NCC230929_FRO Submitted_20230404

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 Belshire
*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).
2. Location of land-disturbing activity: County Union City or Township Indian Trail
Waxhaw-Indian Trail Rd 35.05161 -80.68552
Highway/Street Latltude(decimal degrees) LOngltude(decimal degrees)
3. Approximate date land-disturbing activity will commence:4/7/23
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): 17.2
6. Amount of fee enclosed: $ . 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 ❑x Enclosed ❑x No ❑
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Casey Proffitt E-mail Address [e-mail]
Phone: Office# N/A Mobile# [phone]
9. Landowner(s)of Record (attach accompanied page to list additional owners):
AMH NC Development LP 502-396-2416
Name Phone: Office# Mobile#
23975 Park Sorrento, Suite 300 16905 Northcross Dr, Suite 200
Current Mailing Address Current Street Address
Calabasas, CA 91302 Huntersville, NC 28078
City State Zip City State Zip
10. Deed Book No. 08674 Page No.0264-0268 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).
AMH NC Development LP [e-mail]
Company Name E-mail Address
23975 Park Sorrento, Suite 300 16905 Northcross Dr, Suite 200
Current Mailing Address Current Street Address
Calabasas, CA 91302 Huntersville, NC 28078
City State Zip City State Zip
Phone: Office# Mobile# [phone]
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:
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:
CT Corporation System [e-mail]
Name of Registered Agent E-mail Address
160 Mine Lake Ct, Ste 200 160 Mine Lake Ct, Ste 200
Current Mailing Address Current Street Address
Raleigh, NC 27615 Raleigh, NC 27615
City State Zip City State Zip
Phone: Office# 980-365-5947 Mobile# [phone]
James Martin
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.
James Martin Vice President
Type or print name Title or Authority
l. 3127123
Sig ure Date
I, dhar#n 61146 , a Notary Public of the County of @A.barris
State of North Carolina, hereby certify that t e6 _Maria O 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 crl day of 'vl are,A , 20<✓
A gliti6y,
Notary
Sea 4' J4)t ?& 17
My commission expires
SHARON GRIFFIN
NOTARY PUBLIC
Cabanvs County
North Carolina
My Commission Expires 4/24/2027

BK 8674 PG 0264 FILED ELECTRONICALLY
UNION COUNTY NC
CRYSTAL D. GILLIARD
FILED Mar 20, 2023
AT 12:07:00 PM
BOOK 08674
START PAGE 0264
END PAGE 0268
INSTRUMENT # 06254
EXCISE TAX $6,840.00
Excise Tax:$6,840.00 I Recording Time,Book and Page
Parcel No.:07-135-016
Verified by County on the_day of ,2023;By-
Mail after recording to Grantee
This instrument was prepared by: Alexander Ricks PLLC(MJH)
Brief Description for the index 29.31 acres(+/-)on Waxhaw Indian Trail Road,
Indian Trail,NC
NORTH CAROLINA SPECIAL WARRANTY DEED
THIS DEED made this 1�9 day of March,2023,by and between
GRANTOR GRANTEE
Sinacori Builders,LLC, AMH NC Development LP,
a North Carolina limited liability company a Delaware Iimited partnership
Mailing Address: Mailing Address:
10100 Park Cedar Drive,Suite 166 23975 Park Sorrento,Suite 300
Charlotte,NC 28210 :Calabasas,CA 91302
Enter in appropriate block for each party:name,address,and,if appropriate,character of entity,e.g.,corporation or partnership.
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and
shall include singular,plural,masculine,feminine or neuter as required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby
acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee.in fee simple all that
certain lot or parcel of land situated in the Town of Indian Trail,Union County,North Carolina and more particularly
described as follows(the"Property"):
SEE ATTACHED EXHIBIT A FOR LEGAL DESCRIPTION
The Property herein conveyed does not include the primary residence of a Grantor.
The Property was acquired by Grantor by instrument recorded in Book 8674 at Page 58 of the Union
County public registry(the"Registry").
02149-014/004submitted electronically by "Chicago Title Company, LLC"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the union County Register of Deeds.

BK 8674 PG 0265
TO HAVE AND TO HOLD the aforesaid Property and all privileges and appurtenances thereto belonging to the Grantee
in fee simple.
And the Grantor covenants with the Grantee, that Grantor has done nothing to impair such title as Grantor received,
and Grantor will warrant and defend the title against the lawful claims of all persons claiming by, under or through
Grantor.
Title to the Property hereinabove described is subject to those certain exceptions set forth on Exhibit B attached hereto
and incorporated herein by this reference.
•
[signature appears on the following page]
02149-014/00451021

BK 8674 PG 0266
IN WITNESS WHEREOF,the Grantor has duly executed the foregoing as of the day and year first above written.
Sinacori Builders,LLC,
a.North.Carolina limited liability company
By: ,��
N : ussell Sinacori
Tit e:Manager
State of PC, _ -County of rux
I, the undersigned, a Notary Public of the County and the State aforesaid, certify that Russell Sinacori personally
appeared before me this day and acknowledged that he is the Manager of Sinacori Builders, LLC, a North Carolina
limited liability company,and that by authority duly given and as the act of the limited liability company,he executed
the foregoing instrument:
Witness my hand and official seal,this the I P day of March,2023.
Notary is 1
•
,.may V�� S� �p�,
�� �U Z printed name of Notary �J
pt}�`� - My Commission Expires: I at l'f ? 0 a-
/1HhIN
02I49-014100451021

