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HomeMy WebLinkAboutSW7101113_HISTORICAL FILE_20121219STORMWATER DIVISION CODING SHEET POST -CONSTRUCTION PERMITS PERMIT NO. SW`ZoZ,l DOC TYPE ❑ CURRENT PERMIT ❑ APPROVED PLANS %HISTORICAL FILE ❑ COMPLIANCE EVALUATION INSPECTION DOC DATE YYYYM M D D North Carolina Secretary of State http://www.secretary.state.nc.us/corporations/Corp.aspx?Pitem I d=8... North Carolina Elaine F. Marshall DEPARTMENT OFTHE Secretary ...S' ECRETARY OF STATE PO Box 29622 Raleigh, NC 27626-0622 (919)607-2000 Date: 12/19/2012 Click here to: View Document Filings I File an Annual Report j Print a Pre -populated Annual Report Fillable PDF Form I Amended A Previous Annual Report Corporation Names Name Name Type NC TYSON & HINES INVESTMENTS, LLC LEGAL Limited Liability Company Information SOSID: 0873088 Status: Current -Active Effective Date: 10/19/2006 Annual Report Due Date: Citizenship: DOMESTIC State of Inc.: NC Duration: PERPETUAL Annual Report Status: CURRENT Registered Agent Agent Name: TYSON, CHARLES F Office Address: 2410 M L KING BLVD NEW BERN NC 28563 Mailing Address: P 0 BOX 626 NEW BERN NC 28563 Principal Office Office Address: 2410 M L KING BLVD NEW BERN NC 28563 Mailing Address: P 0 BOX 626 NEW BERN NC 28563 Officers Title: MANAGER/ MEMBER Name: CHARLES F TYSON JR Business Address: P 0 BOX 626 NEW BERN NC 28563 Title: MANAGER/MEMBER Name: MARK S HINES Business Address: P 0 BOX 626 NEW BERN NC 28563 rhis website is provided to the public as a part of the Secretary of State Knowledge Base (SOSKB) system. Version: I of 2 12/19/2012 5:00 PM North Carolina Secretary of State http://www.secretary.state.ne.us/corporations/Corp.aspx?Pitenlld=8... 3812 2 of 2 12/19/2012 5:00 PM cye,,9ao.4/ SW�r1O1113 Mod RECEIVED State of North Carolina Department of Environment and Natural Resources OCT 3 0 2012 Division of Water Quality STATE STORMWATER PERMIT NAME/OWNERSHIP CHANGM_,�/ �JI ^/-� R® I. CURRENT PERMIT INFORMATION 1. Stormwater Mana(eement Permit Number: SyJII 1 011 ( 3 2. Pro, VaIIar Gs,,, e-r�-t — Gre- ,�%LDT�, L 3. Current Permit Holder's C mpany Name/Organization: LL-c 4. Signing Official's Name: eor e I p(� \t-S Title: 5. Mailing Address: �iob Merry- br,"v L S, t 2bo City: l2i L NG State: NG Zip: 6. Phone: (01 y l - 26oI Fax: l,I)C\) 4 S-cl It. 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) ❑ Name change of project (Please complete Item 5 below) �] Change in ownership of the property/company (Please complete Items 1, 2, 3, and 4 below) Mailing address / phone number change. (Please complete Item 4 below) ❑ Other (please explain): 1. Proposed permittee's company name/organization: y5o„ R- H i„cs (x.,c Sl Mj.. k LLC.- 2. Proposed permittee's signing official's name: Ckar)z-5 S:' T\ISav\. 3r. 3. Proposed permittee's title: 0,.Q� IMF ry a-,, 4. Mailing Address: Z D2 Mt- k(A(3 v) City: N e...> J State: r Jc Zip: Z $ S 62 Phone: (2SZ.) 633-5764 Fax: (2s1-1 633— 5. New Project Name to be placed on permit: 0 o(la.r Ge Q-rr l Please check the appropriate box. The proposed permittee listed above is: ❑ HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a recorded easement for all areas that contain stormwater system features. Print name of HOA or POA in #1 above and provide name of HOA/POA's authorized representative 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. Final approval of this transfer will be granted upon receipt of a copy of the recorded deed) ❑ Developer (Complete Property Owner Information on page 4) SSW N/O Change Rev24Sept2012 Page 1 of 4 III. REQUIRED ITEMS A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all of the applicable required items listed below are included with the submittal. Failure to provide the listed items may result in processing delays or denial of the transfer. 1. This completed and signed form. This certification must be completed and signed by both the current permit holder and the new applicant if this is a change of ownership.; 2. Legal documentation of the property transfer to a new owner. 3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit. 4. The designer's certification (DWQ Engineer and Designer Certification Forms are available from each DWQ Regional office), if required by the permit and if not already submitted to DWQ. 5. If the proposed permittee is a firm, partnership, association, institution, corporation, limited liability company, or other corporate entity, provide documentation showing the authority of the named representative to act on behalf of the proposed permittee. 6. The $40.00 processing fee. If this is an initial transfer from the original permittee 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 and fill out the certification below that statement: ❑ Check here if the current permittee is only changing his/her/its name, the project name, or mailing address, but will retain the permit. I, , the current permittee, hereby notify the DWQ that I am changing my 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 or if all required supporting information and attachments listed above are not included, this application package will be returned as incomplete. �v Check here if current permittee is transferring the property to a new owner and will not retain ownef� ip o f the p rmit. 0� ^dove �� rcy L.l-C the current permittee, am submitting this application for a transfer of ownership for per it # S "1101113 . I hereby notify DWQ of the sale or other legal transfer of the stormwater system associated with this permit. I have provided a copy of the most recent permit, the designer's certification for each BMP, any recorded deed restrictions, covenants, or easements, the DWQ approved plans and/or approved as -built plans, the approved operation and maintenance agreement, past maintenance records, and the most recent DWQ stormwater inspection report to the proposed permittee named in Sections II and V of this form. 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 or if all required supporting information and attachments listed above are not included, this application package will be returned as incomplete. I assign all rights and obligations as permittee to the proposed permittee named in Sections II and V of this form. I understand that this transfer of ownership cannot be approved by the DWQ unless and until the facility is in compliance with the permit. Signature: Date: Notary Public for the State of d�7& (AL,. iA44 County of 419xc , do hereby certify that Pci> 7" d9'Gr/c-.I /X— personally appeared before me this the /9 �a day of Oer )&z , 20_Z,2 , and acknowledge the due execution of the for oing instrument. Witness my hand and official seal, tary Signature SSW N/O Change Rev24Sept2012 Page 2 of S p,NN1N Notary Seal) #0TA19 m N 0UBUG ye'Ch 15. ��1, V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the Proposed Permittee for all transfers of ownership) I, Tysw, & i' ."C's I "CA ?_-6 LLC , hereby notify the DWQ that I have acquired through sale, lease or legal transfer, the responsibility for operating and maintaining the permitted stormwater management system, and, if applicable, constructing the permitted system. I acknowledge and attest that I have received a copy of: (check all that apply to this permit) J the most recent permit the designer's certification for each BMP any recorded deed restrictions, covenants, or easements the DWQ approved plans and/or approved as -built plans the approved operation and maintenance agreement past maintenance records from the previous permittee (where required) DWQ stormwater inspection report showing compliance within 90 days prior to this transfer I have reviewed the permit, approved plans and other documents listed above, and I will comply with the terms and conditions of the permit and approved plans. I acknowledge and agree that I will operate and maintain the system pursuant to the requirements listed in the permit and in the operation and maintenance agreement. 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 or if all required supporting information and attachments listed above are not included, this application )package will be returned as incomplete. Signature: C�u fCftl(.� lam' �1� ' Date: /1dreu- nom#!�aY 1 , a Notary Public for the State of Y 01 cCC Iy�l IRGt County of f ;V4V Pw,_J , do hereby certify that I e 5 F_ JrY . personally appeared before me this the o'G(I"a . day of dC /y 20Z, and acknowledge the due execution of the forgoing instrument.. Witness my hand and official seal, !�'`4�- [J. (Notary Sea!j Notary Signature • J\ Additional copies of the original permit and the approved Operation and Maintenance agreement can be obtained from the appropriate Regional Office of the Division of Water Quality. This completed form, including all supporting documents and processing fee (if required), 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 Rev24Sept2012 Page 3 of 4 - ti Beverly Eaves Perdue Governor =' ,�,., r NC®ENR North Carolina Department of Environment and Natural Division of Water Quality Colleen H. Sullins Director Mr. George T. Barnes, Jr., Member/Manager Glandon Forest Equity, LLC 3900 Merton Drive Suite 210 Inca-RO Resources Dee Freeman Secretary s A" `! Raleigh, Nc 27609 r �'�• jyL�f Subject: Stormwater Permit No. SW7101113."'iSP'^ Dollar General - Grantsboro 1 , High Density Commercial Wet Pond Project Pamlico CountydG Dear Mr. Barnes: ' The Washington Regional Office received a complete 'Stormwater Management Permit Application for Dollar General - Grantsboro on March 4, 2011. Staff review of the plans and specifications has determined that the project, as proposed, will comply with the Stormwater Regulations set forth in Session Law 2008-211 and Title 15A NCAC 2H.1000. We are forwarding Permit No. SW7101113 dated May 2, 2011, for the construction of the subject project. May 2, 2011 This permit shall be effective from the date of issuance until May 2, 2021, and shall be subject to the conditions and limitations as specified therein. Please pay special attention to the Operation and Maintenance requirements in this permit. Failure to establish an adequate system for operation and maintenance of the stormwater management system will result in future compliance problems. If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to request an adjudicatory hearing upon written request within thirty (30) days following receipt of this permit. This request must be in the form of a written petition, conforming to Chapter 150B of the North Carolina General Statutes, and filed with the Office of Administrative Hearings, P.O. Drawer 27447, Raleigh, NC 27611-7447. Unless such demands are made this permit shall be final and binding. If you have any questions, or need additional information concerning this matter, please contact Scott Vinson, or me at (252) 946-6481. n , Al Hodge"-'"C_/ Regional Supervisor Surface Water Protection Section AH/ sv: K:\WQS\STORMWATER\PERMIT\SW7101113 cc: Matt Lowder, PE — Triangle Site Design, PLLC Pamlico County Planning/Building Inspections VVVashington Regional Office North Carolina Division of Water Quality Internet. www.ncwaterqualry.org One 943 Washington Square Mall Phone: 252-946-6481 1 FAX 252-946-9215 North Caro I i n a Washington, NC 27889 FAX: 252-946-9215 ly An Equal Opporlunily\AffrmNaturally ative Action Employer ! ` State Stormwater Management Systems Permit No. SW7101113 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY STATE STORMWATER MANAGEMENT PERMIT HIGH DENSITY DEVELOPMENT In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as amended, and other applicable Laws, Rules, and Regulations PERMISSION IS HEREBY GRANTED TO Glandon Forest Equity, LLC Dollar General - Grantsboro Located on Hwy 55, Grantsboro, Pamlico County FOR THE construction, operation and maintenance of a wet detention pond in compliance with the provisions of Session Law 2008-211 and 15A NCAC 2H .1000 (hereafter referred to as the "storm water rules') and the approved stormwater management plans and specifications and other supporting data as attached and on file with and approved by the Division of Water Quality and considered a part of this permit. This permit shall be effective from the date of issuance until May 2, 2021, and shall be subject to the following specified conditions and limitations: I. DESIGN STANDARDS This permit is effective only with respect to the nature and volume of stormwater described in the application and other supporting data. This stormwater system has been approved for the management of stormwater runoff as described in Section 1.7 of this permit. The stormwater control has been designed to handle the runoff from 30,904 square feet of impervious area. The tract will be limited to the amount of built -upon area indicated in Section I. of this permit, and per approved plans. 