HomeMy WebLinkAboutNCC221790_FRO Submitted_20220518FINANCIAL 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 Lachlan Village
2. Location of land -disturbing activity: County Catawba City or Township Hickory
Highway/Street 4 8 th Ave. NE Latitude 3 5. 7966 Longitude - 81 . 2 5 7 7
3. Approximate date land -disturbing activity will commence: 5 / 0 9 / 2 2
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 10 . 31
6. Amount of fee enclosed: $ 910 . 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 X No Enclosed
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Jarred Blanton E-mail Address jarredthomascompany@qmail.com
Telephone 828-639-0157 Cell# 828-639-0157 Fax#
9. Landowner(s) of Record (attach accompanied page to list additional owners):
D&J Properties of North Carolina LLC . 8 2 8- 3 0 8- 319 3
Name Telephone Fax Number
2008 46th AVE. DR NE 2008 46th AVE. DR NE
Current Mailing Address Current Street Address
Hickory NC 28601 Hickory NC 28601
City State Zip City State Zip
10. Deed Book No. 0 3 6 5 6 Page No. 0 2 4 0- 0 2 4 7 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):
DJT Development, LLC jarredthomascompany@gmail.com
Name E-mail Address
2088 46th Ave. Drive NE 2088 46th Ave. Drive NE
Current Mailing Address
Hickory, NC 28601
City State
Telephone 828-639-0157
Current Street Address
Hickory, NC 28601
Zip City State Zip
Fax Number
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
Current Mailing Address
City
Telephone,
E-mail Address
Current Street Address
State Zip City State Zip
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:
Jarred Blanton
Name of Registered Agent
2033 10th St LN
Current Mailing Address
Hickory, NC 28601
City
State Zip
Telephone 828-639-0157
jarredthomascompany@gmail.com
E-mail Address
2033 loth St LN
Current Street Address
Hickory, NC 28601
City State Zip
Fax Number
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.
Jarred Blanton
Type or print name
ignature
Member
Title or Authority
5/5/22
Date
I, Cdr'r�q SL(,r 1Qhn err a Notary Public of the County of CJCttc� ire
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 J day of , 20 ,9a�
Gf._ORIA BURKHA�.Tf=R
Notary Public
Otary
Caldwuniy, North Carolina
My _ om[risswon Expires
September 11, 284
My commission expires
FILED C118Wba COUntY
On May 11, 2021 at 10:42:00 am
Excise Tar $320-00 (CH)
iNST. # 11138
DONNA HICKS SPENCER,
Re gater Of Cis
lw 03656 Pg 02'40-0241
GENERAL WARRANTY DEED
REVENUE: $320.00
Tax Parcel ID No. 3735-13-02-2954 Verified by County on the day of , 20
By:
V/Mail/Box to: Thomas N. Hannah, Attorney at Law, P.O. Drawer 1989, Hickory, NC 28603
This instrument was prepared by: Thomas N. Hannah, Attorney at Law, P.O. Drawer 1989, Hickory, NC 28603
Brief description for the Index:
THIS DEED, made this the 29th day of April 2021, by and between
GRANTOR: CLOYD H. PROPST, JR. and wife, PAMELA S. PROPST and
CATHERINE ELAINE PROPST and spouse, JANET M. MCGOLDRICK and
AMBER ELISE CRUZ (sole heir of Judy P. Stevens) and husband, NICHOLAS CRUZ BENITEZ
LEIGH ANN P. BLODGETT and husband, HARLEY H. BLODGETT
whose mailing address is: 4205 61' St NW, Hickory, NC 28601
(herein referred to collectively as Grantor) and
GRANTEE: D K J PROPERTIES NORTH CAROLINA, LLC
whose mailing address is: 2008 46'" Ave Drive NE, Hickory, NC 28601
(herein referred to collectively as Grantee)
[include mailing address foreach Grantorand Grantee; marital status of each individual Grantorand Grantee; and type of
entity, e.g., corporation, limited liability company, for each non -individual Grantor and Grantee.]
WITNESSETH:
For valuable consideration from Grantee to Grantor, the receipt and sufficiency of which is hereby acknowledged, Grantor
hereby gives, grants, bargains, sells and conveys unto Grantee in fee simple, subject to the Exceptions and Reservations
hereinafter provided, if any, the following described property located in City of , Clines Township, County of Catawba,
State of North Carolina, more particularly described as follows:
BEGINNING at a stone in M.L. Deal's line and comer, and runs with his line North 84° 30' West 591.8 feet to
a stake; thence North 40 55' East450 feet to a stake, comer of tract#5; thence with the line of tract#5, South
810 30' East 680 feet to a stake; thence South 360 30' East 840 feet, passing a stake on the bank of the
highway, to a point in the center of Highway #16; thence with the highway toward Hickory, South 420 30'
West and South 46° 40' West about 464 feet, more or less, to the BEGINNING. This tract lies on the
Northwest side of the said highway, contains about 12.8 acres, and is fully shown on the aforesaid map by
G.S. Rowe, C.E., March 20, 1937 which is duly recorded in Catawba County.
