20052062 Ver 2_Ownership Change_20120117

SUBURBAN ASSET MANAGEMENT
January 12, 2011
North Carolina Department of Environment and Natural Resources
1639 Mail Service Center
Raleigh, NC 27699 -1639
Re: State Stormwater Permit Ownership Change
Dear Ladies /Gentlemen:
Ex P 'bS-
Va
SAM Sanford, LLC purchased the Shoppes at Sanford from Sanford Retail Investment, LLC on
November 30, 2011. A copy of the deed, along with our Ownership Change Form is enclosed
for your records.
If there is any additional information you might need, I can be reach at 757- 671 -1700, extension
303, or via email at ann(@samvirginia.com.
Sincerely,
SUBURBAN ASSET MANAGEMENT
JL 'jy d-4-z�
Ann G. Gurnee
Property Manager
Enclosures
L9 k'Y -5 n
U
-11N 1 7 2012 -
DENR - WATER QUALITY
WEnANDS AND STQRMWATER BRANCH
999 Waterside Drive, Suite 2220, Norfolk, VA 23510 Phone [phone] Fax [phone]

ALT, WA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
STATE STORMWATER PERMIT NAME /OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION
1. Stormwater Management Permit Number: Pao -,«r 4- exP OS-20('.2 y. Z
2. Project Name: SA�al 2oaA s n z� x s - L-L- c-
3. Current Permit Holder's Company Name /Organization: SA*QyA' L XLc-
4. Signing Official's Name: Title: MA,:vA-ke2.1 oQN;&2
(person legally responsible for permit)
5. Mailing Address: Wes r�-- C oke,mflt l 31 Q Su -t"T6 1 0(r-
City: MT TAeAsAv-SV State: SC Zip: 211+6114
6. Phone: (S 3) 2g1- 331 4 �c4,o -7 Fax: (g(+3) 41 ^ 335`1'1
II. PROPOSED PERMITTEE / OWNER / PROJECT / ADDRESS INFORMATION
This request is for: (please check all that apply)
❑ Name change of the owner (Please complete Items 1, 2 and 3 below)
❑ blame change of project (Please complete Item 5 below)
Change in ownership of the property /company (Please complete Items 1,
❑ Mailing address / phone number change. (Please complete Item 4 below)
❑ Other (please explain):
1. Proposed permittee's company name /organiza
2. Proposed permittee's signing official's name: _
3. Proposed permittee's Title: /11 Ck y1a q
4. Mailing Address: c10
City: V / v e.�,v I k
Phone: (1 51)) b I I _ 17ov, X 3v3
2, 3, and 4 below)
tion: SAM �an��6'_d , LL
Ma��4e��nf' q ,19 lF;eS��e /��.LSkzzzo
State: y_A Zip: a 3
Fax: ('% 5 ) G'I I - `? `i -7
5. New Project Name to be placed on permit: 5'A (►'l So 9,0 , LL C--
Please check the appropriate box. The proposed permittee listed above is:
❑ HOA or POA (Attach a copy of the deed transferring ownership of all common areas. Print Name
f HOA or POA in #1 above and provide name of HOA(POA) president in #2 above).
The property owner.
❑ Lessee (Attach a copy of the lease agreement and complete Property Owner Information on
page 4)
❑ Purchaser (Attach a copy of the pending sales agreement and complete Property Owner
Information on page 4)
❑ Developer (Complete Property Owner Information on page 4) EF4@50WOM
SSW N/0 Change Rev16Nov2009 Page 1 of 4 _IAN 1 % 2012
DENR - WATER QUALITY
WETLANDS AND STORMWATER BRANCH

