NCC230284_FRO Submitted_20230203

aN®c% JACKSON COUNTY PERMITTING & CODE ENFORCEMENT
Land Disturbance: OneHay (1/2) or more Acres/Stormwater Installation
Financial Responsibility/Ownership Form
Sylva Office: 938 Scotts Creek Rd, Suite 205, Phone: [phone] /Fox: 828-586-7563
CARo Cashiers Office: 357 Frank Alden Road, Phone: [phone] /Fax: [phone]
No person may initiate a land -disturbing activity and/or stormwater installation before this form has been completed and
an acceptable erosion and sedimentation control/stormwater plan has been approved by the Jackson County Office of
Permitting & Code Enforcement. If work is started without an approved permit your permit fee will be doubled.
• Please type or print, and if any question is not applicable place N/A in the blank.
• Submit three (3) copies of the plan, a narrative, and the appropriate fee; please contact our office for
an accurate fee calculation before submitting paperwork. For fee calculation. call 828-745-6850 or e-
mail tiffan ualls acksonnc.or or'amiebaum arner acksonnc.or .
• A surety bond is required for any disturbance of five (5) acres or more
Part A
1. Project Name: SWLWand Residenge PIN 7580-67-7615
2. Location of land -disturbing activity/stormwater installation: (City or Township) Cashier
Highway/Street Lot FE4 Triple Farm Road Latitude 35.07305 Longitude 83.05720
3. This project will require the review of the following: 0 Erosion Control ❑ Stormwater
Is this project within a regulated district? ONa ❑Yes —District:
4. Approximate date work will begin onsite:.12120 (22
S. Purpose of development (residential, commercial, industrial, etc.)
6. Total acreage disturbed or uncovered (including off -site borrow and waste areas) 2.6
7. Amount of fee $ FOR OFFICE USE: Received? (initial/date)
8. Has an erosion & sedimentation control/stormwater plan been filed? ❑No QYes Enclosed
9. Person to contact should issues arise during land -disturbing activity/stormwater installation:
Name.Keft Custer E-mail Address kasheconstasormail caul,.
Phone [phone] Cell 828-399-0108 Fax
10. Landowners(s) of Record (Use blank page to list additional owners) Deek Bk/Pg 2318/1703 (Provide a copy)
Name Janice Sutherland Phone [phone] Fax
Current Mailing Address 1516 Collier Pl, Smyrna GA 30080
Part B
Cotnpany(ies) or firm(s) who are financially responsible for the land -disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet.) If the company or firm is a sole proprietorship,
the name of the owner or manager may be listed as the financially responsible party.
ligshe Construgtion Inc. a o f 1
Name E-mail Address
PO Box 526 24 Paisley Mtn, Suite
Mailing Address Street Address
Qfahien NC 28717 &ashiers NC 28717
City State Zip Code City State Zip Code
28-743-6350743-6350
Phone Number Fax Number
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.

