20191340 Ver 1_Shoreline Stabilization_20191003

State of North Carolina
Department of Environment and Natural Resources
r10_ Division of Water Resources
Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
ENVIRONMENTAL QUALITY FORM: SSGP 02-2017
Shoreline Stabilization Application Form 2 0 1 9 1 3 4 0
Three copies of the application (including attachments) and the application fee should be sent to:
If sending via US Postal Service If sending via delivery service (UPS, FedEx, etc.)
Karen Higgins Karen Higgins
DWR — 401 & Buffer Permitting Branch DWR — 401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: T)q:K
Mailing Address:
rllell
Telephone Number: '709-'JZZ- 1-67"t Fax Number:-""'vUl
E-mail Address: �QS7PWcihi 10 0► [l rn 3 eaf�
�r %4o
2. Agent/ Contact Person Information h� Se��a�
A signed and dated copy of the Agent Authorization letter must be attached if the Agent has
signed this application form. (A form can be downloaded here:
http://www saw usace army mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
Name: I )C)y) n() 1-' t"1r
Company Affiliation:
Mailing Address: 11 5co
�Pe
Telephone Number: 9- & LO q10 Fax Number: 7,04" 528- 3400
E-mail Address: enyina, IancaefardDchts � a ma: I -cc yn
B. Project Information [15A NCAC 02H .0502(a) & (b)]
1. Attach a vicinity map (i.e. street map) clearly showing the location of the property with
respect to local landmarks such as towns, rivers, and roads.
2. Provide a detailed site plan showing property boundaries and proposed locations of
vegetation clearing, buildings, retaining walls, docks, impervious surfaces, rip rap, excavation
or dredging below Full Pond/ Normal Water Level elevations, and construction access
corridors. You may use the diagram provided at the end of this application form.
FORM: SSGP 02-2017 Page 1 of 3

3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of
some sort- a yard stick, shovel handle, etc.)
4. Location of the �p1roperty (where work is to be conducted) j
County: &c'_fl_ %/\ VNj Ate_ Nearest Town: L V'r)& U
Lake/ river/ ocean adjacent to property: l V Ot'li a 10
Property size (acres): I.N QC YPS
Subdivision name or site address (include phase/lot number):QA-
no
21 ZZ513cyt�eIChurd) G,r neA I u -j 2803
Directions to site - please include road names and numbers, landmarks, etc.: n -p Y i 115 a
Ria1)ronWCa-luwbaAV-e TiGh1 py)- ibe-I ChurrYI+2d Pruixr �j i5on +-he lef l'.
Latitude (in decimal degrees)
Longitude (decimal degrees) 8n.q I I t3�57_,
5. Describe the existing land use or con ition of the site at the time of this application
(residential, undeveloped, etc.): Q
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
7. Will work be conducted from land? a
From water? ['1
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent im acts (includin all excavatioq, backfill, rip rap, retaining walls, etc.) in square feet:
9 � Y C,'r- ---z%A , 1 � c,c P+ �cr'nvn Ih r) ,n n iron
Temp porary impacts in square feet:
None
9. Total amount of impacts above the normal pool lake level / Normal Water Level and 50 feet
land -ward
Permanent ia s, 'impacts (including back fill, excavation, rip rap, retaining et .) in square feet:
/vofIe r'�Qnd-Yli-De ,berms �uf Id
e bu r
Temporary impacts (temporar clearing, construction corridor) in square feet:
Ar-f-)XIn -A
= nnr)Z (NmsAn«-inn C�)rrtdnc:s
10. Please describe the vegetation above the normal pool lake level/Ngrmal Water Level and 50
feet landward to be impacted (number of trees, for instance): O11�
11. Signat e
I
Owner/Age ignature* [15A NCAC 02H .0502(f)l Date
Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017 Page 2 of 4

12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
Full Pond/ Normal Water Le
Shoreline
Plan View
FORM: SSGP 02-2017
Lake
(At Full Pond/ Normal Water Level)
See Ached
SYie�C-h
Lake
(At Full roma/ N-1 water Levey Existing Dock
3oftx7ft
3ftxMft
Below full pond/ NWL
Full Pond/ Normal Water Level
�hore�ne
4 ftx150k
RIPraP Above fwlpond/ nwL
2 ft.x 150 ft
addltlonal clearing
If nary
E AMPLE
Plan View
Page 3 of 4

v
J
La ke IV
(At Full Pond/ Normal Water Level) M
O
C
t0
E
`'O
O s
Z IV)
C
Side View
U-
3 ft. below full pond water level 4 ft. above full pond water level 2 ft. additional clearing
'if necessary
Existing bank
10 ft. bank
Side Vi
F Ia 0
FORM: SSGP 02-2017 Page 4 of 4

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PAUL & BETH JASZEWSKI
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CCRNELIUS. I ENLkiAMC COUNTY, NYX+,N CAROLINA
AS RECrAM IN DEED BOCK 10291, PA„^E 814
.t DEED BOOK 8209, RAGE 404
SURYEC DATE' 08.136/2617
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MECKLENBURG COUNTY, North Carolina
POLARIS 3G PARCEL OWNERSHIP AND GIS SUMMARY
Date Printed:
Identity
Parcel ID GIS ID
00171104 100171104
Zoning
Contact appropriate Planning Department or see Map.
Post Construction District
Water Quality Buffer Jurisdiction Cornelius
Parcel Inside Water Quality Buffer I Yes District Cornelius
09/24/2019
Ownership
Property Characteristics
Legal desc
L3 M64-896
Land Area
1.307 AC
Fire District
CORNELIUS
Special District
FIRE SERVICE B
Account Type
NC CORP
Municipality
CORNELIUS
Property Use
SINGLE FAMILY
RESIDENTIAL -
WATERFRONT
Zoning
Contact appropriate Planning Department or see Map.
Post Construction District
Water Quality Buffer Jurisdiction Cornelius
Parcel Inside Water Quality Buffer I Yes District Cornelius
09/24/2019
Ownership
Owner Name
Mailing Address
PB&J LLC
21225 BETHEL CHURCH RD
CORNELIUS NC 28031
Deed Reference(s) and Sale Price
Deed Sale Date
Sale Price
32378-896 12/29/2017
$910,000.00
30291-817 09/22/2015
INVIEW FEMA FLOODPLAIN TO VERIFY
05127-111 11/19/1985
$0.00
Site Location
ETJ Area
Cornelius
Charlotte Historic District
No
Charlotte 6/30/2011 Annexation Area
No
Census Tract #
62.04
FEMA and Community Floodplain
FEMA Panel#
3710463300J
FEMA Panel Date
03/02/2009
FEMA Flood Zone
INVIEW FEMA FLOODPLAIN TO VERIFY
Community Flood
Zone
OUT:VIEW COMMUNITY FLOODPLAIN
TO VERIFY
Stream Watershed Districts
Stream Watershed Name I LAKE NORMAN
Regulated Drinking Watershed Districts
Watershed Name I LAKE NORMAN
Watershed Class ICA
i3wit-upon Area Kestriction
Situs Addresses Tied to Parcel Limit on amount of Built -Upon Area Yes
21225 BETHEL CHURCH RD CORNELIUS Allowed Built -Upon Area 10.00 sq ft
This map or report is prepared for the inventory of real property within Mecklenburg County and is compiled from recorded deeds, plats, tax maps,
surveys, planimetric maps, and other public records and data. Users of this map or report are hereby notified that the aforementioned public primary
information sources should be consulted for verification. Mecklenburg County and its mapping contractors assume no legal responsibility for the
information contained herein.
Page 1/1

Polaris 3G Map — Mecklenburg County, North Carolina
P B & J LLC
Date Printed: 9/24/2019 11:29:32 AM
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This map or report is prepared for the inventory of real property within Mecklenburg County and is compiled from recorded deeds, plats, tax maps, surreys, planimetric maps, and other public recordsand data.
Users of this map or report are hereby notified that the aforementioned public primary information sources should be consulted for verification. Mecklenburg County and its mapping contractors assume no legal
responsibility for the information contained herein.

