NCC231639_FRO Submitted_20230619

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 South Judd and South Main Operational Improvement Project
2. Location of land-disturbing activity: County Wake City or Township Fuquay-Varina
Highway/Street SE Judd Pkwy&S Main St Latitude(decimai degrees)35.573441 Longitude(decimal degrees)-78.800511
3. Approximate date land-disturbing activity will commence: August 2023
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Intersection Improvement
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): 1 .33
6. Amount of fee enclosed: $200.00 . 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.
7. Has an erosion and sediment control plan been filed? Yes❑ Enclosed El No ❑
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Asa Utterback E-mail Address [e-mail]
Phone: Office# 919-552-1405 Mobile#
9. Landowner(s)of Record (attach accompanied page to list additional owners):
NCDOT Public ROW
Name Phone: Office# Mobile#
Current Mailing Address Current Street Address
City State Zip City State Zip
10. Deed Book No. Page No. 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).
Town of Fuquay-Varina [e-mail]
Company Name E-mail Address
134 N Main Street 134 N Main Street
Current Mailing Address Current Street Address
Fuquay-Varina NC 27526 Fuquay-Varina NC 27526
City State Zip City State Zip
Phone: Office# 919-753-1035 Mobile#
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:
Name of Registered 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 Registered 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.
Matthew B. Poling Engineering Director
Type or print name Title or Authority
Signature Date
I, k-\on 1a\il .1naW , a Notary Public of the County of wa1 1,e
State of North Carolina, hereby certify that MOthWY,W V, Po\vc appeared personally
before me this day and being duly sworn acknowledged that the above foOn was executed by him/her.
Witness my hand and notarial seal, this 5 day of I s. sr1\ , 20 o�3
Hannah Shaw Notary
NOTARY PUBLIC My commission expires \ 01— - ao a
Wake County,NC
My Commission Expires December 07 2026

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:
Town of Fuquay-Varina 919-552-1405
Name Phone: Office# Mobile#
134 N Main Street 134 N Main Street
Current Mailing Address Current Street Address
Fuquay-Varina, NC 27526 Fuquay-Varina, NC 27526
City State Zip City State Zip
Deed Book No.639 Page No. 935 Provide a copy of the most current deed.
Landowner 3 of Record:
CAPPS DEVELOPMENT, LLC 919-422-0384
Name Phone: Office# Mobile#
259 Atkins Road 939 JUDD PKWY SE
Current Mailing Address Current Street Address
Fuquay-Varina FUQUAY-VARINA, NC, 27526
City State Zip City State Zip
Deed Book No. 014621 Page No.2559-2562 Provide a copy of the most current deed.
Landowner 4 of Record:
Christopher S Veasey 919-552-4793
Name Phone: Office# Mobile#
6009 Burt Road 969 S JUDD PKWY SE
Current Mailing Address Current Street Address
Fuquay- Varina Fuquay-Varina, NC 27526
City State Zip City State Zip
Deed Book No. 13484 Page No. 1 705 Provide a copy of the most current deed.
Landowner 5 of Record:
Pipe Dream III Investments, LLC 919-422-0332
Name Phone: Office# Mobile#
301 Montford Drive 935 S JUDD PKWY SE
Current Mailing Address Current Street Address
Garner, NC 27529-6885 Fuquay-Varina, NC 27526
City State Zip City State Zip
Deed Book No. 01 9038 Page No. 1953-1954 Provide a copy of the most current deed.

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.
6
Landowner-2 of Record:
Chad W Gaskins 919-263-9209
Name Phone: Office# Mobile#
931 S JUDD PKWY SE 931 S JUDD PKWY SE
Current Mailing Address Current Street Address
Fuquay-Varina, NC 27526 Fuquay-Varina, NC 27526
City State Zip City State Zip
Deed Book No. 0121 53 Page No. 1060-1 062 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 1 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#