4. All stormwater collection and treatment systems must be located in either dedicated common areas or recorded easements. The final plats for the project will be recorded showing all such required easements, in accordance with the approved plans. 5. The runoff from all built -upon area within the permitted drainage area of this project must be directed into the permitted stormwater control system. The built -upon areas associated with this project shall be located at least 50 feet landward of all perennial and intermittent surface waters. Page 2 of 7 State Stormwater Management Systems Permit No. SW7101113 The following design criteria have been provided in the wet detention pond and must be maintained at design condition: a. b. C. d. Drainage Area, ft2: Total Impervious Surfaces, ft2: Design Storm, inches: Pond Depth, feet: TSS removal efficiency: Permanent Pool Elevation, FMSl2: Permanent Pool Surface Area, ft Permitted Storage Volume, ft : Temporary Storage Elevation, FMSL Predevelopment 1 year 24 hour: Post development 1 year 24 hour: Controlling Orifice: Permitted Forebay Volume, ft3: Fountain Horsepower, HP Receiving Stream/River Basin: Stream Index Number: Classification of Water Body: II. SCHEDULE OF COMPLIANCE 43,500 (property = 1.43ac.) 30,904 1.5" 5.20 (3.0' avg. depth) 90% 14.90 5,445 8,406 at temporary pool elev 16.10 0.09 0.04 1.25"0 pipe 3,138 0, (no fountain allowed) South Prong Bay River / Neuse 27-150-3 "SC: Sw. NSW" 1. The stormwater management system shall be constructed in its entirety, vegetated and operational for its intended use prior to the construction of any built -upon surface. 2. During construction, erosion shall be kept to a minimum and any eroded areas of the system will be repaired immediately. 3. The permittee shall at all time provide the operation and maintenance necessary to assure the permitted stormwater system functions at optimum efficiency. The approved Operation and Maintenance Plan must be followed in its entirety and maintenance must occur at the scheduled intervals including, but not limited to: a. Semiannual scheduled inspections (every 6 months). b. Sediment removal. C. Mowing and re -vegetation of slopes and the vegetated filter strip. d. Immediate repair of eroded areas. e. Maintenance of all slopes in accordance with approved plans and specifications. f. Debris removal and unclogging of outlet structure, orifice device, level spreader, filter strip, catch basins and piping. g. Access to the outlet structure must be available at all times. 4. Records of maintenance activities must be kept for each permitted BMP. The records will indicate the date, activity, name of person performing the work and what actions were taken. 5. Access to the stormwater facilities shall be maintained via appropriate easements at all times. 6. Decorative spray fountains will not be allowed in the stormwater treatment system. The pond volume is too small to accommodate the agitation of water. 7. The facilities shall be constructed as shown on the approved plans. This permit shall become void unless the facilities are constructed in accordance with the conditions of this permit, the approved plans and specifications, and other supporting data. Page 3 of 7 State Stormwater Management Systems Permit No. SW7101113 8. Upon completion of construction, prior to issuance of a Certificate of Occupancy, and prior to operation of this permitted facility, a certification must be received from an appropriate designer for the system installed certifying that the permitted facility has been installed in accordance with this permit, the approved plans and specifications, and other supporting documentation. Any deviations from the approved plans and specifications must be noted on the Certification. A modification may be required for those deviations. 9. If the stormwater system was used as an Erosion Control device, it must be restored to design condition prior to operation as a stormwater treatment device, and prior to occupancy of the facility. 10. The permittee shall submit to the Director and shall have received approval for revised plans, specifications, and calculations prior to construction, for any modification to the approved plans, including, but not limited to, those listed below: a. Any revision to any item shown on the approved plans, including the stormwater management measures, built -upon area, details, etc. b. Project name change. C. Transfer of ownership. d. Redesign or addition to the approved amount of built -upon area or to the drainage area. e. Further subdivision, acquisition, lease or sale of all or part of the project area. The project area is defined as all property owned by the permittee, for which Sedimentation and Erosion Control Plan approval or a CAMA Major permit was sought. f. Filling in, altering, or piping of any vegetative conveyance shown on the approved plan. 11. The Director may notify the permittee when the permitted site does not meet one or more of the minimum requirements of the permit. Within the time frame specified in the notice, the permittee shall submit a written time schedule to the Director for modifying the site to meet minimum requirements. The permittee shall provide copies of revised plans and certification in writing to the Director that the changes have been made. 12. The permittee shall submit final site layout and grading plans for any permitted future areas shown on the approved plans, prior to construction. 13. A copy of the approved plans and specifications shall be maintained on file by the Permittee at all times. III. GENERAL CONDITIONS This permit is not transferable except after notice to and approval by the Director. In the event of a change of ownership, or a name change, the permittee must submit a completed Name/Ownership Change form, to the Division of Water Quality, signed by both parties, and accompanied by supporting documentation as listed on page 2 of the form. The project must be in good standing with the Division. The approval of this request will be considered on its merits and may or may not be approved. The permittee is responsible for compliance with all permit conditions until such time as the Division approves the transfer request. Failure to abide by the conditions and limitations contained in this permit may subject the Permittee to enforcement action by the Division of Water Quality, in accordance with North Carolina General Statute 143-215.6A to 143-215.6C. Page 4 of 7 State Stormwater Management Systems Permit No. SW7101113 The issuance of this permit does not preclude the Permittee from complying with any and all statutes, rules, regulations, or ordinances, which may be imposed by other government agencies (local, state, and federal) having, jurisdiction. 5. In the event that the facilities fail to perform satisfactorily, including the creation of nuisance conditions, the Permittee shall take immediate corrective action, including those as may be required by this Division, such as the construction of additional or replacement stormwater management systems. The permittee grants DENR Staff permission to enter the property during normal business hours for the purpose of inspecting all components of the permitted stormwater management facility. The permit issued shall continue in force and effect until revoked or terminated. The permit may be modified, revoked and reissued or terminated for cause. The filing of a request for a permit modification, revocation and re -issuance or termination does not stay any permit condition. 8. Unless specified elsewhere, permanent seeding requirements for the stormwater control must follow the guidelines established in the North Carolina Erosion and Sediment Control Planning and Design Manual. 9. Approved plans and specifications for this project are incorporated by reference and are enforceable parts of the permit. 10. The issuance of this permit does not prohibit the Director from reopening and modifying the permit, revoking and reissuing the permit, or terminating the permit as allowed by the laws, rules and regulations contained in Session Law 2008- 211, Title 15A NCAC 2H.1000, and NCGS 143-215.1 et.al. 11. The permittee shall notify the Division of any name, ownership or mailing address changes at least 30 days prior to making such changes. 12. This permit shall be effective from the date of issuance until May 2, 2021. Application for permit renewal shall be submitted 180 days prior to the expiration date of this permit and must be accompanied by the processing fee. Permit issued this the 2nd day of May, 2011. ROLINA ENVIRONMENTAL MANAGEMENT COMMISSION for Division of Water Quality By Authority of the Environmental Management Commission Stormwater Permit No. SW7101113 Page 5 of 7 ' State Stormwater Management Systems Permit No. SW7101113 Dollar General - Grantsboro Stormwater Permit No. SW7101113 Pamlico County Designer's Certification I, , as a duly registered in the State of North Carolina, having been authorized to observe (periodically/ weekly/ full time) the construction of the project, (Project) for (Project Owner) hereby state that, to the best of my abilities, due care and diligence was used in the observation of the project construction such that the construction was observed to be built within substantial compliance and intent of the approved plans and specifications. The checklist of items on page 2 of this form is included in the Certification. Noted deviations from approved plans and specification: Signature Registration Number Date SEAL I Page.6 of 7 State Stormwater Management Systems Permit No. SW7101113 Certification Requirements: 1. The drainage area to the system contains approximately the permitted acreage. 