III. REQUIRED ITEMS
This application package will not be accepted by the Division of Water Quality unless all of the
applicable required items listed below are included with the submittal.
1. This completed and signed form.
2. Legal documentation of the transfer of ownership. (For Permit Transfers Complete Current Permittee
and Proposed Permittee Sections)
3. A copy of the recorded deed restrictions, if required by the permit.
4. The designer's certification, if required by the permit and if not already submitted to DWQ.
5. If the Proposed Permittee is a corporation, LLC or General Partnership, provide documentation from
the Secretary of State office, which supports the named president, vice president, member, manager
or General Partner.
6. The $40.00 processing fee. If this is an initial transfer from the original permittee to the property owner
or other responsible party such as an HOA, the processing fee is not required. Subsequent ownership
transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements.
❑ Check here if the Current Owner is only changing the owner name, company name or project
name, or the mailing address, and will retain ownership of the permit.
I, , the current owner, hereby notify the Division of
Water Quality that I am changing my name or company name and /or I am changing my mailing
address and /or I am changing the name of the permitted project. I further attest that this application
for a name /ownership change is accurate and complete to the best of my knowledge. I understand
that if all required parts of this application are not completed and that if all required supporting
information and attachments as outlined above are not included, this application package will be
returned as incomplete.
Check here if Current Owner is transferring (selling) the property to a new owner and will not
retain ownership of the permit.
I, tS e�� etl 01;116e , the current owner, am submitting this application for a transfer of
ownership p for permit # 4)ep as-2ol2 y. 2- . I hereby notify DWQ of the sale or other legal transfer
of the stormwater system associated with this permit. I further acknowledge and attest that I have
transmitted a copy of the most recent permit, a copy of the Designers Certification, a copy of the
DWQ approved plans and /or approved as -built plans, a copy of the approved Operation and
Maintenance agreement and copies of past maintenance records to the Proposed Permittee named
in Sections II and V of this form at the mailing address listed in Section II of this form. I further attest
that I assign all rights and obligations as permittee to the Proposed Permittee named in Section V of
this form. I understand that this transfer of ownership cannot be approved by the Division of Water
Quality unless and until the facility is in compliance with the permit and the Proposed Permittee signs
this form. I understand that in the event the facility is not in compliance or the Proposed Permittee
does not sign this form, the responsibility to bring the facility into compliance and to comply with the
terms and conditions of the permit remains with me until such time as the Proposed Permittee signs
this form and the Division approves it.
Signature: Date:
/ei> e 1� _ z4d , i /oe_ A a Notary Public for the State of
122u W vo /r ��� , County of �2 i -k6A"J , do hereby certify that
S�,- e- � personally appeared before me this the
17 7?-t day of 201L, and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal, (Notary Seal)
otary Signature
SSW N/O Change Rev16Nov2009 Page 2 of 4

V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the
Proposed Permittee for all transfers of ownership)
I, -:S-, C.ti�k e tt,-, , hereby notify the Division of Water Quality that I have
acquired through sale: lease or legal transfer, the responsibility for constructing and /or operating and
maintaining, the permitted stormwater management system. I have examined the permit and
inspected the permitted facility, and agree to assume the rights and liabilities contained in the permit
and to comply with the terms and conditions of the permit.
I attest that I have reviewed this application for an ownership change and it is accurate and complete
to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information and attachments are not included, this
application package will be returned as incomplete.
I further acknowledge and attest that in the event the required facility inspection reveals that the
project is not in compliance with the permit, I understand this transfer of ownership will not be
approved until the project is brought into compliance. I acknowledge and attest that I have received a
copy of the most recent permit, a copy of the Designer's Certification, a copy of the DWQ approved
plans and /or approved as -built plans, a copy of the approved Operation and Maintenance agreement
and copies of past maintenance records from the previous permittee. I further acknowledge and
agree that I will construct and /or operate and maintain the system per the requirements listed in the
permit and in the Op"n and Ma mt a agreement.
Signature: Date: /2,73-1/
1 �Ox- , a Notary Public for the State of
�((►�t� County of Plft-f— , do hereby certify that
personally appeared before me this the
?4 day of XCU%, V j — 20 11 , and acknowledge th ^ Arcs tion of the
forgoing instrument. Witness my hand and official seal, JUDEENoTARyy 9U8L
REGiStRA1JON #7 23775
4
ONWEALtN NF Xp 1
RRESA
QO) COn M� Ah1.$Sa�PU 0 3
Notary natu ^��(R
Additional copies of the original permit and the approved Operation and Maintenance plan can be
obtained from the appropriate Regional Office of the Division of Water Quality.
This completed form, including all supporting documents and processing fee, should be sent to the
appropriate Regional Office of the North Carolina Department of Environment and Natural
Resources, Division of Water Quality, as shown on the attached map.
Please note that if the Proposed Permittee listed above is not the property owner, the property owner
must complete and sign page 4 of this document. Both the lessee / developer and the property
owner will appear on the permit as permittees.
SSW N/O Change Rev16Nov2009 Page 3 of 4

VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION
If the Proposed Permittee listed in Sections II and V of this form is not the Property Owner, the
Property Owner must provide his /her Contact Information below and sign this form.
Printed Name:
Organization:
Title within the Organization:
Street Address:
City:
Mailing Address:
City:
Phone:
Email:
State:
(if different from street address)
State:
Fax:
Zip:
Zip:
I certify that I own the property identified in this permit transfer document and have given permission
to the Proposed Permittee listed in Sections II and V to develop, lease or purchase the property. A
copy of the lease agreement or pending property sales contract has been provided with the
submittal, which indicates the party responsible for the construction and /or operation and
maintenance of the stormwater system.
As the legal property owner I acknowledge, understand, and agree by my signature below, that I will
appear as a permittee along with the lessee /developer and that if the designated Proposed
Permittee dissolves their company and /or cancels or defaults on their lease agreement or pending
sales contract, responsibility for compliance with the DWQ Stormwater permit reverts back to me,
the property owner. As the property owner, it is my responsibility to notify DWQ by submitting a
completed Name /Ownership Change Form within 30 days of procuring a developer, lessee or
purchaser for the property. I understand that failure to operate and maintain the stormwater
treatment facility in accordance with the permit is a violation of NC General Statue 143 - 215.1, and
may result in appropriate enforcement action including the assessment of civil penalties of up to
$25,000 per day, pursuant to NCGS 143 - 215.6.
Signature of the property owner
County of
Date:
, a Notary Public for the State 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 Signature
SSW N/0 Change Rev16Nov2009
Page 4 of 4
(Notary Seal)

BK- 01264 PG:0661
Lee County 11.30-2011
NORTH CAROLINA
Rtul 1: 'S"111:
{ wm: 1.1'� $15.960 00_
j, V,
Excise Tax $ i5 ;aim 0
FILED
LEE COUNTY
MOLLIE A. MCINNIS
REGISTER OF DEEDS
FILED Nov 30, 2011
AT 04:14:03 pm
BOOK 01264
START PAGE 0661
END PAGE 0667
INSTRUMENT # 07008
Recording Time, Book and
Parcel Identifier No. 966116077900
Verified by Lee County on the day of 2011
by
fre�rnectbl VVX u06FvL1 Li:'J DRE
After recording mail to : 30-1 = `Jlt,t,E ST{Li , SiIiT +K 17 =. ",si
Brief Description for the index
THIS DEED made I
NORTH CAROLINA LIMITED WARRANTY DEED
2011 by and between
SANFORD RETAIL INVESTMENT Il, LLC, a South
Carolina limited liability company
300 West Coleman Blvd., Suite 106
Mt. Pleasant, SC 29646
SAM SANFORD, LLC, a Virginia limited liability company
999 Waterside Drive, Suite 2220
Norfolk, VA 23510
Enter in appropriate block for each party: name, 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.
W ITNESSETH, 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 to all that
certain lot or parcel of land situated in the Township of Jonesboro, Lee County, North Carolina and more particularly
described as follows:
See Exhibit "A" attached hereto and Incorporated herein by reference
The property hereinabove described is a portion of the property acquired by Grantor by instrument recorded in
Book 01117, Page 0522 in the Office of the Register of Deeds of Lee County, North Carolina.