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Project
Owner:
Contras
CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A
NCAC 02H .0506 and 15A NCAC 02B.0243(8)]
Trees are not allowed to be removed from Cone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be
removed. Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B.0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243
(6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically
approved by the Division. There are limitation on size for decks. [15A NCAC 02B .0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H.0502 and 15A NCAC 02B.0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non-erosive velocities to the lake. [15A NCAC 02B.0243(5), (6)]
Acknowledgement of Notification
11 _ TULU 1 J LLI_lz PW 51'11 , hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any work conducted in the buffer, not specifically stated in the application and approved
by the Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials. ..
Signature (owner): Date. i—Zs—lq

Duke Energy Lake Services
Guidance for Completing an Excavation Permit Application
Step 1: Contact Duke Energy Lake Services
Complete "Part I" of the application and contact Duke Energy Lake Services to schedule a site
visit. Lake Services will conduct a site visit to determine if Duke Energy will accept an
excavation permit application for the proposed work. If the Lake Services representative
determines the application process may proceed, he/she will initial Part I of the application.
Step 2: Draft Application Development
Complete Parts II -IIIA -G and Part V of the Excavation Permit Application.
Note: If you are proposing excavation in association with the pennitting of a facility under the
Marina or Conveyance Programs, you do not need to complete this application. Instead, you
should incorporate the excavation request into the permit application for the marina/conveyance
using the appropriate application forms.
Step 3: Agency Consultation
Send the draft application developed during Step 2 to the agencies for review and comment on
the proposed activity. Refer to the Agency / Organization List available from Duke Energy to
determine which federal, state, regional, and local agencies and organizations require
consultation or review.
Note: Duke Energy reserves the right to require consultation with additional organizations
beyond those included in the Agency / Organization List.
Each agency / organization must be provided at least 30 days prior notification. Evidence must
be provided (e.g., response letter or Certified Mail receipt) in the complete application to show
each agency / organization was given the opportunity to review the proposal.
Consultation letters must be dated within the two years preceding Duke Energy's receipt of the
application. All permits must be valid at time of application and have a term longer than the
projected schedule for completing the permitted project.
What to Expect During Agency Review and Comment:
• You will typically receive a letter from each agency / organization either documenting its
concurrence with your proposal, requiring additional information, recommending
modifications, or offering no comment. You must address each agency's / organization's
comments with a follow-up letter and in your final application as described in part IV.
If you do not receive any documentation from an agency / organization within 30 days of its
receipt of your proposal, you must provide the agency / organization with a follow-up letter
requesting comment on your proposal within 15 days from the date of the follow-up letter. If
you still do not receive any response as a result of the second letter, type "NO RESPONSE"
at the top of the follow-up letter and include it in the application along with proof of the
agency's / organization's receipt of the letter (e.g., Certified Mail receipt). You may proceed
Duke Energy Page 1 of 14 rev 6/20/17
Excavation Program.

with the application process recognizing, however, that if its comments come later in the
application process, you will be required to address them.
From the United States Army Corps of Engineers (Corps): (* * Note — The Corps may have
additional forms to submit for your proposal and an additional fee.) If the excavation can be
done under the requirements of the General Permit (GP) or a Nationwide Permit (NWP), you
will typically receive a copy of the Corps' tear sheet documenting authorization and
providing any additional instructions. If the excavation isn't covered under the GP or a
NWP, you'll be required to obtain an individual 404 Dredge and Fill permit from the Corps.
You must receive written documentation from the Corps that your application either (1)
meets the requirements of the GP or a NWP or (2) the proper 404 Dredge and Fill permit has
been received before Duke Energy can process your application.
• From the North Carolina Department of Environmental Quality (NCDEQ), Division o/'
Water Resources: (Note —N(,DEQ may have additional forms to submit for your proposal
and an additional fee.) If the proposal meets the requirements of the Clean Water Act Sect.
401 Water Quality Certification, you will typically receive a letter from the NCDEQ Division
of Water Resources documenting Sect. 401 Certification and providing any additional
instructions. You may also receive a letter requiring additional information or
recommending modifications. You must receive written documentation from NCDEQ
noting any required Sect. 401 Certification has been received before Duke Energy can
process your application.
• From the North Carolina Wildlife Resources Commission (NC'WRC): If you do not receive
any documentation from the NCWRC within 30 days of their receipt of your application, you
may proceed with the application process without submitting a follow-up request,
recognizing however if comments come in later in the application process, you will be
required to address them.
From the South Carolina Department of Health and Environmental Control (SCDHE(.):
(Note — SCDHEC may have additional forms to submit for your proposal and an additional
fee.) The SCDHEC conducts a joint application process with the USACOE in S.C. If the
proposal meets any applicable requirements of the Clean Water Act Sect. 401 Water Quality
Certification, you will typically receive a letter from SCDHEC documenting Sect. 401
Certification and providing any additional instructions. You may also receive a letter from
USACOE requiring additional information for the agencies participating in the joint
application process. You must receive written documentation from SCDHEC noting Sect.
401 Certification has been received if required before Duke Energy can process your
application.
• From the South Carolina Institute of Archaeology and Anthropology (SCIAA): The applicant
must wait 30 days after receiving the signed postal returned receipt. If a response from
SCIAA has not been received by this time you may proceed with the application process
without submitting a follow-up request, recognizing however if comments come in later in
the application review process, you will also be required to address them.
Step 4: Final Application & Submittal to Duke Energy
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Excavation Program.

Following the consultation process, finalize the application. The final application submitted to
Duke Energy should incorporate all comments and recommendations provided by agencies and
organizations during the agency consultation process as well as copies of all permits received. In
addition to the final application include the following:
• One check payable to Duke Energy for the application fee and security deposit
• If applicable, a separate check payable to the appropriate Habitat Enhancement Program fund
• Signed Excavation Program Applicant's Agreement
Note: Co -applicants must also submit the application fees and HEP fees, if applicable, with the
application.
Duke Energy Page 3 of 14 rev 6/20/17
Excavation Program.

Duke Energy Excavation Permit Application Form
FOR DUKE ENF.RGV USF. ONLY
Duke I ilc No.
Application Pec $ Security Deposit S _ Check # Date Recv'd Initials
Date of Duke Energy Lake Services, applicant and/or contractor on-site inspections Dat9W � K Initials IMA
Date Final Protection/Avoidance Area Markings Field - Verified Initials
Approved to Start Work By * : Uate
(Print) (Sign)
Date Completion Required - Date of Any Approved Extension Initials
Date Passed Closeout Inspection* Initials
Any Stop Work Orders or SMG Violations*? (check one) DYes ONo (IJ Yes, explain in PARTV)
Date Deposit Refunded Initials Date Permit Database Ilpdated Initials
* Forward copy of approved application (all pages, plus any attachments that Duke Energy changed) back to applicant
with Approval Letter and highlight any changes. File copies of Approval and Close-out Checklists and any Stop Work
Orders with application.
Part I. Applicant Information (Please Print)
2J _3(
L�Q�j'���AjSrj I Telephone -0047 - M " 137Q
Email address: ab- ewbN 10 & Q al 1. Cnm
Lake Addres
Z I ZZ 5 e_ -hel hu h Rd..
C01melim-1, Kc, 2$03t
Contractor Company
Mailing Address (if different)
Contractor Contact Person l) A �{Y' Vip Telephone (-(o2q-jO4(o
Contractor Email Address:
LAKE LOT INFORMA'T'ION
Lake 9LY—ow-ounty� Wity rv)State NG Tax Map No. 00111104-
Subdivision Lot / Section No.13 M(A-B% Lot Size U3 Acres
Duke Energy Page 4 of 14 rev 6/'0/17
Excavation Program.