Site Address PIN Owner Owner Mailing DB,PG Agreement
820 S MAIN ST 656835564 Town of Fuquay-Varina 134 N Main Street DB 639 PG 0935 Municipal Agreement with DOT
Fuquay-Varina
969 S JUDD PKWY SE 656934518 VEASEY,CHRISTOPHER S 6009 BURT RD DB 013298,PG 1789-1792 DB 0191128,PG 1484-1488
FUQUAY VARINA NC 27526-9654
939 S JUDD PKWY SE 656939469 CAPPS DEVELOPMENT LLC 259 ATKINS RD DB 014621,PG 2559-2562 DB 019130,PG 2234-2238
FUQUAY VARINA NC 27526-9654
301 MONTFORD DR
935 S JUDD PKWY SE 666030560 RIPE DREAM III INVESTMENTS LLC GARNER NC 27529-6885 DB 019038,PG 1953-1954 DB 019130,PG 02188-02192
931 S JUDD PKWY SE 666031541 GASKINS,CHAD W 931 S JUDD PKWY SE DB 012153,PG 01060-01062 DB 019190,PG 00333-00337
FUQUAY VARINA NC 27526-6786

Executive Summary
The Executive Summary is a summation of this agreement and is not intended to be used
as the agreement between the Department (North Carolina Department of Transportation)
and the Party (Entity).
Entity: Town of Fuquay-Varina County: Wake
TIP: HL-0041
Project: South Judd Parkway and Main Street intersection
Scope: Constructing additional dedicated left and right turn lanes at the intersection of South Judd
Parkway and Main Street in Fuquay-Varina.
Eligible Activities:
Design
PE 49879.1.1
Environmental
49879.2.1 ROW Acquisition
ROW
49879.2.2 Utility Relocation
CON 49879.3.1 Construction
OTHER
FEDERAL-AID 0401310
Fund Source Federal Funds Reimbursement Non-Federal Non-Federal
Amount Rate Match $ Match Rate
Congestion $494,610 80% $123,653 20%
Mitigation and Air
Quality
Total Estimated Cost $618,263
Responsibility: The Town of Fuquay-Varina shall be responsible for all aspects of the project.
Agreement ID# 11026

NORTH CAROLINA LOCALLY ADMINISTERED PROJECT -
FEDERAL
WAKE COUNTY
DATE: 11/3/2021
NORTH CAROLINA DEPARTMENT OF
TRANSPORTATION
TIP#: HL-0041
AND WBS Elements: PE 49879.1.1
ROW 49879.2.1
UTIL 49879.2.2
TOWN OF FUQUAY-VARINA CON 49879.3.1
OTHER FUNDING:
FEDERAL-AID NUMBER: 0401310
CFDA#: 20.205
Total Funds [NCDOT Participation] $494,610
THIS AGREEMENT is made and entered into on the last date executed below, by and between the
North Carolina Department of Transportation, an agency of the State of North Carolina, hereinafter
referred to as the "Department" and the Town of Fuquay-Varina, hereinafter referred to as the
"Municipality".
WITNESSETH:
WHEREAS, Fixing America's Surface Transportation (FAST)Act allows for the allocation of federal
funds to be available for certain specified transportation activities; and,
WHEREAS, the Municipality has requested federal funding for South Judd Parkway and Main Street
intersection, hereinafter referred to as the Project, in Wake County, North Carolina; and,
WHEREAS, subject to the availability of federal funds, the Municipality has been designated as a
recipient to receive funds allocated to the Department by the Federal Highway Administration (FHWA)
up to and not to exceed the maximum award amount of$494,610 for the Project; and,
WHEREAS, the Department has agreed to administer the disbursement of said funds on behalf of
FHWA to the Municipality for the Project in accordance with the Project scope of work and in
accordance with the provisions set out in this Agreement; and,
WHEREAS, the Department has programmed funding in the approved Transportation Improvement
Program for the Project; and,
WHEREAS, the governing board of the Municipality has agreed to participate in certain costs and to
assume certain responsibilities in the manner and to the extent as hereinafter set out; and,
Agreement ID# 11026 1