This being Lot Number 4 of the T.E. Bowman Property; for reference to title, see Book 284, Page 148 and
Plat recorded in Plat Book 7, at Page 90, Catawba County Registry.
Revised December 17, 2009
I
Said property having been previously conveyed to Grantor by instrument(s) recorded in Book 1788, Page 1102, and
being reflected on plat(s) recorded in Map/Plat Book 7 Page/Slide 90.
Ail or a portion of the property herein conveyed [ ] includes or j X ] does not include the primary residence of a 0241
Grantor.
TO HAVE AND TO HOLD unto Grantee, together with all privileges and appurtenances thereunto belonging, in fee simple,
subject to the Exceptions and Reservations hereinafter and hereinabove provided, if any.
And Grantor hereby warrants that Grantor is seized of the premises in fee and has the right to convey same in fee simple,
that title is marketable and is free and clear of encumbrances other than as set forth herein, and that Grantor will forever
warrant and defend the title against the lawful claims of all persons or entities whomsoever.
This conveyance is made subject to the following Exceptions and Reservations:
This conveyance is made subject to restrictive covenants and encumbrances of record, and to any and all easements and
rights of way on location on the above described property heretofore granted or existing in favor of any individuals,
corporations, public or private associations of individuals, public utilities and governmental agents, commissions or
departments for the purpose of constructing, erecting, laying, building or maintaining any streets, roads, highways, signs,
service alleys, power lines or poles, gas lines, water lines, lines for pipes or sewer lines and any and all other similar or
related public or private utility service facilities or otherwise.
All references to Grantor and Grantee as used herein shall include the parties as well as their heirs, successors and
assigns, and shall include the singular, plural, masculine, feminine or neuter as required by context.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written.
(SEAL)
Amr C Sz
pl
1 k (SEAL)
as Cruz" Benitez
(SEAL)
Catherine Elaine ropst
(SEAL)
Janet M. cGoldrick
STATE OF
COUNTY OF
Cloyd H. Propst, Jr.
Pamela S.
Leigh ArXf P. Blodgett
H. Blodgett
1, G wsc CA , [[prinf/type name of Notary], a Notary
Public in and for the aforesaid County and State, certify that the following
person (s) personally appeared before me this day, each acknowledging to
me that he or she voluntarily signed the going document: Amber Elise
Cruz and husgand Nicolas Cruz Be itez, GRAN -TO). gnatur Notary Public
ires: VIV;i-Q
Revised December 17, 2009
Seal)
co
pTA/
A G
- COv
(SEAL)
(SEAL)
(SEAL)
Said property having been previously conveyed to Grantor by instrument(s) recorded in Book 1788, Page 1102, and
being reflected on plat(s) recorded in Map/Plat Book 7 Page/Slide 90.
0242
All or a portion of the property herein conveyed [ ] includes or [ X ] does not include the primary residence of a
Grantor.
TO HAVE AND TO HOLD unto Grantee, togetherwith all privileges and appurtenances thereunto belonging, in fee simple,
subject to the Exceptions and Reservations hereinafter and hereinabove provided, if any.
And Grantor hereby warrants that Grantor is seized of the premises in fee and has the right to convey same in fee simple,
that title is marketable and is free and dear of encumbrances other than as set forth herein, and that Grantor will forever
warrant and defend the title against the lawful claims of all persons or entities whomsoever.
This conveyance is made subject to the following Exceptions and Reservations:
This conveyance is made subject to restrictive covenants and encumbrances of record, and to any and all easements and
rights of way on location on the above described property heretofore granted or existing in favor of any individuals,
corporations, public or private associations of individuals, public utilities and governmental agents, commissions or
departments for the purpose of constructing, erecting, laying, building or maintaining any streets, roads, highways, signs,
service alleys, power lines or poles, gas lines, water lines, lines for pipes or sewer lines and any and all other similar or
related public or private utility service facilities or otherwise.
All references to Grantor and Grantee as used herein shall include the parties as well as their heirs, successors and
assigns, and shall include the singular, plural, masculine, feminine or neuter as required by context.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written.
(SEAL)
Amber EI'ise nsz
(SEAL)
NJIqolas Cruz Begilki
(SEAL)
Catherine Elaine Propst
(SEAL)
anet M. McGoldrick
STATE
COUNTY OF
Cloyd H. Propst, Jr,
Pamela S.
