NCC233709_FRO Submitted_20231215

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 Airport Hangars Site Development - Lincolnton-Lincoln County Regional Airport
2. Location of land-disturbing activity: County Lincoln City or Township Ironton
Jack Dellinger Dr 35.484539 81.165116
Highway/Street LatltUde(decimal degrees) Longitude(decimal degrees)_
3. Approximate date land-disturbing activity will commence: March 1 , 2023
4. Purpose of development (residential, commercial, industrial, institutional, etc.):Airport Development
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas):30.81 31.81 **
6. Amount of fee enclosed: $3,100.00 $3,200.OQrhe 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 Joe Tate — Airport Manager E-mail [e-mail]
Phone: Office# 704-736-8675 Mobile# NA
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Lincoln County 704-736-8471 NA
Name Phone: Office# Mobile#
P.O. Box 738 353 N. Generals Blvd.
Current Mailing Address Current Street Address
Lincolnton NC 28093 Lincolnton NC 28092
City State Zip City State Zip
10. Deed Book No. 1486 Page No.257 Provide a copy of the most current deed.
* See enclosed check for an additional $100.00 review fee for the revised total disturbed
area of 31.81 acres.
** Revised total disturbed area comprised of 14.82 acres on northwest side (borrow site
side) of Jack Dellinger Drive plus 16.99 acres on southeast side (airport side) of Jack
Dellinger Drive in main project area.

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).
Lincolnton-Lincoln County Regional Airport Authority [e-mail]
Company Name E-mail Address
714 Jack Dellinger Rd. 714 Jack Dellinger Rd.
Current Mailing Address Current Street Address
Iron Station NC 28080 Iron Station NC 28080
City State Zip City State Zip
Phone: Office# 704-736-8675 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:
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:
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.
Lincolnton-Lincoln County Regional Airport Authority
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.
Thomas R. Anderson Chairman
Type or print name Title or Authority
10/12/22
Signature Date
, a Notary Public of the County of -
State of North Carolina, hereby certify that O\'`IK NUC0.S 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 day of , 20
�1p. F. eR.,,� Notary
iss4My commission expires `A k3 I 2v13
NOTARY y'2
AUBLIC
oc -75-2025 •���.
'' Coux,

(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.
Davin WA_ adde County Manager
Ty.- S print/- Title or Authority
c.)/ S12,
Signature Date
Megan H. Gilbert , a Notary Public of the County of Catawba
State of North Carolina, hereby certify that Davin W. Madden 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 1�day of October 20 22
MEGAN H. GILBERT Nota
61/Ca
NOTARY PUBLIC y
Cl&ba County 01/15/2025
North Carolina My commission expires
My Commission Expires Jan. 15,2025

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.
Landowner 2 of Record:
City of Lincolnton
Name Phone: Office# Mobile#
PO Box 617 114 W. Sycamore Street
Current Mailing Address Current Street Address
Lincolnton NC 28093 Lincolnton NC 28092
City State Zip City State Zip
Deed Book No. 1486 Page No. 257 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 B of the Financial Responsibility/Ownership Form for multiple parties.
Attach copies of this page as needed to list all financially responsible parties.
Lincoln County [e-mail]
Company 2 Name E-mail Address
PO Box 738 353 N. Generals Blvd.
Current Mailing Address Current Street Address
Lincolnton NC 28093 Lincolnton NC 28092
City State Zip City State Zip
Phone: Office# 704-736-8471 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#