BK:01264 PG:0662
A map showing the above described property is recorded in Plat Book 2008, at Slide 43.
All or a portion of the property herein conveyed does not include the primary residence of the Grantee.
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 Grantor covenants with Grantee that Grantor has done nothing to impair such title as Grantor received, and
Grantor shall and will warrant and forever defend title to the property hereby conveyed unto Grantee against the lawful
claims of all persons owning, holding, or claiming by, through, or under Grantor except for the encumbrances described
herein as Permitted Exceptions.
Title to the property hereinabove described is subject to the following exceptions ("Permitted Exceptions "):
1. See Exhibit B.
[SIGNATURE ON FOLLOWING PAGE]

BK- 01264 PG: 0663
IN WITNESS WHEREOF, the undersigned Grantor has executed this instrument the day and year first abovo
written.
USE
BLACK SANFORD RETAIL INVESTMENT II, LLC, a South
INK Carolina limited liability company
ONLY
By: SR Investments, Inc., a South
Carolina corporation, authorized to conduct`1�t��itstlrrr
business in the State of North Carolina
SR Investments, Inc. (NC) �.�� �`�
Its: Manager
^ O
GU -
�, . x ).
A ,')
<. t
B : Step en W. Rainer 7� .,J �q,
Its: President �i g��v,;•' %�.�
SEAL -STAMP use I,OLi_� S t + 1J� �5 a Notary Public of the County and State aforesaid, certify that
BLACK Stephen W. Rainer, either being personally known to me or proven by satisfactory evidence,
INK
ONLY personally came before me this day and acknowledged that he is President of SR Investments, Inc., a
South Carolina corporation, the Manager of Sanford Retail Investment II, LLC, a South Carolina limited
liability company, and that he, as President and being authorized to do so, vpluti{ar'Iy.ek teu)ed the
foregoing on behalf of said corporation and limited liability company for the pun) tqd tbeFeit).
Witness by hand and official seal, this theT--S day of NU ✓Q /n
Notary Public >'
My commission expires. 1 "o'+d-d1, �':,,; : .SOJ:••`
NORTH CAROLINA —LEE COUNTY
The foregoing Certificate(s) of Notary Public and Notary Public
is /are certified to be correct. This instrument and this certificate are duly registered at the date and time and in the Book and Page shown on the first
page hereof. REGISTER OF DEEDS FOR LEE COUNTY
By Deputy /Assistant- Register of Deeds.

