HomeMy WebLinkAboutSW8040301_HISTORICAL FILE_20230227 STORMWATER DIVISION CODING SHEET
POST-CONSTRUCTION PERMITS
PERMIT NO. SW8 (jyp3oI
DOC TYPE ❑ CURRENT PERMIT
❑ APPROVED PLANS
HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE 202 3 o22'l
YYYYMMDD
• 3aR STATE a'
ROY COOPER r
Governor
ELIZABETH S.BISER Y M =^
Secretary •�4i"�' •
DOUGLAS P.ANSEL NORTH CAROLINA
interim Director Environmental Quality
February 27, 2023
Ms. Susan Booth Stevenson, current permittee(SW8 900506, SW8 040301, and SW8 080102)
781 Firetower Road
Swansboro,NC 28584-7730
and
Jacksonville Dealership Properties I, LLC, proposed permittee(SW8 900506, SW8 040301,and SW8 080102)
Attn: Mr. Timothy Michael, Manager
4900 Leigh Drive
Raleigh,NC 27616
Subject: PROTECT RETURN
State Stormwater Management Permit Numbers:
SW8 900506: West Fairway Road Development Phases 1 & 2
SW8 040301: Stevenson Toyota
SW8 086102: West Fairway Road Phase 1
Onslow County
Dear Applicants:
The Wilmington Regional Office received and accepted Post-Construction Stormwater Management Permit
Applications for the subjects project on November 7, 2022 and requested additional information on January 24,
2023, which was due on February 23, 2023. A review of the file and delivery logs indicates that, as of this date,
the information requested on January 24, 2023 has not been received in this Office within the stipulated
timefiame. You have requested additional time to obtains scans of the plans in order to complete the
certifications.
Per the requirements of Title 15A NCAC 02H.I 042(3)(a)(ii).I 045(4)(a)(ii)of the Stormwater Management Rules,
this Office is hereby returning the subject applications as incomplete. The three $505.00 application fees
submitted with the subject application package have been forfeited and new fees will need to be provided if you
choose to resubmit this application in the future.
If you wish to pursue transferring this project, you must reapply to the Division. Your application package must
include a completed and signed application form; supplement form; signed O&M agreement; application fee;
signed, sealed and dated calculations; 2 sets of signed, sealed and dated site layout and grading plans with details;
and any supporting documentation necessary to address the items identified in the latest request for additional
information.
Please note that this does not preclude you from obtaining and complying with any and all.other permits or
approvals that are required for this development to take place, as required by any statutes, rules, regulations, or
ordinances, which are imposed by any other Local, State or Federal government agency having jurisdiction.
Please note that the subject permits remain in full force and effect until modified, renewed, or transferred. Please
be aware that the construction of any changes to the originally approved and permitted plans prior to the receipt of
a modified permit is a violation of NCGS 143-215.1 and is subject to enforcement action pursuant to NCGS 143-
215.6A.
ER O%M North Carolina Department of Environmental Quality I Division of Energy,Mineral and Land Resources
Wilmington Regional Office 1 127 Cardinal Drive Extension I Wilmington,North Carolina 28405
uomw cxrouw.
910.796.7215
State Stormwater Permit No. SW8 900506, SW8 040301,SW8 080102
i� Page 2 of 2
If you have any questions concerning this matter, please contact Kelly Johnson at(910) 796-7215 or via e-mail at
ke l ly.p.j ohn son@ncdenr.gov.
Sincerely,
in 'J'
lam/ ' t J"Z_ I"1&
Douglas R. Ansel, Interim Director
Division of Energy, Mineral and Land Resources
DES/kpj: \\\Stormwater\Permits& Projects\1 990\900506 HD\2023 02 return project 900506
\\\Stormwater\Permits& Projects\2004\040301 Offsite\2023 02 return_project 040301
\\\Stormwater\Pennits& Projects\2008\080102 HD\2023 02 return—project 080102
cc: Mr. Rick Muni, Tidewater Engineering
Inspector, Onslow County Building Inspections
Onslow County Engineering
Wilmington Regional Office
®���� North Carolina Department of Environmental Quality I Division of Energy.Mineral and Land Resources
Wilmington Regional Office 1 127 Cardinal Drive Extension I Wilmington,North Carolina 28405
910,796.7215
Johnson, Kelly
From: Johnson, Kelly
Sent: Thursday, February 23, 2023 9:39 AM
To: Susan Stevenson
Cc: Rick Muni; Smith, Ashley M; Boyd Tisdale; tim.michael@capitalautogroup.com; Freeman,
Aisia L
Subject: RE: [External] Stevenson Toyota and West Fairway Road Projects#SW8-900506;
SW8-040301; SW8-080102
Ms. Stevenson,
I do not need to have the plans submitted to me. Your engineer has requested copies of the plans so he can prepare the
certification that the ponds were constructed per the plans. A certification is a document sealed by an engineer with a
checklist of items to verify. 15A NCAC 02H .1045(2)(f) requires the projects to be certified before they can be
transferred. 15A NCAC 02H .1045(4)(a)(i) allows applicants 30 days to respond to requests for additional
information. Ideally, the certification would happen before the transfer application is submitted as opposed to during
the review process. These types of issues have caused our review times to be extended, and upper management has
asked us to enforce the 30 day response time. I am sorry that you are disappointed, but we are following the
regulations.
If you have further questions, please let me know.
Kelly
K.eLLidJOkVUSow
Kelly Johnson
Environmental Engineer
INC Division of Energy, Mineral and Land Resources
Stormwater Permitting
127 Cardinal Drive
Wilmington, INC 28405-3845
Phone: 910.796.7335
From:Susan Stevenson <jostev@earthlink.net>
Sent:Thursday, February 23, 2023 9:28 AM
To:Johnson, Kelly<kelly.p.johnson@ncdenr.gov>
Cc: Rick Muni <office@tidewaterenc.com>; Smith, Ashley M <ashleym.smith@ncdenr.gov>; Boyd Tisdale
<boydl@tisdaleandmcconnell.com>; tim.michael@capitalautogroup.com; Freeman, Aisia L
<a isia.freema n @ ncdenr.gov>
Subject: Re: [External] Stevenson Toyota and West Fairway Road Projects i#SW8-900506; SW8-040301; SW8-080102
CAUTION: External email. Do not click links or open attachments unless you verify.Send all suspicious email as an attachment to
Report Spam.
Kelly,
Question for you to help me understand......if Aisia already has the plans that would need to be scanned for us then why
do we need to submit them to you again? I'm reading that you already have the plans.
1
I am also disappointed that you did not allow an extension for us.
Susan Stevenson
Sent from my iPhone
On Feb 23, 2023, at 9:11 AM,Johnson, Kelly<kelly.p.iohnson@ncdenr.gov>wrote:
Rick,
If you all will need additional time to respond to the request for additional information, we will
unfortunately have to return the applications. If you would like to get scans of the plans (and by that I
assume you mean the whole file for each of the three files?), please work with Aisia Freeman, cc'd. She
can arrange to have the files prepared, and then scanned at a local print shop at your expense. I will
prepare the return letters by the end of the week.
Thanks,
Kelly
f<eL Li J0ko'sow
Kelly Johnson
Environmental Engineer
NC Division of Energy, Mineral and Land Resources
Stormwater Permitting
127 Cardinal Drive
Wilmington, NC 28405-3845
Phone: 910.796.7335
From: Rick Muni <office@tidewaterenc.corn>
Sent:Tuesday, February 21, 2023 4:00 PM
To:Johnson, Kelly<kellv.p.iohnson@ncdenr.gov>
Cc: Smith, Ashley M <ashleym.smith@ncdenr.gov>; Susan Stevenson <iostev@earthlink.net>; Boyd
Tisdale <boydl@tisdaleandmcconnell.com>;tim.michael@capitalautogroup.com
Subject: [External] Stevenson Toyota and West Fairway Road Projects#SW8-900506; SW8-040301;
S W 8-080102
CAUTION: External email. Do not click links or open attachments unless you verify.Send all suspicious email as an
attachment to Report Spam,
Ms.Johnson,
In reference to your Request for Additional Information dated 1-24-23 for the above projects, we submit
the following:
Our Engineer is in the process of certifying the Stormwater Structures. However, we were not able to
locate complete copies of Design Plans and Schematics for the above-referenced projects. At this time,
2
we wish to purchase copies of the Design Plans and Schematics that you may have in your files, as we
have searched our records and have requested copies from other resources, but so far have been
unsuccessful.