Duke Energy Excavation Permit Application Form
Are there any Co -Applicants*? (check one) O es ❑No (If Yes, include names. street
addresses or lot numbers, pier numbers, phone numbers, and email addresses in Part V —
Additional Information)
* Co -Applicants exist when the proposed work is being done under a single application, will be
performed by a single contractor as one continuous project, and is done to benefit multiple
owners / lease holders of Project -front properties within a single development. There can be no
more than 4 co -applicants in addition to the lead applicant on any application.
Do not continue the application until an on-site inspection has been conducted between a
Duke Energy Lake Representative and the applicant and/or the excavation contractor.
NOTE: Initialling this portion of the application by a Lake Representative in no way
constitutes approval or eminent approval of the excavation or any other lake use permitting
activity.
Date of on-site inspection O 14
Initials (Duke Energy) JFAR
(applicant/contractor)
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Excavation Program.

Duke Energy Excavation Permit Application Form
Part H. Description of Project
A. Basic Info
1. Type of excavation: (cheek one) B New excavation ❑ Maintenance excavation
2. Purpose of excavation: (check one) Q'Boat Access Channel
❑ Water Intake Channel ❑ Wastewater Discharge Channel
❑ Other (spec•ify):
3. Lake user category: (check one) 1J'Private ❑Residential Marina
❑Commercial Marina ❑Public
❑Other (spec):
C
"I
4. Max. Exc ation Area Di ensions (ft). I. ngth Width 7
Depth �L'� 5 5 X 5`1 %4 10
(Note: include additional area dimensions if necessary so response to 45 below equals max. area
dimensions in #-t)
5. Volume of Excavated Material (TOTAL_for the project): "' Cubic yards
6._l;ype of material removed (applicant determines byfield sample ifpractic•al): end,
7. Excavation Site area: D. 0 7 Acre (s) Disposal Site area: . Oz_ Acre
(s) 0.011 OZ
8. "Dotal Disturbed Area (including equipment staging area): -69 Acre (s)
09
9. Does the project meet the requirements of the applicable General Permit'? (check one)
IiKes ❑No
10. Do you claim title to the disposal area? (check one) CN'es ❑No
11. Do you claim title to the equipment staging area? (check one) Imes ❑No
12. Are there any water-treatmen facilities within 50 feet of the proposed excavation area?
(check one) ❑Yes go
(ff Yes, specify):
13. How will the excavated material be entral
erosion control plan and disposal area design
br1 rp er
Co h l XYV
s► ►+ ten es
i�, Yunofe u
and the erosion controlled? (e.g see attached
bales wilt be- 1,
er m 5 0.r&, crew
Duke Energy Page 6 of 14 rev 6/20n7
Excavation Program.

Duke Energy Excavation Permit Application Form
15. Will waters or wetlands be crossed in transporting equipment to or from the site'?
16. W i I I return water re-enter the reservoir? (Check one) OYes ONo HN/A
(If Yes, specifv point(s) o1're-entry and show on Excavation Area Drawing)
17. Is there an existing facility (e.g. pier) that access is being maintained to by conducting the
excavation'? C�Yes ONo
Q/'Yes, specify the existing permit number. If*No, include u scaled drawing of he proposeV
.facility). Permit # 1Ne* 60cy, -D be Con-Mrud-ed,
18. Total planned duration of the work (Inc•lude. first equipment mobilization, excavation
through,final mitigation measures complete):
START I—_ / J CJFINISH /ZO
(Month) (Year) (Month) (Year)
Duke Energy Page 7 of 14 rev 6/20/17
Excavation Program.

Duke Energy Excavation Permit Application Form
Part II. (Continued)
B. Protection / Avoidance Area Description
Complete the following table including all land areas within and immediately adjoining the disturbed area:
Protection/Avoidance Areas
check all that apply)
Approx
Identification
Method (*I
Avoid (A) or Mitigate
**
Acre
Field ID
Work Area Dw . ID
a. Marshland, swamp, ponds, beneficial
aquatic vegetation or other potential wetlands
(circle all that apply)
b. Buffer Zones (specify width & source
of requirement)
F'�rn`le��Q G w 1}jrl }��
nea1�04d� i�J�Q} mIa 11
jran5ppor d Ou - b rI
Ode 1.
en
NN OT be-
ed bevy --M° VI P
e
_
c. Environmental Areas as identified by
Duke Energy
d. Natural Areas as identified by Duke
Energy
CJe a lsvgvch
e. Historic properties (specify)
IAL
Duke Energy Page 8 of 9
Excavation Program rev 2/6/17

Duke Energy Excavation Permit Application Form
* For "Field ID" column, specify entity or person that performed the identification and how it was physically marked (e.g. Duke
Energy (John Doe)/Pink and purple -dotted tape, Corps of Eng. (John Smith)/ yellow flagging). For "Work Area Dwg ID" column,
show the symbol that is used on the drawings to identify the protection/avoidance area.
Duke Energy Page 9 of 9 rev 2!6/17
Excavation Program
f. Rare or threatened species (specify)
1v /k
-
g. Buried gas, water, sewer,
communications or electric lines (circle)
IV V
h. Impact Minimization Zones as
identified by Duke Energy
L Other areas requiring specific
avoidance, protection or mitigation (specify)
* For "Field ID" column, specify entity or person that performed the identification and how it was physically marked (e.g. Duke
Energy (John Doe)/Pink and purple -dotted tape, Corps of Eng. (John Smith)/ yellow flagging). For "Work Area Dwg ID" column,
show the symbol that is used on the drawings to identify the protection/avoidance area.
Duke Energy Page 9 of 9 rev 2!6/17
Excavation Program

Duke Energy Excavation Permit Application Form
** List and attach mitigation plans
Duke Energy Page 10 of 9 rev 2/6/t7
Excavation Program

Duke Energy Excavation Permit Application Form
C. Applicant's Signatures
Applicant Name (print) B`t 1 LIL 1�l Q S .
Applicant Signature* OULL9 1Date
Co -Applicant Name (print) `t �� r�L)1 -'-6zP—WS�t
Co -Applicant Signature* + - Date �'Z,�p" jq
Co -Applicant Name (print)
Co -Applicant Signature* Date
Co -Applicant Name (print)
Co -Applicant Signature* Date
Co -Applicant Name (print)
Co -Applicant Signature* Date
*Per my signature, the information provided in this application is correct to the best of my
knowledge.
Duke Energy Page 11 of 14 rev 2/6/17
Excavation Program

Duke Energy Excavation Permit Application Form
Part M. Information Requirements for All Applicants
In addition to the completed application form PARTS I & 11, the following items must be
provided to Duke Energy by all applicants:
. A copy of the deed and registered survey plat or other instrument under which each
applicant and co -applicant claims title to the affected property (the shoreline adjoining the
excavation area, equipment staging area and the disposal area), OR if the applicant(s) is(are)
not claiming to be the owner(s) of said property, then forward a copy of the deed and
registered survey plat or other instrument under which the owner(s) claim title plus written
authorization from the owner(s) to carry out the project on their land.
An accurate scaled drawing (1 "=25' for projects <1000 cubic yards of material removed or
I "= 100' for larger projects) of the area to be excavated. The drawing must show at a
minimum, a North arrow; a vicinity map; the boundaries and acreage of the proposed
excavation area and equipment staging areas; lake, county, city, cove, tributary, road and
subdivision names and lot numbers (as applicable); property corners for project front lots;
the full pond elevation contour and lines dividing the cove width into equal thirds;
approximate volume in cubic yards of the material to be excavated; point(s) of return water
re-entry; the boundaries of any adjoining areas that are to be specifically avoided or
protected during the work and the location (address) of the disposal area for the excavated
material. [NOTE: A copy of this drawing must also be provided to the excavation
contractor to ensure restricted areas are not impacted.]
An accurate scaled drawing (1 "=25' for projects <1000 cubic yards of material removed or
1 "= 100' for larger projects) of the proposed design for the disposal area. The drawing must
show at a minimum, a North arrow; a vicinity map; the boundaries and acreage of the
proposed disposal area; lake, county, city, cove, tributary, road and subdivision names and
lot numbers (as applicable); the full pond elevation contour (unless disposal is well away
from the lake); the boundaries of any adjoining areas that are to be specifically avoided or
protected during the work; the location (address) of the excavation area from which the
material came and a statement of the disposal area's capacity with all dimensions labeled
that were used in the volume calculation. [NOTE: A copy of this drawing must also be
provided to the excavation contractor to ensure restricted areas are not impacted.]
Also note for projects larger than one (1) acre in North Carolina, including excavated,
equipment staging, and disposal areas, you must submit an erosion control plan. For
projects larger than two (2) acres in South Carolina, including excavated, equipment staging
and disposal areas, you must submit an erosion control plan. For projects < two (2) acres in
South Carolina, you must submit a completed standard reporting form for construction sites
disturbing two (2) acres or less to the South Carolina Dept. of Health and Environmental
A map or directions by road showing directions to both the excavation area and disposal
area.
Duke Energy Page 12 of 14 rev 2/6/17
Excavation Program