1. (a) If the Financially .Responsible Patty is not a resident of North Carolina, please give name and street
address of a North Carolina Agent.
Name
Mailing Address
City
Phone
E-mail Address
Street Address
State Zip Code City State Zip Code
Fax Number
(b) If the Financial Responsible Party is a Partnership or other person engaging in business under an
assumed name, attach a copy of the Certificate of Assumed Name. If the Financial Responsible
Party is a Corporation, give name and street address of the Registered Agent.
Rdly Custer
Name of Registered Agent
PO Box 526 _
Mailing Address
Cashiers NC 28717
City State Zip Code
828=743-6350
Phone
kashecor)stna gm_i( corz1 _..
E-mail Address
24 Paisley Mtn, Sui e 2,3
Street Address
Cashiers NC 28717
City State Zip Code
Fax Number
The above information is true and correct to the best of my knowledge and belief and was provided by me under
oath. (This forth must be signed by Financially Responsible Person if an individual or his attorney -in -
fact, or if not an individual, by an officer, director, partner, or registered agent with authority to execute
instruments for the Financially Responsible Person). I agree to provide corrected information should there
be any changes in the information provided herein.
Type or
Pritsident
Title or Au hor' T
Date
I, h to(LNe�� , a Notary Public of the County of
State of North Carolina, hereby certify that tq cyit - ` appeared personally
before me this day and being duly sworn acknowledged that the above form was executed by them.
Witness my hand and notarial seal, this day of '20Z 2
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*,SON JACKSON COUNTY PERMITTING & CODE ENFORCEMENT
Land Disturbance: One -Half (1/2) or more Acres/Stormwater Installation
Owner Affidavit for Financially Responsible Parties
Zp Sylra Office: 538 Scotts Creek Rd, Suite 205, Phone.- 828-586-75601 Fax; 828-586-7563
C Cashiers Office: 357 Frank Allen Road, Phone. [phone]/Pax 828-745-6867
If the Financially Responsible party listed on the application to disturb land is not the owner of the property, this
form must be completed by the property owner and submitted with the application.
Parcel Identification Number and location where land disturbance permitting is requested:
PIN 7580-67-7619 _located at
AAA -310-6844
Fult Printed Name Plione Number
I certify that I am the property owner of record for property mentioned above.
OR
I certify that I am legally authorized to act on behalf of the firm or corporation that owns this
property; owned by:
Prinlecl Nunre of Firm yr Cvrporatii�n
I am appearing personally before the undersigned notary and, being duly sworn, stating that I have
given my consent for a financially responsible party to submit a draft erosion and sedimentation
control plan and to conduct the anticipated land disturbing activity on my property. My authorized
financially responsible party will be:
Kasha Construction Inc.
Financially Responsible parry's Printed Name Firm Name (ijapplicableJ
S' afore of Properly Owner Dale
a Notary Public of the County of �, L
State of �'� �-� , hereby certify that tiEr t& � ;ylt 4,t,,4
appeared
personally before me this day and being duly sworn acknowledged that the above form was executed by them
Witness my band and notarial seal, this ` day of t C1 L�_C �_ 20,12:
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Y• Qoss�nh+�tS'�:
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Signature of Nowry
My Conunission Exp#eS l L

Page 1 of 3
Type_ WARRANTY DEED
Recorded: 11/4/2021 2:25:08 PM
Fee Amt: $2.726.00 Page 1 of 3
Revenue Tax: $2,700.00
Jackson County, NC
Joe Hamilton Register of Deeds
BK 2318 PG 1703 - 1705
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Nov - 04 2021 KH
This instrument prepared by:
Kimberly R. Coward, a licensed
North Carolina Attorney
Coward, Hicks & Siler, P.A.
Post Office Box 1918
Cashiers, NC 28717
Delinquent taxes, if any, to be paid by the closing attorney to the county tax collector upion
disbursement of closing proceeds.
Rev, $2,700.00; unimproved; not primary residence
PIN: 7580-67-7615; whole transfer
STATE OF NORTH CAROLINA
COUNTY OF JACKSON
WARRANTY DEED
THIS WARRANTY DEED is made this day of November, 2021, by and baween
ARTHUR J. HURT, III, a single Haan, of 4 Shadow Lawn Street, Holston, TX 70005,
hereinafter referred to as "Crrantor," and. JANICE SU MERLAND, a si g e woman, of 1516
Collier Place, Smyrna, CA 30080, hereinafter referred to collectively as "Grantee_" The terms
grantor and grantee shall be used as neuter singular designation of the parties hereto, their
personal representatives, heirs, successors and a=ps_
WITNESSETH:
That the Cw mtor, for a valuable consideration paid by the Grantee, the receipt of which is
hereby acknowledged, has and by these presents does grants bargain, sell and convey unto the
Grantee in fee simple, all that certain lot or parcel of land situated in Cashiers Township, Jackson
County, North Carolina, and more particularly described as follows-.
submitted electronically by "Coward Hicks & siler"
in compliance with North Carolina statutes governing recordable documents
----_.—and the terms of the submitter agreement with the Jackson county Register of Deeds.
Rook: 2318 Page: 1703 Seq