Also, due to the added time to acquire copies of requested Plans and Schematics, we respectfully
request additional time to address all certifications and compliance issues. Our anticipated completion
date will be on or about March 31, 2023. Please advise.
Richard C. Muni, P.L.S./djh
306 New Bridge Street
Jacksonville NC, 28540
910-455-2414 ext112
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ROY COOPER OS
Governor C
ELIZABETH S.BISER
secretary
DOUGLAS R.ANSEL NORTH CAROLINA
Interim Director Environmental QuaL ty
January 24, 2023
Via email only: iostev(a)earthlink.com
Ms. Susan Booth Stevenson, current permittee (SW8 900506, SW8 040301, and SW8 080102)
781 Firetower Road
Swansboro,NC 28584-7730
and
Via email only: tim.michael(i�capitalautogroup.com
Jacksonville Dealership Properties 1, LLC, proposed permittee(SW8 900506, SW8 040301, and SW8 080102)
Attn: Mr. Timothy Michael, Manager
4900 Leigh Drive
Raleigh,NC 27616
Subject: Request for Additional Information/Notice of Inspection
State Stormwater Management Permit Numbers:
SW8 900506: West Fairway Road Development Phases 1 & 2
S,W.8 040 03 1 Stevenson Toyota
SW8 080102: West Fairway Road Phase I
Onslow County
Dear Ms. Stevenson& Mr. Michael:
The Wilmington Regional Office of the Division of Energy,Mineral and Land Resources(DEMLR)received and
accepted a signed Permit Transfer Application Form for the subject project on November 7, 2022. The current and
proposed permittees have requested to transfer the permit in accordance with 15A NCAC 02H.1045(1)(a). A
preliminary in-depth review of the documentation submitted with the transfer request determined that the
application is incomplete, and that additional information is needed.
Since this transfer was submitted under the requirements of 15A NCAC 02H.I045(1)(a), please provide the
following documentation in a single,hard copy submittal package to complete the application: Since the
transfer was submitted under NCAC 02H.1045(l)(a) and the proposed permittee did not select the option in
Section F of the application form where they agree to be the entity responsible for addressing any compliance
issues, the project must found be in compliance with the permit prior to approving the transfer. To continue the
review and processing of this transfer request, please provide the following documentation in a single, hard copy
submittal package to complete the application and demonstrate compliance with the permit. Please see the
enclosed Ownership Map. Color copies are available via email.
1. Lessee/Purchaser/Developer:
a. Please identify the relationship between the property owner and the applicant in Section E(1)of each
application.
i. Lessee [15A NCAC 02H.1045(2)(c)]: If the applicant is a lessee, please provide the portion of
the lease indicating that the applicant is responsible for development on the land.
ii. Purchaser [15A NCAC 02H.1045(2)(c)]: If the applicant intends to purchase the land, please
submit the purchase agreement.
iii. Developer[15A NCAC 02H.1045(2)(c)]: Please note that the application asks for a
development agreement if the applicant will develop the land on behalf of the owner, however
that is no longer needed.
b. If the applicant will lease the land, is under contract to buy the land, or will be the developer of the
land please have all property owners sign Section G. For the permits with more than one property
owner, please attach additional Section G sheets. [15A NCAC 02H.1045(2)(c)]
D North Carolina Department of Environmental Quality I Division of Energy.Mineral and land Resources
Wilmington Regional Office 1127 Cardinal Drive Extension I Wilmington,North Carolina 28405
910.796.7215
State Stormwater Permit No. SW8 900506, SW8 040301, SW8 080102
Page 3 of 3
All of the requested information listed above should be received in this Office by February 23,2023 in
accordance with 15A NCAC 02H.I 045(4)(a)(i).Please note that only two letters requesting additional
information is allowed in the State Stormwater Program, this being the first If the required information is not
satisfactorily provided by this date,the project will be returned in accordance with 15A NCAC
02H.1045(4)(a)(ii). If the project is returned and you wish to re-submit later,you will need to resubmit all
required items at that time, including the application fee.
Please note that if, upon review of the submitted information or upon a deficient compliance inspection of the
project, it is determined that a major modification to the permit is required to resolve the compliance issues,the
transfer application will be returned as incomplete. Upon the issuance of the modified permit, and the successful
completion of any work required by the modified permit and/or the restoration of the site to design condition, the
applicant will need to submit an updated transfer application and a new fee to the Division to start the transfer
process over again.
Please remember that the permittee is responsible for complying with the terms and conditions of the permit and
the approved plans and specifications until the Division approves the transfer request.
Please reference the State assigned permit number on all correspondence. If you have any questions concerning
this matter, please feel free to call me at(910)796-7215 or email me at kelly.p.johnson@ncdenr.gov.
Sincerely,
z4 PAW"
Kelly Johnson
Environmental Engineer
Enclosure: SW8 900506, SW8 040301,SW8 080102 Ownership Map
Compliance Inspection Report
Drafted Schedule of Compliance
Previous versions of the O&Ms, SW8 900506, SW8 040301, SW8 080102
DES/kpj: G:\\\Stormwater\Permits&Projects\1 990\900506 HD\2023 01 addinfo CEI addinfo 900506
G:\\\Stormwater\Permits&Projects\2004\040301 Offsite\2023 01 addinfo CEI addinfo 040301
G:\\\Stormwater\Permits&Projects\2008\080102 HD\2023 01 addinfo CEI addinfo 080102
cc: Mr. Richard Muni,PLS;via email: ofce@tidewaterenc.com
Jacksonville Dealership Properties II,LLC,Property Owner,
4900 Leigh Drive,Raleigh,NC 27616
Shellooth Properties,LLC,Property Owner
707 Hwy 24,Newport,NC 28570
RSB Jacksonville,LLC,Property Owner
2223 N.Marine Blvd,Jacksonville,NC 28546-6915
Ashley Smith, Wilmington Regional Office Permitting Assistant; via email _
Wilmington Regional Office Stormwater Permit File
®� North Carolina Department of Environmental Quality I Division of Energy,Mineral and Land Resources
Wilmington Regional Office 1127 Cardinal Drive Extension I Wilmington,North Carolina 28405
+�>+.\ 910.796.7215
1
SW8 900506, SW8 040301, SW8 080102 Ownership Map
h
SW8 040301 Project Area " '"` • '*'+ F Sj
3 d k r' sq
r—t Jacksonville Dealership Properties I, LLC
BK5043/PG704(10/23/19)
Timothy Michael, Manager
SW8 080102 Project Area
i--i Jacksonville Dealership Properties II, LLC
BK5662/PG817(1/12/22)
Timothy Michael, Manager
hk xi
--� Shellooth Properties, LLC
l__I BK3909/PG243-245(12/31/12)
k
Booth Stevenson Parker&Shelley Stevenson Smith,
Managersr '' �♦�a? �'`.''1"dma''2 'fs1+ '�a'u�� QOa9'
SW8 900506 Project Area f>,�. k" a ♦� 4♦♦?�i, ^; Z ,,, � � i �p,G
Shellooth Properties, LLC k !; "� `♦,�♦♦a ,c '" yidt ""�
I__I BK3909/PG243-245(12/31/12) .' as x ♦<'* , t '�"31 v ,e i ,
Booth Stevenson Parker&Shelley Stevenson Smith,
Managers T x.� r`Dt. s F. ♦♦♦ ♦\ �\ . ?
n
Jacksonville Dealership Properties I, LLC �, �a � � f?�'�♦♦ f`♦ ♦ ��� '6 � .
l__I BK5043 PG704-709 10 23 19 P '`` A ' ` ♦�♦` '"' '
/ ( / / ) T ;5�� � ♦♦ -, ; ♦♦x,� , } �- ems,-.
