NCC233082_FRO Submitted_20231012

BK 748 PG 572 DOC# 346463
The property hereinabove described was acquired by Grantor by instrument recorded in Book 633,Page 509.
All or a portion of the property herein conveyed includes or X does not include the primary residence of a
Grantor.
A map showing the above described property is recorded in Plat Book 9,Page 752.
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.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to
convey the same in 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,other than the following exceptions:
Easements,restrictions,rights of way of record,and ad valorem taxes not yet due and payable.
IN WITNESS WHEREOF,the Grantor has duly executed the foregoing as of the day and year first above written.
LOOtokalef KJ (SEAL)
Donald Wayne Freemm�
S 6,1
rflar,._, (SEAL)
Sheri Freeman
State of W County of
I, the undersigned otary Public of the County of VAA- e. and State aforesaid, certify
that Donald Wayne Freeman and Sheri Freeman personally appeared beyore me,the said named to me known and
known to me to be the persons described in and who executed the foregoing instrument, and they acknowledged that
they executed the same, and being duly sworn by me, made oath that the statements in the foregoing instrument are
true.
Witness my hand and Notarial stamp or seal this J6 day of AST: ,2022.
Chit.t\--gdwA--
MyCommission E ires: 1" —a� PubSignature
Expires: a4 Notary
bruki Taal: A-
Notary'sped or Printed Name
(Affix Seal)
• iz,cs r.,

BK 748 PG 573 DOC# 346463
EXHIBIT "A"
Freeman to Taylor
BEING that 34.70 acres, more or less, as shown on a survey by Blue Ridge Land Surveying, Inc.,entitled
"Survey for Owners of Record Donald Wayne Freeman and Sheri Freeman", Job No.21-158-D,the same
being recorded in Plat Book 9, Page 752, Madison County,North Carolina Registry.
TOGETHER WITH AND SUBJECT TO easements, restrictions,rights of way of record and 2022 ad
valorem taxes.
Grandview Road
Alexander, NC
PIN 9714-69-653

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 NCG01 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 Grandview West Subdivision
2. Location of land-disturbing activity: County Madison City or Township Marshall
Highway/Street Grandview Road Latitude(dedmal degrees) 35-45'18"
Longitude(deamai degrees) 82d39'2"
3. Approximate date land-disturbing activity will commence: 9-10-2023
4. Purpose of development(residential, commercial, industrial, institutional,etc.): Residential
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): 5.60 ACRES
6. Amount of fee enclosed: $ 600.00 . 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 El Enclosed ❑ No El
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name William Huyler E-mail Address will(c�carolinalanddesign.com
Phone: Office# [phone] Mobile#
9. Landowner(s)of Record (attach accompanied page to list additional owners):
Rhino Site Developers 919 961 5308 Glenn Taylor Name
Phone: Office# Mobile#
3206 Cobblestone Court,Raleigh NC 27607
Current Mailing Address Current Street Address
Raleigh 27607 Raleigh City
State Zip City State Zip
10. Deed Book No. 159 Page No. 676 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).
Rhino Site Develop rhino.site.developers(a)gmail.com
Company Name E-mail Address
3206 Cobblestone Court
Current Mailing Address Current Street Address
Raleigh NC 27607
City State Zip City State ZiP
Phone: Office# [phone] Mobile#
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:
Glenn Taylor [e-mail]
Name of Registered Agent E-mail Address
3206 Cobblestone Ct 3206 Cobblestone Ct
Current Mailing Address Current Street Address
Raleigh NC 27607 Raleigh NC 27607
City State Zip City State Zip
Phone: Office# 919-961-5308 Mobile# [phone]
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:
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)

(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 shoul. • be any change in the information provided herein.
Glenn Tay!. Managing Manager
Type o •rint na • - Title or Authority
— AMIN. 10/03/2023
Signature Date
I, ' hilt..) \J' Ci^A17e1`) , a Notary Public of the County of au,it -`
State of North Carolina,hereby certify that G/Fti N 1710/ appeared personally
before me this day and being duly sworn acknowledged that the above form was executed by him/her.
K.,1 Q / z
Witness my hand and notarial seal, this j day of , 20 3
4,- bv. ,/,---- '
BRIAN W LINEBERRY Notary
Se Notary Public
Chatham Co.,North Carolina My commission expires O3 1 G ZAZ7
My Commission Expires March 10,2027