012011 B u8 .` C)OPAGE�`7
NORTH CAROLINA, LINCOLN COUNTY
The following certificate of Peter C. Capece, Notary
Public of Catawba County, NC, is certified to be
correct. Presented for registration and recorded
July 15,2003,at 3:07 PM in Book 1496, Page 257.
ELAINE N. HARMON
Register of Deeds for Lincoln County,NC 2
BY:
Deputy/Assistant Register of Deeds
Prepared by: Kennedy&JKYulfhorst P.A
After recording mail to:�r(({{ennedy Rr.Wulfhorst,P A:375R Highway 16 N Denver,NC 914037
STATE OF NORTH CAROLINA
QUITCLAIM DFFD
COUNTY OF LINCOLN
This deed,made this] day of Ju.tA.(J 2003, by and between:
LINCOLNTON-LINCOLN COUNTY AIRPORT AUTHORITY
hereinafter referred to as"Grantor";and
LINCOLN COUNTY a political subdivision and body politic of the State of North Carolina and
the CITY OF L1NCOLNTON,a municipal corporation, 115 West Main Street, Lincolnton
North Carolina, 28092
hereinafter referred to as"Grantee."
The designation "Grantor and Grantee"as used herein shall include said parties,their heirs,
personal representatives, successors and assigns and shall include the singular, plural, masculine,
feminine or neuter as required by the 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 remise,release and forever quitclaim
unto the Grantee all that certain lot or parcel of land situated in Ironton Township,Lincoln County,
N.C.and more particularly described as follows:
TRACT I:
Being that certain property located in Ironton Township,Lincoln County,North Carolina,and
being the same property conveyed to Roderick Lavant Cronland by deed recorded in Book 727
at Page 239 in the Office of the Register of Deeds for Lincoln County,North Carolina,being
more particularly described as follows:
BEGINNING at an iron set in the northern margin of the Airport Road,the southeastern corner
of Rickard B.Cronland,111,and Myna Cronland;and running thence with said margin of said
Road,South 48 deg 11 min.50 sec.West 29.49 feet to a 5/8"iron in said margin,a corner of
Edna Carpenter;thence with Carpenter's northern line,South 85 deg.45 nun.33 sec.West
412.50 feet to an iron,and North 67 deg.53 min.53 sec.West 530.89 feet to a 36"gum tree,
Minnie Cronland's corner;thence with Minnie Cronland's line,North 46 deg.24 nun. 18 sec.
East 592.92 feet to an iron,Richard B.Cronland,Ill's corner;thence with his line the following
courses and distances: South 11 deg.35 min.37 sec.East 30.03 feet to an iron;South 23 deg.
44 min.38 sec.East 298.68 feet to an iron;South 31 deg.24 min. 15 sec.East 110.23 feet to an
iron; South 54 deg.33 nun.23 sec.East 112.32 feet to an iron:South 66 deg.23 min.24 sec.
East 240.72 feet to the place and point of BEGINNING;containing 5.2I acres and being the
property shown on the plat by WK Dickson,Engineers and Surveyors,entitled