Timothy Michael, Manager ♦ c "p ♦ y ♦♦ ♦� �d n.�
i--i RSB Jacksonville, LLC i r'' ;�. - �`♦�` ♦`�R. -
�__j BK5892/PG630-635(12/28/22) " -i" �y �' E♦♦ ^,� ♦♦♦tc` / Pap - ' r
(No managers listed with NC Secretary of State - R.r ,�♦♦` .♦,` ♦ �A>
Attachment D
Schedule of Compliance
Jacksonville Dealership Properties 1, LLC has applied for State Stormwater Permit Transfers for the
following projects:
1. SW8 900506
2. SW8 040301
3. SW8 080102
The compliance inspections by the Division of Energy, Mineral, and Land Resources(DEMLR) on
January 5, 2023, identified the following non-compliant items. As the incoming permittee, I understand
that I will be transferred a non-compliant permit, and I agree to resolve these items to bring the project
into compliance by� Choose;ana`Ca;withihyone year;fie`fore re-submit[irig)
Non-Compliant Items:
1. SW8 900506:
a. The Designer's Certification will be submitted.
b. Vegetation needs to be maintained per the 0&M Agreement.
c. The outlet pipe is shown on the plans to be drain water from the center of the pond. It
could not be located during the inspection, but it may have been underwater. The
designer's certification is needed to verify that the pipe is constructed and functioning
correctly.
2. SW8 040301: The Designer's Certification will be submitted.
3. SW8080102:
a. The Designer's Certification will be submitted.
b. Vegetation needs to be maintained per the O&M Agreement.
DATE
Mr. Timothy Michael, Manager
Tim.Michael@capitalautogroup.com
(910) 999-1400
Johnson, Kelly
From: Johnson, Kelly
Sent: Tuesday,January 24, 2023 11:24 AM
To: jostev@earthlink.com; tim.michael@capitalautogroup.com
Cc: Smith, Ashley M, office@tidewaterenc.com
Subject: Request for Additional Information - State Stormwater - Stevenson Toyota &West
Fairway Road Projects (SW8 900506, SW8 040301, SW8 080102)
Attachments: 2023 01 CEI_BIMS 900506.pdf; 2023 01 pictures 900506_040301_080102_ownership
map.pdf; 2023 01 sched_comp 900506_040301_080102.docx; 2023 01 CEI_BIMS
040301.pdf; 2023 01 CEI_BIMS 080102.pdf; 2023 01 addinfo 900506.pdf
All,
Attached is a pdf of the request for additional information for the subject projects. Please pay special attention to the
due date in the letter, which is February 23, 2023 and in accordance with 15A NCAC 02H. 1045(4)(a)(i).As noted in the
letter, if all of the requested information cannot be provided by this due date,the applications will need to be returned
in accordance with 15A NCAC 02H. 1045(4)(a)(ii) to allow for any additional time needed.
Please let me know if you have any questions or concerns.
Kelly
Ke1,LIi0h Vt,50Vu
Kelly Johnson
Environmental Engineer
NC Division of Energy, Mineral and Land Resources
Stormwater Permitting
127 Cardinal Drive
Wilmington, NC 28405-3845
Phone: 910.796.7335
t
Compliance Inspection Report
Permit: SW8040301 Effective: 10/31/19 Expiration:
Project: Stevenson Toyota
Owner: Susan Booth Stevenson
County: Onslow, Adress: US Hwy 17 FainvayAve
Region: Wilmington
City/State/Zip: Jacksonville NC 28540
Contact Person:Susan Booth Stevenson Title: Phone:
Directions to Project:
On the corner of US Hwy 17& Fairway Avenue
Type of Project: State Stormwater- Off-site
Drain Areas: 1 - (Mill Creek) (03-05-02 ) ( SC;NSW)
On-Site Representative(s):
Related Permits:
SW8900506 John 0 Stevenson Inc-West Fairway Road Phase 1
Inspection Date: 01/05/2023 Entry Time 10:OOAM Exit Time: 11:OOAM
Primary Inspector: Brian P Lambe Phone:
Secondary Inspector(s):
Kelly Johnson
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: State Stormwater
Facility Status: ❑ Compliant ❑ Not Compliant
Question Areas:
State Stormwater
(See attachment summary)
page 1
Permit: SW8040301 Owner-Project: Susan Booth Stevenson
Inspection Date: 01/05/2023 Inspection Type Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
inlets located per plan.
File Review Yes No NA NE
Is the permit active? 0 ❑ ❑ ❑
Signed copy of the Engineer's certification is in the file? ❑ 0 ❑ ❑
Signed copy of the Operation & Maintenance Agreement is in the file? ❑ N ❑ ❑
Copy of the recorded deed restrictions is in the file? ❑ ❑ 0 ❑
Comment: The certification is needed.
The O&M Agreement is needed from the proposed permittee.
Built Upon Area Yes No NA NE
Is the site BUA constructed as per the permit and approval plans? 0 ❑ ❑ ❑
Is the drainage area as per the permit and approved plans? N ❑ ❑ ❑
Is the BUA(as permitted) graded such that the runoff drains to the system? ❑ ❑ ❑
Comment:
SW Measures Yes No NA NE
Are the SW measures constructed as per the approved plans? 0 ❑ ❑ ❑
Are the inlets located per the approved plans? N ❑ ❑ ❑
Are the outlet structures located per the approved plans? 0 ❑ ❑ ❑
Comment:
Operation and Maintenance Yes No NA NE
Are the SW measures being maintained and operated as per the permit requirements? 0 ❑ ❑ ❑
Are the SW BMP inspection and maintenance records complete and available for review or ❑ ❑ ❑
provided to DWQ upon request?
Comment:
page 2
Burd, Tina J
From: Burd, Tina J
Sent: Tuesday, November 8, 2022 3:42 PM
To: jostev@earthlink.net; tim.michael@capitalautogroup.com; office@tidewaterenc.com
Subject: SW8 040301 - Stevenson Toyota
The Wilmington Regional Office of the Division of Energy, Mineral and Land Resources (Stormwater Section) accepted
the Stormwater Transfer Permit Application and $505.00 fee for the subject project on October 31, 2022. The project
has been assigned to Kelly Johnson and you will be notified if additional information is needed.
Best Regards,
Tina Burd
Administrative Associate II
Wilmington Regional Office
Division of Environmental Assistance & Customer Service
Phone 910-796-7215
NCDEQ
Wilmington Regional Office
127 Cardinal Drive Ext.
Wilmington, NC 28405
Email correspondence to and from this ad6ess is subject io the
Not7h C,wctinc Public Records t aw and may be disclosed to third parties.
Website: http.//deci.nc.gov/about/divisions/energy-mineral-land-resources/storn)water
IMany employees are working remotely or are on staggered shifts. Please check with the appropriate staff before visiting our
offices, as we may be able to handle your requests by phone or email.
1
DEMLR USE ONLY
Ij Date ReFeived Fee Paid , Permit Number '
�j
NC DEQ Division of Energy, Mineral and Land Resources .
STATE STORMWATER:
PERMIT TRANSFER APPLICATION FORM
Pursuant to 15A NCAC 02H.1045 and other applicable statues as reference within
Only complete applications packages will be accepted and reviewed. This form and the required items(with
original signatures) must be sent to the appropriate DEMLR Regional Office, which can be determined by locating
the project on the interactive online map at: http://deg.nc.goy/contact/regional-offices.
After this application is accepted, DEMLR will conduct a compliance inspection and report any deficiencies to the
current permittee and/or the proposed permittee. Per the state stormwater rules and the state stormwater permit
conditions, the permit shall not be transferred until:
1. the current permittee resolves all non-compliance issues identified in the inspection report;
2. the current permittee negotiates a resolution with the proposed permittee (in writing and signed by both
entities. The negotiated resolution must identify the necessary actions, the responsible party(ies), and the
timelines to correct the deficiencies. The site must either be found in compliance or a copy of the
negotiated resolution must be submitted prior to the transfer of the permit.); or a
3. in the case where a transfer falls under G.S. 143-214.7(c2) (see also SL 2011-256), the proposed
permittee resolves all non-compliance issues upon acquiring the permit.
