NCC223368_FRO Submitted_20221005

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 Environmental Quality. Submit the completed form to the appropriate
Regional office. (Please type or print and, if the question is not applicable or the e-mail address or phone
number is unavailable, place N/A in the blank.)
Part A.
1. Project NameChestnufi Greek
2. Location of land -disturbing activity: Count C City or Township Ch a pel Hill
SR1 540 35.8600 -79.1629
Highway/StreetLatitude(dec,mal degrees) -Lon gl#UdE(decimal degrees)
3. Approximate date land -disturbing activity will commence. ll/l/22
4. Purpose of development (residential, commercial, industrial, institutional, etc.). residential
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 9-65
6_ Amount of fee enclosed: $ 1000 . The applicatian fee of $100.00 per acre grounded
up to the next acre) is assessed without a ceding amount (Example: 8.10-acre application fey is $900).
Checks should be addressed to NCDEQ.
7. Has an erosion and sediment control plan been filed? Yes 0 Enclosed ❑ No ❑
S. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
NameKirk T. Mett
Phone: Office #
E-mail Address tuscangoupinc@g mail -com
Mobile # [phone]
9. Landowner(s) of Record (attach accompanied page to list additional owners):
The Tuscan Group, Inc
Name
Phone: Office#
919.235-2077
Mobile #
661 cedar Grove Rd
current Mailing Address Current Street Address
Pittsboro NC 27312
City State Zip City State Zip
10. Geed Book No. 02 115 Page No. 0694 Provide a copy of the most current deed.

Part B.
1. Cornpany(ies) who are financially responsible for the land -disturbing activity (Provide a comprehensive list
of all responsible pasties on accompanied fags.) If the company is a sale proprietorship or if the landowner(s) is
an individual(s), the name(s) of the owner(s) maybe listed as the financially responsible party(ies).
The Tuscan Group, INc
Company Name
661 Cedar Grove Rd
current Mailing Address
P'Ittsboro, NC 27312
City Stake Zip
Phase: office #
tuscangrou pinc@g mail com
E-mail Address
Current Street Address
City state Zip
Mobile# [phone]
Note: If the Financially Responsible Party is not the owner of the laid to be disturbed, include with this form
the landowner's signed and dated written consent for the applicant to submit a draft erosion and sedimentation
control plan and to conduct the anticipated land disturbing activity.
2. (a) if the Financially Responsible Party is a domestic company registered on the NC Secretary of State
business registry, give name and street address of the Registered Agent:
Kirk T. Mett
Name of Registered Agent
661 cedar grove rd
Current Mailing Address
pittsboro NC 27312
City State Zip
Phone: Office#
tuscangou pi nc@g mail com
E-mail Address
Current Street Address
City State Zip
Mobile # 919w235z2077
Name of Individual to Contact (if Registered Agent is a company)
(b) if the Financially Responsible
Party
is not a resident
of North Carolina, give name
and street address
of
the
designated
North
Carolina
agent
who
is registered
an the
NC Secretary of State
business registry:
Name of Registered Agent
Current Mailing Address
City State dip
Phone-. office #
E-mail Address
Current Street Address
City State Zip
Mobile #
Name of Individual to Contact (if Registered Agent is a company)

(c) If the Financially Responsible Party is engaging in business under an assumed name, give name under
which the company is Doing Business As. If the Financially Responsible Party is an individual, General
Partnership, or other company not registered and doing business under an assumed name, attach a copy
of the Certificate of Assumed Name.
Company ❑BA Name
The abase information is true and correct to the best of my knowledge and belief and was provided
by me under oath. (This firm must be signed by the Financially Responsible Person if an individual(s)
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 Party}. I agree to provide
corrected information should there be any change in the information provided herein.
Kirk T. Metty
10
Type or pyint
President
Title or Authority
Signature Date
iMmm iii^����A��������iii�ii��ii��ii��i����f ���E������ii ""`... iYi W - --4 � f! w��ii ��liii ��Si �iY Yi YW ���Fi-*rP4 Tr w���w�ii li ��
a Notary Public of the County of (`'WY\AX\ClL-
State of North Ca ro I'l n a, hereby certify that ,Y4'oL k " appeared personally
before me this day and being duly sworn acknowledged that the above form was executed by him/her,
Witness my hand and notarial seal, this r) k day of
Commission expires
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NORTH CAROLIiVA GENERAL WARRAN'TY DEAD
Excise Tax: ."
Parcel anti fi r Nio. 1439
Mail/Box to; 'RAN
This instrument vvas prepared
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BOOK
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PAGE
May 22f 2020
9:45:40 PM
11
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0699
INSTRUMENT
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Brief description f017 the .I I I d L "'I~ � '"I". � '�� �� � tip ' - �&OAD
--- -----.,._. _w --...---.��._, ��....�. , .,T
* � O ION N TIT AS R Q ESTED NO I S 1` E I ��PLIE"PH ., 11 � R �� O . F ` -Z IS DOCUM ENT*
THIS ��� � �� �� of 2 bar and bct- �veo-n
GRANTOR
Douglas E. Page and.spairse,
James N. Firth
Robert Bruce. -Page and spouse,
Linda J. Maynard
MAILING ADDRESS;
GREE'CNSBOR01 NIC 207265"
GR.ANTEE
The "F scan Group- Inc.
NC c
MAILFNIQ ADDRESS:
661 CE_-DAR GROVE ROAD
PROPERTY ADDRESS:
NEARJO ROAD
R O.. } NC 27516
-P 11D, ra -Optlale, character of entity, e.g.
Ei7te)- in appropriale block-fior each Gr-ar.11or cmd Grawee: naive, inailin'K 'ppy
m-ppomfio).1 01--pal-Inv.-Ship,
1-he. r ipdo n Grantor and Grantee as shall l � sald parties, t 'lr he i L : Cc s r� and assigns, all include
singular, plural, mascultric, feminine or neutcr as required by context.
Wl"MESSETH. that tht irec'lnt r.. for a \�ahlj h l c ni tration paid by the Grantee.} the r ipt obi which 18 her(-,b)e acknoANYI edged,. has
and -by these presents does 2.rant., bargaln,. sc.,11 and conVC . UnLo the Grantee in fee si l l ). H that certain lot or parcel o farad situated
in CHATHAM Countv North Carolina and moi-e ar t i c u l i'l described l l o ws� -
SEE ArfACHED EXHIBIT «A»
The pmparty lien-inabove. dincribvd wa3 cnquired by 0r;antor bv instrument recorded 'in Deed Book 1327, P t
All or a portion of the p ro perry he rL6 le e d does not in lLi the p 6nVD.1'V resi'dellC 0P Grant f-.
Submitted. l e c r o n i call "(;un-"(;un-n & MesSick2 L L '"
in complIance withNorth a ro 7 i na statutes gover i rag recordabld documents
and the terms of the sdbmitter agreement with th'eChatham County Register of Deeds.