@JuK1 1116(258
•
"PROPERTY ACQUISTION SURVEY PREPARED FOR LINCOLNTON-LINCOLN
COUNTY AIRPORT AUTHORITY WITH REFERENCE TO PROJECT NO.97323.35
Deed Reference:See Consent Judgment filed in the Office of the Clerk of Superior Court File
No.97-CVS-721 and Deed Book 1167,Page 754,Lincoln County Public Registry
TRACT 11:
BEGINNING at an iron pin in the western line of the property shown in Deed Book 893 at Page
16,Lincoln County Registry,to southeastern corner of the property described in Deed Book 961
at Page 76,and running thence North 74 deg.08 nun.32 sec.East 102.94 feet to a 3/4"iron set in
the southeastern corner of the property shown in Deed Book 467 at Page 178;thence with said
line,North 64 deg. 10 nun.56 sec.West 500.23 feet to a 5/8"iron pin set in an existing rock
pile;thence North 35 deg.09 nun.09 sec.East 292.61 feet to a point;thence South 41 deg.35
min.58 sec.East 573.64 feet to the place and point of BEGINNING;containing 2.27 acres and
being the property shown on the survey prepared by WD Dickson,Engineers and Surveyors,
entitled"PROPERTY ACQUISITION SURVEY PREPARED FOR LINCOLNTON-LINCOLN
COUNTY AIRPORT AUT1ORITY,WITH REFERENCE TO PROJECT NO.97323.35,
DATED MARCH 6, 1998".
Deed Reference:See Consent Judgment filed in the Office of the Clerk of Superior Court File
No.97-CVS-722 and Deed Book 1167,Page 758,Lincoln County Public Registry
TRACT III:
BEGINNING at an iron pin,the southwestern corner of the 2.2 acre tract described above,and
running thence as follows:South 47 deg.05 min.32 sec.West 245.31 feet to a 34"iron;North
42 deg.54 nun.57 sec.West 124.95 feet to a'/a"iron;South 47 deg.05 min.32 sec.West
500.13 feet to a 3"iron;and South 42 deg.56 min.41 sec.East 125.15 feet to a 3/4"iron in the
northern margin of the Airport Road;thence with the northern margin of said road,South 47
deg.03 min. 13 sec.West 519.58 feet;South 47 deg.07 min.00 sec.West 60.48 feet;and South
47 deg.08 min. 12 sec.West 319.86 feet to an iron in the margin of said road,Roderick L.
Cronland's northeastern corner;thence with Roderick's line,North 66 deg.23 min.24 sec.West
240.72 feet to an iron;North 54 deg.33 min.23 sec.West 112.32 feet to an iron;North 31 deg.
24 min. 15 sec.West 110.23 feet to an iron;North 23 deg.44 min.38 sec.West 298.68 feet to
an iron;North 11 deg.35 min.37 sec.West 30.03 feet to an iron in Minnie Chapman's southern
line;thence with her line,North 46 deg.24 min. 18 sec.East 1,311.96 feet to an iron in the
eastern margin of the FOURTH TRACT hereinafter described;thence South 67 deg.24 min.44
sec.East 325.20 feet to a 5/8"iron pin in an existing rock pile;thence South 64 deg. 10 min.56
sec.East 500.23 feet to the point and place of BEGINNING;containing 25.54 acres and being
the property shown on the survey prepared by WD Dickson,Engineers and Surveyors,entitled
"PROPERTY ACQUISITION SURVEY PREPARED FOR LINCOLNTON-LINCOLN
COUNTY AIRPORT AUTHORITY,WITH REFERENCE TO PROJECT NO.97323.35,
DATED MARCH 6, 1998".
Deed Reference:See Consent Judgment filed in the Office of the Clerk of Superior Court File
No.97-CVS-722 Deed Book 1167,Page 758,Lincoln County Public Registry
TRACT IV:
BEGINNING at a 5/8"iron pin set in an existing rock pile,being a corner of the 2.27 acre tract
described above and being in the northeastern line of the THIRD TRACT;and running thence
North 35 deg.09 min 09 sec.East 292.61 feet; thence continuing North 35 dcg.09 min.09 sec.
East 100.52 feet;thence with the centerline of the creek the following courses and distances:
North 75 deg.34 min.24 sec.West 37.86 feet;North 21 deg.34 min.46 sec.West 21.50 feet;
North 75 deg.51 min. 17 sec.West 33.66 feet;North 51 deg.43 min.35 sec.East 37.19 feet;
North 70 deg.32 min.03 sec.East 26.80 feet;North 75 deg.48 min. 15 sec.West 37.20 feet;
North 65 deg. 11 min.56 sec.East 49.92 feet;North 71 deg.31 min.08 sec.West 40.01 feet;
and North 51 deg. 16 nun.06 sec.West 43.35 feet to a point in the centerline of said creek;
thence South 46 deg.24 min. 18 sec.West,passing a 5/8"witness iron at 11,14 feet,in all a
total of 333.83 feet to an iron pin,the northeastern corner of the THIRD TRACT;thence with
the eastern line of the THIRD TRACT,South 67 deg.24 min.44 sec.East 325.20 feet to the
point of BEGINNING;containing 2.25 acres and being the property shown on the survey
prepared by WD Dickson,Engineers and Surveyors,entitled"PROPERTY ACQUISITION
SURVEY PREPARED FOR LINCOLNTON-LINCOLN COUNTY AIRPORT AUTHORITY,