Duke Energy Excavation Permit Application Form
Iz A USGS topographic map with a directional arrow indicating the exact location of the
excavation project and Latitudinal and Longitudinal coordinates for the project site.
A list of names and addresses of adjoining property owners for both the excavation area and
disposal area.
The existing permit number if excavation is being conducted to maintain access to an
existing facility (e.g. pier) or provide an accurate scaled drawing of any proposed facility if a
facility does not currently exist. Note: A separate application and approval is required for
proposed Private Facilities (e.g. pier).
H. A copy of all permits and/or letters of correspondence to/from local, state and federal
agencies that require notification or issue individual permits.
Duke Energy Page 13 of 14 rev 2/6/12
Excavation Program

Duke Energy Excavation Permit Application Form
Part IV. Agency Reviews and Approvals
(Begin this section with a summary table of all agencies consulted, comments received, and
applicant response to agency comments (see example table below). Agencies should be listed in
the order shown in the Agency/Organization List. Consultation letters must be dated within the
two years preceding Duke Energy's receipt of the application.
Table IV -1. Sample Agency Comment and Response Table
Agency
Agency Comment
Applicant Response
Agency 1
The activity is approved as
NA
Issuance
proposed.
Agency 1
Agency 2
The on-site well provides drinking
Contacted Mr. Smith on I/l/20xx.
Agency 2
water to the public. Please contact
No further action needed.
Mr. Smith to discuss the proposed
changes and potential issues
associated with your proposal.
You must contact us immediately if
Applicant will contact Agency 2 if
endangered species are located
endangered species are located
during the course of construction.
during construction
Agency 3
Requested agency comments on
NA
1 / 1 /20xx and again on 2/ 1 /20xx. No
response as of 2/16/20xx.
Following the table of agency comments and applicant responses, include a table of permits and
certifications issued by the reviewing agencies. As with the table of agency comments and
applicant responses, agencies should be listed in the same order as they are listed in the
Agency/Organization List.
Table IV -2. Sample Agency Permits and Certifications Table
Agency
Permit/Certification Name
Date of
Date of
Issuance
Expiration
Agency 1
Surface Water Withdrawal Permit
Agency 2
Section 401 Water Quality Certification
Following the two summary tables, include a copy of all correspondence to and from any local,
regional, state and federal agencies or other organizations with which you are required to
consult, including any required permits (e.g., Section 401 water quality certifications, Section
404 dredge/fill permits, building permits, etc.) or other approvals or comments which have been
obtained from these organizations regarding this activity. Include a copy of any local, regional,
state or federal regulations or guidelines that will be followed. All permitting issues must be
resolved and clearly documented. Correspondence should be organized in the order the
agencies are listed on the Agency/Organization list with the applicant's request for comments
followed by additional correspondence in chronological order. All permits must be valid at time
Duke Energy Page 14 of 14 rev 2/6i17
Excavation Program

Duke Energy Excavation Permit Application Form
ol'application and have a term longer than the prgjected schedule for completing the permitted
project.
Part V. Additional Information
(provide am, relevant additional information. Reference previous parts as applicable. Inch4de
the FERC -required Environmental Assessment if applicable. If there are co -applicants, this is
where, their information would be provided.)
CO --I 1 I can- - i Tr oYY)OL4 i s io
e 1b � 3- I LI -C- I�au 1 3a52�eyv 51 fi 1
&8dre55 = � �
12 2 ��,re SS -
�1n e l Church Rd . ,
Ue+bel Chun -h �
I Z` q �e (�r1ne uS, ANG 25 3
z C 28031
Lr.. n zl , ut--), 1�
Duke Energy Page 15 of 14 rev 2/6/17
Excavation Program

Excavation Project User's Agreement Letter
(Please Dill in the blanks. Please Print)
Date c_Z_5_ jq
TO: Duke Energy
C/o Lake Services -- E(' 12Q
526 S. Church Street
Charlotte. NC 28202
RE: Excavation For (Suhtlit'i i n mul Lw # or Other; )inject Name)
(LakelC ountr/C'iti-)
NG `'� r�lOiogeev°t)
IApplit•ant's Jill nanny) gUIME7 w5hereby agrees to comply with all
reconunendations, requirements and/or conditions of Duke Energy Lake Services, General
Permit(s) (i applicable) and other federal, state and local agency requirements pertaining to tile.
application to excavate for the purpose of a _�,tT 1DCir-C1-t�6
In addition, /Are have rears and agree to comply with Duke's current Shoreline Management Plan
(SMP), much of which is repeated herein, and understand that written authorization must he
ohtained front Duke Energy Lake Services prior to beginning any activity within the IFFIRC
project boundary or on Duke Energy land. The excavation will he completed as described in the
approved application and within eighteen (1 K) months front the date of' written approval by Lake
Services, unless speril-ically noted otherwise in the application or unless I/we obtain approval for
a single, time extension (maximum of one year) in writing front Duke Energy Lake Services.
I111W understand that if the SNIP or other applicable rules change during any extension period,
I/we will he expected to comply with the new requirements to the maximum extent practicable.
I/we also recognize that failure to complete the excavation within this build -out period will
require the filing of it new application within the then -current SMP and the new application must
include any applicable fees and security deposits.
I/we attest to be the owner(s) or lease holder(s) of the land immediately adjoining the project
boundary or Duke-oNvned peripheral strip where the excavation activity is to take place, or if not
the owner or lease holder, I/we have included proof of title to the property and NNritten
authorization from the owner(s) or lease holder(s) to carry out the proposal within the project
boundary adjacent to their land.
I/tine attest to he the owner(s) or lease holder(s) of the land that will he used for equipment
staging and disposal of excavated material or if not the owner or lease holder, IA,e have included
proof of title to the property and written authorization from the owner(s) or lease holder(s) to
carry out the work on their land.
Page 1