2. The drainage area to the system contains no more than the permitted amount of built -upon area. 3. All the built -upon area associated with the project is graded such that the runoff drains to the system. 4. All roof drains are located such that the runoff is directed into the system. 5. The outlet/bypass structure elevations are per the approved plan. 6. The outlet structure is located per the approved plans. 7. Trash rack is provided on the outlet/bypass structure. 8. All slopes are grassed with permanent vegetation. 9. Vegetated slopes are no steeper than 3:1. 10. The inlets are located per the approved plans and do not cause short- circuiting of the system. 11. The permitted amounts of surface area and/or volume have been provided. 12. Required drawdown devices are correctly sized per the approved plans. 13. All required design depths are provided. 14. All required parts of the system are provided, such as a vegetated shelf, and a forebay. 15. The required system dimensions are provided per the approved plans. cc: NCDENR-DWQ Washington Regional Office Pamlico County Building Inspections Page 7 of 7 Nit 71, - -- — ' NX kk 'Pf;0eLj--�;-� M a2\��rr i %% CD IYR 1347 6 . o� 1 1106 _ f 1331 ARAPAHOE 7 Mi. 5011333 1 1334 (ARAPA 5654 11, a Geological Survey 'Zjb� # SCALE �l u Iq 83 MN 1000 0 1000 2000 300 0Bf121 O e. �II GN 3, s 0 _ R I A N V L E 4006 Barrett Drive, Suite 203 ®� S I T E D E S I G N Raleigh, North Carolina, 27609 TEL (919) 553-6570 Transmittal Date: March 2, 2011 Job Number: 001017 Project Name: Dollar General — Grantsboro, NC To: NCDENR Stormwater c,c.Ct7 VIdS, I-t 943 Washington Square Mall Washington, NC 27889 —n .r.• - —t 2582-946-6481 MAR 4 2011. We are sending these by ❑ U.S. Mail ® UPS ❑ Hand Delivery ❑ Other 1Ve are sending you ❑ Attached ❑ Under separate cover via the following items: ❑ Shop drawings ® Pnnts/Plans ❑ Samples ❑ Specifications ❑ Change Orders ❑ Other Cnniec /)(oe Nn /)ncrrintinn 3 Civil Site Drawings 2 Gn�Gy C %�E2r7ri �P/itrA�ia,r� These are transmitted as checked below: ❑ For your use ❑ Approved as submitted ❑ Resubmit ❑ Copies for approval ❑ As requested ❑ Approved as noted ❑ Submit ❑ Copies for distribution ® For review and comment ❑ Returned for corrections ❑ Return ❑ Corrected prints Remarks: Copy to: Signed: /o�tYl/�C Brent Purdum February 17, 2011 NCDENR Washington Regional Office 943 Washington Square Mall Washington, NC 27889 To Whom It May Concern: \' (h V MAR 4 2011 Glandon Forest Equity, LLC is authorized to submit a land disturbance permit application for a proposed Dollar General Development .on the property owned by James A. Tingle.. The specific property is found on NC Highway 55 in the Town of Grdntsboro, Pamlico County and is described as a portion of Parcel #6544-84-0785 in the Pamlico County records (Deed Book 144, Page 215). Yours Truly, I, AI/7i6-N • L%wmG,, M(AVAp K a Notary Public for the State of �I�JrJa 1 �GrU1Jr —,County of MCOrCC do hereby certify that �7 z46 �rR -,; 1e 57�a /e r personally appeared before me this day of and acknowledge the due execution of this authorization to submit a land disturbance permit application. Witness my hand and official seal, [NORA L. BOWMAN MAYNORNOTARY PUBLICMOORECOUNTYNORTH CAROLINAY COMMISSION EXPIRES MAY B. 2012 My commission expires417 0�01 /L February 17, 2011 NCDENR Washington Regional Office 943 Washington Square Mall Washington, NC 27889 To Whom It May Concern: MAR 4 2011 ,F1.Glt- Glandon Forest Equity, LLC is authorized to submit a land disturbance permit application for a proposed Dollar General Development on the property owned by the Norfolk Southern Railroad. The specific property is found on NC Highway 55 in the Town of Grantsboro, Pamlico County as shown in the Pamlico County records. Yours Truly, JEFFREY W. LYNCH a Notary Public for the State of CITY VIRGINIA MXMX%/ of ROANOKE do hereby certify that 1XrHkm 7w4^ � personally appeared before me this 28t1day of FEBRUARY 2011 and acknowledge the due execution of authorization to submit a land disturbance permit application. Witness my hand and official seal, JEFFREY WILLIAM LYNCH NOTARY PUBLIC Commonwealth of Virginia Reg. #3376W M Commission Expires May 31, 2011 SEAL My commission expires MAY 31, 2011 ' r DWQ USE ONLY Date Received Pee Paid Permit Number jj Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph 11 - Post Construction (select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Managemen Plan ❑ Other WQ M mt Plan: sidAck 1iZ1SZ)6 State of North Carolina Department of Environment and Natural Resources Division of Water Quality NOV 16 2010 STORMWATER MANAGEMENT PERMIT APPLICATION FORM, This form may be photocopied for use as an original I. GENERAL INFORMATION (. 1. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans, IC� specifications, letters, operation and maintenance agreements, etc.): Dollar General - Grantsboro 2. Location of Project (street address): City:Grantsboro County:Pamlico Zip:28529 3. Directions to project (from nearest major intersection): .6 mile East on Hwy 55 from intersection of NC HHry 55 and NC 306 4. Latitude:35° 08' 37" N Longitude:76° 49' 58" W of the main entrance to the project. IL PERMIT INFORMATION: 1. a. Specify whether project is (check one): ®New ❑Modification b.If this application is being submitted as the result of a modification to an existing permit, list the existing permit number , its issue date (if known) and the status of construction: ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification 2. Specify the type of project (check one): ❑Low Density 21-ligh Density ❑Drains to an Offsite Stormwater System ❑Other 3. If this application is being submitted as the result of a previously returned application or a letter from DWQ requesting a state Stormwater management permit application, list the stormwater project number, if assigned, and the previous name of the project, if different than currently proposed, 4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be obtained by contacting the Customer Service Center at 1-877-623-6748): ❑CAMA Major ®Sedimentation/Erosion Control: 1.4 ac of Disturbed Area ❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts b.lf any of these permits have already been acquired please provide the Project Name, Project/Permit Number, issue date and the type of each permit: Form SWU-101 Version 07Jun2010 Page I of 6 III. CONTACT INFORMATION 1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee, designated government official, individual, etc. who owns the oroiect): Applicant/ Organization: Glandon Forest Equity, LL�/C� Signing Official & Title:George T. Barnes, Jr. /� /pw. hw b.Contact information for person listed in item la above: Street Address:3900 Merton Drive Suite 210 City:Raleigh State:NC Zip:27609 Mailing Address (if applicable): City: Phone: (919 ) 459-2601 Email:gbariies@vatiguardl2g.com Fax: (919 ) 459-2604 c. Please check the appropriate box. The applicant listed above is: ❑ The properly owner (Skip to Contact Information, item 3a) ❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below) ® Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and 2b below) ® Developer* (Complete Contact Information, item 2a and 2b below.) 2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the person who owns the property that the project is located on): Property Owner/Organization:Glandon Forest Equity, LLC Signing Official & 7'itle:George'r. Barnes, Jr. b.Contact information for person listed in item 2a above: Street Address:3900 Merton Drive Suite 210 City:Raleigh State:NC Zip:27609 Mailing Address (if Phone: (919 ) 459-2601 Ema il:gbarnes©vangua rd pg.com State: Zip: Fax: (919 ) 459-2604 3. a. (Optional) Print the name and title of another contact such as the projects construction supervisor or other person who can answer questions about the project Other Contact Person/Organization:Triangle Site Design PLLC Signing Official & Title:Matt Lowder, PE b.Contact information for person listed in item 3a above: Mailing Address:4006 Barrett Drive Suite 203 City:Raleigh State:NC Zip:27609 Phone: (919 ) 553-6570 Fax: ( ) EmaiLmlowder©trianglesitedesign.com 4. Local jurisdiction for building permits: Point of ContactRay Bennett Phone #: (252 ) 745-3092 Fonn SWU-101 Version 07Jun2010 Page 2 of 6 IV. PROJECT INFORMATION 1. In the space provided below, briefly summarize how the stormwa ter runoff will be treated. Stormwater runoff from the site will be treated within a wet detention pond. 2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved: ❑ Approval of a Site Specific Development Plan or PUD Approval Date: ❑ Valid Building Permit Issued Date: ❑ Other: Date: b.lf claiming vested rights, identify the regulation(s) the project has been designed in accordance with: ❑ Coastal SW -1995 ❑ Ph II - Post Construction 3. Stormwater runoff from this project drains to the 4. Total Property Area: 1.5 acres River basin. 5. Total Coastal Wetlands Area: 0 acres 6. Total Surface Water Area: 0 acres 7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project Area+:1.5 acres Total project area slwll be calculated to exclude the follorving the normal pool of imppounded structures, the area bef yen the books of strenws and leers, the area below flue Normal Higgh Water (NHW) line or Mean High Water (MHW) line, and coastal wetlands landward frour the NHW (or MHW) line. The resultant project area is used to calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NHW (or MHW) line pray be included in the total project area. 8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 9. How many drainage areas does the project have? I (For high densihj, count I for each proposed engineered stornnoater BMP. For low density and other projects, use I for the whole property area) 10. Complete the following information for each drainage area identified in Project Information item 9. If there are more than four drainage areas in the project, attach an additional sheet with the information for each area provided in the same format as below. Basin Information Drainage Area 1 Drainage Area _ Drainage Area Drainage Area -- Receiving Stream Name South Prong Bay River Stream Class SC;SW,NSW Stream Index Number * 27-150-3 Total Drainage Area (so 43,500 On -site Drainage Area (so 43,500 Off -site Drainage Area (so 0 Proposed Impervious Area** (so 30,904 Im iervious Area** total 71.0% Impervious** Surface Area - Drainage Area'_ Drainage Area Drainage Area Drainage Area - On -site Buildings/Lots (so 9,014 On -site StreeLs (so 0 On -site Parking (so 20,416 On -site Sidewalks (so 1,474 Other on -site (so 0 Future (so 0 Off -site (sf) 0 Existing 13UA*** (so 0 Total (so: 30,094 Stream Class and Index Nu»rber can be determined at: luttp://portnLnede»r.org uebhoq(ps/esu/clnssifcntious * Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas, sidewalks, gravel areas, etc. Form SWU-101 Version 07Jun2010 Page 3 of 6 'Report only that mtwtmt of existing BUA that will remain after development. Do not report any existing BUA that is to be renmved and which will be replaced by nezo BUA. 11. 