project must be directed into the permitted stormwater control system
The following design criteria have been provided in the wet detention pond and
must be maintained at design condition
a Drainage Area acres
Onsite ft2
Offsite, ft2
b Total Impervious Surfaces', ftz
c Pond Depth feet
d TSS removal efficiency
e Design Storm inches
f Permanent Pool Elevation FMSL
g Permitted Surface Area @PP ft2
h Permitted Storage Volume ft3
i Temporary Storage Elevation FMSL
J Controlling Orifice
k Permitted Forebay Volume, ft3
I Fountain Maximum hp
m Receiving Stream / River Basin
n Stream Index Number
o Classification of Water Body
'See Attachment A for Impervious Allocation details
II SCHEDULE OF COMPLIANCE
0
Pond 9 Pond 10
Sales Center Wellness Center
144
126
627 267
548 859
None
None
405,110
240,000
7
7
90%
90%
10
10
330
330
22 200
79,000
51,625
273,725
345
345
2 0' 0 pipe
2 0" O pipe
10,200
54 350
1/6
1
Piney Branch / Cape
Fear
C P F 17 18-77-3-1
,C Sw"
The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface
During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately
Records of maintenance activities must be kept and made available upon
request to authorized personnel of DEMLR The records will indicate the date,
activity, name of person performing the work and what actions were taken
The facilities shall be constructed, operated and maintained in accordance with
the provisions of this permit, the approved plans and specifications, and the
supporting documents attached to this permit and on file with the Division
Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and prior to operation of this permitted facility, a certification must be received
from an appropriate designer for the system installed certifying that the permitted
facility has been installed in accordance with this permit, the approved plans and
specifications, and other supporting documentation Any deviations from the
approved plans and specifications must be noted on the Certification A
modification may be required for those deviations
Page 4 of 10

State Stormwater Management Systems
Permit No SW8 060901
The permittee shall at all times provide the operation and maintenance
necessary to assure the permitted stormwater system functions at optimum
efficiency The approved Operation and Maintenance Plan must be followed in its
entirety and maintenance must occur at the scheduled intervals including, but not
limited to
a Semiannual scheduled inspections (every 6 months)
b Sediment removal
c Mowing and re -vegetation of slopes and the vegetated filter
d Immediate repair of eroded areas
e Maintenance of all slopes in accordance with approved plans and
specifications
f Debris removal and unclogging of outlet structure, orifice device, flow
spreader, catch basins and piping
g Access to the outlet structure must be available at all times
7 Decorative spray fountains will be allowed in the stormwater treatment system,
subject to the following criteria
a The fountain must draw its water from less than 2' below the permanent
pool surface
b Separated units, where the nozzle, pump and intake are connected by
tubing, may be used only if they draw water from the surface in the
deepest part of the pond
c The falling water from the fountain must be centered in the pond, away
from the shoreline
d The maximum horsepower for the fountain's pump is based on the
permanent pool volume as designated in section 15 of this permit
If the stormwater system was used as an Erosion Control device, it must be
restored to design condition prior to operation as a stormwater treatment device,
and prior to occupancy of the facility
Access to the stormwater facilities for inspection and maintenance shall be
maintained via appropriate recorded easements at all times
10 The Director may notify the permittee when the permitted site does not meet one
or more of the minimum requirements of the permit Within the time frame
specified in the notice, the permittee shall submit a written time schedule to the
Director for modifying the site to meet minimum requirements The permittee
shall provide copies of revised plans and certification in writing to the Director
that the changes have been made
Page 5 of 10

