WQ0038619_Application_20181015

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
SEWER SYSTEM PERMIT OWNERSHIP/NAME CHANGE
1Nalertonatm INSTRUCTIONS FOR FORM: PNOCF 0146
[. EXISTING PERMITTEE INFORMATION:
I. Permittce's name: Main Development Companv, LLC
2. Signature authority's name: K61, J per ISANCAC_02T.01060
3. Signature authority's title:
4. Permittee's mailing address: 3920 Magazine Street
City: New Orleans
5. Permittee's contact information:
tI. APPLICANT INFORMATION:
State: Louisiana Zip: 70 t I S-_
Phone number: (JG��vG `%3tx' Fax Number
Email Address: Ljrwo � f � 'U � C O t
1. Applicants name: Publix North Carolina LPrr
2. Signature authority's name: _Joh►1 A A f'f'cL!cA �t Jr per 15A NCAC O3T .0106(b)SEP
J _
3. Signature authority's title: 5ecfel
4. Applicant's mailing address: 3300 Publix Corporate Parkway
City: Lakeland State: Florida Zip: 33811-3002
5. Applicant's contact information: Phone number: [phone] Fax Number [phone]
Email Address: Jessica. Massa nelli�ublix.com
6, Representative's name: Jessica Massanelli
7, Representative's title: ESP Program Coordinator
8. Representative's contact information
III. PERMIT INFORMATION:
Phone number; (863J 688-I L88 Fax Number [phone]
Email Address: Jessica.
Massanelli�iupublix.com
1. Existing permit number: W0003R619 and most recent issuance date: 07/25/2016
2. Reason for the permit application: Change of Ownership
3Has the facility been constructed? ®Yes or ❑ No
4. Has the facility been certified per I SA NCAC 021' .0116?
If other, attach detaile
.
d explanation
® Yes or � No
FORM: PNOCF 01-16 Pagc 1 of 2

IV. CERTIFICATIONS:
Existing Permittee's Cer"Heanon per ISA NCAC 02T .0106(b):
I rte__ f 7
(Signature Authority's name & title from Application Item 1,2 & 3)
that this application
has been reviewed by me and is accurate and complete to the best of my knowledge, I understand that prior to reissuance of the
permit into the Applicant's name, I will continue to be responsible for compliance with the current permit and any discharge of
wastewater from this system to surface waters or the land may result in an enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution, I will also make no claim against the Division of Water Resources should a condition of
the existing permit be violated, I also understand that if all required parts of this application are note completed and that if all required
supporting information and attachments are not included, this application will be returned to me as incomplete,
NOTE — [n accordance with General Statutes 143-215,bA and 1.143-215.bB, any person who knowingly makes any false statement,
representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: r / ~7 -- -- Date:
Applicant's Certification per 15A NCAC 02T .0106(b):
Joh
(Signature
ty's name &title from Applieation Item Ii.2&3.}
that this application
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that after issuance of the permit into
the Applicant's name, I will be responsible for compliance with the issued permit and any discharge of wastewater from this non.
discharge system to surface waters or the land may result in an enforcement action that may include civil penalties, injunctive relief,
and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition of this permit be
violated. I also understand that if all required parts of this application package are not completed and that if all required supporting
information and attachments are not included, this application package will be returned to me as incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613
, any person who knowingly makes any false statement,
representationI orcertification in an a plied ckage shall be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed $10,000 ell as ivi Cal, t 2 ,000 per violation
5ignahtrc: Date:
i
FORM: PN�CF 01-16 Page 2 oft