WHEREAS, this Agreement is made under the authority granted to the Department by the North
Carolina General Assembly including, but not limited to, the following applicable legislation: General
Statutes of North Carolina (NCGS) Section 136-66.1, Section 136-71.6, Section 160A-296 and 297,
Section 136-18, Section 136-41.3 and Section 20-169, to participate in the planning, construction
and/or implementation of the Project approved by the Board of Transportation.
NOW, THEREFORE, this Agreement states the promises and undertakings of each party as herein
provided, and the parties do hereby covenant and agree, each with the other, as follows:
1. GENERAL PROVISIONS
FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT
All parties to this Agreement, including contractors, subcontractors, and subsequent workforces,
associated with any work under the terms of this Agreement shall provide reports as required by
the Federal Funding Accountability and Transparency Act(FFATA)for this Project.
AGREEMENT MODIFICATIONS
Any modification to scope, funding, responsibilities, or time frame will be agreed upon by all
parties by means of a Supplemental Agreement.
LOCAL PUBLIC AGENCY TO PERFORM ALL WORK
The Municipality shall be responsible for administering all work performed and for certifying to the
Department that all terms set forth in this Agreement are met and adhered to by the Municipality
and/or its contractors and agents. The Department will provide technical oversight to guide the
Municipality. The Department must approve any assignment or transfer of the responsibilities of
the Municipality set forth in this Agreement to other parties or entities.
PERSON IN RESPONSIBLE CHARGE
The Municipality shall designate a person or persons to be in responsible charge of the Project, in
accordance with Title 23 of the Code of Federal Regulations, Part 635.105. The person, or
persons, shall be expected to:
■ Administer governmental project activities, including those dealing with cost, time,
adherence to contract requirements, construction quality and scope of Federal-aid
projects;
Agreement ID# 11026 2

• Maintain knowledge of day to day project operations and safety issues;
• Make or participate in decisions about changed conditions or scope changes that
require change orders or supplemental agreements;
• Visit and review the project in accordance with the project scope and scale;
• Review financial processes, transactions and documentation to reduce the likelihood
of fraud, waste, and abuse;
• Direct project staff, agency or consultant, to carry out project administration and
contract oversight, including proper documentation; and
• Be aware of the qualifications, assignments and on-the-job performance of the
agency and consultant staff at all stages of the project.
The person in responsible charge must be a full-time employee of the Municipality, but the duties
may be split among several employees, if necessary.
COMPLIANCE WITH STATE/FEDERAL POLICY
The Municipality, and/or its agent, including all contractors, subcontractors, or sub-recipients shall
comply with all applicable Federal and State policies and procedures, stated both in this
Agreement and in the Department's guidelines and procedures, including the Local Programs
Management Handbook.
FAILURE TO COMPLY-CONSEQUENCES
Failure on the part of the Municipality to comply with any of the provisions of this Agreement will
be grounds for the Department to terminate participation in the costs of the Project and, if
applicable, seek repayment of any reimbursed funds.
2. SCOPE OF PROJECT
The Project consists of constructing additional dedicated left and right turn lanes at the
intersection of South Judd Parkway and Main Street in Fuquay-Varina.
The Department's funding participation in the Project shall be restricted to the following eligible
items:
Agreement ID# 11026 3

■ Design
■ Environmental Documentation
■ ROW Acquisition
■ Utility Relocation
■ Construction
as further set forth in this Agreement.
3. FUNDING
PROGRAMMING AND AUTHORIZATION OF FEDERAL FUNDS
The funding currently programmed for the project in the State Transportation Improvement
Program (STIP) is Congestion Mitigation and Air Quality. The funding source may be modified
with the coordination and approval of the respective Metropolitan Planning Organization (MPO)
and/or the Department prior to authorization of funds. The Department will authorize and
reimburse federal funding based on the type of federal funding that is programmed in the STIP at
the time of the authorization request. The Department will notify the Municipality of the type of
federal funds authorized by issuing a Technical Amendment— Funds Authorization letter. A
modification in the source of funds will have no effect on project responsibilities outlined in this
agreement.
REIMBURSEMENT FOR ELIGIBLE ACTIVITIES
Subject to compliance by the Municipality with the provisions set forth in this Agreement and the
availability of federal funds, the Department shall reimburse 80% of eligible expenses incurred by
the Municipality up to a maximum amount of Four Hundred Ninety Four Thousand Six Hundred
Ten Dollars ($494,610), as detailed below. The Municipality shall provide the non-federal match,
as detailed in the FUNDING TABLE below, and all costs that exceed the total estimated cost.
FUNDING TABLE
Fund Source Federal Funds Reimbursement Non-Federal Non-Federal
Amount Rate Match $ Match Rate
Congestion $494,610 80% $123,653 20%
Mitigation and Air
Quality
Total Estimated Cost $618,263
Agreement ID# 11026 4