//11V undcrStand Ihat all excav,►tion Work must he done directly in front of 111Y/our property and
within the third of the cove nearest ntx-loser properly or within any middle third cif the cove that
Duke owns, or 1/11-C have written authorisation h-onl the owner(s) or lease holdcr(s) to
Carly out the proposal within the project boundary adjacent to/on their land. 1/11-c also understand
that access channels must run perpendiculau- to the shoreline while within the third of the cove
area that is nearest my/our property.
/1we under.Stand that for proposed excavations, 1/tV must IlotIfy the appropriate local, state and
federal agencies in advance of' the activity by sending them a completed copy of Duke's
Excavation Permit Application Form and other required information. Ywe understand that
written authorization and/or other permits may be required by some of these agencies and such
required authorizations must be obtained before Mire submit the final application to Duke
Energy Lake Services.
Mi'e understand that except for maintetimice e ceweitions, any excavation exceeding 2000 cubic
yards of material renwved or any excavation or shoreline stabilization work needed to support an
application that requires Federal Fnergy Regulatory Commission (FERC) review does itself
require specific review and approval by the FERC before Duke Energy can issue any approvals.
1/we agree that unless specifically approved otherwise in the application, explosives will not he
used as part of this excavation activity.
1111V understand that every reasonable effort must he made to minimize any adverse impact on
fish, wildlife and other natural resources.
1/11'e understand that applicants in South Carolina proposing excavations that are not covered
Under the General 1'erinit, or are greater than 150 cubic yards, must receive prior written
authorization from the South Carolina Department of Health and Environmental Control
(SCDHEC) or the LIS Army Corps of Engineers (us cr1)1Vic able) before subnlittin(3 the completed
application to Lake Services.
Mwe agree that excavation activities in North Carolina and South Carolina will not occur durin<(I
the months of March, April, May and June because of the potential impacts to fish spawning
areas.
Mwe understand that trees and vegetation growing within or adjoining the lake play an important
role in its overall environmental condition, and the ecological benefit the vegetation has on fish
and wildlife habitat directly supports a sound and healthy lake environment. Ywe also understand
that unauthorized removal of shoreline vegetation (e.g. button bushes, willows, cattails, etc.)
and/or disturbance of the shoreline huffer may result in suspension or denial of lake use
permitting requests, forfeiture of security deposits and require re-establishment of vegetation at
I►Iv/our expense, particularly if the disturbance is found to be in violation of state or local
ordinances or impacts FERC project buffers.
IMAs I.1k•1L% Page til'v: 6/I6/I7

1/11 e agree that all rxraN atcd ►naUcrial �N ill he placed in upland areas, Iand��ard of the project
hound,ufv, and confined to prevent erosion and sedimentation hack into the laky or nearhv
"tream".
1/►re agree to adequately stahilizc all excavated material and all disturbed ,shoreline to prevent
erosion and runoff into the lake.
1/11•e understand that the double handling of excavated material will not he allowed; therefore, all
excavated material must be placed above the project boundary in one handling.
1/we have designed the hydraulic excavation process (il uir�� Will he risen/) so that return k�'ater re-
enters the lake in the same general vicinity and cove as the excavation, to the maximum extent
practicable.
Uwe agree that the proposed excavation will not be l'or the purpose of creating additional
shoreline. will not alter the project houndary or the full pond contour, and will not impact
threatened or endangered species, historic properties, or environmentally -important areas, unless
Special public entity provisions \vere made in the application.
1/11-e recognize that it is mylour responsibility to clearly locate in the field and label on imlo rr
work area drawings any areas that require specific protection or avoidance during this excavation
work. Examples of these protection/avoidance areas include but arc not limited to, any
Environmental Areas, 1\lalural Areas or Impact Minimization Zones as identified by Duke;
jurisdictional wetlands; historic properties; rare or threatened species; and buried gas, water,
sewer, electric or communications lines. Mwe agree to provide ort -lour contractor with a copy of
these work area drawings showing these areas to stress the necessary protection measures.
1/►re agree that if any archaeological resources (e.g. pottery shards, Indian artifacts, etc.) are
discovered during the excavation, work shall he halted immediately. I/tie will then notify Duke
Energy Lake Services and the State Historic Preservation Office to determine what measures. if
any, //we must pursue to protect or salvage the archaeological resources.
//ire agree that any excavation from within the project boundary will not exceed the volume as
outlined in the application and will remove and disturb only what is absolutely necessary to
achieve the project's stated purpose.
11we agree to be fully responsible f*or the permitted lake use and 1/11-e understand that this
responsibility is considered to transfer automatically along with ownership and leases of the
adjoining tract.
11VV - understand Duke Energy representatives may issue Stop Work Directives for violations of
the SMP and other consequences may result from such violations, including but not limited to
suspension or cancellation of approved permits, increases in fees, modification or removal of
non -complying structures and restoration of disturbed areas at mylour own expense or loss of any
consideration for future lake use permits. 11we agree to immediately comply with any Stop Work
I)uk, I w, Page 3 u,. aurin

Directives, to fully cooperate with Duke Energy Lake Services and other agencies its necctisary.
and to perform the neceSSary remedial actions within the specified tittle I'rune.
//we aorce to develop any required linttgation planS and to complete any required nlitl-�Ition
activities at mYlour own expense within the specified tinge frames. I/ire recognize that the
excavation work is not considered complete and deposit.S will not he refuncled until the
nliticlatloll requirements (if any) have been Satisfactorily fulfilled.
Mve agree to notify Lake Services by phone when the excavation IS 1111t1atCCl MId to CIISLII-C that
during the excavation period I/we will host Duke Energy's approval letter in a clear waterproof
bag at the job site and visible from the water's edge
//we agree to notify Lake Services in writing when the excavation is completed (including any
required mitigation measures) and that the excavation was completed per the approved
application, so a close-out inspection can be performed.
/AlT recognize Security depoSitS will not he refunded if any violations of the SMP Or this user's
a�-'rccnlcnt occur.
IAVC understand there will he no change in hydro project operations as a rcSult of the excavation
and/or utilization of the excavated area.
1/we a`Tree to maintain the work area in a safe condition and to gully indemnify and save Duke
Energy harmless from any and all claims, liability, loss or darnape that may cu,ise frons this
excavation protect.
VIVe understand that this LISCCS agreement does not, in any way, constitute the transfer of any
rights in real property and that MIAMI/- use and enjoy111ent of FERC project I<ulds and waters shall
not hinder the general pLIMIC'S lawful LISC anti enjoyment of the sante.
Sincerely,
1, r
- I ---
Applicant's Name (Print) AIp
a 's Signature
Co -Applicant's Nance (Print) �� ticant's Si_n.Uurc
Co-ApplicanCs Name (Print) Co -A licani's Signature
Co -Applicant's Name (Print) CO -Applicant's Sionature
Co -Applicant's Name (Print) Co -Applicant's Signature
DA'. I'iu y , Noe 4 Kc,: 0/16/17

B32378 - P896
For Registration Fredrick Smith
Register of Deeds
Mecklenburg County, NC
Electronically Recorded
2017 Dec 29 02.30 PM RE Excise Tax. $ 1802.00
Book: 32378 Page: 896 Fee: $ 26.00
Instrument Number: 2017174345
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $ 1,802.00
Parcel Identifier No. 00 17 1104 verified by ! County on the day of 20_
By:
MaillBox to: Thebeau & Associates PA,19600 W. Catawba Ave., Bldg. A, Ste. 100. Cornelius, NC 28031
This instrument was prepared by: Thebeau & Associates. PA, 19600 W. Catawba Ave- Bldg. A Ste. 100 Cornelius NC 2803 I
Brief description for the Index: LUT Metes and Bounds.
THIS DEED made this 28th day of December , 2017 , by and between
GRANTOR
William B. Hillegass and Doris R. Hillegass,
Trustees under The Hillegass Family
Legacy Trust, dated July 22, 2015, and any
amendments thereto, and William B.
Hillegass and Doris R. HiIlegass
GRANTEE
PB&J, LLC, a North Carolina Limited Liability
Company
Property Address: 21225 Bethel Church Rd
Cornelius, NC 28031
Mailing Address: 19449 Peninsula Shores Drive
Cornelius, NC 28031
Enter in appropriate block for each Grantor and Grantee: name, mailing address. and, if appropriate, character of entity, e,g.
corporation or partnership.
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include singular,
plural, masculine, fenunine or neuter as required by context.
WITNF,SSETH, 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, parcel of land or condominium unit
situated in the City of Cornelius Township, Mecklenburg_ County.
North Carolina and more particularly described as follows:
See Attached
The property hereinabove described was acquired by Grantor by instrument recorded in Book page
All or a portion of the property herein conveyed __ includes or X does not include the primary residence of a Grantor.
A map showing the above described property is recorded in Plat Book page
Page I of 2
NC Bar Association Form No. 3 0 1976, Revised 0 1977, 2002, 2013 This standard form has been approved by:
Punted by Agreement with the NC Bar Association —1931 North Carolina Bar Associalion — NC Bar Form No. 3
submitted electronically by "Thebeau and Associates"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Mecklenburg county Register of Deeds.