STATE OF NORTH CAROLINA
COUNTY 01: Guilford
Co El f
p 2018
ermit Now�
This AGREEMENT made pcusuant to G.S, t43-215,1 (dl) artd entered itltotliis 12th
day of
July ._ by and between the North Carolina. Environmental Management
C0111mission, an agency of the State of North Carolina, hereinafter known as the COMMISSION; and
Main Development Company, LLC , a corporation/general partnership registered/licensed to do
busI
ness ii1 the.State ofNotth Carolina, hereinafter knowtl as the DEVELOPER.
WITNESSETH;
I, The DEVELOPER is the owner of. the certain lands lying :h1 ulif°rd _Cour+ upon
Which it is erecting and will erect dwelling units and other:improvements, said development to be known
as
Westchester Square (hereinafter the Development),
Z. The DEVELOPER desires, to construct a wastewater collection system with pumps, wastewater treatment
works, and/or disposal facilities (Hereinafter Disposal System) to provide sanitary sewage disposal to serve
the Development on said lands.
3. The DEVEI..("I
PER has applied to the COMMISSION far the isst.tauce of a permit pursuant to G:S: 143-
2I5.1. to construct,: inaffitain, and operate the Disposal System,
4, The DEVELOPER has created or shall create unit ownership in said dwellings milts, other improvements
and lands through filing.of a. Declaration of Unit Ownership (llere';hafter Dectaratiotl),. pursuant to Chapter
47C or 47F of the Nortll Carolina General Statutes.
5. The DEVELOPER. has caused to be fol°teed .or will cause to be fortnecl at the' time cif filing of file
Declaration, tile &I it Owners' Association) (hereinafter
Association),, a non.profit corporation organized and existing+ under and by the virtue of the laws of the
State of North.
Carolina, for the purpose, among others, of handling the property, affairs and business of
the Development; of operating, maintaining, re -constructing. and repairing. the common elements of the
lands and h provements subject to unit ownership, including :the Disposal. System; and of collecting dices
and assessments to provide funds for such operation, maintenance, re=construction and repair,
6; The COMMISSION desires to assure that the _Disposal. System of the Development is properly
constructed, maintained and operated In accordance with.law and- permit provisions In order to .protect the
quality of the waters of the State and the.public interest therein,
NOW, THEREFORE, in considelati°n of the promises and the benefits
to• be derived by each of the parties
hereto, t11e GOIVIMISSIONand DEVELOPER:do llet•eby tnt.ttuatly agree as follows;
1, The DEVELOPER shall construct tile: Disposal. System in accordance -with the permit and plans and
speEifieations hereafter issued and approved by the COMMISSION, and shall thereafter properly. operate
and maintain: such systems and facilities in accordance with applicable perillit provisions, and law,
2, The'DEVELOPER shall not transfer ownership and/or control of the Disposal System to the Association
until construction has been completed, In accordance with the permit and approved.plans, and the staff.of
the Division of Water Resources has inspected and approved of the facilities. In. order to change the name
of the.permit holder, the DEVELOPER must request. that the permit be. reissued to. the Association, The
request must include a copy of the Association Bylaws and Declaration,
3. The DEVELOPER shallp not transfer, convey, assign or otherwise relinquish or release its responsibility
for the operation and maintenance of its Disposal System until a permit has been reissued to the
DEVELOPER's successor,
FORti1; DEV 08-13 Page l of 2

4. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System and
appurtenances thereto are part of the common elements and shall thereafter be properly maintained and
operated in conformity with law and. the provisions of the pet•IIIIt for construction, operation, repair, and
maintenance of the system and facilities. The Declaration and Bylaws shall Identity the entire wastewater
treatment, collection and disposal system as a common element which will receive the highest priority foil
expenditures by the Association except for Federal, State, and local taxes and Insurance,
5, The.DEVELOPCR shall PIOVItte III the DCCIaI'atiOII affil ASSOCIation Bylaws that the Disposal System will
be maintained out of the common expenses, hI order to assure that there shall be fiends readily available to
repair, maintain or construct the Disposal System, beyond the routine operation and maintenance
expenses, the :Declaration and Association Bylaws shall provide that a fundbe created out of the common
expenses, Such fund shall be separate from the routine maintenance fiends allocated for the facility and
shall be part of the yearly budget.
b• G► the event the common expense allocation and separate fir41 are Ilot adequate for the construction,
repair, and maintenance of the Disposal System, the Declaration and Association Bylaws shall provide for
special assessments to cover such necessary costs. There shall be no limit on the amount of such
assessments, and the Declaration and Bylaws shall provide that such special assessments can be made as
necessary at any time.
7. If a wastewater collection system and wastewater treatment and/or disposal facility provided by atry city,
town, village, county, water and sewer authorities, or other unit of government shall hereinafter become
available to serve the Development, the DEVELOPER shall take such action as is necessary to cause the
existing and future wastewater of the Development to be accepted and discharged into said governmental
system, and shall convey or transfer as much of tele Disposal System and such necessary easements as the
governmental unit may. require as condition Of accepting the Development's wastewater.
8. Recognizing that it would be contrary to the public interest and to the public health, safety and welfare for
the Association to enter into voluntary dissolution without having made adequate provision for the
continued proper maintenance, repair and operation of its Disposal System; the DEVELOPER shall
provide in the Association Bylaws that the Association shall not .enter into voluntary dissolution without
first having transferred its said system and facilities to some person, corporation or other entity acceptable
to and approved by the COMMISSION by the.issuanee of a permit.
9. The agreements set forth in numbered .paragraphs 1, 2, 3, 4, 5, 6, 7, and 8 above shall be conditions of any
peemit issued by the COMMISSION to the DEVELOPER for tete construction, maintenance, repair and
Operation of the Disposal System.
10. A copy of this agreement shall be filed at the Register of Deeds in the County(ies) where tete Declaration is
filed and in the offices of the Secretary of State of Nortel Carolina with the Articles of Incorporation of the
Association,
IN WITNESS WHERCOF, t(Iis agreement was executed in duplicate originals by the duly authorized
representative of tele patties hereto ou the day and year �vr'itten as indicated by each of t11c parties nanlcd below:
IrOR THE ENVIRONMENTAL
MANAGEMENT CQMMiSSION
S. Jay Zinlrnerman, Y.G.
Ditector, Division of Water Resources
Main Development Co., LLC
Name of DEVELOPER
Gordon H Kolb, Jr. Manager
Print Name and Title
July 12, 2016
(Date)
FARM: DEV 08-13 Page 2 oft

NORTH CAROLINA- SPECIAL WARRANTY DEED
Excise Tax: $36,613.00
P
`q� �` gyrv�,ss 't
d, ..d k
g k� Bk
A
Parcel Identifier No: Verified by County on flie day of 2p
By: —
MaWBox to:
Tliis nshument was prepared by; Brian W. Byrd, Smith Moore Leathetwood LLP
Brief description for the Index: Lot 2 Plat Book 192 Page 7
THIS DEED made this 1'+ day of /k_L�tvit t S L , 2018, by and between
GRANTOR
MAIN DEVELOPMIJNT COMPANY, LLC,
a GRANTEE
North Caronna limited liability company
Mailing Address:
c/o Gordon H. Kolb
G.H.K. Developments, Inc.
3920 Magazine Street
New Orleans, Louisiana 70115
Enter in appropriate block for each
name, address, and, if
PUBLIX NORTH CAROLINA LP,
a Florida limited partnership
Iyiailina Address:
Cot•porate Office
3300 Publix Corporate Parkway
Lakeland, Florida 33811-3002
character ofentity, e,g, corporation or
The designation Grantor and Grantee as
herein steal l include said
used parties, their heirs, successors, and assigns, and steal l include
singular, plural, masculine, feminine or neuter as requh'ed 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 or near the City of High Point; High Point Township, Guilford County, North Carolina and more particularly described
as follows:
SEE EXHIBIT A ATTACHED HERETO AND INCORPORATED HEREIN BY
REFERENCE.
The property described hereat does not include the primary residence of the Grantor.
NC Bar Association Farm No• 6 ©1977, 2002
Printed by Agreement with the 1�IC Bar Association —1981 -Chicago Title Insurance Company
GREENSBORO 1342287.2