Signature requirements for the named signing official(for current and proposed permittee)must meet the following:
• Corporation-a principal executive officer of at least the level of vice-president;
• Limited Liability Company(LLC) -the designated manager, (Documentation from the NC Secretary of
State or other official documentation must be provided that states the titles and positions held by the
person who signed the application (pursuant to 02H.1040) that shows they have legal authority to sign for
the LLC)
• Municipality-a ranking official or duly authorized employee,
• Partnership or limited partnership-the general partner,
• Sole proprietor,
• The signature of the consultant or other agent shall be accepted on this permit transfer application only if
accompanied by a letter of authorization signed by one of the signatories noted in a-e above, as
applicable.
A. GENERAL INFORMATION
1. State Stormwater Permit Number: SWB-900506,%SW8=0403019
2. Project name: West Fairway Road Development Phases(1 and 2)and Stevenson Toyota
Is this an updated project name from the current permit? ❑ Yes ® No
3. Reason for the permit transfer request: °
Transfer of Ownership
OCT 31 2022 ,)
Stormwater Permit Transfer Application Form Page 1 of 7 April 27,2018
B. PERSON(S)WHO HAVE SIGNED THIS FORM (select only one response below)
® 1. Both the current and proposed permittees
❑ 2. Only the current permittee of a condominium or planned community (skip Part F& G).
In accordance with G.S. 143-214.7(c2) (see also SL 2011-256), this type of transfer is allowed only
when all of the following items can be truthfully checked:
❑ Any common areas related to the operation and maintenance of the stormwater management
system have been conveyed to the unit owners' association or owners' association in
accordance with the declaration; '
❑ The declarant has conveyed at least fifty percent(50%)of the units or lots to owners other than
a declarant(provide documentation per submittal requirements below);
❑ The stormwater management system is in compliance with the stormwater permit.
NOTE: If subdivision was built prior to 1999, the Declarant's Attorney can make a determination that
the elements of the Planned Community Act(see§47F) have been met by the Declarant for the
subdivision. If the Declarant chooses to use this type of transfer, the determination must be in
writing, signed by the attorney, and submitted to DEMLR with this form.
❑ 3. Only the proposed permittee (skip Part D below).
In accordance with G.S. 143-214.7(c5) (see also SL 2013-121), this type of transfer is allowed only
when all of the following items can be truthfully checked.,
❑ a. The proposed permittee is either(select one of the following):
❑ The successor-owner who holds title to the property on which the permitted activity is
occurring or will occur;
❑ The successor-owner who is the sole claimant of the right to engage in the permitted
activity.
❑ b. The current permittee is (select at least one of the following, but all that apply):
❑ A natural person who is deceased.
❑ A partnership, Limited Liability Corporation, corporation, or any other business
association that has been dissolved o
❑ A person who has been lawfully and finally divested of title to the property on which the
permitted activity is occurring or will occur.
❑ A person who has sold the property on which the permitted activity is occurring or will
occur.
❑ Other(please explain):
❑ c. The proposed permittee agrees to the following requirements (all must be selected):
❑ There will be no substantial change in the permitted activity.
❑ The permit holder shall comply with all terms and conditions of the permit until such
time as the permit is transferred.
❑ The successor-owner shall comply with all terms and conditions of the permit once the
permit has been transferred.
i
OCT 3 1 2022 a
o BY. �I
Stormwater Permit Transfer Application Form Page 2 of 7 April 27, 2018
e
C. SUBMITTAL REQUIREMENTS
Please mark"Y"to confirm the items are included with this form. Please mark"X"if previously provided. If not
applicable or not available, please mark N/A.:
Y 1. A processing fee of five hundred and five dollars ($505.00) per G.S. 143-215.3D(e)(2).
Y 2. Two hard copies (with original signatures)and one electronic copy of this completed form and the
required items.
Y 3. For proposed permittees that are corporations or LLC's, documentation from the NC Secretary of
State demonstrating that the proposed permittee is a legal and viable entity able to conduct
business in North Carolina.
X 4. If Part B, Items 1 or 3 of this form is selected,the signed and notarized
applicable 0&M agreement(s)from the proposed permittee, as required by the permit.
Y 5. Legal documentation that the property has transferred to the proposed permittee (such as a
recorded deed for the property, uncompleted development and/or common areas)or legal
documentation demonstrating that the proposed permittee is the sole claimant of the right to
engage in the permitted activity.
X 6. If required by the permit and if the project has been built, a signed, sealed and dated certification
document from a licensed professional stating that the stormwater management system has been
inspected and that it has been built and maintained in accordance wifh the approved plans.
X 7. A copy of the recorded covenants and deed restrictions, if required by the permit. If the project has
been built, documentation that the maximum allowed per lot built-upon area or the maximum
allowed total built-upon area has not been exceeded. If the project has not been built, the new
owner shall provide a signed agreement to submit final recorded deed restrictions and protective
covenants.
N/A 8. If transferring under G.S. 143-214.7(c2) (i.e., Part B, Item 2 of this form is selected),
documentation verifying that 50% or more of the lots have been conveyed to individuals(not
builders). Copies of the deeds of conveyance or a chart listing the lot number, lot address,
owner's name, conveyance date and deed book and page number are acceptable.
N/A 9. If transferring under G.S. 143-214.7(c5) (i.e., Part B, Item 3 of this form is selected), provide legal
documentation supporting the dissolution of the corporation or documentation supporting the
current permittee was lawfully and finally divested of title of the property.
N/A 10. A copy of the lease agreement if the proposed permittee is the lessee.
N/A 11. A copy of the pending sales agreement if the proposed permittee is the purchaser.
N/A 12. A copy of the development agreement if the proposed permittee is the developer.
OCT 3 1 2022
BY;
Stormwater Permit Transfer Application Form - Page 3 of 7 April 27, 2018
D. CURRENT PERMITTEE INFORMATION AND CERTIFICATION Please be sure to provide Email.
1. Current Permit Holder's Com ny Name/Organization:
2. Signing Official's Name:
3. Signing Official's Title: r
4. Mailing Address: VVer
City: State: C zip : $ -
5. Street Address:
City: State: ZIP :
6. Phone: O) 33q- Sg?q Email: ,.i rf�hl�n k . ne f
1, Susan R. Stevenson the current permittee, am submitting this application for a
transfer of ownership for the above listed stormwater permit under the General Statute and Session Law identified
on Page 1 of this application. I hereby notify DEMLR of the sale or other legal transfer of the property/project
and/or the stormwater system associated with this permit. I have provided a copy of the following documents to
the proposed permittee named in this application form: (select all that apply)
❑ the most recent permit;
❑ the designer's certification for each SCM;
❑ any recorded deed restrictions, covenants, common areas, drainage easements or plats;
❑ the approved plans and/or approved as-built plans;
❑ the approved operation and maintenance agreement;
❑ past maintenance records from the previous permittee (where required);
❑ a copy of the most recent inspection report;
I further attest that this application and request for a permit transfer is accurate and complete to the best of my
knowledge. I attest that I have provided all of the required items per the law to transfer this permit. I understand
that if all required parts of this request are not completed or if all required supporting information and attachments
listed above are not included, this request package will be returned as incomplete I assign all rights and
obligations as permittee to the proposed permittee named below. I understand that this request to transfer the
permit may not be approved by the DEMLjR�un�I ss and until the facility is in compliance with the permit.
Signature ( OA Date: 02/03/2022
I, Agnes M. %rshal l a Notary Public for the State of
North Carolina County of Onsl ow do hereby certify
that Susan B. Stevenson personally appeared before me
this the 3rd day of February 20__2? , and acknowledge the due
execution of the forgoing instrument. Witness my hand and official seal,
(Notary Seal) �S MA p fy
v� z Vr IL.
� r j
Notary Signature: r � NOTARY ,
1 J
My commission expir Sept 7 PUBLIC OCT 3 12022 2026 O
BY:_ --_�
COUNT
Stormwater Permit Transfer Application Form Page 4 of 7 April 27, 2018
E. PROPOSED PERMITTEE INFORMATION
1. Throposed permittee is the:
M Property owner(Also complete Part F.)
