NCC230374_FRO Submitted_20230209

SOIL EROSION and SEDIMENTATION CONTROL
Lincoln County Natural Resources Department
115 West Main Street, Lincointon, NC 28092 704-736-8501 Fax: [phone]
A01 I Alf"
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 has been completed and approved by the Lincoln County Natural Resources Department.
(Please type or print. 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 Victory Baptist Church
2. Location of land -disturbing activity: Latitude 35.531 Longitude -81.078
Parcel Identification Number (PIN) 3685147968 Watershed Area
Highway/Street Address— 6041 King Wilkinson Rd Denver NC 28037
3. Approximate date land -disturbing activity will commence: Jan 1, 2023
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Commercial
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 0.85
6. Amount of fee enclosed: $ 200.00 . The Standard Permitting application fee of $200.00 per acre
(rounded up to the next acre) is assessed without a ceiling amount (Example: 9 acres total $1,800). The Express
Permitting application fee is a dual charge. The normal fee of $200.00 per acre (rounded up to the next acre) is
assessed without a ceiling amount. In addition, the Express Permitting supplement is $250.00 per acre up to eight
acres, after which the Express Permitting supplemental fee is a fixed $2,000.00 (Example: 9 acres total $3,800.00).
Has an erosion and sediment control plan been filed? Yes— No Enclosed x
8. Local appointed person to contact should erosion and sediment control issues arise during land -disturbing activity:
2(-"XU'N<;P *,.L C_z>-L
Name G"Svn _mail Address 06=ttgmmmmom
Telephone Cell # Fax#
Landowner(s) of Record (attach accompanied page to list additional owners):
13 cdr�surl.
Victory Baptist Church of Denver . [e-mail]
Name Telephone (none) Fax Number
%iks-A-A'k -CX'"_C1
6041 King Wilkinson Rd 6041 King Wilkinson Rd
Current Mailing Address Current Street Address
Denver NC 28037 Denver NC 28037
City State Zip City State Zip
10. Deed Book No. 3130 Page No. 62 most recently filed in Lincoln County Register of Deeds.
11. Future Landowner(s) if applicable: (attach accompanied page to list additional owners):
Name Telephone Fax Number
Current Mailing Address Current Street Address
City State Zip City State Zip

SOIL EROSION and SEDIMENTATION CONTROL
Lincoln County Natural Resources Department
115 West Main Street, Lincointon, NC 28092 704-736-8501 Fax: [phone]
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):
Victory Baptist Church of Denver
Name
6041 King Wilkinson Rd
Current Mailing Address
Denver NC 28037
City State Zip
Telephone None
.8"an
_-hffWt(cDvictorvdenvemc.com
E-mail Address
6041 King Wilkinson Rd
Current Street Address
Denver NC 28037
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 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:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip city State Zip
Telephone Fax Number
(c) In order to facilitate Permitting, it is necessary to be able to contact the Engineer or other consultant who can
assist in providing any necessary information regarding the plan and its preparation:
Shabeldeen Engineering danO-shabeldeen-engineering.com
Engineering Firm or other consultant E-mail Address
3145 Tate Blvd SE Box A Hickory NC 28602
Current Mailing Address city State Zip
Dan Shabeldeen 828-320-7252
Individual contact person (type or print) Telephone Fax Number

SOIL EROSIONand SEDIMENTATION CONTROC
Lincoln• Resources Department
(d) Contractors and/or Subcontractors (person(s) or firm(s) engaging in the land -disturbing activity:
Building Systems of Catawba County
Name of Person or Firm Name of Person or Firm
675 Lenoir Rhyne BLVD SE
Current Mailing Address Current Street Address
Hickory NC 28603
City State Zip City
State Zip
Trinity Price
Individual contact person (type or print) Individual contact person (type or print)
Telephone [phone] Telephone
Fax Number
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 by any change in the information provided
herein and any other associated documents. I understand that all documents that are associated with this project and
project number are parts of the complete project document.
Permission to Enter on Land
I certify that I am authorized to grant and do in fact grant permission to the Natural Resources Erosion Control Inspector
and his agents to enter on the land in question in connection and/or related to this permit.
Type or print name Title or Authority
�I,tl�3
Sig ure Date
1, Pdoliavi M & V11-le v , a Notary Public of the County of L i y1 at Yt
State of North Carolina, hereby certify that clym con VAwice�!:l appeared personally before
me this day and being duly sworn acknowledged thak the above form w s executed by him.
Witness my hand and notarial seal, this l day of 20
M
Not ry
Seal
My commission expires 01 / 2 71 Z©21.
fMJl7�0�
'" ►� �°Kl8Lie . A

BK 3130 PG 62 - 63 (2)
This document presented and filed:
01/25/2022 02:23:42 PM
DEED
Fee $26 00 Transfer Tax: $0.00
646407 111111111111111111111
Lincoln County North Carolina
Danny R. Hester, Register of Deeds
0 (; X) Excise Tax $0.00
Parcel Identifier No. 53619 & 53620
Mail after recording to: Grantee
This instrument was prepared by: D. TODD WULFHORST - Kennedy & Wulfhorst, P.A., 3758 Hwy 16 N, Denver, NC
Brief description for the index Tract 1— 8.126 Acres
US DEED made this le day of
and
VICTORY BAPTIST CHURCH by and through the duly
authorized and elected and empowered Trustees: Mark
Steven Davis and Christopher S. Ramsey
6041 King Wilkinson Road
Denver. NC 28037
DO-1 _pit a
VICTORY BAPTIST OF DENVER NC,
a North Carolina Non Profit Church
6041 King Wilkinson Road
Denver, NC 28037
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
the Town of Denver, Catawba Springs Township, Lincoln County, North Carolina and more particularly described as follows:
BEING the entire and full contents of Tract No. 1, containing 8.126 acres, as so shown, designated and
delineated on that certain plat entitled "Exempt Recombination for Victory Baptist Church," which is
duly recorded in Plat Book 21, at Page 62, Lincoln County Public Registry, and, by this reference, a
description of said Tract 1 is made a part hereof as fully as if copied herein by metes and bounds in full.
The property does not include the primary residence of the Grantor.

The property hereinabove described was acquired by Grantor by instrument recorded in Book 735, Page 61
A map showing the above -described property is recorded in Map Book 21, Page 62
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:
All valid and enforceable reservations, restrictions, easements, conditions and right-of-ways in the record chain of title.
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 the day and year fast above written.
SEAL -STAMP
D. TODD WULFr -ORST
NOTARY PUBLIC
Lincoln County
North Carolina
My Commission Expires May 9, 2023
VICTORY BAPTIST C CH
13 (SEAL)
Mak Steven Davis, Trustee
By: �L.. S. (SEAL)
Christopher S. Ramsey, Trustee
STATE OF NORTH CAROLINA COUNTY OF LINCOLN
I, the undersigned, a Notary Public of the County and State aforesaid, certify that
Mark Steven Davis and Christopher S. Ramsey, Trustees of Victory Baptist Church
Grantor, personally appeared before me this day and acknowledged the execution of the
foregoing instrument.
Witness my hand and official seal, this the 25`' day of January, 2022.
W
Notary ublic
My Commission Expires: -'el%Z)—QD