NCC230164_FRO Submitted_20230120

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 Soil Erosion and
Sedimentation Control Ordinance of the City of Greenville (Title 9, Chapter 8) before this form and an
acceptable erosion and sedimentation control plan have been completed and approved by the City of
Greenville, Engineering Division. (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.
Project Name Star Hill Farm
2. Location of land -disturbing activity: County —A, rl City or Township z tcA v1 ///It
Highway/Street , T�,o � - �',i Latitude S 7 q 5713 Longitude 7 '7
3. Approximate date land -disturbing activity will commence:_//5�1�
4. Purpose of development (residential, commercial, industrial, institutional, etc.):
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): s 3'D
6. Amount of fee enclosed: $ 30 , ad . The application fee of $100.00 per acre (rounded
to the tenth of acre) is assessed without a ceiling amount (Example: a 9-acre application fee is $900).
7. Has an erosion and sediment control plan been filed? Yes No ti' Enclosed
8. Person to contact should
erosion and sediment control issues arise during land -disturbing activity:
Name rTS�i�y G/�s E-mail Address ees�`�
Telephone2-) -zSZ_ 9J!Y_ Cell #'S1 %/y -SW _ Fax #
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Name Telephone
L'
Current Mai ing Address
City State Zip
10. Deed Book No. Page No
Part B.
Current Street Address
City
State
Fax Number
Zip
Provide a copy of the most current deed.
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):
Name E-mail Address
Current Mailing Address Current Street Address
✓J/lam 4ZL ;),7i Jp
City State Zip
Telephone.25--,, - 7/9 F4,4 f
City
Fax Number
State
Zip

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 State
Telephone
E-mail Address
Current Street Address
Zip City
Fax Number
State Zip
(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:
Name of Registered Agent
Current Mailing Address
City
State Zip
E-mail Address
Current Street Address
City
Telephone Fax Nu
State Zip
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 by any change in the information provided herein.
Type o int name T tle or Authority
ma
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I,> QncQ" K. Li i I 1 i c� m S , a Notary Public of the County of721 1+
State of North Carolina, hereby certify that /-'t 5�'1 r' u - � \c S 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 I b day of 20c)
SANDRA K WILLIAMS
Notary Public A �1 •� 5CJ(�L�
North Carolina Notary
S al Pitt County
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Page 1 of 5
Type: CONSOLIDATED REAL PROPERTY
Recorded: 1/6/2021 2:04:08 PM
Fee Amt: $305.00 Page 1 of 5
Revenue Tax: $279.00
Pitt County, NC
Lisa P. Nichols REG OF DEEDS
BK 4037 PG 121 - 125
------------------[SPACE ABOVE THIS LINE RESERVED FOR RECORDING DATA] ----
STATE OF NORTH CAROLINA Prepared By: HORNE & HORNE, PLLC
COUNTY OF PITT -Mail To: GRANTEE
1145 Eaglechase Lane
Tax Parcel No: 52696 Greenville, NC 27858
Excise Tax: $279.00
GENERAi, WARRANTY DEED
The Preparer is informed that all or a portion of the property herein conveyed does not include the principal residence of
the Grantor. This instrument prepared by Stephen F. Horne,171, a licensed North Carolina attorney. Delinquent taxes, if
any, to he paid by the closing attorney to the county tax collector upon disbursement of closing proceeds.
THIS DEED, made and entered into this the 5th day of January, 2021, by and
between DAVID R. GIBBS, as Trustee of the John W. Gibbs, III Revocable/Irrevocable Trust, dated
January 3, 2012 and Amended and Restated January 3, 2012, October 18, 2018 and December 31, 2018,
and DAVID RANDOLPH GIBBS, individually and as Executor of the Estate of John Willard Gibbs,
III, whose address is 204 Dryden Lane, Richmond VA 23229, hereinafter called GRANTOR;
and SOHIR ASHKAR, whose address is 1145 Eaglechase Lane, Greenville NC 27858,
hereinafter called GRANTEE;
WITNESSETH:
That whereas, John Willard Gibbs, III, died testate on February 11,2020 leaving a last will
and testament, which is duly probated and recorded in the office of the Clerk of Court of Pitt County in
Estate File 20E208, to which reference is hereby made; and
submitted electronically by "Horne & Horne, PLLC"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Pitt county Register of Deeds.
Book: 4037 Page: 121 Page 1 of 5