The property hereinabove described was acquired by Grantor by Deed recorded in Book 7830, Page 2549, Guilford County
Registry,
A Plat showing the above-described property is recorded in Plat Book 192, Page 7, Guilford County Registry,
n
n fee simple. HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee
i
And the Grantor covenants with tite Grantee, that Grantorhas done nothing to impair such title as Grantor received, and Grantor will
warrant and defend the title against the lawful claims of all persons claiming by, under or through Grantor, other than the exceptions
shown on EXHIBIT B attached hereto and incorporated herein by reference.
1N WITNESS WHEREOp, the Grantor lias duly executed the foregoing as of the day aitd year fn st above WL itten under seal•
MAIN DEVELOPMENT COMPANY, LLC,
a North Carolina limited liability company
By (SEAL)
Print Name: Gordon H. KoIb, Jr.
Title: Manager
STATE OF LOUISIANA —PARISH OF ORLEANS
I certify that the following person personally appeared befot•e me this day acicnowledgit;� to me that he signed the foregoing
document: Gordon H. Kolb, Jr. j
Today's Date;
P}�III� d®V. Slav®ria, J
Notary Public
State of Louisiana
Louisiana Bar Roil# 29126
My Commission is Issued For Life
[Afitx Notary StamplSeal in Space Above]
as name appears on seal]
[Nry's printed name as na
ot
f
appears
on seal]
My conmtission is issued for life.
NC Bai• Association Form No. 6 O 1977, 2002
Printed by Agreement with the NC Bar Association —1981 -Chicago Title Insurance Company
GREENSBORO t342287.2

EXHIBIT A
TO SPECIAL WARRANTY DEED
Legal Description of Property
ALL that certain piece, parcel or tract of land lying and being in High Point Township, Guilford County,
North Carolina, and being more particularly described as follows:
BEING ALL OF LOT NUMBER TWO (2), containing 9.364 acres, more or less, as shown on the plat entitled
"Exclusion Plat for Main Development Company, LLC of Westchester Drive, North Main St, Idol St & Fisher
Ave" which plat is duly recorded u1 the Office of the Register of Deeds of Guilford County in Plat Book 192,
Page 7.
Together with easements arisilug pursuant to the Declaration of Easement Agreement with Covenants,
Conditions and Restrictions recorded in Book 7830, Page 2667, Guilford County Registry.
Together with easements arising pursuant to the Declaration of Sewer Easement recorded in Boole 7830,
Page 2662, Guilford County Registry.
Together with easements arising pursuant to the Access Easement Agreement recorded in Book 7830,
Page 2639, Guilford County Registry.
Together with the easement arising pursuant to the Easement Agreement recorded in Boole 7830, Page 2626,
Guilford County Registry.
Together with easements arising pursuant to the Reciprocal Access Easement Agreement recorded in
Bonk 5461, Page 1488, as amended by Fust Amendment of Reciprocal Access Easement Agreement recorded
in Book 7830, Page 2606, Guilford County Registry,
NC Bar Association Form No• 6 ©.1977, 2002
)?rimed by Agreement with thQ NC, Bar Assoeiatiou —1981 - Chicagp Title Insurance Corupany
GRF;HN$�C�RO 1342287.2