Leigh A96 P. Blodgett
H. Blodgett
I, f nt/type name of Notary], a Notary
Public in and for the aforesaid and State, certify that the following
person (s) personally appeared fore me this day, each acknowledging to
me that he or she voluntari igned the foregoing document: Amber Elise
Cruz and husband Nic Cruz Benitez, GRANTOR(S).
Date:
Signature of Notary Public
Revised December 17, 2009
(OfficiallNotarial Seal)
(SEAL)
(SEAL)
(SEAL)
STATE OF COUNTY OF
(Official/Notarial Seal)
1, , Vpfinte4g49 me of Notary], a Notary
Public in and for the afo d County an e, certify that the following
person (s) personally appear be this day, each acknowledging to
me that he or she voluntarily si the foregoing document Cloyd H.
Propst Jr and Pamela S. P pst, NTOR(S).
Date:
Sig ture of Notary Public
My mission expires:
STATE OF I i
(Official/Notarial Seal)
COUNTY OF 0011"AL)(&_
1, 1 [[prinbtype name of Notary], a Notary
Public in and for the aforesaid Co ty and State, certify that the following
person (s) personally appeared re me this day, each acknowledging to
me that he or she voluntarily signed the oing document: Catherine
Elaine Propst and Janet M. McGold k, GRANT R(
Date: vVL�41L/�'�o
gnature of Notary Public
AMC
NOTARY
PUBLIC
My Commission
GG Expires
?�
COL)
My Commission expiresjo-nA t900i(g
STATE OF
(Official/Notarial Seal)
COUNTY OF
1, , [ jprin name of Notary], a Notary
Public in and for the afar id Coun d State, certify that the following
person (s) personally appear re me this day, each acknowledging to
me that he or she voluntarily ed the foregoing document: Leigh Ann P.
Blodgett and Harley H. g GRANTOR(S).
Date:
ignature of Notary Public
My Commission expires:
Revised December 17, 2009
Said property having been previously conveyed to Grantor by instrument(s) recorded in Book 1788, Page 1102, and
being reflected on plat(s) recorded in Map/Plat Book 7 Page/Slide 90. 0244
All or a portion of the property herein conveyed [ J includes or [ X ] does not include the primary residence of a
Grantor.
TO HAVE AND TO HOLD unto Grantee, togetherwith all privileges and appurtenances thereunto belonging, in fee simple,
subject to the Exceptions and Reservations hereinafter and hereinabove provided, if any.
And Grantor hereby warrants that Grantor is seized of the premises in fee and has the right to convey same in fee simple,
that title is marketable and is free and clear of encumbrances other than as set forth herein, and that Grantor will forever
warrant and defend the title against the lawful claims of all persons or entities whomsoever.
This conveyance is made subject to the following Exceptions and Reservations:
This conveyance is made subject to restrictive covenants and encumbrances of record, and to any and all easements and
rights of way on location on the above described property heretofore granted or existing in favor of any individuals,
corporations, public or private associations of individuals, public utilities and governmental agents, commissions or
departments for the purpose of constructing, erecting, laying, building or maintaining any streets, roads, highways, signs,
service alleys, power lines or poles, gas lines, water lines, lines for pipes or sewer lines and any and all other similar or
related public or private utility service facilities or otherwise.
All references to Grantor and Grantee as used herein shall include the parties as well as their heirs, successors and
assigns, and shall include the singular, plural, masculine, feminine or neuter as required by context.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written.
Amber Elise Cruz
Nicolas Cruz nitez
Catheriin Elaine Propst
Jan M. McGoldrick
STATE OF
COUNTY OF
-YV- /1] t>�� - - (SEAL)
Clo d H. Propst, Jr.
SEAL
Pamela S. Propst
(SEAL) (SEAL)
Leigh An P. odgett
(SEAL) (SEAL)
Harley . Blodgett
I, , [(prin name of Notary], a Notary
Public in and for the aforesaid County I State, certify that the following
person (s) personally appeared bef me this day, each acknowledging to
me that he or she voluntarily sippA the foregoing document: Amber Elise
Cruz and husband Nicola ruz Benitez, GRANTOR(S).
Date:
December 17, 2009
Signature of Notary Public
(Official/Notarial Sea[)
0245
STATE OF K nrfh j larZjl COUNTY OF i%faWbA,
(OfficiallNotarial Seal)
,,�111t111���I
I, DeniSt.S�ur- C.enho, [fprfnt/fype name of Notary], a Notary
f,� V1SF YI�
`` ��
Public in and for the aforesaid County and State, certify that the following
, ���,
person (s) personally appeared before me this day, each acknowledging to
iC�.0
me that he or she voluntarily signed the foregoing document: Cloyd H.
a
� r
Propst Jr and Pamela S. Propst, GRANTOR(S).