B32378 - P897
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Crantce in fee
simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to coney the same in fee
simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the lawful
claims of all persons whomsoever. other than the following exceptions:
All such valid and enforceable easements and restrictions of record.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written.
State of RU, - Counry or City of _ Mecklenburg,
I, the undersigned Notary Public of the County or City of ` and Sta ff! f%g5aid• certify that;"v t',; ;,rr /i
dersbtl ytappe �tf'tS 3� j Q. t'tirs day and acknowledged the due
execution of the foregoing instntment for the purposes therein expressed. Witness my hand and- ial stamp or seal this 28th day of
December f � 7
My Commission Expires: ; ��� ��Ir�. �. : zat lea i Notary Puhlic
(Affix Seal) Notary's Painted or Typed Name
State of County or City of
I, the undersigned Notary Pulic of -the Coun and State aforesaid, certify that
_ IR OWN HAN,�ersonall gyred b f tI ' d d
execution of the foregoing instrument
My Commission Expires:
(Affix Seal)
y ppe� a ore me ns ay an acl.nowledged the due
purposes tlkt4'c+i`�fit' Witness y hand and Notarial stamp or seal ;his day of
Mc�cler u ' -
North Carotins
My Commission Expires Oct 21. 2020
Notary Public
Notary's Printed or Typed Name
State of - County or City of
1. the undersigned Notary Public of the County or City of and State aforesaid, certify that
personally came before me this day and acknowledged that
_he is the of . a North Carolina or
corporation/limited liability company/general partnership/limited partnership (strike through the
inapplicable), and that by authority duly given and as the act of such entity, _he signed the foregoing instrument in its name on its
behalf as its act and deed. Witness my hand and Notarial stamp or seal, this day of _ 20`.
My Commission Expires:
(Affix Seal)
Notary's Printed or Typed Name
Votary Public
Page 2of2
NC Bar Associatioa Form No. 3 A 1976• Revised ® 1977. 2002,2013 ibis standard form has been approved by:
Printed by Agmment with the NC Bar Association —1951 North Carolina Bar Association — \C Bar Form No. 3
(SEAL)
(Entity Name)
PrincfType Name:
Printlfype lame & Title:
(SEAL)
Print/Type Name:
By:
Prinu Type Tame & Title:
- %./.4=Lr� SEAL
Printffype Name:
By:
Print/Type Name & Title:
(SEAL)
Printffype Name:
State of RU, - Counry or City of _ Mecklenburg,
I, the undersigned Notary Public of the County or City of ` and Sta ff! f%g5aid• certify that;"v t',; ;,rr /i
dersbtl ytappe �tf'tS 3� j Q. t'tirs day and acknowledged the due
execution of the foregoing instntment for the purposes therein expressed. Witness my hand and- ial stamp or seal this 28th day of
December f � 7
My Commission Expires: ; ��� ��Ir�. �. : zat lea i Notary Puhlic
(Affix Seal) Notary's Painted or Typed Name
State of County or City of
I, the undersigned Notary Pulic of -the Coun and State aforesaid, certify that
_ IR OWN HAN,�ersonall gyred b f tI ' d d
execution of the foregoing instrument
My Commission Expires:
(Affix Seal)
y ppe� a ore me ns ay an acl.nowledged the due
purposes tlkt4'c+i`�fit' Witness y hand and Notarial stamp or seal ;his day of
Mc�cler u ' -
North Carotins
My Commission Expires Oct 21. 2020
Notary Public
Notary's Printed or Typed Name
State of - County or City of
1. the undersigned Notary Public of the County or City of and State aforesaid, certify that
personally came before me this day and acknowledged that
_he is the of . a North Carolina or
corporation/limited liability company/general partnership/limited partnership (strike through the
inapplicable), and that by authority duly given and as the act of such entity, _he signed the foregoing instrument in its name on its
behalf as its act and deed. Witness my hand and Notarial stamp or seal, this day of _ 20`.
My Commission Expires:
(Affix Seal)
Notary's Printed or Typed Name
Votary Public
Page 2of2
NC Bar Associatioa Form No. 3 A 1976• Revised ® 1977. 2002,2013 ibis standard form has been approved by:
Printed by Agmment with the NC Bar Association —1951 North Carolina Bar Association — \C Bar Form No. 3

B32378 - P898
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee
simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the same in fee
simple, that title is marketable and free and clear of all encumbrances. and that Grantor will warrant and defend the title against the lawful
claims of all persons whomsoever, other than the following exceptions:
All such valid and enforceable easements and restrictions of record.
IN WITLESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written.
The Hillegass Family Legacy Trust, dated July 22.2015 (SEAL)
(Entity Fame) Print/Type Name:
By;
Print(Type Name & Title: William B. Hillegass,Trustee
By: z ;�
Print/Type Name & Title: Doris R, Hl rustee
By: �L/rziei / // Glc-;�lc�a/ �f'l2ti•zt�
Print/Type Name & Title:
State of
- County or City of
the undersigned Notary Public of the County or City of
execution of the foregoing instrument for the purposes therein expressed
— ----- , 20_.
My Cornmission Expires:
(Affix Seal)
State of 1-
1, the undersigned Notary P>:
execution of the foregoing instrument
20
My Commission Expires:
(Affix Seal)
County or Cil
is of the C6MY!o*tgRtR
MyAdorth Carolina
(SEAL)
Print/Type Name:
(SEAL)
PrintlType Name:
-
(SEAL)
Print/Type Name:
__ and State aforesaid, certify that
personally appeared before me this day and acknowledged the due
Witness my hand and Notarial stamp or seal this day of
Notary Public
Notary's Printed or Typcd Name
and State aforesaid, certify that
r appeared before me this day and acknowledged the due
my hand and Notarial stamp or seal this day of
Notary's Printed or Typed Name
Notary Public
State of -County or City of Mecklenburg
I. the undersignotary Pu o the County or City of Mecklenburg and State aforesaid, certify that
William B. Hille ass c}' %S r.. • (� j personally an efor a day and acknowledged that
Tis the Trustee'" of The illegass Family Legacy Trust�t a o h aro t 11 ZeII j
{ `�� 11 eez�nr�rionllimited liability company/general partnership/ i itspa—erchip (strike through the
inapplicable), and that by authority duly given and as the act of such entity, _he signed the foregoing instrument in its name on its
behalf as its act and deed. Witness my hand andNotarial stamp or seal, this 28th d of December _2017
M Commission Expires: I �` fl+
My p ✓ rotary Public
(Affix Seal) Notary's Printed or yped Name
Page 2 of 2
NC Bar Association Form No. 3 C 1976, Revised ®1977, 2002. 2013 This standard form has been approved by:
Printed by agreement with the NC Bar Association — 1981 North Carolina Bar Associalion - NC Ba- Form No. 3