WORK PERFORMED BY NCDOT
All work performed by the Department on this Project, including, but not limited to, reviews,
inspections, and Project oversight, during any phase of the delivery of the Project, shall reduce
the funding available to the Municipality under this Agreement. The Department will set aside ten
percent(10%) of the total estimated cost, or$61,826.30 to use towards the costs related to
review and oversight of this Project, including, but not limited to review and approval of plans,
environmental documents, contract proposals, engineering estimates, construction engineering
and inspection oversight, and other items as needed to ensure the Municipality's appropriate
compliance with state and federal regulations.
In the event that the Department does not utilize all the set-aside funding, then those remaining
funds will be available for reimbursement to the Municipality at the above reimbursement rate.
For all costs of work performed on the Project, whether incurred by the Municipality or by the
Department, the Municipality shall provide the non-federal match. The Department will bill the
Municipality for the non-federal match of any costs that the Department incurs on the Project and
for any costs that exceed the Total Estimated Cost.
4. PERIOD OF PERFORMANCE
The Municipality has five (5)years to complete all work outlined in the Agreement from the date
of authorization of Federal funds for the initial phase of work. Completion for this Agreement is
defined as completion of all construction activities or implementation activities, acceptance of the
project, and submission of a final reimbursement package to the Department.
If additional time is needed to complete the Project, then a supplemental agreement must be
executed. The Department and/or FHWA reserves the right to revoke the funds awarded if the
Municipality is unable to meet milestone dates included herein.
5. PRELIMINARY ENGINEERING AUTHORIZATION
If Preliminary Engineering is an eligible expense, then upon receipt of an executed agreement,
the Department will authorize Preliminary Engineering funds and shall notify the Municipality, in
writing, once funds have been authorized and can be expended. The Municipality shall not
initiate any work, nor solicit for any professional services prior to receipt of written authorization
from the Department to proceed. Any work performed, or contracts executed, prior to receipt of
written authorization to proceed will be ineligible for reimbursement.
Agreement ID# 11026 5

6. PROFESSIONAL AND ENGINEERING SERVICES
The Municipality shall comply with the policies and procedures of this provision if the Municipality
is requesting reimbursement for the Preliminary Engineering contract or the Construction
Contract Administration /Construction Engineering and Inspection contract.
PROCUREMENT POLICY
When procuring professional services, the Municipality must adhere to Title 2 Code of Federal
Regulations Part 200; Title 23 of the Code of Federal Regulations, Part 172; Title 40 United
States Code, Chapter 11, Section 1101-1104; NCGS 143-64, Parts 31 and 32; and the
Department's Policies and Procedures for Major Professional or Specialized Services Contracts.
Said policies and standards are incorporated in this Agreement by reference at
www.fhwa.dot.gov/legsregs/legislat.html and www.ncleg.net/gascripts/Statutes/Statutes.asp.
■ The Municipality shall ensure that a qualified firm is obtained through an equitable
selection process, and that prescribed work is properly accomplished in a timely manner
and at a just and reasonable cost.
■ All Professional Services Firms shall be pre-qualified by the Department in the Work
Codes advertised.
■ A pre-negotiation audit will be conducted by the Department's External Audit Branch.
The Municipality shall not execute a consultant contract until the Department's review has
been completed.
SMALL PROFESSIONAL AND ENGINEERING SERVICES FIRMS REQUIREMENTS
Any contract entered into with another party to perform work associated with the requirements of
this Agreement shall contain appropriate provisions regarding the utilization of Small Professional
Services Firms (SPSF). This policy conforms with the SPSF Guidelines as approved by the
North Carolina Board of Transportation.
■ The Municipality shall not advertise nor enter into a contract for services performed as
part of this Agreement, unless the Department provides written approval of the
advertisement or the contents of the contract.
■ If the Municipality fails to comply with these requirements, the Department will withhold
funding until these requirements are met.
Agreement ID# 11026 6

