NCC231455_FRO Submitted_20230516

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 Name s C_.$50"`
2. Location of land-disturbing activity: County tA,Sw . City or Township
1 ^ ! 'cr��� �Longitude decimal degrees) �S• 3 7
Highway/Street Qc;e<.v� c,�,w�Latitudetdecimal degre
3. Approximate date land-disturbing lactivittyy will commence: /,2_ / Z. - 2 Z
4. Purpose of development(residential, commercial, industrial, institutional, etc.): eouOt.e,/--6 ��
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): 2. • T
6. Amount of fee enclosed: $ ,300. '' . The application fee of$100.00 per acre (rounded
up to the next acre) is assessed without a ceiling amount (Example: 8.10-acre application fee is $900).
Checks should be addressed to NCDEQ.
sediment control plan been filed? Yes Enclosed ❑ No E
7. Has an erosion and
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Namr4 4 -r� 4'4" E-mail Address rl ',,,-- � ' ( . �c't"'�
Phone: Office# v.-4_ Mobile# Lc-t v)-7 40 —� 5- L-17
9. Landowner(s) of Record (attach accompanied page to list additional owners):
.5 �pd r-a'I ( ')iY 7 ?
e M `�j r�-�^ Pone: Office# Mobile#
Name i•o
70 3ax 9G7 3 TT v tel:zS .eu .- .
Current Mailing Address Current Street Address
City State Zip City State Zip
10. Deed Book No. Li'79 4- Page No. —7 9- Provide a copy of the most current deed.

Part B.
1. Company(ies)who are financially responsible for the land-disturbing activity(Provide a comprehensive list
of all responsible parties on accompanied page.) If the company is a sole proprietorship or if the landowner(s)is
an individual(s), the name(s)of the owner(s)may be listed as the financially responsible party(ies).
K./filSi�j� _ l _t�Gar�or' 14 "i TTZQ. 0G1nGcLe, l,Q —
Company Nance/ E-mail Address
c 0X `kJ7 -35-s-0 /,'zw _,A R .
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# 4 i 7.34- ' 7 ( Mobile# 4 7 '7(../9 -2. /7
Note: If the Financially Responsible Party is not the owner of the land 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:
/1) 79
Name of R istered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# Mobile#
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 on the NC Secretary of State business registry:
Name of R gister d Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# 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 DBA Name
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(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.
Ty e or print name Title or Authority
l2 a-622-
Signature Date '
I c a \i4 IN, tit 11617 , a Notary Public of the County of ek((kPLSW Ir✓1�
State of North Carolina, hereby certify that IR 00-0( ))(4 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 \5
1—day of If2,0 AOU1 , 20
(AMA
Notary
Melanie W Miller A y ,
NOTARY PUBLIC My commission expires UV':()Cal
Brunswick County,NC
My Commission Expires October 04,2025

Continued from Items 9 & 10 in Part A of the Financial Responsibility/Ownership Form for multiple
owners. Attach copies of this page as needed to list all landowners.
Landowner 2 of Record:
Name Phone: Office# Mobile*
Current Mailing Address Current Street Address
City State Zip City State Zip
Deed Book No. Page No. Provide a copy of the most current deed.
Landowner 3 of Record:
Name Phone: Office# Mobile#
Current Mailing Address Current Street Address
City State Zip City State Zip
Deed Book No. Page No. Provide a copy of the most current deed.
Landowner 4 of Record:
Name Phone: Office# Mobile#
Current Mailing Address Current Street Address
City State Zip City State Zip
Deed Book No. Page No. Provide a copy of the most current deed.
Landowner 5 of Record:
Name Phone: Office# Mobile#
Current Mailing Address Current Street Address
City State Zip City State Zip
Deed Book No. Page No. Provide a copy of the most current deed.

Continued from Item ? in Part B of the Financial Responsibility/Ownership Form for multiple parties.
Attach copies of this page as needed to list all financially responsible parties.
Company 2 Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# Mobile#
Company 3 Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# Mobile#
Company 4 Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# Mobile#
Company 5 Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# Mobile#