B32378 - P899
EXHIBIT "A"
Legal Description
For 21225 Bethel Church Road, Cornelius, NC 28031
BEGINNING at a computed point in the centerline of Bethel Church Road, SR #2189, and
running South 80-02-59 East 123.76 feet to a computed point in the centerline of Bethel Church
Road, SR #2189; thence turning and running South 29-1345 West 311.70 feet to a #4 rebar set,
running through a #4 rebar set at 31.49 feet; thence turning and running South 77-17-05 West
31.00 feet to a #5 rebar; thence turning and running South 27-44-13 West 123.96 feet to a #5
rebar; thence tuming and running South 82-17-32 West 123.24 feet to a 94 rebar set; thence
turning and running North 29-24-21 East 545.69 feet, running through a #5 rebar bent at 458.22
feet, to the point and place of BEGINNING, containing 1.192 acres, more or less, as shown on
survey prepared by Professional Property Surveyors, Inc. dated June 30, 2017.
Along with the following parcel described as:
BEGINNING at a #4 rebar and being a common point Nvith the Lacy L. McGraw and Joan S.
McGraw Property, now or formerly, and Parcel #001-711-04, and running North 82-17-32 East
123.24 feet to a #5 rebar; thence turning and running North 2744-13 East 123.96 feet to a #5
rebar; thence turning and running North 77-17-05 East 31.00 feet to a #4 rebar set; thence
turning and running North 80-32-37 East 81.25 feet to a #5 rebar; thence turning and running
South 05-02-26 East 29.63 feet to a computed point; the next 13 calls and distances running
along a line with Lake Norman, thence turning and running North 48-10-30 West 16.31 feet to a
computed point; thence turning and running North 72-39-10 West 24.93 feet to a computed
point; thence turning and running South 79-39-56 West 27.85 feet to a computed point; thence
turning and running South 48-11-49 West 24.42 feet to a computed point; thence turning and
running South 40-55-27 West 19.08 feet to a computed point; thence turning and running South
20-56-00 West 66.10 feet to a computed point; thence turning and running South 32-13-35 West
43.43 feet to a computed point; thence turning and running South 49-53-00 West 20.39 feet to a
computed point; thence turning and running South 62-27-44 West 28.18 feet to a computed
point; thence turning and running South 73-16-51 West 44.55 feet to a computed point thence
turning and running South 81-23-07 West 52.68 feet to a computed point; thence turning and
running South 86-00-34 West 44.33 feet to a #4 rebar set; thence turning and running North 29-
24-21 East 54.21 feet to a #4 rebar, being the POINT AND PLACE OF BEGINNING,
containing 0.280 acres, more or less, identified as Parcel 1 on the survey prepared by
Professional Property Surveyors, Inc., dated June 30, 2017.
Being the same property conveyed by deed recorded in Book 30291 at Page 817 and Book 8209
at Page 404.

i
lip
HE
NS
1,4
111D #
E!b
00 1 7 1 1 01
i,in
TOTAL AREA
00 f 71 1 - 04
99,934 5Q. FT
TCTAI AREA
1375 ACRES
51.935 SQ. FT
1.192 ACRES
"is E.
IV
.
ZrI
L 4 A'A'
—OPMAN
451-4-,
It
0
PPM AT
t:21
�, z 1.
T! P �E
JC­C"A PRt��W7- Nf
& N11G SET
!M,
,T1
-IRV E
PHYSICAL �'URVFY
i Lpl; I OF
171 . 1.nl
:14 W111-- il
1, MEX ENEII;qC., P4-1.
'
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'.' - ?- -71 1 :4:
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I ur% e% 6rs. In,
9 A W: I H 4',I
—7s

B32487 - P423
For Registration Fredrick Smith
Register of Deeds
Mecklenburg County, NC
Electronically Recorded
2018 Feb 26 01 47 PM RE Excise Tax $ 1182 00
Book: 32487 Page_ 423 Fee $ 26.00
Instrument Number 2018021769
NORTH CAROLINA GENERAL `'VARRANTY DEED
Excise Tax: $ 1,182.00
Parcel identifier No. 00171103 _ Verified by County on the __ day of 20
By: —
Mail/Box to: 'fbcbeau & Associates, PA, 19600 W Catawba Ave., Bldg. A Ste. 100 Cornelius NC 28031
This instrument was prepared by: Thebeau & Associates, PA. 19600 W Catawba Ave Bldg Ste 100 Cornelius NC 28031
Brief description for the Index:—LOT Metes and Bounds,
THIS DEED made this _26th___ day of February 20 18 , by and between
GRANTOR
William B. Hiliegassand Doris R. Hillegass,
Trustees under the Hillegass Family
Legacy Trust, dated July 22, 201 5, and
any amendments thereto
404 Trinity Oaks Drive
Salisbury, NC 28144
GRANTEE
PB&J, LLC,
a North Carolina Limited Liability Company
Mai I ing Address: 19449 Peninsula Shores Drive
Cornelius, NC 28031
Property Address: 21219 Bethel Church Road
Cornelius, NC 28031
Enter in appropriate block for each Grantor and Grantee: name, mailing address, and, if appropriate, character of entity, e.g.
corporation or partnership.
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, parcel of land or condominium unit
situated in the City of Cornelius Township, Mecklenburg County,
North Carolina and more particularly described as follows:
See Attached
The property hereinabove described was acquired by Grantor by instni ment recorded in Book 30291 page ^_ 814
All or a portion of the property herein conveyed includes or
-2L does not include the primary residence of a Grantor.
A map showing the above described property is recorded in Plat Book page
Page 1 of 2
NC Bar Association Form No. 3 9 1976, Revised ©1977, 2002. 2013 This standard form has been approved by:
Printed by Ageement with the NC Bar Assmiation —1981 North Carolina Bar Association IAC Bar Form No. 3
submitted electronically by "Thebeau and Associates"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Mecklenburg county Register of Deeds.

B32487 - P424
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee
simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the prenvses in fee simple, has the right to convey the same in fee
simple, that ride is marketable and free and clear of all encutr,brances, and that Grantor will warrant and defend the bile against the lawful
claims of all persons whomsoever, other than the following exceptions,
All such valid and enforceable easements and restrictions of record.
IN WII:NESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written.
the
leo ss Family LegaLv Trust, dated July 22. 2015
{Gnticy ?K"erne�.f. �
NnUType Name & TitIe: William B. ilillegass,Trustae
X'91�
Print/Type Name & Title: - Doris R. FAlegass, Trustee
By:
Print/Type Name & Title:,
State of
NV _ - County or City of JE
1, the undersigned Notary Public of the County or Ci
t&�s r parks t2.ihllows 1'-' --des of My
r of the fore ping instgnt for the purposes therein
My Commission Expires:
(Affix Seal)
(SEAL)
Print/Type Name:
S( EAL)
Print/Type Name:
(SEAL)
Print/Type Name:
----
(SEAL)
Print/Type Name:
>e ape nd,e "ifo
t�eiissadidy, cef th it t S
g to
Witness rn hand and'Notarial stamp or seal this 2 da
Y p day of
Va Nvtary Public
NoUry's Prinled or Typed Name
State of I —M `" -- --
--
1. the undersigned Notary Puklic ¢f the
execution of the foregoing instrument
— -- — — 20_
Ity Commission Expires:
(Affix Seal)
ptuposesthataitY0gw1i9sed. Witness
My Commission Expires Oct 21. 2020
-- and State aforesaid, certifv that
)eared before 1ne this day and acknowledged the due
hand and Notarial stamp or seal this —__ day of
Notary's Printed or Typed Name
Notary Public
State of N C - County or City of Mecklenburg
1, the undersigned Notary Public of the Count or City of Mecklenhnru and State aforesaid, certify that
William B. Hillecass d i�51"l$ - �. I fi I l �C�`S personally came before me this day and acknowledged that
Ills the TrusteeS of William B. Hilleeass and Doris R a NorJt Carolina or
1 corporation/limited liability company/general partnership/limited partnership (strike through the
inapplicable). and that by authority duly given and as the act of such entity, _he signed the foregoing instntrnent in its name on its
behalf as its act and deed, Witness my hand and Notarial stamp or seal, this 26th day of February 2018 .
My Conunission Expires:
(Affix Seal)
Notary Public
Notary's Printed or Typed Nagle
Parte 2 of 2
NC Bar .Association Fo m No. 3 ® 1976, Rcviscd ® 1977. 200' 2013 This standard foam has been approved bryby:
Printed by A� eoment with the NC Bar Association — 1981 North Carolina Bar m.N Association — NC Bar Foro. 3