WORK BY ENTITY
If the Design, Planning, Contract Administration and/or Construction Engineering and Inspection
required for this project will be undertaken by the Municipality, and the Municipality requests
reimbursement, then the Municipality must submit a request and supporting documentation to the
Department for review and approval, prior to any work being initiated by the Municipality.
7. PLANNING / ENVIRONMENTAL DOCUMENTATION
The Municipality shall prepare the environmental and/or planning document, including any
environmental permits, needed to construct the Project, in accordance with the National
Environmental Policy Act (NEPA) and all other appropriate environmental laws and regulations.
All work shall be performed in accordance with Departmental procedures and guidelines. Said
documentation shall be submitted to the Department for review and approval.
■ The Municipality shall be responsible for preparing and filing with all proper agencies the
appropriate planning documents, including notices and applications required to apply for
those permits necessary for the construction of the desired improvements. Copies of
approved permits should be forwarded to the Department.
■ The Municipality shall advertise and conduct any required public hearings.
■ If any permit issued requires that action be taken to mitigate impacts associated with the
improvements, the Municipality shall design and implement a mitigation plan. The
Department will determine if any mitigation costs are eligible for reimbursement. The
Municipality shall bear all costs associated with penalties for violations and claims due to
delays.
■ The Municipality shall be responsible for designing an erosion control plan if required by
the North Carolina Sedimentation Pollution Control Act of 1973, NCGS 113A, Article 4,
incorporated in this Agreement by reference at
www.ncleg.net/gascripts/Statues/Statutes.asp and obtaining those permits required
thereby in order to construct the Project. During the construction of the improvements,
the Municipality, and its contractors and agents, shall be solely responsible for
compliance with the provisions of said Act and the plan adopted in compliance therewith.
Agreement ID# 11026 7

8. DESIGN
CONTENT OF PLAN PACKAGE
The Municipality, and/or its agent, shall prepare the Project's plans, specifications, and a
professional estimate of costs (PS&E package), in accordance with the Department's guidelines
and procedures, and applicable Federal and State standards. All work shall be submitted to the
Department for review and approval. The plans shall be completed to show the design, site
plans, landscaping, drainage, easements, and utility conflicts.
9. RIGHT OF WAY/ UTILITY AUTHORIZATION
If the costs of right of way acquisition or utility relocation are an eligible expense, the Municipality
shall submit a letter of request to the Department to authorize and set up right of way and/or utility
funding. The acquisition for right of way, construction easements, and/or utility relocation may be
undertaken only after the Municipality receives written authorization from the Department to
proceed.
10.PROJECT LIMITS AND RIGHT OF WAY (ROW)
The Municipality shall comply with the policies and procedures of this provision regardless of
whether the Municipality is requesting reimbursement for the Right of Way phase of the Project.
SPONSOR PROVIDES ROW
The Municipality, at no liability whatsoever to the Department, shall be responsible for providing
and/or acquiring any required ROW and/or easements for the Project.
ROW GUIDANCE
The Municipality shall accomplish all ROW activities, including acquisition and relocation, in
accordance with the following: Title 23 of the Code of Federal Regulations, Part 710, Subpart B
and Title 49 of the Code of Federal Regulations, Part 24, [Uniform Act] incorporated by reference
at www.fhwa.dot.gov/legsregs/directives/fapgtoc.htm; NCGS, Chapter 133, Article 2, Sections
133-5 through 133-18, Relocation Assistance, incorporated by reference at
www.ncleg.net/gascripts/Statutes/Statutes.asp; and the North Carolina Department of
Transportation Right of Way Manual.
Agreement ID# 11026 8