State Stormwater Management Systems
Permit No SW8 060901
11 The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to those listed
below
a Any revision to any item shown on the approved plans including the
stormwater management measures built -upon area, details, etc
b Project name change
c Transfer of ownership
d Redesign or addition to the approved amount of built -upon area or to the
drainage area
e Further subdivision acquisition lease or sale of all or part of the protect
area The project area is defined as all property owned by the permittee,
for which Sedimentation and Erosion Control Plan approval or a CAMA
Major permit was sought
f Filling in altering or piping of any vegetative conveyance shown on the
approved plan
g The construction of any permeable pavement for BUA credit
12 Prior to the construction of any permitted future areas shown on the approved
plans, the permittee shall submit final site layout and grading plans to the
Division for approval
13 A copy of the approved plans and specifications shall be maintained on file by
the Permittee at all times At the time the permit is transferred to a new owner,
the permittee shall forward the approved plans to the new owner
14 If the use of permeable pavement for BUA credit within the lot is desired, the
permittee shall direct the lot owner to submit an application with all supporting
documentation and the application fee to the Division and receive a permit prior
to construction of the permeable pavement
III GENERAL CONDITIONS
This permit is not transferable to any person or entity except after notice to and
approval by the Director The permittee shall submit a completed and signed
Name/Ownership Change Form, accompanied by the supporting documentation
as listed on the form, to the Division of Energy Mineral and Land Resources at
least 60 days prior to any one or more of the following events
a An ownership change including the sale or conveyance of the project area
in whole or in part, except in the case of an individual lot sale that is made
subject to the recorded deed restrictions,
b The sale or conveyance of the common areas to a Homeowner's or
Property Owner's Association, subject to the requirements of Session Law
2011-2y ,
c Bankruptcy,
d Foreclosure, subject to the requirements of Session Law 2013-121,
e Dissolution of the partnership or corporate entity, subject to NCGS 57D-2-
01(e) and NCGS 57D-6-07,
f A name change of the current permittee,
g A name change of the protect,
h A mailing address change of the permittee,
2 The permittee is responsible for compliance with all permit conditions until such
time as the Division approves the transfer request Neither the sale of the protect,
in whole or in part, nor the conveyance of common area to a third party
constitutes an approved transfer of the stormwater permit
Page 6 of 10

State Stormwater Management Systems
Permit No SW8 060901
3 The permittee grants DEMLR Staff permission to enter the property during
normal business hours for the purpose of inspecting all components of the
permitted stormwater management facility
4 Any individual or entity found to be in noncompliance with the provisions of this
stormwater management permit or the requirements of the Stormwater rules is
subject to enforcement procedures as set forth in NCGS 143 Article 21
5 The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules regulations or ordinances which may be imposed by
other government agencies (local, state and federal) having jurisdiction
6 In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems
7 The permit remains in force and effect until modified, revoked, terminated or
renewed The permit may be modified, revoked and reissued or terminated for
cause The filing of a request for a permit modification, revocation and re -
issuance or termination does not stay any permit condition
8 Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual
9 Approved plans and specifications for this protect are incorporated by reference
and are enforceable parts of the permit
10 The permittee shall notify the Division of any name, ownership or mailing address
changes at least 30 days prior to making such changes
11 The permittee shall submit a permit renewal request at least 180 days prior to the
expiration date of this permit The renewal request must include the appropriate
documentation and the processing fee
Permit modified, and re -issued this the 11th day of October 2018
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
�, iam o y m Jr, , Interim Director
Division of nergy, ineral and Land Resources
By Authority of the Environmental Management Commission
Page 7 of 10

State Stormwater Management Systems
Permit No SW8 060901
Brunswick Forest Phase 6, Section 1
Stormwater Permit No SW8 060901
Brunswick County
Designer's Certification
I , as a duly registered in the
State of North Carolina, having been authorized to observe (periodically/ weekly/ full
time) the construction of the protect,
(Protect)
for (Protect Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the protect
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications
The checklist of items on page 2 of this form is included in the Certification
Noted deviations from approved plans and specifications
Signature
Registration Number
Date
SEAL
Page 8 of 10

State Stormwater Management Systems
Permit No SW8 060901
Certification Requirements
1 The drainage area to the system contains approximately the permitted
acreage
2 The drainage area to the system contains no more than the permitted
amount of built -upon area
3 All the built -upon area associated with the project is graded such that the
runoff drains to the system
4 All roof drains are located such that the runoff is directed into the system
5 The outlet structure elevations are per the approved plan
6 The outlet structure is located per the approved plans
7 Trash rack is provided on the outlet structure
8 All slopes are grassed with permanent vegetation
9 Vegetated slopes are no steeper than 3 1
10 The inlets are located per the approved plans and do not cause short-
circuiting of the system
11 The permitted amounts of surface area and/or volume have been
provided
12 Required drawdown devices are correctly sized and located per the
approved plans
13 All required design depths are provided
14 All required parts of the system are provided, such as a vegetated shelf,
and a forebay
15 The required system dimensions are provided per the approved plans
16 All components of the stormwater BMP are located in either recorded
common areas, or recorded easements
cc NCDEQ-DEMLR Regional Office
Brunswick County Building Inspections
Page 9 of 10