WITH REFERENCE TO PROJECT NO.97323.35,DATED MARCH 6, 1998".
Deed Reference:See Consent Judgment filed in the Office of the Clerk of Superior Court File
No.97-CVS-722 Deed Book 1167,Page 758,Lincoln County Public Registry
FIFTH TRACT:
All rights of the Grantors in and to that certain easement from Lincoln County and the City of
Lincolnton to R.B.Cronland,lll,and wife,Myna Houser Cronland,dated June 27, 1986,and
recorded in Book 655 at Page 664.Lincoln County Registry.
Deed Reference:See Consent Judgment filed in the Office of the Clerk of Superior Court File
No.97-CVS-722 Deed Book 1167,Page 758.Lincoln County Public Registry
SIXTH TRACT:
BEGINNING at a 36"gum tree,a corner of the Rickard B.Cronland,Ill,and Myna Cronland
property in the northern line of Edna Carpenter;and running thence with Carpenter's line,North
67 deg.27 nun.56 sec.East 455.64 feet to an iron,thence North 44 deg.01 min. 14 sec.West
344.94 feet to an iron pin in the line of Kimberly Hoyle;thence with Hoyle's line,North 46 deg.
20 min. 16 sec.East 299.53 feet to a I"iron;thence North 46 deg.3I min.48 sec.East '.
1,289.92 feet to an axle;thence North 44 deg.04 min. 12 sec.East 164.39 feet to an axle,a
corner of another tract of Rickard B.Cronland,111;thence with Rickard's line,South 67 deg.24
min.44 sec.East 836.78 feet to an iron;thence with another tract of Rickard B.Cronland,111,
South 46 deg.24 nun. 18 sec.West 1,311.96 feet to an iron,a corner of Roderick L.Cronland;
thence with Roderick's line,South 46 deg.24 min. 18 sec.West 592.92 feet to the place and
point of BEGINNING;containing 32.68 acres,this description being taken from a survey
prepared by WK Dickson,Engineers and Surveyors,and entitled"PROPERTY ACQUISITION
SURVEY PREPARED FOR LINCOLNTON-L1NCOLN COUNTY AIRPORT AUTHORITY
WITH REFERENCE TO PROJECT NO.97323.35.
Deed Reference:See Consent Judgment filed in the Office of the Clerk of Superior Court File
No.97-CVS-723 Deed Book 1167,Page 764,Lincoln County Public Registry
HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances
thereunto belonging to the said Grantee free and discharged from all right,title,claim or interest of
the Grantor or anyone claiming by,through or under Grantor.
IN WITNESS WHEREOF.the Grantor has hereunto set his hand and seal, the day and year first
above written.
LINCOL,NTON-LINCOLN. Y AIRPORT AUTHORITY
By: IN\Iptgeil.
DAY I D E. LoWE, C++AleMAN
STATE OF NORTH CAROLINA
COUNTY OF LIN COtM
I. the undersigned,a Notary Public of the County and State aforesaid.certify that
tbAV I b E. LoW E personally came before me this day and acknowledged that he/she
is the Chairman of the Lincolnton-Lincoln County Airport Authority and that by authority duly
given and as the act of the authority,the foregoing instrument was signed by him as Chainnanpuad
xmtlednvitlxitsseatc all by authority duly granted by the members of the Lincolnton-Lincoln County
Airport Authority.
r{ 3
Witness my hand and Notarial Seal,this / day of Ju�y ,2002f.. ,
7Z(." ............
4 140TAnk VII
Notary Publi 0 .•'OUBUG
4 1y�•. I
My commission expires: /-0/P-aOO� q COOC .
1 li I,IIMM•r``

Additional Deeds Listing for Airport Property:
Deed Book Page Number
731 801
751 088
755 076
782 646
790 370
790 779
790 781
790 783
790 785
852 489
853 034
854 339
857 319
855 030
863 220
865 779
969 390
973 520
1050 098
1215 863
1503 780
1595 153
1648 082
1668 799
1695 169
1781 495