❑ Home Owners Association (HOA),Property Owners Association(POA),or Unit Owner Association
(UOA)(Also complete Part F.)
❑ Lessee-Attach a copy of the lease agreement. Both the lessee and the property owner will appear on
the permit as co-permittees. If the lease is terminated, responsibility for the permit reverts to the property
owner. (Also complete Parts F& G.)
❑ Purchaser-Attach a copy of the pending sales agreement. The permit will require submission of a copy
of the recorded deed after the purchase has taken place. If the purchase agreement is cancelled the
permit reverts to the property owner. (Also complete Parts F&G.)
❑ Developer-Attach a copy of the development agreement. Both the developer and the property owner
will appear on the permit as co-permittees. If the development agreement is terminated, responsibility for
the permit reverts to the property owner. (Also complete Parts F&G.)
2. Pro osed permittee name(check one of the following and provide the name):
Ltd Corporation, LLC, Partnership, Municipality name:�ft"S0lddd( , AkAWR"St-hp rtzpx r(a (V
❑ HOA/POA/UOA name:
❑ Sole Proprietor
3. Proposed permittee contact information:
Please be sure to provide Email.
a, Signing Official's Name: Iv t�t( �f���K�i(/
b. Signing Official's Title*
�l \ I�AV&L- r �9V-
c. Mailing Address: E1460- utaku- OHOJ6
City: State: 4 ZIP:,blk.(b
d. Street Address: �AMG
City: State: —ZIP: _
e. Phone: 8A) 9 J,jg00 Email: f(K. wM"AVi,0e1�I - hCD�9R011P.�
4. If there is a Management Entity that manages the property for an HOA, PDA or UOA, please provide:
Please be sure to provide Email.
a. Management Company or Business name:
b. Contact Name: Title:
c. Mailing Address:
d. City: State: ZIP:
e. Phone: Email:
''A-
OCT 3 1 2022
Stormwater Permit Transfer Application Form Page 5 of 7 April 27}2018
BY:
F. PROPOSED PERMITTEE CERTIFICATION
I, JJ M1 M 11) . �, hereby notify the DEMLR that I have acquired through sale, lease,
development agree ent,or other legal transfer,the project/property covered by the stormwater management
permit and/or the responsibility for constructing and/or operating and maintaining the permitted stormwater
management system. I acknowledge and attest that I have received a copy of: (select all that apply):
❑ the most recent permit;
❑ the designers certification for each SCM;
❑ any recorded deed restrictions, covenants, common areas, drainage easements or plats;
❑ the approved plans and/or approved as-built plans;
❑ the approved operation and maintenance agreement;
❑ past maintenance records from the previous permittee(where required);
❑ a copy of the most recent inspection report;
❑ Check here if the proposed permittee agrees to be the entity responsible for addressing any compliance
issues outlined in the Compliance Inspection Report. If checked, the proposed permittee must provide a
written document statement, with a"plan of action and schedule"addressed to this once stating that they will
bring the project into compliance upon receipt of the transferred permit. This written"plan of action and
schedule"must be received by the Division before the Division will transfer the permit.
I have reviewed the permit, approved plans and other documents listed above,and I acknowledge that I will
comply with the terns and conditions of the permit. I will constr�uct-theeT-project's built-upon area as shown on the
approved plans; and I will{construct),operate and main irrffie approved stormwater management system
pursuant to.the-requi ents isle 'n a per d ' heypefat!on and maintenance agreement.
Signature: 7 44.", . / Date: JUL 2 1 2022
Timer Hallock a Notary Public for th State of
County of do hereby certity that
persoQ#Iy,app�red before me this the U day ofJMI 2 and
10" , execution of the forgoing instrument.Witness my had and official seal,
-` (Nbtarys"P,
MY" lr5r�tw+�p fit res
OCT 3 12022
BY:
Stornwater Permit Transfer Application Form Page 6 of 7 April-27-2018
G. PROPERTY OWNER INFORMATION AND CERTIFICATION
Fill out this section only if the property owner is different from the proposed permittee. The permit will revert to
the property owner if the purchase agreement, development agreement or lease expires or is terminated.
Company Name/Organization:
Signing Official's Printed Name:
Signing Official's Title:
Mailing Address:
City State: ZIP :
Phone: (_) Email:
1, hereby certify that I currently own the property identified in
this permit transfer document and acknowledge that the Proposed Permittee listed in Part F will be purchasing the
property, developing the property on my behalf, and/or leasing the property from me. A copy of the purchase
agreement, development agreement or the lease agreement,which names the party responsible for the
construction and/or operation and maintenance of the stormwater system, has been provided with the permit
transfer request.
I agree to notify DEMLR within 30 days if there are any changes to the purchase, developer or lease agreements
and will submit the applicable completed and signed Permit Information Update Form, or Permit Transfer
Application Form to address these changes. As the legal property owner, I acknowledge, understand, and agree
by my signature below, that the permit will revert to me and I will be responsible for complying with the DEMLR
Stormwater permit if the property purchase, lease or developer agreement/contract is cancelled or defaults. I
understand that any individual or entity found to be in noncompliance with the provisions of the stormwater
management permit or the stormwater rules, is subject to enforcement action as set forth in NC General Statute
(NCGS) 143, Article 21.
Signature of the property owner Date:
I. a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this the day of
, 20 and acknowledge the due execution of the forgoing instrument. Witness
my hand and official seal,
(Notary Seal)
Notary Signature
My commission expires
Clv gWGi
OCT 3 1 2022
BY: '
Stormwater Permit Transfer Application Form Page 7 of 7 April 27,2018
Pa;�e 1 or 6�
IF
r
Type: CONSOLIDATED REAL PROPERTY -�
Recorded: 10/23/2019 2:46:34 PM
Fee Arm: $9,226.00 Page 1 of 6
Revenue Tax: $9,200.00
Onslow County, NC
Rebecca L. Pollard Reg. of Deeds
BK 5043 PG 704 - 709
Excise Tax: $9,200.00
PIN: 049724, 040154 &022676
Prepared by: Robert A. Bass, Esq. of Bass Sox Mercer
2822 Remington Green Circle
Tallahassee,FL 32308
Reviewed by: Shawn M.Mercer,Esq., Bass Sox Mercer of Raleigh,NC
After recording,
Return to: Robert A.Bass, Esq.
Bass Sox Mercer
2822 Remington Green Circle
Tallahassee, FL 32308
Brief Description: 2325 N. Marine Blvd.
GENERAL WARRANTY DEED
THIS DEED is made this�day of October,2019,by and between the following:
GRANTOR:
SUSAN BOOTH STEVENSON, a single woman, whose mailing address is 781 West Firetower Road,
Swansboro,North Carolina 28584 (the"Grantor")to
GRANTEE: —
IJACKSONVILLE DEALERSHIPPROPERTIES 1,L LC,a North Carolina limited liability company,
whose mailing address is 4900 Leigh Drive,Raleigh;North Carolina 27616(the"Grantee").
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 hereby grant, bargain, remise, confirm, sell and convey
unto the Grantee and Grantee's successors and assigns forever in fee simple, all of the following
described land, situate lying and being in Jacksonville, Onslow County, North Car lines and more
particularly described as follows: LIZ 1 -
a ova V
See Exhibit"A" attached hereto. OCT 3 12022 ''I
Submitted electronically by "First American Title Insurance Company - charlotte NC-----
in compliance with North Carolina statutes gover ingg rea�pp d 1 documepy
and the terms of the submitter agreement with th N>R.�:Axb,. ¢ 6M,4�ef ,rwrent: 704 Seq: 1
Pa6e 2 of 6
g
Together with all and singular, the rights, benefits, privileges, easements, tenements, hereditaments,
appurtenances and interests thereon or anywise appertaining thereto and with all improvement located
thereon (said land, rights, benefits, privileges, easements, tenements, hereditaments, appurtenances,
improvements and interest being hereinafter referred to as the "Property"), free from all exemptions and
rights of homestead, in fee simple forever.