SW8 060901 - Impervious Allocation Data
10/11/18
Offsite Permit
Number
Mite Permitl
Date
Pond 9
Pond 10
Permit
11/16/16
Permit
3/6/18
Permit
10/11/18
Permit
11/16/163
Impervious Total
405,1101
405,110
405,110
240,000
Commerciall
115,423
115,423
115,423
142,000
Onsite Buildings
10,000
10,000
10,000
Unknown
Onsite Streets
58,958
58,958
58,958
Unknown
Onsite Parking
22,010
22,010
22,010
Unknown
Onsite Sidewalks
24,455
24,455
24,455
Unknown
Residential
61,6001
61,6001
70,0001
0
Number of Lots
1 141
141
141
0
BUA/Lot
1 4,4001
4,4001
5,0001
0
Lot 1'
N/A
N/A
21,209
21,209
21,209
0
Onsite Buildings
-
-
3,192
3,192
3,192
0
Onsite Streets
-
-
0
0
0
0
Onsite Parking
-
-
15,131
15,131
15,131
0
Onsite Sidewalks
-
-
1,886
1,886
1,886
0
Other
-
-
1,000
1,000
1,000
0
Lot 2
SW8 180113
1 2/9/2018
1 01
15,3731
15,3731
0
Other
01
01
01
72,000
Future
186,688
191,505
183,105
26,000
Contingency
1 20,1901
01
01
0
'Outside Lots 1 and 2
2Lot 1 is owned by the SW8 060901 permittee, and so an offsite permit is not required An offsite permit will be required if/when
the lot is sold
3The Pond 10 allocation data was not modified on 3/6/18 or 10/11/18
This permit has historically used the terms "contingency" and "future" On 3/6/18, the term "contingency" was removed All
impervious area that is available for future use is allocated as "future"

DEMLR USE ONLY
Date Received Fee Paid Permit Number
STORMWATER PERMITTING FORM 7
MINOR MODIFICATION
Standard Permitting Program — No Fee for Minor Modification
Express Permitting Program — See Express Fee Schedule
Only complete applications packages will be accepted and reviewed This form and the required items (with
onginal signatures) must be sent to the appropriate DEMLR Regional Office, which can be determined by locating
the project on the interactive online map at http //dea nc gov/contacUreaional-offices
This form is to only to be used by the current permittee to notify the Division of a minor
modification Pursuant to Rule 15A NCAC 02H 1002 a minor modification is a change to the project that
1) does not increase the net built -upon area, and/or
2) does not change the size or design of the SCM(s)
A GENERAL INFORMATION
1 State Stormwater Permit Number SW8 060901
2 Current Permit Holder's Company Name/Organization Funston Land & Timber, LLC
3 Signing Official's Name Allen Jefferson Earp
4 Signing Official's Title Manager
5 Mailing Address 1007 Evangeline Drive
City Leland, INC State INC ZIP 28405
6 Street Address (if different)
City State ZIP
7 Phone [phone] Email rrussell(a)brunswickforest cam
8 Describe the minor modifications that you are requesting, including any revised BUA allocations (attach
additional pages or supporting tables similar to Section IV 10 of the original application, if needed)
8,400 SF of Future impervious is being allocated to lots 1-14 evenly bring the allowable BUA per
Lot to 5000 sf and reducing the future BUA to 183,105 sf
B SUBMITTAL REQUIREMENTS
Please mark "Y" to confirm the items are included with this form Please mark "X" if previously provided If not
applicable or not available, please mark N/A
Y 1 Two hard copies (with original signatures) and one electronic copy of this completed form
Y 2 Two hard copies and one electronic copy of the revised plan sheets (must be a revision of the
originally approved plan sheets)
Y 3 If there is reallocation of lot BUA, a copy of the revised recorded deed restrictions and protective
covenants OR the proposed recorded deed restrictions and protective covenants documenting
the changes and a signed agreement to provide the final recorded document
Y 4 If applicable, the appropriate Express review fee
ECEIVE
SEP 011018
By:_---------
Stormwater Permit Form 7 Minor Modification Page 1 of 2 July 14 2017