B32487 - P425
ATTACHMENT
"Exhibit k"
BEGINNING at a computed point in the centerline of Bethel Church Road, SR #2189, and running South 80-02-59
East 184.86 feet to a computed point in the centerline of Bethel Church Road, SR #2189; thence turning and
running South 28-52-36 West 418.16 feet, being a common boundary with the Richard A. Mellone and Sara K.
Mellone Property, now or formerly, running to a 1" Pipe, passing through a 1" Pipe Bent at 27.88 feet; thence
turning and running North 39-51-56 West 55.02 feet to a #5 Rebar; thence turning and running North 38-31-10
West 15.08 feet to a computed point; thence turning and running North 05-02-26 West 56.10 feet to a computed
point; thence continuing North 05-02-26 West 29.63 feet to a #5 Rebar; thence turning and running South
80-32-37 West 81.25 feet to a #4 Rebar Set; thence turning and running North 29-13-45 East 280.21 feet to a #4
Rebar Set; thence continuing on North 29-13-45 East 31.49 feet to the POINT AND PLACE OF BEGINNING,
containing 1.375 acres, more or less, located in Mecklenburg County, as shown on survey prepared by
Professlonal Property Siurveyors, Inc., dated June 30, 2017, attached hereto as Exhibit "B" for reference.
Along with the following parcel described as;
BEGINNING at a 1" Pipe and being a common point with Parcel ID #001-711-03 and the Richard A. Mellone and
Sara K, Mellone Property, now or formerly, and running South 71-07-28 West 13.88 feet to a #5 Rebar; thence
turning and running North 49-00-37 West 9.84 feet to a computed point; thence turning and running North
20-03-33 West 42.88 feet to a #5 Rebar; thence turning and running South 39-51-56 East 55.02 feet to the POINT
AND PLACE OF BEGINNING, containing 0.010 acre, more or less, located in Mecklenburg County, as shown on
the survey attached as Exhibit "B" for reference.
Being the same property conveyed by deed recorded in Book 30291, Page 814 and deed recorded in Book 8209,
Page 404.
P8&J, LLC
21219 Bethel Church Road, Cornelius, NC 28031

RE
G�ALATIONAN�IMD ASM
REQUIREMENTS FOR PLATS
twlt.»t. �" aY'h w LeP
B32487 - P426
['EXHIBIT B[I
m.a. nb, m n. nr �Nt Ir,ab nr1'-r.Y.tar
ai int .ns 1 rfew,n r.,kret.l e! wtlen bre
aTa^uae r�w- w- 110.000 wal M ea.pr b.e n,re
^ /ea br tfe et rawrwotl 1t Y, bt AaMbyl aV.
ob bara�r a. sero tbw .ne.
rb_wIH. 'Ml n�JN rt1�✓N r Nlprn ttMM C C
Dof a Ir,p 9. over :-N'1
P'f-
RCLx v oAD
Aa°HP kP .tE�. CO US1 -
Pro r
OOr—ill-03
TOTALAAEA
ST -93435 i*.
L175 ACMES
�. r ee.r o Tr•
�1
W;wos'mro�
7�_F3 1
OleHarylad 1.:.1..6,. 1 � Nr 1
of+17a ry v '� 1
C
1 1
1
80
I
LAAW NORMAN
YHYSIC,1L SURVEY OF PARLEL IF S
091-711-�3, 001-71!-Ol k ALXAT 44L $14.P5
- PWJPCR Y 0•' -
PALI1. b. 9Eftl JASZEWSJ
2,2 2.s k 71719 SE74FL CMIYCN NAAn
=t1R11[Wly MECRLLVYJ9: CMWTV. NOM OAR01.0-
AS RECORDED IN OLID DOOR 30791. Mf AI[
DIM RDOt k -m. PAfF eoe
S.wt{(Y DATL 06!30,12M7
Pyr1I�
MC saw+ar RO
t.lq-C Drs, Tnc. N) 74- 1 78031
rTew xr.a -nu (r9a) ns-slsa r.r,yra,
lt�(A
^mral rs ols'btl:
Y• eTMrr :T
camtlac wrlT
', u.rY rats
Att
74Y.Ot't rAWCWT Lw
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- PROPERTY OF -
PAUL do BETH JASZEwiK.I
21.25 & 21219 BETHEL CHFIRCH ROAD
C;Rf1e'OS MECKLENWAG COUNTY, NORTH CAROU11A
AS RE_,)RJtD IN GEED BC4)k 30291, PACE 814
Y DEED BOCK 8209, PACE 4d4
SORVU GATE'. 6636/2017
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DUKE ENERGY DIRECTIONS BY ROAD FORM
Lake Use Permit Applicants and Contractors: Ease of' locating the proposed project
sit e canhavea big, impact on permitting processing time. Please complete this form and
return it along xN ith N our completed application to:
DUKE ENERGY
CIO LAKE SERVICES - EC 12 Q
526 SOUTH CHURCH STREET
CHARLOTTE, NC 28202
Applicant's Name: PB &J LLC Paul Jaszewski
Street Address (at lake): 21225 Bethel Church Road Cornelius, NC 28031
Lake Name: Norman
Subdivision Name:
Property Section:
Lot #: Lot 3 M64-896
City: Cornelius County:
State: N
Zip:
Telephone: Cell 704-728-1379
Directions (from major road or highway):
Mecklenbur
28031
From I-77 North Bound, take Exit 28, left onto West Catawba Ave.,
Right onto Bethel Church Road. Property is on the left just beyond
Pinehurst Drive.
Descriptive Structure(s) on Property (i.e. brick garage, white fence,
mobile home, etc.)
*Note: Please use the back of this form if desired to draw us a map to the site.

DUKE ENERGY DIRECTIONS BY ROAD FORM
Lake Use Permit Applicants and Contractors: Ease of locating the proposed project
site canliavea big impact on permitting processing time. Please complete this form and
return it along with your completed application to:
DUKE ENERGY
CIO LAKE SERVICES — EC 12 Q
526 SOUTH CHURCH STREET
CHARLOTTE, NC 28202
Applicant's Name: P B & J LLC Paul Jaszewski
Street Address (at lake):
Lake Name: N
Subdivision Name:
Property Section:
City:
Cornelius
21219 Bethel Church Road Cornelius. NC 28031
Lot #: Lot 1 M64-896
County: Mecklenburg
State: NC Zip: 28031
Telephone: Cell 704-728-1379
Directions (from major road or highway):
From I-77 North Bound, take Exit 28, left onto West Catawba Ave.,
Right onto Bethel Church Road. Property is on the left just beyond
Pinehurst Drive.
Descriptive Structure(s) on Property (i.e. brick garage, white fence,
mobile home, etc.)
*Note: Please use the back of this form if desired to draw us a map to the site.

L/�7�/{7 U S. DEPARTMENT OF TME WTERIOR a,r.+ir LAKE NORMAN SOUTH QUADRANGLE
US E�xo*uSUpvfy rga WORTMCAWAI
o..A..�..0 .J US Topo 7.5 K''WM SERIES
:55.ABM1 4
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J'AlFr6
L. - j[TT -14 jtp
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1 • f _ ��ty , ,, R EW DR
v b 93 LC-
zI 225 Bethel Church �I .
Urnel!Wb, IVC, 2-g051
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t
,
st
r 't
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-
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v b 93 LC-
zI 225 Bethel Church �I .
Urnel!Wb, IVC, 2-g051
uKc w SWTH. MC

P,FM/�C U.S. DEPARTMENT OF THE WTERIOR p, W Op LAKE NORMAN SOVTN QUADRANGLE
(�� os GEOLOIt (u SUPAY ' w US TOpO WRTM EAROLWA
�r,dT7� 3• T5-PUM TF SERFS
BSS --
12 l Q Bei -he I aurc k Rd .
Uvv le h u5, N c, Z BO 31
L"c WL"". W -
.I.

P B &J, LLC
21225 Bethel Church Road
Cornelius, NC 28031
Excavation and Disposal Neighbors
P B & J, LLC
21219 Bethel Church Road
Cornelius, NC 28031
Joan S McGraw
21301 Bethel Church Road
Cornelius, NC 28301

PB&J, LLC
21219 Bethel Church Road
Cornelius, NC 28031
Excavation and Disposal Neighbors
P B & J, LLC
21225 Bethel Church Road
Cornelius, NC 28031
Richard & Sara Mellone
21213 Bethel Church Road
Cornelius, NC 28301