BK- 01264 PG:0664
EXHIBIT A
Legal Description
LOT 2
Commencing at the NGS MON. "JONESBORO 2 RESET" having N.C. Grid coordinates N 622113.4800 E
1955685.1900, and Lat. 35 -27- 33.390 Long. 79- 08- 55.739; thence with a tie line S 44 -41 -06 E for 6517.41 feet
to an iron pin located along the southeastern right-of-way of Wilson Road, SR 1136 (60' R/W) and being the
common corner of Coggins (Deed Book 675 -468); thence along southeastern right -of -way, N 48 -31 -29 E for
280.89 feet to an iron pin; thence leaving southeastern right-of-way and along the common line of Minims,
Deed Books 345 -299 R 260 -488 respectively, S 33 -18 -37 E for 304.91 feet to an iron pin; thence N 47 -53 -59 E
for 175.91 feet to an iron pin; thence along the common line of Lot 6, S 34 -28 -26 E for 287.46 feet (LI 8) to an
iron pin; thence S 79 -28 -26 E for 21.21 feet (1,19) to an iron pin; thence N 55 -31 -34 E for 162.82 feet (L20) to
an iron pin being the Point of Beginning; thence continuing along the common line of Lot 6 N 55 -31 -34 E for
181.83 feet (L21) to an iron pin located on the southwestern right -of -way of N.C. Hwy. 87 "Horner Road ";
thence along said right -of -way, S 34 -28 -26 E for 39.88 feet (L5) to an iron pin; thence along the common line
of LotS, S 54 -36 -58 W for 7.31 feet (1-22) to an iron pin; thence S 55 -31 -34 W for 115.52 feet (L23) to an iron
pin; thence along a curve concave to the southeast having a radius of 40.00 feet, an arc length of 51.51 feet and
a chord bearing and distance of S 18 -38 -02 W for 48.02 feet (Ci) to an iron pin; thence along the common line
of Lots 3, 4 and 5, S 18 -15 -29 E for 521.81 feet to an iron pin; thence along the common line of Lot 3 along a
curve concave to the northeast having a radius of 190.00 feet, an arc length of 37.50 feet and a chord bearing
and distance of S 23 -54 -45 E for 37.44 feet (C2) to an iron pin; thence S 29 -34 -01 E for 59.42 feet (L29) to an
iron pin; thence along a curve concave to the southwest having a radius of 240.00 feet, an arc length of 47.37
feet and a chord bearing and distance of S 23 -54 -46 E for 47.29 feet (C5) to an iron pin; thence S 18 -15 -31 L='
for 39.63 feet (L30) to an iron pin; thence along a curve concave to the northeast having a radius of 40.00 feet,
an are length of 40.33 feet and a chord bearing and distance of S 47 -08 -22 E for 38.64 feet(C4) to an iron pin;
thence along the common line of the Wal -Mart Tract, S 28 -51 -41 W for 59.58 feet (LI3) to a PK nail; thence S
71 -44 -30 W for 398.20 feet to a PK nail; thence N 18 -15 -28 W for 447.61 feet to an iron pin; thence along a
curve concave to the southwest having a radius of 65.08 feet, an arc length of 41.52 feet and a chord bearing
and distance of N 36 -50 -07 W for 40.82 feet (C8) to an iron pin; thence N 62 -05 -23 W for 78.28 feet (1-14) to
an iron pin; thence along a curve concave to the northeast having a radius of 80.00 feet, an arc length of 61.20
feet and a chord bearing and distance of 40 -10 -26 W for 59.72 feet (C7) to an iron pin; thence N 18 -15 -30 W
for 1.32 feet (1-15) to an iron pin; thence running with the common line of Lot 1 N 71 -43 -57 E for 286.00 feet
(L34) to a point; thence S 18 -15 -30 E for 29.63 feet (1-33) to a point; thence N 71 -44 -30 E for 167.70 feet (L32)
to a point; thence N 18 -15 -30 W for 268.83 feet (1,31) to the Point of Beginning. Said tract contains 6.044
acres (263,284 sq. ft.), more or less.

BK- 01264 PG-0665
EXHIBIT B
Permitted Exceptions
1. Real and Personal Property Taxes assessed and /or imposed for the year 2012 and
subsequent years.
2. Deed of Trust, Security Agreement and Fixture Filing from SANFORD RETAIL
INVESTMENT II, LLC, A SOUTH CAROLINA LIMITED LIABILITY COMPANY
to THE FIDELITY COMPANY, Trustee for THE LINCOLN NATIONAL LIFE
INSURANCE COMPANY, dated April 16, 2008, filed for record April 16, 2008 at 3:53
PM in Book 1311, page 110, Lee County Registry, securing $7,800,000.00; assumed by
SAM Sanford, LLC, a Virginia limited liability company, and modified pur Mt to
Assumption and Modification Agreement (the "Agreement ") dated R'E'P' , , 2011,
by and among SAM Sanford, LLC, a Virginia limited liability company, and The
Lincoln National Life Insurance Company, an Indiana corporation, and The Fidelity
Company, a North Carolina corporation, Trustee, recorded in Book l , Page
, Lee County Registry (the "Modification').
3. Terms, provisions, options, right of first refusal, covenants, conditions, restrictions,
easements, charges, assessments, and liens provided for in Easements with Covenants
and Restrictions Affecting Land filed for record in Book 1023, page 686, Lee County
Registry (see in connection therewith Declaration of Notice recorded in Book 1117, page
535, Lee County Registry); as amended by First Amendment to Easements with
Covenants and Restrictions Affecting Land recorded in Book 1141, page 742; Second
Amendment to Easements with Covenants and Restrictions Affecting Land recorded in
Book 1164, page 626; and Third Amendment to Easements with Covenants Affecting
Land recorded in Book 1239, page 510, Lee County Registry; and any related maps,
plans, bylaws and other document(s) and amendment(s).
4. Any right, easement, setback, interest, claim, encroachment, encumbrance, violation,
variation, or other adverse circumstance affecting the Title disclosed by plat(s) recorded
in Plat Cabinet 2006, Slides 69 & 70; Plat Cabinet 2007, Slides 253, 254 & 255; and Plat
Cabinet 2008, Slide 43, all Lee County Registry.
5. Any discrepancy, conflict, access, shortage in area or boundary lines, encroachment,
encumbrance, violation, variation, overlap, setback, easement or claim of easement,
riparian right, and title to land within roads, ways, railroads, watercourses, burial
grounds, marshes, dredged or filled areas or land below the mean highwater mark or
within the bounds of any adjoining body of water, or other adverse circumstance
affecting the Title that would be disclosed by a current inspection and accurate and
complete land survey of the Land.