EXHIBIT B
TO SPECIAL WARRANTY DEED
Title Exceptions
a
1. Taxes for the year 2018, which are a lien, but not yet due and payable, and all subsequent.
years.
2, Sidewalk Easement Agreement to Main Outparcel, LLC, a Nor th Carolina limited liability
company recorded in Book 7973, Page 2859, Guilford County Registry,
3. Easement Agreement by and amongNPC Quality Burgers, Inc., a Kansas corporation, Fisher
Outparcel, LLC, a North Carolina limited liability company and Main Development
Company, LLC, a North Carolina limited liability company recorded in Book 7907,
Page 264, Guilford County Registry.
4. Terms, provisions, covenants, conditions, easements and restrictions as provided in
Declaration of Easement Agreement with Covenants; Conditions and Restrictions, recorded
I
n Book 7830, Page 2667; as affected by First Amendment of Declaration of Easement
Agreement With Covenants, Conditions and Restrictions in Book 7905, Page 1935; and as
affected by Consent and Agreement to Execute in Book 7909, Page 759, Guilford County
Registry,
5. Declaration of Sewer Easement by Main Development Coanpany, LLC, a North Carolina
limited liability company recorded in Book 7830, Page 2662, Guilford County Registry.
6. Temporary Non-1!Jxclusive Parl�ing Easement Agl°eement to Westchester Baptist Church, Inc,
of High Point, a North Carolina non-profit corporation recorded in Book 7830, Page 2653,
Guilford County Registry,
7. Access Easement Agreement by and between Main Development Company, LLC, a North
Gar01111a limited liability company and The Sherwin-Williams Company, an Ohio
corporation (successor by merger to Sherwin-Williams Development Corp.) recorded in
Book 7830, Page 2639, Guilford County Registry,
8. Easement Agreement to Main Development Company, LLC, a North Carolina limited
liability company recorded ui Boolc 7830, Page 2626, Guilford County Regishy.
9. Terms; provisions, covenants, conditions, easements and restrictions as provided in North
Carolina Special War7anty Deed, recorded in Boob 7830, Page 2554, Guilford County
Registry.
10. Declaration of Storni
Drainage Easement to WH Capital, L.L.G., a Georgia limited liability
company .recorded in Book 7271, Page 2599 and as affected by First Amendment to
Declaration of Storni Drainage Easement in Book 7874, Page 194, Guilford County Registry,
NC Bar Association Form No. 6 ©1977, 2002
Prilted by Agreement with the NC Bar Association —1981 -Chicago Title lnsurance Company
GRE N ht S B ORO 13 422 8 7, 2

11. Reciprocal Access Easement Agreement by and between Hambone Dog Properties, LLC, a
North Carolina limited liability company and Walgreen Co., an Illinois corporation recorded
I
n Book 5461, Page 1488; as affected by First Amendment to Reciprocal Access Easement
Agreement in Book 7830, Page 2606; as affected by Consent and Agreement to Execute in
Book 7909, Page 759; and as affected by Consent and Waiver in Book 7912, Page 2886,
Guilford County Registry,
12. Joint Driveway Agreement to Spillers &Tillle, a general partnership and King Development
Associates, a general partnership recorded in Book 3830, Page 847 and as affected by Access
Easement Agreement in Book 7830, Page 2639, Guilford County Registry,
13. Deed of Easement to Board of Transportation, an agency of the State of North Carolina
recorded in Book 2744, Page 729, Guilford County Registry,
14. Easements and any other facts as shown on plat recorded in Plat Boolc 192, Page 7, Guilford
County Registry.
15. Easements and any other facts as shown on plat recorded in Plat Book 181, Page 7, Guilford
County Registry,
16. Easements and any other facts as shown on plat recorded in Plat Boolc 180, Page 148
Guilford County Registry. ,
17, Easements and any other facts as shown ole plat recorded in Plat Book 58, Page 83, Guilford
County Registry,
18, Easerttents and any other facts as shown on plat recorded u1 Plat Book 31, Page 40, Guilford
County Registry.
19. Easements and any other facts as shown on plat recorded in Plat Book 5, Page 309, Guilford
County Registry.
20. Riglrts of parties in possession as tenants onl3r, under unrecorded leases(s) or rental
agreernerzt(s), as reflected on the Assigrunent and Assumption of Leases delivered
contemporaneously with this North Carolina Special Warranty Deed,
NC Bar Association For7u No. 6 O 1977, 2002
Printed by Agreement with the NC Bar Association -1981- Chicago Title Insurance Company
GRiENSROttO 1342287.2