For the same consideration recited above, Grantor hereby bargains, sells and transfers all interest, if any,
of Grantor in (i) strips or gores, if any, between the Property and abutting or immediately adjacent
properties, and (ii) any land lying in or under the bed of any street, alley, road or right-of-way, opened or
proposed, abutting or immediately adjacent to the Property.
And Grantor covenants that Grantor is well seized of an indefeasible estate in fee simple in said Property
and has a good right to convey the same; that it is free of lien or encumbrances, and that Grantor,
Grantor's heirs, executors, administrators, successors and assigns, will forever warrant and defend title to
the above-described property against the lawful claims of all persons whomsoever, subject to the
permitted exceptions set forth in Exhibit B attached hereto which are not hereby reimposed (the
"Permitted Exceptions").
[SIGNATURE PAGE TO FOLLOW]
OCT 3 12022
BY.• �:
Book: 5043 Page, 1977-Current: 704 Seq: 2
Page,3 o16,
SIGNATURE PAGE
GRANTOR: SUSAN BOOTH STEVENSON
GRANTEE: JACKSONVILLE DEALERSHIP PROPERTIES I,LLC
IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal the day and year first above
written.
By: 4 'L.11�� C (�Glo�/L
USAN BOOTH STEVENSON
STATE OF NORTH CAROLINA
COUNTY OF ONSLOW
I, A d /0 , lNewS)Itl11 , the undersigned Notary Public for the above County and State, do
hereIV certify that SUSAN BOOTH STEVENSON, personally appeared before me this day and
acknowledged the due execution of the foregoing General Warranty Deed.
'Ili
Witnesseth my hand and notarial seal this 1 day of October, 2019.
G �. �v�a/�q.,l•l./
Nod�j r Public /n //�
Prihl otaryName: A 1PS ��• Aivr6h14
My Commission Expires:y� ' 11 9! 0��•
i
�V da
OCT 3 1 2022 1 1
Book: 5043 Page, 1977-Current: 704 Seq: 3
Page 4 of 6.
EXHIBIT A
PARCEL I:
FOR INFORMATION ONLY:
2325 NORTH MARINE BLVD.,PARCELS O40154 &022675
BEING ALL OF TRACT 1 (0.96 ACRES) AND TRACT U (0.41 ACRES) AS SHOWN ON THAT
CERTAIN MAP ENTITLED 'RECOMBINATION PLAT FOR SHELLOOTH PROPERTIES, LLC,
U.S. HIGHWAY 17 & DIXIE TRAIL, JACKSONVILLE TWSP., ONSLOW COUNTY NC"
PREPARED BY LANIER SURVEYING COMPANY ON JULY 8, 2003 AND RECORDED ON JULY
23,2003 IN MAP BOOK 44,PAGE 237, SLIDE K-1903,ONSLOW COUNTY REGISTRY.
PARCEL 2:
FOR INFORMATION ONLY:
2325 NORTH MARINE BLVD.,PARCEL NO. 049724
LYING AND BEING SITUATE IN ONSLOW COUNTY, NORTH CAROLINA, AND MORE
PARTICULARLY DESCRIBED AS FOLLOWS:
BEING ALL OF THAT CERTAIN TRACT OR PARCEL OF REAL PROPERTY DEPICTED AS
TRACT II CONTAINING 4.93 ACRES AS SHOWN ON A PLAT CAPTIONED "FINAL PLAT
SHOWING PROPERTY OF JOHN 0.. STEVENSON" AS SURVEYED.BY BARDEN-LANIER_&
ASSOCIATES ON MARCH 14, 1990,A PLAT OF WHICH IS RECORDED IN MAP BOOK 27, PAGE]
�76,-SLIDE E=344 OFi THE ONSLOW COUNTY REGISTRY, SAID PLAT BEING INCOR-PORAT D
HEREIN-BY-REFERENCE AS THOUGH FULLY HEREIN SET FORTH.
OCT 3 12022 1
Book: 5043 Page, 1977-Current: 704 Seq: 4
Page;6 0 6,
EXHIBIT B
PERMITTED EXCEPTIONS
1. Easements and any other facts as shown on plat recorded in Map Book 44, Page 237, Slide K-
1903, Onslow County Registry and as approximately shown on Survey by Jimmy F. Cain of Cain
Surveying, P.C. dated June 20, 2019. (Parcel 1) _........
2. Easements and any other facts as shown on plat recorded in Map Book 27, Page 76, Slide E- 344,
Onslow County Registry and as approximately shown on Survey by Jimmy F. Cain of Cain
Surveying, P.C. dated June 20, 2019. (Parcel 2)
3. Easement to Carolina Telephone &Telegraph Company recorded in Book 844, Page 598, Onslow
County Registry. (Parcel 1)
4. Easement to Carolina Power and Light Company recorded in Book 379, Page 297; Book 390,
Page 688; Book 701, Page 617; and Book 973, Page 192, Onslow County Registry. (Parcel 2)
S. Right of way to the State Highway Commission recorded in Book 373, Page 378; and Book 379,
Page 109, Onslow County Registry. (Parcel 2)
6. Easement to Carolina Telephone and Telegraph Company recorded in Book 3, Page 465, Onslow
County Registry.
7. Easement to Carolina Power and Light Company recorded in Book 382, Page 541; Book 413,
Page 89; and Book 701, Page 616, Onslow County Registry. (Parcel 2)
8. Easement to City of Jacksonville recorded in Book 835, Page 271; Book 866, Page 670; Book 866,
Page 679; and Book 1623, Page 19, Onslow County Registry. (Parcel 2)
9. Rights of others in and to that certain outdoor advertising sign referenced in that certain
Assignment and Assumption of Lease recorded in Book 2935, page 583, Onslow County Registry;
however, this reference shall not serve to reimpose, ratify or acknowledge any alleged rights,
agreements or obligations described therein.
10. Any facts, rights, interests or claims that may exist or arise by reason of the following matters
disclosed by an ALTA/NSPS survey made by Cain Surveying, P.C. on June 20, 2019 and last
revised September 5, 2019, designated: (A) Overhead Power Lines; (B) Manholes; (C) Drainage
Easement; (D) Power Poles; (E) Water Meters; and (F) Fence.
OCT 3 12022 '
BY:
Book: 5043 Page, 1977-Current: 704 Seq: 5
Page,6 rf 6.
DEPARTMENT OF TAX ADMINISTRATION
Tax Certification Form
(Check One Box)
✓❑ This certifies that there are no delinquent ad valorem taxes, or other
taxes which the Onslow County Tax Collector is charged with
collecting, that are a lien on:
Parcel Identification Number:
049724, 040154 & 002676 AND GRANTEE: JACKSONVILLE
DEALERSHIP PROPERTIES I, LLC
This is not a certification that this Onslow County Parcel
Identification Number matches the deed description.
No certification required, as attorney statement that any delinquent
taxes will be paid from closing proceeds is included on first page of
deed.
ElBalance due on account. It must be paid to Onslow County Tax Collector
within 5 days of closing.
: �'1 qMNF1L.•W.w
°"' "�'°°�"°"��°"°"�" 10/23/2019
Eileen Wagner •-•�•���•����-�•••
Tax Collections Staff Signature Date
This parcel may have deferred taxes which become due upon transfer of the
property. Call the Tax Office, Land Records Division at 91 -989-2204 for
more information. %-&=a V k 1
OCT 3 12022 i
234 NW Corridor Blvd•Jacksonville,North Carolina•28540-Phone:(910)989-2200•Fax:(910)989-5818•OnsloZountyN gov/tax
Book: 5043 Page, 1977-Current: 704 Seq: 6
1.1.1 3 LLLI pc-) o-,l?
114.
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FLOOD INFORMATION:
TH[S PROPERTY IS LOCAIED IN FLOOD ZONE'C'
'S .A_. ACCORDING TO FIOOD INSURANCE RATE MAP
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_____ \ TOTAL AREA:1.37 ACRES
' swww zwar e+ w•.r.ev 3zs.ze ,m„
RECOMBINATION PLAT
FOR:
- SEIBLLOOTH PROPERTEES LLC.