APPRAISAL
The Municipality shall submit the appraisal to the Department for review and approval in
accordance with Departmental policies and procedures.
CLEARANCE OF PROJECT LIMITS/ROW
The Municipality shall remove and dispose of all obstructions and encroachments of any kind or
character(including hazardous and contaminated materials)from said ROW, with the exception
that the Municipality shall secure an encroachment agreement for any utilities (which shall remain
or are)to be installed within the Department's ROW, or follow other applicable approval process,
for utilities within the Municipality's ROW. The Municipality shall indemnify and save harmless
the Department, Federal Highway Administration, and the State of North Carolina, from any and
all damages and claims for damages that might arise on account of said right of way acquisition,
drainage, and construction easements for the construction of said Project. The Municipality shall
be solely responsible for any damages caused by the existence of said material now and at any
time in the future and will save the Department harmless from any legal actions arising as a result
of this contaminated and/or hazardous material and shall provide the Department with
documentation proving the proper disposal of said material.
RELOCATION ASSISTANCE
The Municipality shall provide relocation assistance services and payments for families,
businesses, and non-profit organizations being displaced by the Project in full accordance with
the Federal relocation requirements of Title 49 Code of Federal Regulations, Part 24 [Uniform
Act], as amended. Relocation assistance services and payments may be accomplished by
contract with any other municipal corporation, or State or Federal agency, rendering such
services upon approval by the Department and Federal Highway Administration.
11.UTILITIES
The Municipality, and/or its agent, at no liability to the Department, shall relocate, adjust, relay,
change or repair all utilities in conflict with the Project, regardless of ownership. All utility work
shall be performed in a manner satisfactory to and in conformance with State and Federal rules
and regulations, prior to Municipality beginning construction of the project. This Agreement does
not modify or supersede any existing Utility Encroachment Agreements that may be in place.
Agreement ID# 11026 9

12.RIGHT OF WAY/ UTILITY/ RAILROAD CERTIFICATION
The Municipality, upon acquisition of all right of way/property necessary for the Project, relocation
of utilities, and coordination with the railroad shall provide the Department all required
documentation (deeds/leases/easement/plans/agreements)to secure certification. Certification is
only issued after all ROW is in public ownership or property is publicly accessible by a legal
document; utilities in conflict with the project are relocated, or a plan for their relocation during
construction has been approved; and coordination with the railroad (if applicable) has occurred
and been documented.
13.CONTRACT PROPOSAL AND ENGINEER'S ESTIMATE
CONTRACT PROPOSAL
The Municipality shall develop a contract proposal that will be advertised for bids. The proposal
shall comply with NCDOT Specifications and Standard Drawings as applicable to the Project.
The proposal shall also contain provisions, as applicable, per Title 23 Code of Federal
Regulations 633 and 635 to include, but not be limited to: FHWA 1273, Buy America, Davis-
Bacon Wage Rates, Non-discrimination, DBE Assurances, Contractor Certification regarding
suspension and debarment, and other provisions as required by the Department.
ENGINEER'S ESTIMATE
The Municipality shall develop an itemized engineer's estimate to show items referenced to the
NCDOT Standard Specifications, if applicable, along with units and unit price. The engineer's
estimate will be used as the basis for comparing bids received.
14.CONSTRUCTION AUTHORIZATION
The Municipality shall submit the required environmental and/or planning document, ROW
certification, final construction plans, total contract proposal, and an estimate of Project costs
(final PS&E package)to the Department for review and approval.
■ After approval of all documentation, the Department will request construction
authorization from the Federal Highway Administration.
■ The Municipality shall not advertise for bids prior to receiving written construction
authorization from the Department.
Agreement ID# 11026 10