1-low was the off -site impervious area listed above determined? Provide documentation. Projects in Union County: Contact DWQ Central Office staff to check if the project is located within a Threatened & Endangered Species watershed that may be subject to more stringent stornavater requirements as per NCAC 02B .0600. V. SUPPLEMENT AND O&M FORMS The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded from http://portal.ticdenr.org/web/wq/ws/su/bmp-manual. VI. SUBMITTAL REQUIREMENTS Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ). A complete package includes all of the items listed below. A detailed application instruction sheet and BMP checklists are available from http://portal.ncdenr.org/web/wq/ws/su/statesw/forms does. The complete application package should be submitted to the appropriate DWQ Office. (The appropriate office may be found by locating project on the interactive online map at http://12ortal.ncdenr.org/web/wg/ws/su/maps.) Please indicate that the following required information have been provided by initialing in the space provided for each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions for each submitted application package from http://portal.ncdenr.org/web/wq/ws/su/statesw/forms does. Initials 1. Original and one copy of the Stormwater Management Permit Application Form. WKL 2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants h1 A Form. (if required as per Part VIl below) 3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M agreement(s) for each BMP. 4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to http:/ /www.envhclp.org/pages/onestopexpress.html for information on the Express program and the associated fees. Contact the appropriate regional office Express Permit Coordinator for additional information and to schedule the required application meeting.) 5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor the project. This is required in addition to the brief summary provided in the Project Information, item 1. 6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the mile radius on the map. 7. Sealed, signed and dated calculations. 8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including: a. Development/Project name. b. Engineer and firm. c. Location map with named streets and NCSR numbers. d. Legend. e. North arrow. f. Scale. g. Revision number and dates. h. Identify all surface waters on the plans by delineating the normal pool elevation of impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal waters, and any coastal wetlands landward of the MHW or NNW lines. • Delineate the vegetated buffer landward from the normal pool elevation of impounded structures, the banks of streams or rivers, and the MHW (or NI-IW) of tidal waters. i. Dimensioned property/project boundary with bearings & distances. j. Site Layout with all BUA identified and dimensioned. k. Existing contours, proposed contours, spot elevations, finished floor elevations. I. Details of roads, drainage features, collection systems, and stormwater control measures. in. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a qualified person. Provide documentation of qualifications and identify the person who made the determination on the plans. MV, V"iL vMLI 41KS VK2L Fomz SWU-101 Version 07Jun2010 Page 4 of 6 n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations. o. Drainage areas delineated (included in the main set of plans, not as a separate document). p. Vegetated buffers (where required). 9. Copy of any applicable soils report with the associated SHWT elevations (Please identify yyyF b elevations in addition to depths) as well as a map of the boring locations with the existing elevations and boring logs. Include an 8.5"x11" copy of the NRCS County Soils map with the project area clearly delineated. For projects with infiltration BMPs, the report should also include the soil type, expected infiltration rate, and the method of determining the infiltration rate. (Infiltration Devices submitted to WiRO: Schedule a site visit far DWQ to verifij the SHWT prior to submittal, (910) 796-7378.) 10. A copy of the most current property deed. Deed book: 144 Page No: 215 Lt- 11. For corporations and limited liability corporations (LLC): Provide documentation from the NC vvttt- Secretary of State or other official documentation, which supports the titles and positions held by the persons listed in Contact Information, item la, 2a, and/or 3a per NCAC 2H.1003(e). The corporation or LLC must be listed as an active corporation in good standing with the NC Secretary of State, otherwise the application will be returned. littp://www.secretary.state.iic.us/Coi-poratioiis/CScarcli.aspx V1L DEED RESTRICTIONS AND PROTECTIVE COVENANTS For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed 13UA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and protective covenants forms can be downloaded from Imo://portal.ncdennory/web/wq/ws/su/statesw/forms does. Download the latest versions for each submittal. In the instances where the applicant is different than the property owner, it is the responsibility of the property owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring that the deed restrictions are recorded. By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and protective covenants for this project, if required, shall include all the items required in the permit and listed on the forms available on the website, that the covenants will be binding on all parties and persons claiming under them, that they will run with the land, that the required covenants cannot be changed or deleted without concurrence from the NC DWQ and that they will be recorded prior to the sale of any lot. VIII. CONSULTANT INFORMATION AND AUTHORIZATION Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as addressing requests for additional information). Consulting Enginecr:Matt Lowder, PE Consulting Firm: Triangle Site Design, PLLC Mailing Address:4006 Barrett Drive Suite 203 City:Raleigh Phone: (919 ) 553-6570 Email:mlowder©trianglesitedesign.com State:NC Zip:27609 Fax: ( ) IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled ont, complete this section) 1, (print or type name of person listed in Contact Information, itent 2a) George T. Barnes, fr. , certify that I own the property identified in this permit application, and thus give permission to (print or type name of person listen in Contact Information, itent la) George T. Barnes, Jr. with (print or type name of organization listen in Contact Information, item In) Glandon Forest Equity, LLC to develop the project as currently proposed. A copy of the lease agreement or pending property sales contract has been provided with the submittal, which indicates the party responsible for the operation and maintenance of the stormwater system. Poor SWU-101 Version 07Jun2010 Page 5 of 6 As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their lease agreement, or pending sale, 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 immediately and submit a completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment facility without a valid permit. I understand that the operation of a stormwater treatment facility without a valid permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including the assessment of civil onalties of to $25,000 er day, pursuant to NCGS 143-215.6. Signature: �J k - Date: a Notary Public for the State of NG . County of WAKG do hereby certify that (o,604il % 649 *&5 J/l personally appeared before me this/,L1_//Hay of e) ✓5MI16C 00/0 , and acknowledge the due execution of the application for a stonnwater permit. Witness my hand and official seal, N i =CO NOTARY N' PUBLIC ///F CIO UI�l�����°\ X. APPLICANT'S CERTIFICATION SEAL My commission expires cd - /°1 -d! // I, (print or type name of person listed in Contact Information, item la) George T. Barnes, Jr. - Glandon Forest Equitit, LLC, certify that the information included on this permit application form is, to the best of my knowledge, correct and that the project will he constructed in conformance with the approved plans, that the required deed restrictions and protective cove ants will be recorded, and that thproposed project complies with the requirements of the applicable storm er rulu ndeG�=e 0, SL 2006-246 (Ph. II -Post Constructs n) r SL 2008-211. Signature: � Date: 1 1 11 � D I, %- fRe MIIIJ W zyyPS a Notary Public for the State of /Ve. County of "C- do hereby certify that ( ic0,4t E r &W &ES � personally appeared before me this/Zfhday of �) / and ackk! owledge the due execution of the application for a stormwater permit. Witness my hand and official seal, �Alal—t4 Ct IrLll �Iye 4i�.e o'N N I IV,/////i =� NOTARY N= PUBLIC j �C0UNI SISAL My commission expires J- 1\5- -ay // Form SWU-101 Version 07Jun2010 Page 6 of 6 September 13, 2010 Mr. George Barnes Vanguard Property Group 3900 Merton Drive Suite 210 Raleigh, NC 27609 Dear Mr. Barnes: PO Box 1387 Richlands, NC 28574 NOV 16 2010 {� 1 The following is a summary. of the soil profiles taken at the proposed C General site located off Highway 55 in Grantsboro, NC. The purposeo evaluation was to determine estimated Seasonal High Water Table (SF and conduct hydraulic conductivity evaluations. A hand auger was use obtain the soil profiles and the compact constant head permeameter (Amoozemeter) was used to obtain hydraulic conductivity in -situ data. techniques outlines in the North Carolina Laws and Rules for Sewage Treatment and DisposalSystems were used to determine soil texture, structure, consistency and soil wetness condition. Boring 1 Depth to SHWT (From land surface): <12" Hole depth: 60" Depth to groundwater observed in bore hole: >48" liar the to Depth Inches Texture Structure Matrix Color Mottle Color I 0-12 Loamy sand Granular 2.5 3/1 I 12-36 Clay loam sbk 2.5 6/1 2.5 3/1 I 36-60 Clay loam abk 2'.5 6/1 2.5 3/1 I I ( ( Several borings revealed the same soil characteristics. I Soil wetness condition was determined by the indication of colors of i 2 or less utilizing a Munsell Soil color Chart at >2% of soil volume in or matrix of a horizon or horizon subdivision. I I A summary of the data of hydraulic conductivity readings follows: Boring 1 Depth 30 cm: 1.5 inches/hour, Depth 60 cm: 0.2 inches/hour, Depth 80 cm: 0.1-0.2 inches/hour, If you have any questions, please feel free to contact me at (910) Thank you. Respectfully, R. aywood Pittman, LSS ma 784. North Carolina Secretary of State http: //w ww. secretary. state. nc.us/corporaf ons/Corp.aspx? Pi temld=7... North Carolina Elaine F. Marshall DEPARTMENT OF THE Secretary SECRETARY OF STATE Date: 5/2/2011 PO Box 29622 Raleigh, NC 27626-0622 (919)807-2000 Click here to: View Document Filings I Sign Up for E-Notifications I J Pre -populated Annual Report Fillable PDF Form I File an Annual Report I Corporation Names Name Name Type N C_GLANDO N,FO RESL�EGAL IE(]UITYJC='A Limited Liability Company Information SOSID: 0851022 Status: Current -Active Effective Date: 6/14/2006 Dissolution Date: Annual Report Due Date: Citizenship: DOMESTIC State of Inc.: NC Duration: PERPETUAL Annual Report Status: CURRENT Registered Agent Agent Name: Office Address: Mailing Address: Principal Office HEPPS, SHERRI 3900 MERTON DRIVE, SUITE 210 RALEIGH NC 27609 3900 MERTON DRIVE, SUITE 210 RALEIGH NC 27609 Office Address: 3900 MERTON DRIVE, SUITE 210 RALEIGH NC 27609 Mailing Address: 3900 MERTON DRIVE, SUITE 210 RALEIGH NC 27609 Officers Title: MEMBER'., Name: ,PEORGE T=BARNESJR__� Business Address: 3900 MERTON DRIVE, SUITE 210 RALEIGH NC 27609 This website is provided to the public as a part of the Secretary of State Knowledge Base (SOSKB) system. Version: 3386 