U.S.HfGHWAY I]&OIXIE TWJIZAML
IACKSONWLLE TWSP.,ONSLOW COUNTY NC
DATE: J 2003
U.S. HWY. 17 —¢ R/W VARIES � )
SCALE: F=40'I B,
111RXCELON6 CPd1PoY
ILA,' SURVEYING- PLANNING-MAPPING F.B. PG.4
239 NEW BRIDGE STREET CAD TECE H.: F.WINBER0.Y
¢mNUTEOEwnrEYA"oralwcr JACKSONVILLE,N.C.2B540 ZIP DISK: #19
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_ _ \ ;\�INPEMZY SNDMIN6 Pfl0PF11EY OF
�'p] ,• + \�= JOHN 0 . STEVENSON
JACKSONVILLE TWP.. ONSLOW COUNTY. N.C.
BARDEN LANIER AND ASSOCIATES
LAND SURVEYING-LAND PLANNING-COMPUTER MAPPING
239 NEW BRIDGE STREET
U.S. HWY, 17 (H/W VARIES) JACKSONVILLE. N.C. 29540
_. PHONE: (919) 455-3BB9
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SOSID: 1850394
Date Filed: 5/31/2019 9:21:00 AM
Elaine F. Marshall
• State of North Carolina North Carolina Secretary of State
Department of the Secretary of State C2019 150 01970
Limited Liability Company
ARTICLES OF ORGANIZATION
Pursuant to §57D-2-20 of the General-Statutes of North Carolina,the undersigned does hereby submit these
Articles of Organization for the purpose of forming a limited liability company.
1. The name of the limited liability company is: Jacksonville Dealership Properties I, LLC
2. The name and address of each person executing these articles of organization is as follows:
Galen G. Craun,III, Organizer
100 N. Cherry Street, Suite 600
Winston-Salem, NC 27101
3. The name of the initial registered agent is: Bell,Davis & Pitt,P.A.
4. The street address and county of the initial registered office of the limited liability company is:
Number and Street: 100 N. Cherry Street, Suite 600
City, State, Zip Code: Winston-Salem, NC 27101 County: Forsyth
5. The mailing address of the initial registered office is:
PO Box 21029
Winston-Salem, NC 27120-1029
6. The limited liability company has a principal office. The street address, mailing address and county of
the principal office of the limited liability company is:
Number and Street: 4900 Leigh Drive
City, State, Zip Code: Raleigh,NC 27616 County: Wake
7. These articles will be effective upon filing.
This is the 30 day of May, 2019.
Galen G. Craun, Ill, Organizer
OCT 31 2022 ]I i
BUSINESS REGISTRATION DIVISION P.O. Box 29622 RALEIGH,N_Z 27626-0622__.
(Revised August 2017) (Form L-01)
#747046
LIMITED LIABILITY COMPANY ANNUAL REPORT
IOROV+
NAME OF LIMITED LIABILITY COMPANY: ,Jacksonville Dealership Properties I, LLC
Fll'mg Office Uso Only
SECRETARY OF STATE ID NUMBER: 1850394 STATE OF FORMATION: NC E-Filed Annual Report
1850394
CA202019602677
REPORT FOR THE CALENDAR YEAR: 2020 7/14/2020 05:00
SECTION A: REGISTERED AGENT'S INFORMATION Changes
1. NAME OF REGISTERED AGENT: Bell, Davis & Pitt, P.A.
2. SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS& COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
100 North Cherry Street,Suite 600 100 North Cherry Street, Suite 600
Winston Salem, NC 27101 Forsyth County Winston Salem, NC 27101
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: REAL ESTATE
2. PRINCIPAL OFFICE PHONE NUMBER: (919) 999-1400 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS
4900 Leigh Drive 4900 Leigh Drive
Raleigh, NC 27616 Raleigh, NC 27616
6. Select one of the following if applicable. (Optional see instructions)
❑ The company is a veteran-owned small business
❑ The company is a service-disabled veteran-owned small business
SECTION C: COMPANY OFFICIALS(Enter additional company officials in Section E.)
NAME: TIMOTHY W MICHAEL NAME: STUART C PARKS NAME: CHESTER A MICHAEL III
TITLE: President TITLE: Treasurer TITLE: Secretary
ADDRESS: ADDRESS: ADDRESS:
4900 LEIGH DRIVE 4900 LEIGH DRIVE 4900 LEIGH DRIVE
RALEIGH, NC 27616 RALEIGH, NC 27616 RALEIGH, NC 27616
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity.
TIMOTHY W MICHAEL 7/14/2020 _
SIGNATURE DATE [� Q
Form must be signed by a Company Official listed under Section C of This farm.
TIMOTHY W MICHAEL President OCT 3 12022
Print or Type Name of Company Official Print or Type Title of Compan lOfficial
SUBMIT THIS ANNUAL REPORT WITH THE REQUIRED FILING FEE OF $200.00 Y.�
MAIL TO:Secretary of State, Business Registration Division,Post Office Box 29525,Raleigh,NC 27626-0525
SECTION E: ADDITIONAL COMPANY OFFICIALS
NAME: RENEE C PAKKALA NAME: NAME:
TITLE: Assistant Secretary TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
4900 LEIGH DRIVE
RALEIGH, NC 27616
NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
NAME: NAME: Name:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
NAME: NAME: - NAME:
TITLE: TITLE: TITLE: �^�l j^.' 4,
1
ADDRESS: ADDRESS: ADDRESS: OCT' 3 2022
BY. _ k:8
kI0O^Atlil R: Mt77C—F
t? LIMITED LIABILITY COMPANY ANNUAL REPORT
mnov- ___
NAME OF LIMITED LIABILITY COMPANY: Jacksonville Dealership Properties 1, LLC r'
r Filing Office Use Only
SECRETARY OF STATE ID NUMBER: 1850394 STATE OF FORMATION: NC E - Filed Annual
REPORT FOR THE CALENDAR YEAR: 2021 Report
1850394
SECTION A: REGISTERED AGENT'S INFORMATION Changes
1. NAME OF REGISTERED AGENT: Bell, Davis & Pitt, P.A.
2. SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
100 North Cherry Street,Suite 600 100 North Cherry Street, Suite 600
Winston Salem, NC 27101 Forsyth County Winston Salem, NC 27101
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: REAL ESTATE
2. PRINCIPAL OFFICE PHONE NUMBER: (919) 999-1400 3.PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS
4900 Leigh Drive 4900 Leigh Drive
Raleigh, NC 27616 Raleigh, NC 27616
6. Select one of the following if applicable. (Optional see instructions)
❑ The company is a veteran-owned small business
❑ The company is a service-disabled veteran-owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: T mi othy-W-Michael NAME: Chester A Michael , III NAME: Parks Holdings, LLC
TITLE.—Managing Member TITLE: Managing Member TITLE: Managing Member
ADDRESS: ADDRESS: ADDRESS:
4900 Leigh Drive PO Box 5657 PO Box 21284
Raleigh, NC 27616 Winston-Salem, NC 27113 Winston-Salem, NC 27120
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity.
Timothy W. Michael 4/7/2021
SIGNATURE DATE VVIT
Form must be signed by a Company Official listed under Section C of This form.Timothy W. Michael Managing Member ,l I
Print or Type Name of Company Official Print or Type Title of Com omEial r t ULL I
This Annual Report has been filed electronically. � Fi arty L;
MAIL TO:Secretary of State, Business Registration Division,Post Office Box 29525,Raleigh,NC 27626-0525 8Y.---_—
ENGINEERS • SURVEYORS PLANNERS X��^^
E97.1961 JACKSONMILLE , NORTH CAR OLINA
I EI
OCT 0 61022
By.�_LETTER OF TRANSMITTAL
TO: Ms. Christine Hall -NCDEQ DATE: October 4, 2022
127 Cardinal Dr. Ext. REF: Stevenson Toyota and West Fairway
Wilmington,NC 28405-3845 Road Development Phases 1 and 2
SW8-040301 and SW8-900506
Stormwater Transfer
WE ARE SENDING YOU:
State Stormwater Permit Transfer Application Form, Check 941908 in the amount of$505.00, Deed of Conveyance,
Secretary of State Report, Articles of Organization for the above referenced Permits.