Page 2 of 3
BERG ALL of Lot FE-4, Silver Run Reserve, conWriing 10.99 acres, as shown on a plat
thereof prepared by Aaron Garrett Land Surveying, P.C., dated August 24, 2020 and
recorded in Plat. Cabinet 24, Slide 234, Jackson. County Registry, to which reference is
specifically made.
ALSO BEING all of same lands as described in that certain deed, recorded. in Book 2308,
Page 1911, Jackson County Registry, to which reference is specifically made_
TOGETHER WITH a non-exclusive right-of-way over the existing access road shown on
the above -referenced plat, together with continuations thereof, £or purposes of ingress
and egress between subject property and North Carolina Highway 107.
SUBJECT TO the ,right-of-way of the existing subdivision access road shown on, the
above -referenced plat.
SUBJECT TO that certain Declaration of Covenants, Conditions, Restrictions and
Easements for Silver Run Reserve recorded in Book 2252, Pate 810, as amended by First
Amendment to the Declaration of Covenants, Conditions, Restrictions and Easements fox
Silver Run Reserve recorded in Book 2273, Page 1507, Jackson County Registry, to
which reference is specifically made, together with any and all recorded supplements and
amendments thereto of public record_
In accepting this conveyance, the Grantee herein acknowledges that membership in Silver
Run Reserve Association, Inc. is an appurtenance to the property hereinabove, conveyed,
that the benefits and burdens of such membership cannot be severed from the fee to
which they are appurtenant, and that said benefits and burdens shall run perpetually with
the load.
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, subject to the reservations,
exceptions and limitations contained herein.
And the Grantor covenants with. the Grantee, that Grantor is seized of the primes in fee
simple, has the right to convey the same hX 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 hereinafter state&
Title to the property hereimbove described is conveyed subject to the following
exceptions:
Exceptions and reservations coziWned in this deed and/or in instruments referenced.
herein.
Easements and fights -of -way for public and private roads and utilities, of lrublic record.
Book: 2318 Page: 1703 Seq: 2

Page 3 of 3
Lien of ad valorem taxes for the current year and subsequent years, not yet due and
pavable.
IN Wn NES S WHEREOF, the Grmtor has hereunto sex its hand and seal, the day, and
year Furst above -written.
'+ (SEAL)
ART T, III
STATE OF ,...—_. ..�
COUNTY OF „.,.,.,...,_
I, a Notmy Public of County and the State aforesaid, certify that the
following person(s) personally appeared before me this day, each acknow,iedgzug to me
that he or she signed the foregoing document: ARTHUR J. HURT, III, a single man..
DATE: k ADA �
(OFFICIAL SEAL)
11 W�" `r'AMAN6A SUCK
r°g Notary Public, State of Texas
C Notary IDr13226267423
My Commission Expires:
21-15491wdttct
NotaryPublic
(Prmted Name of Notary)
Book: 2318 Page: 1703 Seq:3

1217122, 9:41 AM
Jackson County, NC
*' ackson, County, NIC
(1 of1) Clear
zoom to
Parcels: 7580-67-7615
PIN:
7580-67-7615
PropAddr:
LT FE4 TRIPLE FARM RD
Cu rrO wn a rAcct:
189405
CurrentOwnerl:
SUTMERLAND, )ANICE
CurrentOwnerZ:
MailingAddmS.51:
1516 COLLIER PL
MaflingAddress2:
MailingCityState:
SMYRNA GA
MaiimgZip:
30080
PropDesc.,
LT FE4 SILVER RUN
RESERVE
AssessedAcres: 10.99
TransferringRef.2318/1703
SaleDate:
11/4/2021
SalePrice:
1,350,000.00
PlatRef:
24/234
Town Cade:
07
Township:
CASHIERS
NbrhdCode:
07DB6
NbrhdName:
SILVER RUN RESERVE
FireDist:
CASHIERS 5 MI
rotBldgValue:
0. Do
TotLandVal ue:
1,025, 000.00
TaxableValue.,
1,025, 000.00
fix-
Collector Website
Re9i�ter of Deeds,S,arch
`Far parcel inquiries, con€oct Land Records at 828-
586-7539
View PRC View Report
ioott
https://gis.jacksonne.org/rpvl 112

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