I of 1 5/2/2011 5:51 PM pEPnRTAr�T LIMITED LIA131LITY COMPANY €' ANNUAL REPORT NAME OF LIMITED LIABILITY COMPANY- Glarutlon Forest ligrtity, LLC SECRETARY OF STATE L.L.C. ID NUMBER: 0851022 NATURE OF BUSINESS: Real Estate REGISTERED AGENT: Heppe, Sherri REGISTERED OFFICE MAILING ADDRESS: 3900 Merton Drive, Suite 210 Raleigh, NC 27609 &Filed Annual Report -1-0avy036 1 For year 2010 Do not data enter manually. STATE: OF INCORPORATION: NC RUGISTEIZED OFFICE STREET ADDRESS: 3900A1erion Drive, Suite 210 Raleigh, NC 27609 Wake County PRINCIPAL OFFICE TELE"ITIONF., NUMBER: (919) 459-2600 PRINCIPAL OFFICE MAILING ADDRESS: PRINCIPAL OFFICE, STREET ADDRESS MANAGERS/M EMB UIZ S/OIZGA N EL.EIZS: Name: George T. Barnes Jr. Title: A/rmher Irlrhess: 3900,11erton Drive, Suite 210 Raleigh, NC 27609 3900 Merlon Drive, Suite 210 Raleigh, NC 27609 3900 Merton Drive, Suite 210 Raleigh, NC 27609 NOV 16 2010 CERTIFICATION OF ANNUAL REPORT MIDST BE COMPLETED 13Y ALL LIMITED LIABILITY COMPANIES George T. Bames Jr. PORN NIUST B17 SIGN I) BY A NJANAG17R/NlEJ1BFR George T. Barnes Jr. 04/06/2010 DATE Member TYPE. OR PRINT NAME TYPE OR PRINT TITLE ANNUAL REPORT FEE: $200 MAIL TO: Secretaryof State • Corporations Division • Post Office Box 29525 • Rateiglt NC 27626-0525 't"F.Lwc'.t it'.x 4N NOV 16 2010 REALTORS' Comm ercialAiliance LL, AGREEMENT FOR PURCHASE AND SALE OF REAL PROPERTY REALTORO North Carolina Association ofREALTORS® THIS AGREEMENT, including any and all addenda attached hereto ("Agreement"), is by and between Glandon Forest Equity, LLC a(n) North Carolina Corporation ("Buyer"), and (individual or State of formation and type of entity) James A. Tingle, et al , a(n) individual ("Seller"). (individual or State of formation and type of entity) FOR AND IN CONSIDERATION OF THE MUTUAL PROMISES SET FORTH HEREIN AND OTHER GOOD AND VALUABLE CONSIDERATION, THE RECEIPT AND SUFFICIENCY OF WHICH ARE HEREBY ACKNOWLEDGED, THE PARTIES HERETO AGREE AS FOLLOWS: Section 1. Terms and Definitions: The terms listed below shall have the respective meaning given them as set forth adjacent to each term. (a) "Property": (Address) 0 Hwy 55 West All M A portion of the property in Deed Reference: Book 144 , Page No. 215 , Pamlico County; consisting of approximately 1 .5 acres. Plat Reference: Lots) N/A , Block or Section N/A , as shown on Plat Book or Slide N/A at Page(s) N/A N/A County, consisting of N/A acres. If this box is checked, "Property" shall mean that property described on Exhibit A attached hereto and incorporated herewith by reference, (For information purposes, the tax parcel number of the Property is: 6541840785 together with all buildings and improvements thereon and all fixtures and appurtenances thereto and all personal property, if any, itemized on Exhibit A. $ 175, 000. 00 (b) "Purchase Price" shall mean the sum of One Hundred Seventy -Five Thousand Dollars, payable on thefollorving terms: $ 1,000.00 (i) "Earnest Money" shall mean One Thousand Dollars or terms as follows: N/A Upon this Agreement becoming a contract in accordance with Section 14, the Earnest Money shall be promptly deposited in escrow with Aldridge and Southerland, Inc. (name of person/entity with whom deposited), to be applied as part payment of the Purchase Price of the Property at Closing, or disbursed as agreed upon under the provisions of Section 10 herein. Page l of 8 This form jointly approved by: SI'n1 aD FORM 580-T North Carolina Bar Association Re...a 7/2008 Nurth Caro ' ggociation of REALTORS©, Inc. Eouuxlwsmc REACTOR® [; �. �A arron.uxnv ©7/"LUe_ Buyer Initi Is Seller Initials Aldridge&Southed.rd REALTORS®226 Commerce Strat Grccevllle, NC 27859 Phone:252-756-3500 Fax'. 252-756-4159 Glandon Forest Jenny Mullarkey Produced with ZipForm'D by apt-ogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 w zinl_ooix mm ANY EARNEST MONEY DEPOSITED BY BUYER IN A TRUST ACCOUNT MAY BE PLACED IN AN INTEREST BEARING TRUST ACCOUNT, AND: (check only ONE bar) ANY INTEREST EARNED THEREON SHALL BE APPLIED AS PART PAYMENT OF THE PURCHASE PRICE OF THE PROPERTY AT CLOSING, OR DISBURSED AS AGREED UPON UNDER THE, PROVISIONS OF SECTION 10 HEREIN. (Buyer's Taxpayer Identification Number is: N/A ) ® ANY INTEREST EARNED THEREON SHALL BELONG TO THE ACCOUNT HOLDER IN CONSIDERATION OF THE EXPENSES INCURRED BY MAINTAINING SUCH ACCOUNT AND RECORDS ASSOCIATED THEREWITH. $ N/A (ii) Proceeds of a new loan in the amount of Dollars for a term of N/A years, with an amortization period not to exceed NIA years, at an interest rate not to exceed % per annum with mortgage loan discount points not to exceed % of the loan amount, or such other terms as may be set forth on Exhibit B. Buyer shall pay all costs associated with any such loan. $ N/A (iii) Delivery of a promissory note secured by a deed of trust, said promissory note in the amount of Dollars being payable over a term of N/A years, with an amortization period of N/A years, payable in monthly installments of principal, together with accrued interest on the outstanding principal balance at the rate of percent ( °/u) per annum in the amount of $ N/A , with the first principal payment beginning on the first day of the month next succeeding the date of Closing, or such other terms as may be set forth on Exhibit B. At any time, the promissory note may be prepaid in whole or in part without penalty and without further interest on the amounts prepaid from the date of such prepayment. (NOTE: In the event of Buyer's subsequent default upon a promissory note and deed of trust given hereunder, Seller's remedies may be limited to foreclosure of the Property. If the deed of trust given hereunder is subordinated to senior financing, the material terms of such financing must be set forth on Exhibit B. If such senior financing is subsequently foreclosed, the Seller may have no remedy to recover under the note.) $ N/A (iv) Assumption of that unpaid obligation of Seller secured by a deed of trust on the Property, such obligation having an outstanding principal balance of $ N/A and evidenced by a note bearing interest at the rate of percent ( N/A %) per annum, and a current payment amount of $ N/A . The obligations of Buyer under this Agreement are conditioned upon Buyer being able to assume the existing loan described above. If such assumption requires the lender's approval, Buyer agrees to use its best efforts to secure such approval and to advise Seller immediately upon receipt of the lender's decision. Approval must be granted on or before N/A . On or before this date, Buyer has the right to terminate this Agreement for failure to be able to assume the loan described above by delivering to Seller written notice of termination by the above date, time being of the essence . If Buyer delivers such notice, this Agreement shall be null and void and Earnest Money shall be refunded to Buyer. If Buyer fails to deliver such notice, then Buyer will be deemed to have waived the loan condition. Unless provided otherwise in Section 3 hereof, Buyer shall pay all fees and costs associated with any such assumption, including any assumption fee charged by the lender. At Closing, Seller shall assign to Buyer all interest of Seller in any current reserves or escrows held by the lender, any property management company and/or Seller, including but not limited to any tenant improvement reserves, leasing commission reserves, security deposits and operating or capital reserves for which Seller shall be credited said amounts at Closing. $ 174,000 (v) Cash, balance of Purchase Price, at Closing in the amount 9f one Hundred Seventy —Four Thousand Dollars. Page 2 of 8 Buyer Initia& — Seller Initials L STANDARD FORM 580-T Revised 7/2008 © 7/2009 Produced with ZipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 w zioLoai corn Glandon Forest (c) "Closing" shall mean the date and time of recording of the deed. Closing shall occur on or before N/A or 30 days after the initial due diligence period (d) "Contract Date" means the date this Agreement has been fully executed by both Buyer and Seller. (e) "Examination Period" shall mean the period beginning on the Contract Date and extending through 60 days from the execution of the contract TIME IS OF THE ESSENCEAS TO THE EX4AHNAT/ON PERIOD. (t) "Broker(s)" shall mean: Aldridge and Southerland Inc ("Listing Agency"), Justin Mullarkev ("Listing Agent" - License # 225875 ) Acting as: Q Seller's Agent; M Dual Agent and ("Selling Agency"), ("Selling Agent"- License # ) Acting as: M Buyers Agent; ❑ Seller's (Sub) Agent; 0 Dual Agent (g) "Seller's Notice Address" shall be as follows: PO Box 424 Southern Pines, NC 28388 except as same may be changed pursuant to Section 12. (h) "Buyer's Notice Address" shall be as follows c/o George T. Barnes 3900 Merton Drive Suite 200 Raleigh, NC 27609 except as same may be changed pursuant to Section 12 In (i) If this block is marked, additional terms of this Agreement are set forth on Exhibit B attached hereto and incorporated herein by reference. (Note: Under North Carolina law, real estate agents are not permitted to draft conditions or contingencies to this Agreement.) Q) If this block is marked, additional terms of this Agreement are set forth on the Additional Provisions Addendum (Form 581-T) attached hereto and incorporated herein by reference. Section 2. Sale of Property and Payment of Purchase Price: Seller agrees to sell and Buyer agrees to buy the Property for the Purchase Price. Section 3. Proration of Expenses and Payment of Costs: Seller and Buyer agree that all property taxes (on a calendar year basis), leases, rents, mortgage payments and utilities or any other assumed liabilities as detailed on attached Exhibit B, if any, shall be prorated as of the date of Closing. Seller shall pay for preparation of a deed and all other documents necessary to perform Seller's obligations under this Agreement, excise tax (revenue stamps), any deferred or rollback taxes, and other conveyance fees or taxes required by law, and the following: as required by law or custom Pa e3of8 Buyer Initials Seller Initials L STANDARD FORM 580-T Produced with ZipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 mm,zi Lp_ogix corn Revised 7/2008 © 7/2009 Glandon Forest Buyer shall pay recording costs, costs of any title search, title insurance, survey, the cost of any inspections or investigations undertaken by Buyer under this Agreement and the following: Each party shall pay its own attorney's fees. Section 4. Deliveries: Seller agrees to use best efforts to deliver to Buyer as soon as reasonably possible after the Contract Date copies of all information relating to the Property in possession of or available to Seller, including but not limited to: title insurance policies, surveys and copies of all presently effective warranties or service contracts related to the Property. Seller authorizes (1) any attorney presently or previously representing Seller to release and disclose any title insurance policy in such attorney's file to Buyer and both Buyer's and Seller's agents and attorneys; and (2) the Property's title insurer or its agent to release and disclose all materials in the Property's title insurer's (or title insurer's agent's) file to Buyer and both Buyer's and Seller's agents and attorneys. If Buyer does not consummate the Closing