BOOK:4794 PAGE:779 02/10/2022
8:5;40.002
II I II 'I' I II I III III 1 II I I I'I I I 1"""I' Brenda M.Ominous.Brunswick County.NC Register of Deeds Eage 1 of 6
Brenda M.Clemmons,Brunswick County,NC Register of Deeds
02/10/2022 08:57:40.002 NC REVENUE STAMP.82000.00
Excise Tax$ 2,000.00 y DEED
NORTH CAROLINA GENERAL WARRANT
Tax Block: Lot: Parcel No.: 1820008504
Prepared by&return to:Eric West,Attorney at Law;50o N.Walnut Street,Lumberton,NC 28358
This instrument was prepared by Eric West,Attorney at Law,a licensed NC attorney. Delinquent taxes,if any,
will be paid by the closing attorney to the county tax collector upon disbursement of closing proceeds.
This property is not the primary residence of the Grantors.
Brief Description for the Index:
6.109 Acres, US Hwy 17—Lockwood Folly Township
THIS DEED made this 8th day of February,2022,by and between
GRANTOR GRANTEE
KERMIT M.HUGHES K.M. BIGGS,INCORPORATED
and wife,SUSAN G.HUGHES (a NC corporation)
(a 2/3 undivided interest)
125 35th Avenue NE P.O. Box 967
Hickory,NC 286oi Lumberton,NC 28359
VIVIAN STANLEY HUGHES,Trustee of the
GEORGE ROSCOE HUGHES REVOCABLE
TRUST dated October 31,2000
(a 1/3 undivided interest)
3509 Sloan Court
Raleigh,NC 27606
1
Submitted electronically by Eric West,Attorney at Law,PLLC in compliance with North Carolina statutes governing recordable
documents and the terms of the submitter agreement with the Brunswick County Register of Deeds.

BOOK:4794 PAGE:780 02/10/2022
68:57:40.002
Page 2 of 6
Brenda M.Clenunons.Brunswick County.NC Register of Deeds E
The designation Grantor and Grantee as used herein shall include
masculisad emini paties,
their
n heiruters,
successors, and assigns,and shall include singular,plural,
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
Lockwood Folly Township,Brunswick County,North Carolina and more particularly
described as follows:
See Exhibit"A" attached hereto and incorporated herein by reference.
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 ad valorem taxes; all applicable zoning and land use ordinances, statutes
and regulations; and to the provisions of all applicable restrictive covenants and utility
easements of record.
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 first above written.
(Seal)
Kermit M. Hughes
(Seal)
Susan B. Hughes
2

1111 I III 11111111111I �II1111111111111 BOOK:4794 PAGE:781 02/140 oz
111111111111
I" Page 3 of 6
Brenda M.Clenunons.Brunswick County.NC Register of Deeds E
STATE OF NORTk-i CAROLINA
COUNTY OF (,I,-(l+ti�/
I A v t t 1 C{ t S -{ci Tv( , a Notary Public for said County and State,
do hereby certify that Kermit M.Hughes and Susan B. Hughes, personally known to me
and personally appeared before me this day and acknowledged the voluntary execution of the
foregoing instrument.
Witness my hand and official seal this the day of February , 2022.
` tiiII!}ill,
! ,
Ne
NorA.p..t, m! Notary public
n ,,,, My Commission Expires: �� ` J�' a
UBLIG
3

III 11 1111 111111 l II I 1 I'I I"I 1 I II 'I' BOOK:4794 PAGE:782 02/1 /2022
'I' Page 4 of 6
Brenda M.Clenuttons.Brunswick County.NC Register of Deeds E
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 first above written.
GEORGE ROSCOE HUGHES
REVOCABLE TRUST AGREEMENT
dated October 31, 2000
By: U,e.. -e �d&e-ZC, (Seal)
Vivian Stanley HughaI
STATE OF NORTH CAROLINA
COUNTY OF L3
I, ilt % U. Lt .,cY , a Notary Public for said County and State,
do hereby certify that Vivian Stanley Hughes,Trustee of the George Roscoe Hughes
Revocable Trust Agreement dated io/31/2000, personally known to me and
personally appeared before me this day and acknowledged the voluntary execution of the
foregoing instrument on behalf of the Trust and in the capacity stated above.
Witness my hand and official seal this the day of February
2022. y p/ /
�.� ,N• LEio ,,, Notar�Public
���<0 T'cy 1,
O +''rARy My Commission Expires: g\ ;f)\ C,7
#iJBL0
;i i-14, C000"`` %
tt11111;10
4