BK 8674 PG 0267
EDIT A
LEGAL DESCRIPTION
Lying and being situate in Union County,North Carolina,and being more particularly described as follows:
TRACT 1:
BEGINNING at a point in the center of Indian Tral Waxhaw Road,a corner of the Frank S. Foard property
(108/39 UCR); running thence with the said Foard line S. 77-37-08 W.passing an iron(set)at 33.12 feet
for a total of 484.16 feet to an iron(set),a corner of the Walter D. Dale property(1 666/098 UCR);thence
with said Dale line two calls as follows: (1)S.85-18-13 W.802.48 feet to an iron and(2)S. 51-11-42 W_
93.02 feet to an iron;a corner of the Cody Keziah property(74/475 UCR);thence with said Keziah line S.
39-29-29 W.526_31 feet to an iron on the line of the Earl S_Stegall property(379/133 UCR);thence with
the line of the said Stegall property S. 89-58-07 W.362.80 feet to an iron,a corner of Lot 43 of Wellington
Woods IV(Plat Cab A, File 198 A 8 B UCR);thence with the line of Lots 43 and 44 S_ 89-54-43 W.512.45
feet to an iron;a corner of Lots 44,45 and 48 of said subdivision;thence with the line of Lot 48 of said
subdivision and of Lot 20 of Wellington Woods V(Plat Cab B, File 286A UCR)two calls as follows:(1)N.
05-02-43 E 329.83 feet to an iron and(2)N.05-00-01 E.330.07 feet to an iron,a corner of the Don E.
Moore property(930/292 UCR);thence with said Moore line two calls as follows:(1) N. 82 32-58 E.
2,295.10 feet to a found iron and (2)N. 13-57-39 E. 19.15 feet to an iron,a corner of the Catherine R.
Privette property(458/330 UCR);thence with said Privette line N.86-15-22 E_passing an iron at 26726
feet for a total of 298.64 feet to a point in the center of Indian Trail-Waxhaw Road;thence with said road
S. 13-11-51 W. 100.08 feet to a point,a corner of the Earl Jordan property(537/191 UCR)thence with
said Jordan property three calls as follows: (1)S. 86-21-02 W. passing an iron at 30_53 feet for a total of
299.17 feet to an iron; (2)S. 13-01-03 W. 132.23 feet to an iron,and(3)N. 79-53-55 E.passing an iron at
271.39 feet for a total of 312.25 feet to a point in aforesaid road thence with said road S. 12-31-02 W.
171.63 feet to the point and place of BEGINNING and containing 29.33 acres more or less all according to
a survey by Donald Lawrence, PLS dated January 28,2005_
LESS AND EXCEPT the land conveyed by North Carolina General Warranty Deed recorded in Book 7486
at Page 5, Union County Registry.
TRACT 2:
BEGINNING at a point at or near the center of Waxhaw-Indian Trail Road (SR 1008),a corner of the
Donald A. McInnis and Sharon H.McInnis property(3780/536 UCR)and northeastern corner of the
Edelmira Garcia Mendoza property(62301107 UCR);thence with the Waxhaw-lndian Trail Road S.
12-40-18 W. 40.60 feet to a point;thence a new line N. 63-16-20 W. 77.06 feet to a point on the line of the
aforesaid McInnis property;thence with said McInnis line N. 86-21-02 E.77.89 feet to the point and place •
of BEGINNING and containing _035 acre(1,518 square feet)all according to a survey by Donald F. - .
Lawrence,PLS dated October 30,2017, revised October 24,2018_
02149-014/00451021

BK 8674 PG 0268
EXHIBIT B
PERMITTED EXCEPTIONS
I. Taxes or assessments for the year 2023,and subsequent years,not yet due or payable.
2. Local zoning ordinances and regulations.
3. Matters disclosed by survey entitled "ALTA/NSPS Survey 2432 Waxhaw-Indian Trail Road"by Christopher
D.Faulk,P.L.S.of Metrolina Land Surveying,Inc.,and dated November 8,2022.
4. Sewer Right of Way Agreements to Union County recorded in Book 805,page 222; and Book 805,page 225
of the Registry.
5. Sanitary Sewer Line Easement to Union County recorded in Book 1978,page 567 of the Registry.
6. Consent Judgment in favor of Union County recorded in Book 2004,page 889 of the Registry. In connection
therewith Memorandum of Action recorded in Book 1991,page 154 of the Registry.
7. Title to any portion of the Property lying within the right of way of Waxhaw Indian Trail Road also known as
Indian Trail-Waxhaw Road.
8. Rights of others in and to the continuous and uninterrupted flow of the waters bounding or crossing the
Property and riparian and/or littoral rights incident to the Property.
•
02149-014/00451021