NCC220681_FRO Submitted_20220214

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 Harmony Subdivision
2. Location of land -disturbing activity: County Cabarrus City or Township Harrisburg
Highway/Street Staliings Rd. Latitude 35' 18' 58" N Longitude 80' 37' 55" W
3. Approximate date land -disturbing activity will commence: January 1, 2020
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 85.82
6. Amount of fee enclosed: $ 5,590.00 . 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 Rick Burrage E-mail Address [e-mail]
Telephone [phone] Cell # 704-791-6898 Fax # [phone]
9. Landowner(s) of Record (attach accompanied page to list additional owners)
Farmingdale, LLC
704-701-1071 N/A
Name
Telephone Fax Number
19 Franklin Ave.
19 Franklin Ave.
Current Mailing Address
Current Street Address
Concord NC
28025
Concord NC
28025
City State
Zip
City State
Zip
10. Deed Book No. 13530
Page No.
0113 Provide a copy of the most current
deed.
Part B.
1. 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):
Farmingdale, LLC
[e-mail]
Name
E-mail Address
19 Franklin Ave
19 Franklin Ave
Current Mailing Address
Current Street Address
Concord NC
28025
Concord NC
28025
City State
Zip
City State
Zip
Telephone [phone]
Fax Number N/A

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:
N/A
Name
E-mail Address
Current Mailing Address
Current Street Address
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:
Robert W. Nixon
[e-mail]
Name of Registered Agent
E-mail Address
19 Franklin Ave.
19 Franklin Ave.
Current Mailing Address
Current Street Address
Concord NC 28025
Concord NC 28025
City State Zip
City State Zip
Telephone [phone] Fax Number N/A
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.
Robert W. Nixon Member / Manager
Type or print name
Title or Authority
Signature Date
------------------------------------------------------------------------------------------------------------------------------------
I, , a Notary Public of the County of
State of North Carolina, hereby certify that appeared
personally before me this day and being duly sworn acknowledged that the above form was
executed by him.
Witness my hand and notarial seal, this day of , 20
Notary
Seal
My commission expires

13530 0113 - f
Excise Tax $5,000.00
FILED
CABARRUS COUNTY NC
WAYNE NIXON
REGISTER OF DEEDS
FILED May 31, 2019
AT 08:53 am
BOOK 13530
START PAGE
0113
END PAGE
0115
INSTRUMENT #
13202
EXCISE TAX
55,000.00
skis
Recording Time, Book and Page
NORTH CAROLINA GENERAL WARRANTY DEED
Tax Lot No.
Parcel Identifier No. 5517-34-7132.0000, 5517-23-1220.0000 and 5517-23-3134.0000
Verified by County on the day of
by
Mail after recording to GRANTEE
This instrument was prepared by RYAN C. HAWKINS. Ferguson, Hayes, Haskins K DeMay, PLLC
NO TITLE OPINION EXPRESSED OR EM-PLIED BY PREPARER
Brief Description for the index
THIS DEED made this 146 day of MAN' 2019, by and between
GRANTOR
iLZARGARET AININ STALLINGS, and husband
BILLY RAY MCHARNEY
i%9ailin2 Address:
3550 STALLINGS RD
HARRISBURG, NC 28075
GRANTEE
FARAIIINGDALE, LLC
a North Carolina limited liability company
Mailing Address:
19 FRANKLIN AVENUE
CONCORD. NC 28025
Enter in appropriate block for each part: name, address, and; if appropriate, character of entity, e.g.; corporation or partnership.
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns. and shall include
singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee. the receipt of which is hereby acknowledged, has
and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of land situated in
CABARRUS County North Carolina and more particularly described as follows:
SEE ATTACHED EXHIBIT "A"
3(ab

135300114
The property hereinabove described was acquired by Grantor by instrument recorded in Deed Book 553, Page 328 and Deed Book 2970,
Page 304.
All or a portion of the propem, herein conveyed ❑ does or ❑ does not include the primary residence of a Grantor.
A map showing the above described property is recorded in Map Boot: 68. Page 28 and N-lap Book 78. Page 78.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee
simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple. has the right to convey the same in fee
simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the lawful
claims of all persons whomsoever except for the exceptions hereinafter stated.
Title to the property hereinabove described is subject to the following exceptions:
SUBJECT TO easements and restrictions of record.
SUBJECT TO easements and setback lines as shown on the recorded plat.
IN WITNESS WHEREOF. the Grantor has hereunto set his hand and seal. or if corporate, has caused this instrument to be signed in its
corporate name by its duly authorized officers and its seal to be hereunto affixed by authority of its Board of Directors. the day and year
first above written.
011Wi,FilA (SEAL)
MA ABET ANN STALLIKKGS
C EAL)
16A *24- Z
BILLY kAY M ARNEY
STATE OF NORTH CAROLINA. COUNTY OF CABARRUS
I certify that the following person(s) personally appeared before me this day, each acknowledging to me
that he or she signed the foregoing document:
MARGARET ANN STALLINGS, and husband
BILLY RAY MCHARNEY
Date: IbLo I
Notary Public
(Official Seal)
11 `N01I I I I111111/1It�
16,
Notary Public
Stonty County —
='Ay Commission Expires
10/28/2020
Printed or Typed Name: J" Ca- D, j-pJt_
My Commission Expires: }

441*111111M
Tract 1
Lying and being in Number One (1) Township, Town of Harrisburg, Cabarrus County, North Carolina on the northern
side of Stallings Road and being a 82.053 acre parcel designated as LOT #2 as shown on the plat entitled "108.768 AC —
Stallings Road" as same is shown on map recorded in Map Boos: 78. Page 78, Cabarrus County Registry, to which
reference is hereby made for a complete description thereof as to metes and bounds.
Tract 2
Lying and being in Number One (1) Township, Town of Harrisburg, Cabarrus County, North Carolina on the southern
side of Stallings Road and being a 1.31 acre parcel designated as LOT l as shown on the plat entitled "MARGARET
ANN STALLINGS PROPERTY AND PARCEL 91, `RAGING RIDGE ROAD RIW' PLAT" as same is shown on map
recorded in Map Book 68, Page 28, Cabarrus County Registry. to which reference is hereby made for a complete
description thereof as to metes and bounds.
Tract 3
Lying and being in Number One (1) Township; Town of Harrisburg, Cabarrus County, North Carolina on the southern
side of Stallings Road and being a 2.13 acre parcel designated as LOT 2 as shown on the plat entitled "MARGARET
ANN STALLINGS PROPERTY AND PARCEL 41, `RAGING RIDGE ROAD R/W PLAT" as same is shown on map
recorded in Map Book 68, Page 28, Cabarrus County Registry, to which reference is hereby made for a complete
description thereof as to metes and bounds.