131 111 111111111111111111111113
I1111111I "II ' I'II"'I3 "I) BOOK:4794 SPcAk GE:783isterofDeeds E ge 5 2022
EXHIBIT "A"
All that tract or parcel of land being part of the"8.638 Acres"parcel as shown in Map Book U,
at Page 155, situate in Lockwood Folly Township, Brunswick County, State of North Carolina,
said parcel being more particularly described as follows:
Beginning at an iron rod on the southern line of US Highway 17 - Ocean Highway West; said
iron rod located at the northwest corner of the lands of the State Employee's Credit Union,
recorded in Deed Book 1330, at Page 492 and as shown on the map recorded in Map Bookfeete1,
at Page 381; thence South 14 degrees 52 minutes 49 seconds East a distance of 453.9
2 along the line between said lands of the Credit Union on the east and the lands of Kermit M.
Hughes, et al as recorded in Deed Book 2348, at Page 636 on the west to an iron rod; said
iron rod located on the line between said lands of Hughes on the north and Tract 4 of the
lands of Thomas Henderson Holden as shown in Map Book 2, at Page 137 on the south;
thence South 60 degrees 59 minutes 37 seconds West along said line a distance of 576.94 feet
to an iron pipe in the center of Williams Branch, said iron pipe located on the line between
said lands of Hughes on the east and the lands of AJA Adventures as recorded in Deed Book
4433, at Page 1297 and as shown in Map Book 123, at Page 17, on the west; thence along the
centerline of Williams Branch in a generally northerly direction the following six (6) courses
and distances: (1) thence North 62 degrees 27 minutes o8 seconds West a distance of 30.54
feet; (2) thence North oi degrees 07 minutes 27 seconds East a distance of 77.39 feet; (3)
thence North 63 degrees 45 minutes 20 seconds East a distance of 43.16 feet; (4) thence
North 21 degrees 27 minutes 39 seconds West a distance ofeo thence
o.86 feet;
( )North degrees 56
thence
North
46
degrees 11 minutes 18 seconds West a distance of 65.39
minutes 3o seconds East a distance of 17.55 feet to a point in the centerline of said branch
that is on the line between said lands of Hughes on the east and
the
ewestl lands of
f along Milliken the
Investments, Inc. as recorded in Deed Book 611, at Page 1077, the
centerline of Williams Branch in a generally northerly direction the following six (6) courses
and distances: (1) thence North 35 degrees 56 minutes 30 seconds East a distance of 48.91
feet; (2) thence North 38 degrees 57 minutes 25 seconds East a distance of 42.65 feet;thence North 61 degrees 43 minutes 12 seconds West a distance ffe 8.88 t et; (eS thence
outh 75
North 43 degrees 18 minutes 22 seconds West a distance of 53.57
degrees 32 minutes 22 seconds West a distance of 59.96 feet; (6)thence North 38 degrees 34
minutes 46 seconds West a distance of 95.75 feet to a point on the southerly highway
boundary of US Highway 17 — Ocean Highway West; thence North 64 degrees 42 minutes 55
seconds East along said highway boundary a distance of 37.81 feet to a NCDOT rod with cap;
thence North 66 degrees 52 minutes 41 seconds East along said highway boundary a distance
of 169.96 feet to a NCDOT rod with cap; thence North 76 degrees 21 minutes o8 seconds East
along2 said way boundary1seconds Eat alo g said highway boundary a distance of 271 03 feet
T rod with cap; thence North
62 degrees 40 minutes 4
to the Point of Beginning, containing 266,129 +/-square feet or 6.109 +/- acres.
Subject to a 6o-ft. right of way and easement along a portion of the line between said lands of
Hughes on the west and said lands of the State Employees Credit Union on the east; said
easement is shown on the map recorded in Map Book 21, at Page 381; said easement being
more particularly as follows: Beginning at an iron rod on the southern line of US Highway 17
5

BOOK:4794 PAGE:784 08::5�40.002
II I II I II I II I I III I I I II I ICI I II I I II I III Brenda M.Ciemmons.Brunswick County.NC Register of Deeds Eage 6 of 6
- Ocean Highway West; said iron rod located at the northwest corner of the lands of the State
Employee's Credit Union, recorded in Deed Book 133o, at Page 492 and as shown on the map
recorded in Map Book 21, at Page 381;thence South 14 degrees 52 minutes 49 seconds East a
distance of 30o.0o feet along the line between said lands of the Credit Union on the east and
the lands of Kermit M. Hughes, et al as recorded in Deed Book 2348, at Page 636 on the west;
thence South 75 degrees o7 minutes 11 seconds West through said lands of Hughes a distance
of 60.0o feet; thence North 14 degrees 52 minutes 49 seconds West parallel with the line
between Hughes and the Credit Union, a distance of 286.78 feet to a point on the southerly
highway boundary of US Highway 17 — Ocean Highway West; thence North 62 degrees 4o
minutes 41 seconds East along said highway boundary a distance of 61.44 feet to the Point of
Beginning, containing 17,603 +/-square feet or o.404 +/- acre.
TOGETHER WITH AND SUBJECT TO the rights and obligations of the parties contained in
the Lease Agreement dated July 25, 2019 and a Memorandum of which is recorded in Deed
Book 4237, at Page 738, Brunswick County Register of Deeds. This deed shall act as an
Assignment of the Lease Agreement to the Grantor.
6