S—
`r n
Date: 'T''9� -Aoai `
� COS
0. 0,
Signature of N
My Commission expires: '7- -0?0
'- `ryi1NG,��.�
(Official/Notarial Seal)
STAT F
COUNTY OF
I, pe name of Notary], a Notary
Public in and for the afore 'd Cou and State, certify that the following
person (s) personally appear Wore me this day, each acknowledging to
me that he or she voluntar' sign the foregoing document: Catherine
Elaine Propst and Ja M. McGo "ck, GRANTOR(S).
Date:
Signa of Notary Public
My mmission expires:
(Official/Notarial Seal)
STATE
COUNTY OF
1, , [fpri pe name of Notary], a Notary
Public in and for the afore Coun nd State, certify that the following
person (s) personally appeare re me this day, each acknowledging to
me that he or she voluntan ign the foregoing document: Leigh Ann P.
Blodgett and Harley . lodgett, NTOR(S).
Date:
SignhtZ of Notary Public
My ommission expires:
Revised December 17, 2009
Said property having been previously conveyed to Grantor by instrument(s) recorded in Book 1788, Page 1102, and
being reflected on plat(s) recorded in Map/Plat Book 7 Page/Slide 90. 0246
All or a portion of the property herein conveyed [ ] includes or [ X ] does not include the primary residence of a
Grantor.
TO HAVE AND TO HOLD unto Grantee, togetherwith all privileges and appurtenances thereunto belonging, in fee simple,
subject to the Exceptions and Reservations hereinafter and hereinabove provided, if any.
And Grantor hereby warrants that Grantor is seized of the premises in fee and has the right to convey same in fee simple,
that title is marketable and is free and clear of encumbrances other than as set forth herein, and that Grantor will forever
warrant and defend the title against the lawful claims of all persons or entities whomsoever.
This conveyance is made subject to the following Exceptions and Reservations:
This conveyance is made subject to restrictive covenants and encumbrances of record, and to any and all easements and
rights of way on location on the above described property heretofore granted or existing in favor of any individuals,
corporations, public or private associations of individuals, public utilities and governmental agents, commissions or
departments for the purpose of constructing, erecting, laying, building or maintaining any streets, roads, highways, signs,
service alleys, power lines or poles, gas lines, water lines, lines for pipes or sewer lines and any and all other similar or
related public or private utility service facilities or otherwise.
All references to Grantor and Grantee as used herein shall include the parties as well as their heirs, successors and
assigns, and shall include the singular, plural, masculine, feminine or neuter as required by context.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written.
Amber Elise Cruz
Nicolas Cruz enitez
Catherin laine Propst
Jane M. McGoldrick
STATE OF
COUNTY OF
(SEAL)
(SEAL)
Cloyd H. Pro t, Jr.
(SEAL)
Pamela S. Propst
I. , ((p ' name of Notary], a Notary
Public in and for the aforesaid Coun and State, certify that the following
person (s) personally appeared b re me this day, each acknowledging to
me that he or she voluntarily s' ned the foregoing document: Amber Elise
Cruz and husband Nicol Cruz Benitez, GRANTOR(S).
Date:
December 17, 2009
Signature of Notary Public
(Official/Notarial Seal)
(SEAL)
M
W7
(Official/Notarial Sea[}
STATE OF COUNTY OF
I, , I(prin pe name of Notary], a Notary
Public in and for the aforesaid C n d State, certify that the following
person (s) personally appeared b e me this day, each acknowledging to
me that he or she voluntarily ' ned th foregoing document: Cloyd H.
Propst Jr and Pamela S ropst, GRA OR(S).
Date:
Signatu of Notary Public
My Commission expires:
(Official/Notarial Seal)
STATE OF
COUNTY OF
I , nn Pe name of Notary], a Notary
Public in and for the aforesaid Coun d State, certify that the following
person (s) personally appeared re m this day, each acknowledging to
me that he or she voluntani gned the for oing document: Catherine
Elaine Propst and Jane . McGoldrick, G NTOR(S).
Date:
Signature of Notary Public
My Commission expires:
STATE OF N0Y -1'h C'aY 0\%.1&,
(Official/Notarial Seal)
COUNTY OF I-if\aXy-0
J
I, LOY%04NA CAYIQ.AVl \0 ([pririnNypename ofNotary],allotary
Public in and for the aforesaid County and State, certify that the following
person (s) personally appeared before me this day, each acknowledging to
me that he or she voluntarily signed the foregoing document: Leigh Ann P.
Blodgett and Harley H. Blodgett, GRANTOR(S).'
LORIANN OANAPINNO
NOTARY PUBLIC
Mecklenburg County
North Carolina
My Commission Expires June 10, 2023
Date: 'it 29\ Z) 2_ w
Signature of Notary Public
My Commission expires: lob tO t 2.62-'J
Revised December 17, 2009