Page 2 of 5
Whereas, under the will the property herein was devised and bequeathed to the John W. Gibbs,
III Revocable/Irrevocable Trust, dated January 3, 2012 and Amended and Restated January 3, 2012,
October 18, 2018 and December 31, 2018; and
Whereas, pursuant to the will, David Randolph Gibbs, the Grantor herein, was duly qualified and
made Executor under the will of John Willard Gibbs, III, and has continued in such capacity since his
death, and is now engaged in the administration of said estate and the distribution of the assets therein;
and
and
Whereas, the Notice to Creditors was published according to North Carolina General Statutes;
Whereas, the said Executor has made provisions for the payment of all administration expenses
and all estate taxes, if any, and for the payment and settlement of the bequests and devises set out in such
will; and
Whereas, it is the purpose and intention of the Grantor, as Executor of the will of John Willard Gibbs,
III, deceased, to convey the hereinafter described property in fee simple to the Grantee herein;
Now, therefore, the Grantor, acting individually and as Executor for and in consideration of TEN
DOLLARS ($10.00) and other good and valuable consideration to him in hand paid by Grantee, the
receipt of which is hereby acknowledged, has given, granted, bargained, sold and conveyed and by these
presents does give, grant, bargain, sell and convey unto the said Grantee, his heirs and assigns, in fee
simple, the following described real property, to -wit:
Being all of Lot No. 17 of Star Hill Farm Subdivision, which appears of record in Map Book 42,
Page 168, as revised by Map entitled "Revisions to Lot 22, 23 and 25, Star Hill Farm" according
to map or Plat recorded in Map Book 43, Page 153 of the Pitt County Registry, to which map is
herein referenced for a more complete and accurate description. Being the identical property
conveyed from David F. Meadows and Denise D. Meadows to David Hill and Stacy Hill, in that
certain Deed dated May 4, 2005 of record in Deed Book 1908, at Page 521 of the Pitt County
Registry.
Book: 4037 Page: 121 Page 2 of 5

Page 3 of 5
SUBJECT to those Restrictive Covenants appearing of record in Deed Book 523, Page 540 of the
Pitt County Registry. In addition, this conveyance is also made subject to the following
restrictions: So long as David Hill and Stacy Hill are still the owners of Lot 21 in Star Hill Farm,
any building plans must be submitted for review and approval by the Hill's prior to construction.
Approval of the building plans shall not be unreasonable withheld. Also any residence
constructed on Lot No. 17 shall contain no less than 5000 square feet of living area, of which 500
square feet can be a pool house or garage.
TO HAVE AND TO HOLD the above described real property with all the rights, privileges and
appurtenances thereunto belonging or in anywise appertaining unto the said Grantee, his heirs and
assigns, in fee simple forever.
And the Grantor, for himself, his heirs and assigns, covenants with Grantee, his heirs and assigns,
that he is seized of said premises in fee and has the right to convey the same in fee simple; that the same
is free and clear from all encumbrances except easements and restrictions of record and 2021 ad valorem
takes which are to be prorated between Grantor and Grantee at the time of closing, noncompliance with
local, county, state or federal governmental laws, ordinances, or regulations relative to zoning,
subdivision, occupancy, use, construction or the development of the subject property, if any, and that he
will warrant and defend the title to the same against the lawful claims of all persons whomsoever.
When reference is made to the Grantor or Grantee, as used herein, shall include said parties, their
heirs, successors and assigns, and shall include the singular and plural, and any reference to gender shall
include masculine, feminine and neuter.
Book: 4037 Page: 121 Page 3 of 5

Page 4 of 5
IN WITNESS WHEREOF, Grantor has adopted the word "SEAL" as his seal and has hereunto
set his hand and seal on this the day and year first above written.
x (SEAL) t <, F
- _. � - _.(SEAL)
Y BS, as Tru .DAVID OLPH BBS, In ' idually
of the John W. Gibbs, III And as Executor of the Estate of
Revocable/Irrevocable Trust, John Willard Gibbs, III
dated January 3, 2012 and
Amended and Restated
January 3, 2012, October 18,
2018 and December 31, 2018
STATE/COMMONWEALTH OF VIRGINIA
COUNTY OFJtAILL
I, a Notary Public of " County, Virginia do hereby certify that David R. Gibbs, as
Trustee of the John W. Gibbs, III, Revocable/Irrevocable Trust, dated January 3, 2012 and Amended and
Restated January 3, 2012 and October 18, 2018 and December 31, 2018, personally appeared before me
this day and acknowledged the due execution of the foregoing deed of conveyance.
Witness my hand and Notarial Seal, this the _�- day of T1 ! 411,202
T
(AI; IX `TEAL HERE)
NOTARY PUBLIC
Printed/Typed Name: ,��t�l11T, 2!l r P• �
My Commission Expires:
CAROLINE PAIGE BECK
COMMONOWEALTH OF VIRGINIA
MY COMMI$SION 5LT t JULY 31, pppq
,_ COMMISSION # 7gg5598
Book: 4037 Page: 121 Page 4 of 5

Page 5 of 5
STATE/COMMONWEALTH OF VIRGINIA
COUNTY OF&AaLC)
I, a Notary Public of e ('� County, Virginia do hereby certify that DAVID RANDOLPH
GIBBS personally appeared before me this day and acknowledged the due execution of the foregoing
deed of conveyance. _ �q
Witness my hand and Notarial Seal, this the " day of )� . (1�V� 202
(AFFTX SEAL IRE)
NOTARY PUBLIC
Printed/Typed Name: Oxjll j7f- f
My Commission Expires:
CAROLINE PAIGE BECK
NOTARY PUBLIC
COMMON"ALTH OF VIRGINIA
MY COMMISSION EXPIRES JULY 31, 2024
I-- COMMISSION N 7885596
Book: 4037 Page: 121 Page 5 of 5