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HomeMy WebLinkAboutNCC240710_FRO Submitted_20240313 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 and/ or fax information unavailable, place N/A in the blank.) Part A.1. Project Name Chapel Ridge Lot 111 2. Location of land-disturbing activity: CountyChatham City or TownshipPlttSbOrO Highway/Street High Ridge Dr Latitude39.4675 Longitude-79'6151 3. Approximate date land-disturbing activity will commence:3/25/2024 4. Purpose of development (residential, commercial, industrial, institutional, etc.):Residential 5. Total acreage disturbed or uncovered (including off-site borrow and waste areas):0.38 6. Amount of fee enclosed: $ 100 . The application fee of $100.00 per acre (rounded up to the next acre) is assessed without a ceiling amount(Example: 8.10 ac = $900.00). 7. Has an erosion and sediment control plan been filed? YesX No Enclosed 8. Person to contact should erosion and sediment control issues arise during land-disturbing activity: NameJeff Easterling E-mail Addressjeff@easterlingfinehomes.com Telephone Cell # 919-260-2207 Fax# 9. Landowner(s) of Record (attach accompanied page to list additional owners): Easterling Fine Homes 2 LLC 919-260-2207 Name Telephone Fax Number 609 Aberdeen Dr 609 Aberdeen Dr Current Mailing Address Current Street Address Chapel Hill, NC 27516 Chapel Hill, NC 27516 City State Zip City State Zip 10. Deed Book No.1 116 Page No.71 5 Provide a copy of the most current deed. Part B. 1. Company(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. Easterling Fine Homes 2 LLC jeff@easterlingfinehomes.com Name E-mail Address 609 Aberdeen Dr 609 Aberdeen Dr Current Mailing Address Current Street Address Chapel Hill, NC 27516 Chapel Hill, NC 27516 City State Zip City State Zip Telephone919-260-2207 Fax Number 2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address of the designated North Carolina Agent: Name E-mail Address Current Mailing Address Current Street Address City State Zip City State Zip Telephone Fax Number (b) If the Financially 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 Financially Responsible Party is a Corporation, 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 Telephone 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 form must be signed by the 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 the authority to execute instruments for the Financially Responsible Person). I agree to provide corrected information should there be any change in the information provided herein. Jeff Easterling Member Type not n e Title or Authority 3/07/2024 Signature Date I, le Tar \..0c-( ) ccf1f) 1 , a Notary Public of the County of c; {M.� J State of North Carolina, hereby certify that e 1 C i_Ci.S U11 C4 appeared personally before me this day and being duly sworn acknowledged' that the above form was executed by him. 0 \Ilil!)/ Witness\� h4 a l'Aptarial seal, this 8 day Rf Ord\ , 20 2 �ti� �OTARy fir: / �'?j�� � � My Commission Expires `�� � �� 1 VV�Y 2-13-2027 - Notary . fik As\�� My commission expires laa7 // 6%l A4 C O�a ��. NORTH CAROLINA GENERAL WARRANTY DEED Prepared by: Beemer, Hadler&Willett,P.A. Excise Tax: $329.00 Return to: Grantee Parcel Id: 0081483 THIS DEED made this day of February, 2024 by and between GRANTOR Terrence L. Heflin and Suzanne S. Heflin, Trustees of the Stratton Heflin Family 2012 Trust dated June 15, 2012, and any amendments thereto 26-64 Blackwood Ct, Lanark, IL 61046 ❑ If checked,the property includes the primary residence of at least one of the Grantors. (NC GS§/05-317.2) GRANTEE Easterling Fine Homes 2 LLC 609 Aberdeen Drive, Chapel Hill, NC 27516 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 County of Chatham,North Carolina, and more particularly described as follows: See EXHIBIT A attached hereto and incorporated herein by reference. All or a portion of the property hereinabove described was acquired by Grantor by instrument recorded in Book 1839, Page 763, Chatham County Registry. TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee, their heirs, successors, and assigns, 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 except for the exceptions hereinafter stated. Title to the property hereinabove described is subject to the following exceptions: Subject to 2024 taxes, easements, conditions and restrictions of record, if any. IN WITNESS WHEREOF, the Grantor has hereunto set their hands and seals, or if corporate, has caused this instrument to be signed in its corporate name by its duly authorized officer(s), the day and year acknowledged below. [SIGNATURE AND NOTARY PAGE(S) TO FOLLOW] EXHIBIT A Legal Description All that certain lot or parcel of land situated in Hadley Township, Chatham County, North Carolina, and more particularly described as follows: BEING all Lot Numbered 111D, as shown on the plat entitled, "PLAT OF SUBDIVISION `CHAPEL RIDGE' —PHASE ONE", including a Project Sheet, Sheets One through Three and a Dimension Table, dated July 7, 2004, by Absolute Land Surveying and Mapping, P.C., recorded at Plat Slides 2004-221 through 2004-225, Chatham County Registry (the "Plat"); together with all appurtenant rights and privileges in the common areas and roads, including the right of ingress and egress along the private roads, as shown on the Plat and all other recorded plats for Chapel Ridge, described in the Declaration of Covenants, Conditions, and Restrictions for Chapel Ridge recorded in Book 1116, Page 715, Chatham County Registry,as amended. The property hereinabove described was acquired by Grantor by instrument recorded in Deed Book 1839, Page 763,Chatham County Registry. Site Address: 143 High Ridge Lane,Pittsboro,NC 27312 Parcel: 0081483