C CONTACT INFORMATION
2
1 The Design Professional who is authorized to provide information on the Applicant's behalf
Design Professional's Name Adam H Grady
Consulting Firm Hanover Design Services, PA
Mailing Address 1123 Floral Parkway
City Wilmington State NC Zip 28403
Phone [phone] Fax [phone]
Email agrady(a)hdsilm com
[OPTIONAL] If you would like to designate another person to answer questions about the project
Name & Title
Organization _
Mailing Address
City
Phone
Email
D CERTIFICATION OF PERMITTEE
in Section A and shown
complete to the best of,
Signature
State
Zip
mittee, certify that I have authorized the minor modifications listed
sheets I further attest that this information is accurate and
2'lllg
I, a, M • SIdMYY1e/W^+ , a Notary Public for the State of {y0 /+A CA tVy%A
County of Pand6/ , do hereby certify that M1'Cr\ JfJftaQn 1—cW�
personally appeared before me this the 2'l day of tC!&A Luis 201_?, and
acknowledge the due execution of the forgoing instrument Witness my hand and official seal,
(Notary Seal) SUMtijF'••,
40 SOT � n R`21
Notary Signature I�l JXAFIVL ® U
A PUa�,\G 2
My commission expires el 21 "R COO •°
WOO
Stormwater Permit Form 7 Minor Modification Page 2 of 2
Oct 6, 2017

Application Completeness Review Checklist
Project Name �jn,c.yx,sr�ZQ� _A,j. P�C,� (e Date Delivered to WIRO A cl 2,C, '�(�
c �, aC�r BIMS Received/Accepted Dater` -)
Project County/Location *BIMS Acknowledged Date
Rule(s) "2017 Coastal "2008 Coastal "1995 Coastal "Phase II "Universal "1988 Coastal
Permit Action New / Major Mod Minor Mo Renewal / Transfer **New Permit tt
Permit Type / LD / LD Overall / HD &LD Combo Existing Permit # S (../ p o
General Permit / Offsite / Exempt / Rescission F 1PE Cert on File?
SCM Type(s) Offsite to SW8
Development Type Commercial / Other Master PE Cert on File?
Subdivided'>C��n or Single Lot
For New or Transferred Permits Permittee is Stream Class
7Property Owner(s) Developer Lessee ❑Purchaser ❑HOA EISA Map E_1ORW Map
Paperwork Emailed Engineer on
F7Supplement(s) (1 original per BMP)
FJO&M with correct/original signatures (1 original per BMP except LS/VFS and swoles)
implication with correct/original signatures
Corp or LLC Sig Auth per SoS or Signature Authorization letter or report
M$505 (within 6mo) Check#(s) ENo Fee
Soils Report w/SHWT or General Report _ +A/ 104-4
Calculations (signed/sealed) �� -ka
Deed Restrictions, if subdivided a,, fokS
1M**Signed &Notarized Template fti l Ae ,i SvL,,,.—
—7
(Correct Template (Comm/Res & HD/LD) or Dec Covenants P. RPst
"Recorded Covenants
Recorded Plats 0% or more Lots Sold List
Project Narrative
MUSGS Map
mail Address Design Engineer
Email Address Rre vine
Deed
Email Address Lessee
Lease Agreement
Email Address Purchaser
Purchase Agreement
Email Address Developer
Email Address HOA Representative
Plans f`7�a"
E]I 4-0 A— Wetlands Delineated or No Wetlands
OVicmity Map Project Boundaries
Legend Layout (proposed BUA dimensions)
QDA Maps Details (roads, cul-de-sacs, curbs, sidewalks, BMPs, Buildings, etc)
Existing Conditions Landscape Plan
Grading F TE Seal
REVIEWER NAME NOTES TO REVIEWER *Enter BIMS Acknowledged Date on this Sheet
**FOR NEW Projects -Enter New Permit # on
Supplements & Deed Restiction Templates
r
G WQ\\\Reference Library\Procedures\Checklists\Completeness Review Checklist_2018 03 13