BK: 01264 P&0666
6. Rights of tenants in possession, as tenants only, under unrecorded leases for a duration
of less than three (3) years.
7. Easements to Carolina Power & Light Company recorded in Book 12, page 298; Book
318, page 983; Book 602, page 12; and Book 299, page 135, Lee County Registry.
8. Electric Line Right -of -Way Easement to Central Electric Membership Corporation
recorded in Book 349, page 921; Book MCI 16, page 452; and Book MC127, page 218,
Lee County Registry.
9. General Permit to Carolina Telephone and Telegraph Company recorded in Book
MCI 16, page 373; Boole 21, page 257; Book 21, page 271; and Book 67, page 48, Lee
County Registry.
10. Telephone line easement to Heins Telephone Company recorded in Book MC116,
pages 404 and 431, Lee County Registry.
11. Terms and conditions of Drainage Easement Agreement by and between William
Thomas Adams and Patricia Wright Adams, Trustees of the W. Thomas and Patricia
W. Adams Trust dated April 4, 2003 and Sanford Retail Investment, L.L.C, recorded
in Book 1023, page 673, Lee County Registry.
12. Terms and conditions of Easement Agreement by and between William Thomas
Adams and Patricia Wright Adams, Trustees of the W. Thomas and Patricia W.
Adams Trust dated April 4, 2003 and Sanford Retail Investment, L.L.C., recorded in
Book 1023, page 664, Lee County Registry.
13. Memorandum of Development Agreement recorded in Book 1023, page 704, Lee
County Registry.
14. Utility Easement to Public Service Company of North Carolina, Incorporated recorded
in Book 1096, page 924, as amended in Book 1129, page 698, Lee County Registry.
15. Deed of Easement to City of Sanford recorded in Book l 100, page 456, Lee County
Registry.
16. Easement to Carolina Power & Light Company recorded in Book 667, page 949, Lee
County Registry.
17. Absolute Assignment of Rents and Profits and Collateral Assignment of Leases to The
Lincoln National Life Insurance Company recorded in Book 1131, page 157, Lee
County Registry.

BK- 01264 PG: 0667
18. UCC -1 Financing Statement from Sanford Retail Investment 11, LLC (Debtor) to The
Lincoln National Life Insurance Company (Secured Party) recorded in Book 1131,
page 171, Lee County Registry; as amended by UCC -3 Financing Statement
Amendment changing Debtor to SAM Sanford, LLC as recorded in Book
page �I_, Lee County Registry.
19. UCC Financing Statement from SAM Sanford, LLC, a Virginia limited liability
company (Debtor) to T e Lincoln National Life Insurance Company (Secured Party)
recorded in Book Qt , page_, Lee County Registry.