for any reason other than Seller default, then Buyer shall return to Seller all materials delivered by Seller to Buyer pursuant to this Section 4 (or Section 7, if applicable), if any, and shall, upon Seller's request, provide to Seller copies of (subject to the ownership and copyright interests of the preparer thereof) any and all studies, reports, surveys and other information relating directly to the Property prepared by or at the request of Buyer, its employees and agents, and shall deliver to Seller, upon the release of the Earnest Money, copies of all of the foregoing without any warranty or representation by Buyer as to the contents, accuracy or correctness thereof. Section 5. Evidence of Title: Seller agrees to convey fee simple marketable and insurable title to the Property free and clear of all liens, encumbrances and defects of title other than: (a) zoning ordinances affecting the Property, (b) Leases (if applicable) and (c) matters of record existing at the Contract Date that are not objected to by Buyer prior to the end of the Examination Period ("Permitted Exceptions"); provided that Seller shall be required to satisfy, at or prior to Closing, any encumbrances that may be satisfied by the payment of a fixed sum of money, such as deeds of trust, mortgages or statutory liens. Seller shall not enter into or record any instrument that affects the Property (or any personal property listed on Exhibit A) after the Contract Date without the prior written consent of Buyer, which consent shall not be unreasonably withheld, conditioned or delayed. Section 6. Conditions: This Agreement and the rights and obligations of the parties under this Agreement are hereby made expressly conditioned upon fulfillment (or waiver by Buyer, whether explicit or implied) of the following conditions: (a) hjgyil� The Buyer mus t be able to ebtain the loan, if any, refereFteed iR Seetion 1(b)(ii). Buyel; must be able to obtain a firm eemmitynent for this loan an or befBFe N/A I effeetk,e thfeugh the date ef Glesing. Buyer agrees to use its best effents ta seetife sueh eamfnit t And to HH-iqP, 8P.P.PF imfliediately upon receipt of lender's deeisien. On a before the above date, Buyer has the right to terminate this ' - I I - .. to obtain the lean fefefeiieed iii Seetien 1(b)(imo-b�- If Buyer delivers such notice, !his Agreenient shall be null and void and RaFnest Money shall be fef�Fded to Buyef. if Buyef flails te deliver stteh notiee, then Btt5,eF will be deemed to have vvak,ed the loan erudition. NoPwithstafld`g 'i-e- aftef the above date, Sellef fAay FeEluest in NvAting ftem Btiyei- a eepy ofthe eoraninnent letteF. lfBuyeF fails to pfavide Seller a eopy of the eenimitment lettef within five (5) days Of Feeeipt of Seller's requ- I, then Sellev Yna), terminate this Agreement by wFitten notiee to Buyer fit an), time tliereaflei6, preN'ided Sellef has net then feeeiyed a eapy ofthe eommitmeiA lettef, and l3ttyef shall Feeeive a return ofEta,nest Money. ( ) Quafifienfign for Fi if ith , Buyer agFees to use its best effefts te quali6, fef the assumption. Should Buyef ---- il te qualify, Buyer shall nefl6Seller in wfifing- and PC..........t nd.v..,... ren this reement shall o T (c) Title Examination: After the Contract Date, Buyer shall, at Buyer's expense, cause a title examination to be made of the Property before the end of the Examination Period. In the event that such title examination shall show that Seller's title is not fee simple marketable and insurable, subject only to Permitted Exceptions, then Buyer shall promptly notify Seller in writing of all such title defects and exceptions, in no case later than the end of the Examination Period, and Seller shall have thirty (30) days to cure said noticed defects. If Seller does not cure the defects or objections within thirty (30) days of notice thereof, then Buyer may terminate this Agreement and receive a return of Earnest Money (notwithstanding that the Examination Period may have expired). If Buyer is to purchase title insurance, the insuring company must be licensed to do business in the state in which the Property is located. Title to the Property must be insurable at regular rates, subject only to standard exceptions and Permitted Exceptions. (d) Same Condition: If the Property is not in substantially the same condition at Closing as of the date of the offer, reasonable wear and tear excepted, then the Buyer may (i) terminate this Agreement and receive a. return of the Earnest Money or (ii) proceed to Closing whereupon Buyer shall be entitled to receive, in addition to the Property, any of the S-Iler's insurance proceeds payable on account of the damage or destruction applicable to the Property. Page 4 of 8 Buyer Initial Seller Initials L r,4, STANDARD FORM 580-T Revised 7/2008 © 7/2009 Produced with ZipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 wwa.zioLoeix.com Glandon Forest (e) Inspections: Buyer, its agents or representatives, at Buyer's expense and at reasonable times during normal business hours, shall have the right to enter upon the Property for the purpose of inspecting, examining, performing soil boring and other testing, conducting timber cruises, and surveying the Property. Buyer shall conduct all such on -site inspections, examinations, soil boring and other testing, timber cruises and surveying of the Property in a good and workmanlike manner, shall repair any damage to the Property caused by Buyer's entry and on -site inspections and shall conduct same in a manner that does not unreasonably interfere with Seller's or any tenant's use and enjoyment of the Property. In that respect, Buyer shall make reasonable efforts to undertake on -site inspections outside of the hours any tenant's business is open to the public and shall give prior notice to any tenants of any entry onto any tenant's portion of the Property for the purpose of conducting inspections. Upon Seller's request, Buyer shall provide to Seller evidence of general liability insurance. Buyer shall also have a right to review and inspect all contracts or other agreements affecting or related directly to the Property and shall be entitled to review such books and records of Seller that relate directly to the operation and maintenance of the Property, provided, however, that Buyer shall not disclose any information regarding this Property (or any tenant therein) unless required by law and the same shall be regarded as confidential, to any person, except to its attorneys, accountants, lenders and other professional advisors, in which case Buyer shall obtain their agreement to maintain such confidentiality. Buyer assumes all responsibility for the acts of itself, its agents or representatives in exercising its rights under this Section 6(e) and agrees to indemnify and hold Seller harmless from any damages resulting therefrom. This indemnification obligation of Buyer shall survive the Closing or earlier termination of this Agreement. Buyer shall, at Buyer's expense, promptly repair any damage to the Property caused by Buyer's entry and on -site inspections. Except as provided in Section 6(c) above, Buyer shall have from the Contract Date through the end of the Examination Period to perform the above inspections, examinations and testing. IF BUYER CHOOSES NOT TO PURCHASE THE PROPERTY, FOR ANY REASON OR NO REASON, AND PROVIDES WRITTEN NOTICE TO SELLER THEREOF PRIOR TO THE EXPIRATION OF THE EXAMINATION PERIOD, THEN THIS AGREEMENT SHALL TERMINATE, AND BUYER SHALL RECEIVE A RETURN OF THE EARNEST MONEY. Section 7. Leases (Check one of the following, as applicable): Xp If this box is checked, Seller affirmatively represents and warrants that there are no Leases (as hereinafter defined) affecting the Property. M If this box is checked, Seller discloses that there are one or more leases affecting the Property (oral or written, recorded or not - "Leases") and the following provisions are hereby made a part of this Agreement. (a) All Leases shall be itemized on Exhibit B; (b) Seller shall deliver copies of any Leases to Buyer pursuant to Section 4 as if the Leases were listed therein; (c) Seller represents and warrants that as of the Contract Date there are no current defaults (or any existing situation which, with the passage of time, or the giving of notice, or both, or at the election of either landlord or tenant could constitute a default) either by Seller, as landlord, or by any tenant under any Lease ("Lease Default"). In the event there is any Lease Default as of the Contract Date, Seller agrees to provide Buyer with a detailed description of the situation in accordance with Section 4. Seller agrees not to commit a Lease Default as Landlord after the Contract Date, and agrees further to notify Buyer immediately in the event a Lease Default arises or is claimed, asserted or threatened to be asserted by either Seller or a tenant under the Lease. (d) In addition to the conditions provided in Section 6 of this Agreement, this Agreement and the rights and obligations of the parties under this Agreement are hereby made expressly conditioned upon the assignment of Seller's interest in any Lease to Buyer in form and content acceptable to Buyer (with tenant's written consent and acknowledgement, if required under the Lease), and Seller agrees to use its best efforts to effect such assignment. Any assignment required under this Section 7 shall be required to be delivered at Closing by Seller in addition to those deliveries required under Section I I of this Agreement. (e) Seller agrees to deliver an assignment of any Lease at Closing, with any security deposits held by Seller under any Leases to be transferred or credited to Buyer at Closing. Seller also agrees to execute and deliver (and work diligently to obtain any tenant signatures necessary for same) any estoppel certificates and subordination, nondisturbance and adornment agreements in such form as Buyer may reasonably request. Section 8. Environmental: Seller represents and warrants that it has no actual knowledge of the presence or disposal, except as in accordance with applicable law, within the buildings or on the Property of hazardous or toxic waste or substances, which are defined as those substances, materials, and wastes, including, but not limited to, those substances, materials and wastes listed in the United States Department of Transportation Hazardous Materials Table (49 CFR Part 172.101) or by the Environmental Protection Agency as hazardous substances (40 Cl,R Part 302.4) and amendments thereto, or such substances, materials and wastes, which are or become regulated under any applicable local, state or federal law, including, without limitation, any material, waste or substance which is (i) Page 5 of 8 Buyer Initial, Seller Initials e! f. 1. STANDARD FORM 580-T Revised 7/2008 © 7/2009 Produced with ZipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 www io oo'x in Glandon Forest petroleum, (ii) asbestos, (iii) polychlorinated biphenyls, (iv) designated as a Hazardous Substance pursuant to Section 311 of the Clean Water Act of 1977 (33 U.S.C. §1321) or listed pursuant to Section 307 of the Clean Water Act of 1977 (33 U.S.C. §1317), (v) defined as a hazardous waste pursuant to Section 1004 of the Resource Conservation and Recovery Act of 1976 (42 U.S.C. §6903) or (vi) defined as a hazardous substance pursuant to Section 101 of the Comprehensive Environmental Response, Compensation and Liability Act of 1980 (42 U.S.C. §9601). Seller has no actual knowledge of any contamination of the Property from such substances as may have been disposed of or stored on neighboring tracts. Section 9. Risk of Loss/Damage/Repair: Until Closing, the risk of loss or damage to the Property, except as otherwise provided herein, shall be borne by Seller. Except as to maintaining the Property in its same condition, Seller shall have no responsibility for the repair of the Property, including any improvements, unless the parties hereto agree in writing. Section 10. Earnest Money Disbursement: In the event that any of the conditions hereto are not satisfied, or in the event of a breach of this Agreement by Seller, then the Earnest Money shall be returned to Buyer, but such return shall not affect any other remedies available to Buyer for such breach. In the event this offer is accepted and Buyer breaches this Agreement, then the Earnest Money shall be forfeited, but such forfeiture shall not affect any other remedies available to Seller for such breach. NOTE: In the event of a dispute between Seller and Buyer over the return or forfeiture of Earnest Money held in escrow by a licensed real estate broker, the broker is required by state law to retain said Earnest Money in its trust or escrow account until it has obtained a written release from the parties consenting to its disposition or until disbursement is ordered by a court of competent jurisdiction, or alternatively, the party holding the Earnest Money may deposit the disputed monies with the appropriate clerk of court in accordance with the provisions of N.C.G.S. §93A-12. Section 11. Closing: At Closing, Seller shall deliver to Buyer a general warranty deed unless otherwise specified on Exhibit B and other documents customarily executed or delivered by a seller in similar transactions, including without limitation, a bill of sale for any personally listed on Exhibit A, an owner's affidavit, lien waiver forms and a non -foreign status affidavit (pursuant to the Foreign Investment in Real Property Tax Act), and Buyer shall pay to Seller the Purchase Price. At Closing, the Earnest Money shall be applied as part of the Purchase Price. The Closing shall be held at the office of Buyer's attorney or such other place as the parties hereto may mutually agree. Possession shall be delivered at Closing, unless otherwise agreed herein. Section 12. Notices: Unless otherwise provided herein, all notices and other communications which may be or are required to be given or made by any party to the other in connection herewith shall be in writing and shall be deemed to have been properly given and received on the date delivered in person or deposited in the United States mail, registered or certified, return receipt requested, to the addresses set out in Section l(g) as to Seller and in Section 1(h) as to Buyer, or at such other addresses as specified by written notice delivered in accordance herewith. Section 13. Entire Agreement: This Agreement constitutes the sole and entire agreement among the parties hereto and no modification of this Agreement shall be binding unless in writing and signed by all parties hereto. Section 14. Enforceability: This Agreement shall become a contract when signed by both Buyer and Seller and such signing is communicated to both parties; it being expressly agreed that the notice described in Section 12 is not required for effective communication for the purposes of this Section 14. This Agreement shall be binding upon and inure to the benefit of the parties, their heirs, successors and assigns and their personal representatives. Section 15. Adverse Information and Compliance with Laws: (a) Seller Knowledee: Seller has no actual knowledge of (i) condemnation(s) affecting or contemplated with respect to the Property; (ii) actions, suits or proceedings pending or threatened against the Property; (iii) changes contemplated in any applicable laws, ordinances or restrictions affecting the Property; or (iv) governmental special assessments, either pending or confirmed, for sidewalk, paving, water, sewer, or other improvements on or adjoining the Property, and no pending or confirmed owners' association special assessments, except as follows (Insert "None" or the identification of any matters relating to (i) through (iv) above, if any): Note: For purposes of this Agreement, a "confirmed" special assessment is defined as an assessment that has been approved by a governmental agency or an owners' association for the purpose(s) stated, whether or not it is fully payable at time of closing. A "pending" special assessment is defined as an assessment that is under formal consideration by a governing body. Seller shall pay all owners' association assessments and all governmental assessments confirmed as of the time of Closing, if any, and 91ver shall take title subject to all pending assessments disclosed by Seller herein, if any. Seller represents that the regular owners' association dues, if any, are $ per N/A NPage 6nof 8 Buyer Initials Seller Initialsr STANDARD FORM 580-T Revised 7/2008 © 7/2009 Produced with ZipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 www.zioLooix.com Glandon Forest (b) Conmliance: To Seller's actual knowledge, (i) Seller has complied with all applicable laws, ordinances, regulations, statutes, rules and restrictions pertaining to or affecting the Property; (ii) performance of the Agreement will not result in the breach of, constitute any default under or result in the imposition of any lien or encumbrance upon the Property under any agreement or other instrument to which Seller is a party or by which Seller or the Property is bound; and (iii) there are no legal actions, suits or other legal or administrative proceedings pending or threatened against the Property, and Seller is not aware of any facts which might result in any such action, suit or other proceeding. Section 16. Survival of Representations and Warranties: All representations, warranties, covenants and agreements made by the parties hereto shall survive the Closing and delivery of the deed. Seller shall, at or within six (6) months after the Closing, and without further consideration, execute, acknowledge and deliver to Buyer such other documents and instruments, and take such other action as Buyer may reasonably request or as may be necessary to more effectively transfer to Buyer the Property described herein in accordance with this Agreement. Section 17. Applicable Law: This Agreement shall be construed under the laws of the state in which the Property is located. This form has only been approved for use in North Carolina. Section 18. Assignment: This Agreement is freely assignable unless otherwise expressly provided on Exhibit B. Section 19. Tax -Deferred Exchange: In the event Buyer or Seller desires to effect a tax -deferred exchange in connection with the conveyance of the Property, Buyer and Seller agree to cooperate in effecting such exchange; provided, however, that the exchanging party shall be responsible for all additional costs associated with such exchange, and provided further, that a non -exchanging party shall not assume any additional liability with respect to such tax -deferred exchange. Seller and Buyer shall execute such additional documents, at no cost to the non -exchanging party, as shall be required to give effect to this provision. Section 20. Memorandum of Contract: Upon request by either party, the parties hereto shall execute a memorandum of contract in recordable form setting forth such provisions hereof (other than the Purchase Price and other sums due) as either party may wish to incorporate. Such memorandum of contract shall contain a statement that it automatically terminates and the Property is released from any effect thereby as of a specific date to be stated in the memorandum (which specific date shall be no later than the date of Closing). The cost of recording such memorandum of contract shall be home by the party requesting execution of same. Section 21. Authority: Each signatory to this Agreement represents and warrants that he or she has full authority to sign this Agreement and such instruments as may be necessary to effectuate any transaction contemplated by this Agreement on behalf of the party for whom he or she signs and that his or her signature binds such party. Section 22. Brokers: Except as expressly provided herein, Buyer and Seller agree to indemnify and hold each other harmless from any and all claims of brokers, consultants or real estate agents by, through or under the indemnifying party for fees or commissions arising out of the sale of the Property to Buyer. Buyer and Seller represent and warrant to each other that: (i) except as to the Brokers designated under Section 1(I) of this Agreement, they have not employed nor engaged any brokers, consultants or real estate agents to be involved in this transaction and (ii) that the compensation of the Brokers is established by and shall be governed by separate agreements entered into as amongst the Brokers, the Buyer and/or the Seller. ❑ EIFS/SYNTHETIC STUCCO: If the adjacent box is checked, Seller discloses that the Property has been clad previously (either in whole or in part) with an "exterior insulating and finishing system" commonly known as "EIFS" or "synthetic stucco". Seller makes no representations or warranties regarding such system and Buyer is advised to make its own independent determinations with respect to conditions related to or occasioned by the existence of such materials at the Property. THE NORTH CAROLINA ASSOCIATION OF REALTORS©, INC. AND THE NORTH CAROLINA BAR ASSOCIATION MAKE NO REPRESENTATION AS TO THE LEGAL VALIDITY OR ADEQUAC SPECIFIC TRANSACTION. IF YOU DO NOT UNDERSTAND THIS FORM YOUR LEGAL NEEDS, YOU SHOULD CONSULT A NORTH CAROLINA IT. Page 7 of 8 Buyer Initialc-Eb Seller Initials C Y OF ANY PROVISION OF THIS FORM IN ANY OR FEEL THAT IT DOES NOT PROVIDE FOR REAL ESTATE ATTORNEY BEFORE YOU SIGN STANDARD FORM 580-T Revised 7/2008 Produced with ZipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 www.zioLoaix.com © 7/2009 Glandon Forest BUYER: Individual Date: Date: Business Entity C L j D FC51 Glandon Ecruitv QrMM, LLC (Nat of Entity) By:OU Name: i,<<°� "✓° e� �� Title: SCT-r Date: 1 I I� 0 SELLER: Individual Date: Alty-, Date:'. Business Entity By: Name: Title: Date: of Entity) The undersigned hereby acknowledges receipt of the Earnest Money set forth herein and agrees to hold said Earnest Money in accordance with the terms hereof. 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Ler eelo hurhm A,towhing her voluntary exe0utlo w.tl.e or ,d; ti v ot, th,t rl.. line: tt, sore f:',cly and v.11:nterily,aithoul fear or .a 'I I, • .,: `-", I+ r,,r h•.h.r- in: ;•th• . sot+: rind Wit -'hr. iteth still voluntarily ;It::td: :p land tot 1:otL.101 COwL, :h:o the YOth doy Of Augu.t.1933. a PI .. Yy rrac'••a S1:'0T t.1"37... ob :y 14 c MSTH GaX r; 1, ( V.}Y1: cc I!O:,a-,. mr ct. of L°i..., a ct.ry Public of Parallel, coon Lcy, Iv „bn.: for beI in du! e." .od t000rdtng to lea,Thorufore let the foregoing lnotx \':I '.u• • eOrlifieotao to r.gletered, 1TIo [I joy of Audu.t,19S5. Z' i•T' `_I"_ .. re'�-' ice'_ n...c".".a ',.g''=: )1,_9)?