Hanover Design Services, P.A.
Land Surveyors, Engineers, Land Planners * E7
August 29, 2018
Ms Georgette Scott, Stormwater Supervisor �`(`�'` ` 4 k'
w 1V-)6
Department of Environment and Natural Resources
Division of Water Quality
127 Cardinal Drive Extension AtIor
Wilmington, NC 28405-3845 prj 29,7018
Re SW8 060901 Permit Transfer
Brunswick Forest Phase 6 Section 1
Georgette
Attached please find a permit transfer package for the above listed permit The phase and
section is predominantly built out and a permit ownership change to the HOA is being
requested The following is included in the package
• Transfer Package �✓b�► Z� per, ..,
Minor Lot BUA reallocation with Updated Deed Restrictions
• $505 Fee
If you have any questions please do not hesitate to contact me
Sincer
Adam Grady, PE
Hanover Design Services P A
agrady@hdsilm com
[phone] Office
[phone] Fax
screIvc-
SEP 0 7 20%
1123 Floral Parkway Wilmington, NC 28403 Phone [phone] Fax [phone]
Business Firm License No C-0597

LIMITED LIABILITY COMPANY ANNUAL REPORT
0 200 7
NAME OF LIMITED LIABILITY COMPANY Funston Land &Timber, LLC)
SECRETARY OF STATE ID NUMBER 0648424 STATE OF FORMATION NC
REPORT FOR THE CALENDAR YEAR 2018
SECTION A REGISTERED AGENT'S INFORMATION
1 NAME OF REGISTERED AGENT CT Corporation System
2 SIGNATURE OF THE NEW REGISTERED AGENT
E Filed Annual Report
0648424
CA201810208090
4/12/2018 05 04
Changes
SIGN,TURE CONSTITUTES CONSENT TO THE APPOINTMENT
3 REGISTERED OFFICE STREET ADDRESS & COUNTY 4 REGISTERED OFFICE MAILING ADDRESS
160 Mine Lake Ct Ste 200 160 Mine Lake Ct Ste 200
Raleigh, NC 27615-6417 Wake County Raleigh, NC 27615-6417
SECTION B PRINCIPAL OFFICE INFORMATION
1 DESCRIPTION OF NATURE OF BUSINESS Land and Timber Investment
2 PRINCIPAL OFFICE PHONE NUMBER [phone] 3 PRINCIPAL OFFICE EMAIL Privacy Redaction
4 PRINCIPAL OFFICE STREET ADDRESS & COUNTY
1007 Evangeline Drive
Leland, NC 28451 Brunswick Countv
5 PRINCIPAL OFFICE MAILING ADDRESS
1007 Evangeline Drive
Leland, NC 28451
6 Select one of the following if applicable (Optional see instructions)
The company is a veteran -owned small business
The company is a service -disabled veteran -owned small business
SECTION C COMPANY OFFICIALS (Enter additional company officials in Section E )
NAME
Lord Baltimore Capital Partners LLC
NAM
1 AIlenE Jefferson Earpj
TITLE
Manager
TITL t
Manager
ADDRESS
ADDRESS
6225 Smith Avenue 1007 Evangeline Drive
Baltimore, MD 21209-3623 Leland, NC 28451
NAME
TITLE
ADDRESS
SECTION D CERTIFICATION OF ANNUAL REPORT Section D must be completed in its entirety by a person/business entity
Lord Baltimore Capital Partners LLC by Karen Davidson Corporate Secretary 4/1 2/201 8
SIGNATURE
Form must be signed by a Company Official hsled under Section C of This form
DAIE
Lord Baltimore Capital Partners Ll C by Karen Davidson Corporate Secretary Manager
Print or Type Name of Company Official Pont or Type T itle of Company
This Annual Report has been 'tied electronically
MAIL TO Secretary or State Business Registration Division Post Office Box 29525 Raleigh NC 21626 0525