DELIVERY VIA:
0 Regular Mail ❑ Hand ❑ Federal Express
❑ UPS Overnight ❑ UPS Ground ❑ Other
THESE ARE TRANSMITTED AS CHECKED BELOW:
N For Approval ❑ As Requested ❑ For Review and Comment
❑ For Your Use ❑ For Bids Due
❑ Other
COMMENTS:
Ec: Richard . Muni, P.L.S.
Copies To: Garrett Zorda NCDEQ (w/ enclosures) Contract Administrator
Boyd Tisdale (LOT Only)
Mollie Tisdale Fisher (LOT Only)
CF (P), LAM, JAH
(f enclosures. are not as noted, kindly notify us at once) =%_P=0
secretary.c3.2022.Project.WestFairwayRoad-Stevenson'royota.LDT.Stor nwaterTransrer.10.03.22 i
OCT 3 1 2022
P� "J
V.
306 New Bridge Street I P.O. Box 976 1 Jacksonville, NC 28541-0976 (910)455-2414-------
Firm License Number F-0108 I www.tidewaterenc.com
Beasley, Michelle
From: Beasley, Michelle
Sent: Friday, October 7, 2022 3:27 PM
To: office@tidewaterenc.com
Cc: Hall, Christine; Sams, Dan
Subject: SW8 900506 8'S.WZ040301?- Requested Transfer Application
Mr. Muni,
I am also in possession of a joint application for the two above-referenced state stormwater permits requesting transfer
from current permit holder Susan B. Stevenson to new property owners Jacksonville Dealership Properties,
Inc. Unfortunately, as was the case I emailed about yesterday (SW8 080102), permit SW8 900506 expired on
1/23/2022. Therefore, we will also have to renew that permit with the existing permit holder before we can transfer the
permit as requested. Additionally, permit SW8 040301 is an off-site permit from major permit SW8 900506. Although
off-site permits do not expire, SW8 040301 will need a separate request for transfer. We cannot process the combined
application request for the two permits under one application:_Ifypu app� ro e, I can go ahead and proceed with the
iffransfer application'requ'est on.permit.SW8 040301"using the application and ch"e kr#.41908 already submitted. Then
you can simply complete both a renewal application for permit SW8 900506 with all necessary documents and fees PLUS
a transfer application for SW8 900506 with all necessary documentation and fees to be completed once the renewal of
the permit is complete. These permit applications can be accessed on this website see right hand column in blue,
Permit Transfers& Renewal.
I look forward to hearing back from you to confirm how you would like to proceed.
Thank you for your understanding in this matter. Should you have any questions and/or comments or need additional
information, please feel free to contact me.
Michelle Beasley(she/her/hers)
Stormwater Environmental Specialist
Division of Energy, Mineral, and Land Resources
North Carolina Department of Environmental Quality
Office: (910)796-7215 1 Direct: (910)796-7287
Address: 127 Cardinal Drive Ext., Wilmington, NC 28405
m ichelle.beasley@ ncdenr.eov
NORTH CAR LINAD_E Q5
Oepa ent of Envirenmenial Quality
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.
t
1
Transfer Application Completeness Review Checklist-Short VersionVT
/
Permit#: 04OL01 Date Delivered to WIRO:
Project Name: eh\-- 0 BIMS Received/Accepted Date:
Project County/Location: 6 ( Date Given to Admin: �j' 52 a
BIMS Acknowledged Date': p v
Permit Expiration Date*:
w/in 6 mo,STOP-needs renewal first. Exception: only new permittee is
submitting.Then transfer is logged in first
Proposed Permittee Signed Application? N If N, it will be evaluated under GS 143-214.7(c2), which requires:
Common Area Deed in HOA's Name
050%Sold List
Current Permittee Signed Application? Ply If N, it will be evaluated under GS 143-214.7(c5)
Proposed Permittee Type&Documents Needed:
Property Owner(s) Purchaser Lessee E]HOA Developer
Viable? Viable? Viable? Viable? Viable?
Deed Purchase Agmt Lease Election Minutes
FiNotSubdivided: Deed Deed Restrictions Recorded
Subdivision: Common Area Deed F—IBUA/Lot Summary
F—IO&M (If HOA Signed Application)
Paperwork /
Application
1;�]$505 Fee(within 6mo) Check#(s):
Deed Restrictions,if subdivided: \ /
PE Certification(if built or partially built) /Y
Project Narrative
Easements, Recorded(2017 Rules)
FJO&M on File(unless new one from HOA)
FlElectronic Copies
NOTES:
lEnter BIMS Acknowledged Date on this Sheet n
EMAILED ENGINEER DATE:
REVIEWER NAME:
</xG:\\\Reference Library\Procedures\Checklists\Completeness Revie Checklis 202110 OS �/1 ,Jv ► `/
Ste-
7,1011-ro-Al- ��
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• Print a Pre-Populated Annual Report form
Business Corporation
Legal Name
C John O. Stevenson, Inc. ;.
Information
Sosld: 0559486
Status: Dissolved O
Date Formed: 8/3/2000
Citizenship: Domestic
Fiscal Month: December
Annual Report Due Date: April 15th
Registered Agent: Stevenson, Susan B
Addresses
Mailing Principal. Office Reg Office
3124 New Bern Hwy 3124 New Bern Hwy 3124 New Bern Hwy
Jacksonville, NC 28546 Jacksonville, NC 28546 Jacksonville, NC 28546
Reg Mailing
3124 New Bern Hwy
Jacksonville, NC 28546
Officers
President Secretary
C Susan B Stevenson Susan B Stevenson
3124 New Bern Hwy 3124 New Bern Hwy
Jacksonville NC 28546 Jacksonville NC 28546
Stock
SOSI D: 0559486
Date Filed: 12/27/2018 7:43:00 AM
Elaine F.Marshall
North Carolina Secretary of State
JOHN O. STEVENSON, INC. C2018 355 00540
ARTICLES OF DISSOLUTION
The undersigned North Carolina corporation hereby submits these Articles of Dissolution
for the purpose of dissolving the corporation:
1. The name of the corporation is John O. Stevenson, Inc.
2. The name, title and address of the officers and directors of the corporation are:
Name Address
Susan B. Stevenson 3124 New Bern Hwy
President Jacksonville,NC 28546
3. The dissolution of the corporation was authorized on the 13`h day of November, 2018.
4. Shareholder approval for the dissolution was obtained as required by the North Carolina
General Statutes.
5. These articles will be effective upon filing.
This the 19' day of December 2018.
[Signature Page to Follow]
N 7037195 I.Doc
V
[Signature Page to Articles of Dissolution]
JOHN O. STEVENSON,INC.
BY:CI4414 //1 .
Name: Susan B. Stevenson
Title: President
97037195 i.n�
212/22, 10:05 AM North Carolina Secretary of State Search Results
• File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online
Add Entity to My Email Notification List • View Filings • Print a Pre-Populated Annual Report form • Print
an Amended a Annual Report form
Limited Liability Company
Legal Name
Jacksonville Dealership Properties I, LLC
Information
Sosld: 1850394
Status: Current-Active O
Date Formed: 5/31/2019
Citizenship: Domestic
Annual Report Due Date: April 15th
CurrentpnnuaL Report Status:
Registered Agent: Bell, Davis & Pitt, P.A.
Addresses
Reg Office Reg Mailing Mailing
100 North Cherry Street, Suite 600 100 North Cherry Street, Suite 600 4900 Leigh Drive
Winston Salem, NC 27101 Winston Salem, NC 27101 Raleigh, NC 27616
Principal Office
4900 Leigh Drive
Raleigh, NC 27616
Company Officials
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
Managing Member Managing Member Managing Member
Chester A Michael , III Timothy W. Michael Parks Holdings, LLC
PO Box 5657 4900 Leigh Drive PO Box 21284
Winston-Salem NC 27113-5657 Raleigh NC 27616 Winston-Salem NC 27120
https://w .sosnc.gov/online_services/search/Business_Registration_Results 1/1