„nnA rOCleterad, I Alfred Le•l, _J I ..Oy la er n_ n0 a. ! 'f:L 1!II'21!YMIN .`.U"t 'Flo the ?Nth 1ny Of Augce t,l9SS.pweuant to an order N of tic CuLr'I 0.''ple C,lA-:y Ord Etutu, bt Jullue 0. Doe,.th, underalenad Ccdalq. fo•<r, p. rt) rf p:¢ ]-fret rart,t, the J.tlentlt JOIN, -teed land Bank of Rolelgh.e responds 1 fr, 1n;"f, Ir :;ce end rule tin; urAxr end by ufrluo of en Aet of congreeo of the United ^__b: c: c: •. ••i:: '•1^•: ^.•` !l^n l;r'• r;i nr .-1 rtl iOca l Ideof filter eads rr 1w tlty Of *r)n fn,rm'h`t••n: n:e .Tr :vet ni^d n:breal rt Ioll, accepted bidder for the )r• •v hve7a'•"rr nreerlMd;M'P rf f`m nresnd fart. • +'R+T Ns III -WI r rV l` ci,len fl•`J '[ rntd fi,n, re r rporl en tN 1Rtb b} dry of 1'r yo]ppe :'.e welant:n :r'r, 1.st 1.rd 'nY w.'p rgh, n COnporatlin.afal not I L'r. In)a ^t rJ`., :' R. Farr l; Arm1,. rife„ro rile Eno].; (.a r-.;p P. i'n0r tttr ono has Lsnd.V. V. 1':Cn t Ler,glrxn V. rev!] rr[ eJ tF, Ire tirt11.Y.e rr+•or •fwe:,F err PI rre ,ell aA Ornd Loa I. we 1L. , RPtll;lvlluv 11 Yr<)) Pre Hn' Ia n,h ffrrll,Cra'ler Ynrll.(nr>. retell end Roy 0. Ewell, < dnf••ndvrtr,r 'e col nt one .03Y trlrreA eo the ,•re ,4r,, of :uty 1?SS,In favor or the Dlantlf ' pm v4af ros ire 4ei endortr,ICJ udrine that the cold 1010 E.PII „ua!Jitw Indebted to the Die lnli ll,l` +ti e:�•. rf :er<r,Ivar Yrr,d-rE El gtry, tro ur].lor, rrd rho rty.r0 cent. (111.182.3 r All: Invtl[r !.)r it" let dn•; of ]s./y.19:.1, Loge tlyd rith 1`1 Prate of the action, sell n C•nttir, ft•s:!;txr r0 er 1Pt unrt.... executed end de). Ness' tv ire said R. V. Ewell and tl �. r•rr;:, nq it)-l-11 Jrl!: aocY Lino, Dank c. ' relgh, tr the ]Ath day of DecoLbor •r: b .' u' VICCroce I: Polk dg,roge aC9,1, tip d CCI.nt); en C3'f ice of lb Ra ale tar of Deeds of col r::r/u, the C.7, 4.1 yr rp; AIn:11, on ode. f on.r In old •rr•-crr on' tr run• r.;tY.nr]ret .r.q /h'r;:ed,nftr: ad••o••t lr6rg.' veld Londe de re9uire0 by 1 n•' t: r r.r tp rl Ibh'.'< 1.; I•lrn of t:. b Li'y r;ur tLow•0 do„r in Bald County and .'••: .'r r ^-a•.' ;,-Lr l•'.r' ••f el IL l t, itv, ds LLnne agrOeebly to iho e•w.; 1 • IiIAN t, I'', vr:il [-fr CnonC nr Lour on the 5lh dny of Auruet,19S5, after e d,erti, ing it,;:, lxndv fur er•. elO I¢;r' ^11-1y to sold Jlggotent Ind order of tale end the Len I' 1101th Cerallm, 1,E. e- •• 11er a •] ]is•e der lcr,:v.' 1• t1., le^1)1 rualere Of oals.wOtlon n 1•i :Nl or Al llr a 'Ltcfy 'A -hr :Inrq Crur'Fv t:nt ,'c, r, ^.l; tht I.Aful hours of tiler ter. rI _l', v;. •,' -_yr rl'ae•1 L1ndr ..] IL[=l:e e,t Fit ar: "rce ti,t t; ee. ill Jc]nt'took L.,d Ran ett `'e sett 'A'! ":It's: Flrna' '.I lerf_r At ILI, price of One Thouond cw",i on, r<( •1••tln•i,xh tr:h t!r ,n• l`.rr^n t:r 0,:, a'fte tt rht ^'ern of the tuperlor •, •' ee'+ C•• lv tie t•.!et, 1•vti, r„ Co'O Qitr: ar,ene tnitrrnfter upon the expiration rJ' ' '' a•d •t) ID^! cols U.rr:frnra,co lull it,, 1-gr]ne br ^.'. fllyd,¢ald report ear dul tto ��n-x e'Dr e[ ['�0eln'v.: I' w: Ocn o•'rtd and directed by Judger. ,� sr r'"' r+. e;. r, •el r,r tI. eeld ':rclrat'. land euffletent deed to told J1°-r: r: cr sJl r.r.nrll r r�]' I-ntih 'F.r ,:r de•r If rn I i.•LenCd :nt Ityvent Of the purcluee 0 f PC . T1Elr:- T;, 'o: Ild :r. coret(OneUon Of Inv pe-Mae end the sum of 1 1]n0 'i F,oueo•If (!' :-'[ M1n) P-11tyr.•it rtr. .'l: eFlrrrf- r he;-Pb) s<hnm:+edged,tM uradsre l6'nsd r c°^.'." .11 1. r... li, ,: Ir_ •-a-r 0' Iv't II'TI rrd h• 11"I'l It' more Pf. hoe bergis road j p , ln, r1. nerr tr d ke.,sy nF Pgn!nrel? nr,t c tr.rd unto the I :.'.^`•:r^ e? +•�^ •'i .. .•.. ••i r. 'h• `r, , I e'err n•rnlv,rfrofter deecrlbed,vlri ,rr n T+•-r •A," tl:ee car -In ntet•e rr rrrrr• rr Ifs[ 0t efrflying and be log In 1r,rw-, lc' rrt- t..• _. I'c-'h :,r ., I•+• , er ell th efoe or public li Pmd ;n r. cfi na, -• n a^ ee •'•..ih,,-'9 [r•t.;�-. UI•;eI" ^[c[Vtbrd er,d bounced ae toll, . Y. :...,. •s ,,^,ot-1,t '..r. I'.r to I1,r 1 r - s car!n of ?nvnv 'lath log ton; Lionel i'f' 1.� .v-t\` .e "•e' .1' tr•n:r •e.n ^r ergrall I. C1T feet to the line 1a-•'..•V. itI'r tR• a 1'-'••P,�" -re.r o.•• (p•n feet to R. Y. Estelle I r"- ' t-t •) ^.• toe Tent t �,'e.t Ic t!• sold R. V. }:tell s North A 1 crr^rr,.. `, •• t•i, ,•^nr N Ir+,; f•..I s•' r.^ , ,nr•I., I.+rnrs f.}• Users.. I5590 feet j I ,.1r ; _ J' Ir^ ncr•:a er1 ,Id, ' r. L. ry i., -s^ ce,:r•eee V. 1580 fee' -,".i 'd i•;•••r lrc )In.-- I•:ro¢ •-rd te'^,g III "I, I,Oli to rnnityrd by Pauline It11: !y leed •1xte1 rap'arber ytr A,l"MeceP recorded In the Office of IJL vier; (C t�7 1' rf:,, iC.t•.,[ ':n,Ie'y I', Rre_ .:ego .e�. 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"- Appul Mon n ml, W W. ur!:v eu4 •�+,, mw OE,y h n� Pmn f1.9.n �- s�..l. .. AA :x"nne'.fm 'qbo \s... ri,e 1yJ x.A..e.° oNam• ' f 8TA'.1 V,f 1101,14 O LiNA 'I e.. '1.YO M, ' :'• C ^ "Yn f.. .�i6Kwa!, ..df KY'v.-EL.fLei f'.�....�, ! UMV Nub d � i .� . `l JZ'w'},.G'1•: ✓ ....Jnv,'•, \t Wlr:'Pd u h +inM .A IW bY.4 iA IM KIW!14 e m6l�iamL ' I � Nliuln a9 6ssA oo/ A41s1 wa4 -1ti � 9 —�,A'N K4 n A. A IAI..Z e 'lam'...' ... r., cc�..+e�•��I^,rarlw;v�-r^e�r�lnruOlran . ivl , ti o .. n ..An1. TRIANGLE s`4 S I T E D E S I G N e.q Transmittal i % a'?--: NOV 16 2010 ;-31;,1( ��4` $n a� 4006 Barrett Drive, Suite 203 Raleigh, Nonh Carolina, 27609 TEL (919) 553-6570 Date: November 12, 2010 Job Number: 001017 Project Name: Dollar General — Grantsboro, NC To: NCDL'NR Stormwater 943 Washington Square Mall Washington, NC 27889 2582-946-6481 We are sending these by ❑ U.S. Mail ® UPS ❑ Hand Delivery ❑ Other We are .rending you ❑ Attached ❑ Under separate cover via thefollowing items: ❑ Shop dnawings ® Prints/Plans ❑ Samples ❑ Specifications ❑ Change Orders ❑ Other Conies Date No. Descrintion a� Civil Site Drawings 1 Stormwater Permit Application Form 1 Stormwater Fee (S505.00) 1 Agreement for Purchase and Sale of Real Property 1 Limited Liability Company Annual Report 1 Wet Detention Basin Operation and Maintenance Agreement I U5C�5 N/1 5/ W� re These are transmitted as checked below: ❑ For your use ❑ Approved as submitted ❑ Resubmit ❑ Copies for approval ❑ As requested ❑ Approved as noted ❑ Submit ❑ Copies for distribution ® For review and comment ❑ Returned for cmrectimu ❑ Return ❑ Coneeted prints Remarks: Copy to: Signed: (/ ,'rt� Brent Purdum FINANCIAL RESPONSIBILITY/OWNERSHIP FORM SEDIMENTATION POLLUTION CONTROL ACT No person may initiate any land -disturbing activity on one or more acres as covered by the Act before this form and an acceptable erosion and sedimentation control plan have been completed and approved by the Land Quality Section, N.C. Department of Environment and Natural Resources. (Please type or print and, if the question is not applicable or the e-mail and/or fax information unavailable, place N/A in the blank.) Part A. 1. Project Name Dollar General NOV 18 2010 2. Location of land -disturbing activity: County Pamlico City or Township Grantsboro t-Jr' Highway/Street NC Hwy 55 Latitude N35-08'37" Longitude W76-49'58" 3. Approximate date land -disturbing activity will commence: January 2011 4 Purpose of development (residential, commercial, industrial, institutional, etc.): Commercial 5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 1.4 6. Amount of fee enclosed: $ 130.00 . The application fee of $65.00 per acre (rounded up to the next acre) is assessed without a ceiling amount (Example: a 9-acre application fee is $585). 7. Has an erosion and sediment control plan been filed? Yes No Enclosed X 8. Person to contact should erosion and sediment control issues arise during land -disturbing activity: Name_Georoe T. Barnes Jr -Glandon Forest Equity LLC E-mail Address gbarnest7a vanguardpg.com Telephone (919) 459-2601 Cell # (919) 524-2020 Fax # (919) 459-2604 9. Landowner(s) of Record (attach accompanied page to list additional owners): Name Telephone Fax Number Current Mailing Address Current Street Address oar ern �ht°s kt .2939E City State --Zip City State Zip 10. Deed Book No. RE 144 Page No. 215 Provide a copy of the most current deed. Part B. Person(s) or firm(s) who are financially responsible for the land -disturbing activity (Provide a comprehensive list of all responsible parties on an attached sheet): George T. Barnes. Jr.-Glandon Forest Equity LLC gbarnes(@yanquardpq.com Name E-mail Address 3900 Merton Drive, Suite 210 a� Current Mailing Address Current Street Address Raleigh INC 27609 O City State Zip City State Telephone -'•`u'OU;A"JTYS Ti^! p (919) 459-2601 Fax Number (919) 459-2604z,�. ' . 4 LOrfi E 2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address of the designated North Carolina Agent: Name E-mail Address Current Mailing Address Current Street Address l� City ' State Zip City State Zip Telephone Fax Number (b) If the Financially Responsible Party is a Partnership or other person engaging in business under an assumed name, attach a copy of the Certificate of Assumed Name. If the Financially Responsible Party is a Corporation, give name and street address of the Registered Agent: Sherri Heops Glandon Forest EquityLLC Name of Registered Agent 3900 Merton Drive Suite 210 Current Mailing Address shepps(@vanguardpg.com E-mail Address Raleigh NC 27609 _ City State Zip City Street Address State Telephone (919) 459-2605 Fax Number (919) 459-2904 The above information is true and correct to the best of my knowledge and belief and was provided by me under oath (This form must be signed by the Financially Responsible Person if an individual or his attorney -in -fact, or if not an individual, by an officer, director, partner, or registered agent with the authority to execute instruments for the Financially Responsible Person). I agree to provide corrected information should there be any change in the information provided herein. George T. Barnes, Jr. member/manager Type,o{ print nam Title or Authority SignaTu � Date I, lL E Z&z9dY djZ z oo S //attNotary Public of the County of )11-9 41 State of North Carolina, hereby certify that _(w2Ge % 6X I71eS \,A appeared personally before me this day and being duly sworn acknowledged that the above form was executed by him. Witness� \��tnlntri iq�a t�1hp)arial seal -o =O NOTARY N_ FJJBLIC 4 C) this day of r1 i/20/_ - tary �2 My commission expires ** SHIP TICKET ** Order # S2994331.001 DUNCAN-PARNELL RALEIGH Page #: 1 PO BOX 10865 201 GLENWOOD AVENUE RALEIGH, NC 27603 Ph : (919) 833-4677 Fax (800) 849-5988 ** C.O.D. ** C.O.D. ** C.O.D. ** Bill To: Shipp To: CASH RALEIGH 7.75% TAX CASH RALEIGH 7.75% TAX RALEIGH, NC 27603 NCDENR Stormwater Phone # 0--0 943 Washington Square Mall WASHINGTON, NC 27889 Phone # 0--0 14:09:15 03 MAR 2011 Order -Date -Shipp -Date -------------- Writer -------------- Ship Via------------- 03/03/11 03/03/11 ALEXISP PU PICK-UP Purchase Order #------ Release #------------- Salesman ----------- Picker ---------- Grantsboro HOUSE2 Ln --- Order-Avail-Ship'd-Descrip*tion--------------- LocationUnit Price Extended *** ***** Shipping Instructions ********** * Attn Scott Vinson 1 1 1 NO CHARGE DELIVERY 0.000ea 0.00 Ref S2994322 Overnight Customer Signature Date : ORDER TOTAL Invoice Amount ** AMOUNT DUE ** MAR 4 2011 This signed receipt acknowledges that the above merchandise has been delivered and /or received in perfect condition. 0 00 0.00 0 00