15.CONTRACTOR PROCUREMENT
ADVERTISE FOR BIDS
Upon receipt of written construction authorization from the Department, the Municipality may
advertise the Project. The Municipality shall follow applicable Federal and/or State procedures
pertaining to the advertisement of the Project, bid opening, and award of the contract, according
to Title 2 of the Code of Federal Regulations, Part 200 and Title 23 of the Code of Federal
Regulations, Part 633 and Part 635, incorporated by reference at
www.fhwa.dot.gov/legsregs/directives/fapgtoc.htm; and NCGS, Chapter 143, Article 8 (Public
Contracts), incorporated by reference at www.ncleg.net/gascripts/Statutes/Statutes.asp.
CONSTRUCTION CONTRACTOR REQUIREMENTS
All Contractors submitting bids on the project shall be pre-qualified by the Department. All
proposed subcontractors must be pre-qualified before construction work begins. Any
subcontractors who are proposed to meet the Disadvantaged Business Enterprise goal must be
certified by the Department.
CONSTRUCTION SUBCONTRACTOR REQUIREMENTS
Any contract entered into with another party to perform work associated with the requirements of
this Agreement shall contain appropriate provisions regarding the utilization of Disadvantaged
Business Enterprises (DBEs), or as required and defined in Title 49 of the Code of Federal
Regulations, Part 26 and the North Carolina Administrative Code. These provisions are
incorporated into this Agreement by reference
https://connect.ncdot.gov/projects/Contracts/Pages/LGA-Projects.aspx.
■ The Municipality shall not advertise nor enter into a contract for services performed as
part of this Agreement, unless the Department provides written approval of the
advertisement or the contents of the contract.
■ If the Municipality fails to comply with these requirements, the Department will withhold
funding until these requirements are met.
AWARDING CONTRACT
After the advertisement of the Project for construction bids, the Municipality shall request
concurrence from the Department to award the construction contract by submitting a letter along
Agreement ID# 11026 11

with tabulated bids received depicting Disadvantaged Business Enterprises (DBE)goals, and a
resolution recommending award of the Project to the lowest responsible, responsive bidder. The
Department will review the submitted information and provide written approval to the Municipality
prior to the contract being awarded by the Municipality.
DELAY IN PROCUREMENT
In the event the Project has not been let to contract within six (6) months after receiving
construction authorization from the Department, the Municipality shall be responsible for
documenting to the Department justification for project delay and that the Project remains in
compliance with the terms of this Agreement, the approved plans and specifications, and current
codes.
FORCE ACCOUNT
Force account work is only allowed when there is a finding of cost effectiveness for the work to be
performed by some method other than a contract awarded by a competitive bidding process, or
there is an emergency. Written approval from the Department is required prior to the use of force
account by the Municipality. Federal Highway Administration regulations governing Force
Account are contained in Title 23 Code of Federal Regulations, Part 635.201, Subpart B; said
policy being incorporated in this Agreement by reference
www.fhwa.dot.gov/legsregs/directives/cfr23toc.htm. North Carolina General Statutes governing
the use of Force Account, Chapter 143, Article 8 (Public Contracts)can be found at
www.ncleq.net/gascripts/Statutes/Statutes.asp.
16.CONSTRUCTION
The Municipality, and/or its agents shall construct the Project in accordance with the plans and
specifications of the Project as filed with, and approved by, the Department. During the
construction of the Project, the procedures set out below shall be followed:
CONSTRUCTION CONTRACT ADMINISTRATION
The Municipality shall comply with the NCDOT Construction Manual as referenced at
http://www.ncdot.orq/doh/operations/dp%5Fchief%5Fenq/constructionunit/formsman uals/construc
tion/, which outlines the procedures for records and reports that must be adhered to in order to
obtain uniformity of contract administration and documentation. This includes, but is not limited
to, inspection reports, material test reports, materials certification, documentation of quantities,
Agreement ID# 11026 12

project diaries, and pay records. The Municipality, and/or its agent, shall perform the construction
engineering, sampling and testing required during construction of the Project, in accordance with
Departmental procedures, including the Department's Guide for Process Control and Acceptance
Sampling and Testing. The Municipality shall document that said compliance was accomplished
in accordance with State and Federal procedures, guidelines, standards and specifications.
RETAINAGE
The Municipality shall not retain any portion of a payment due the contractor.
SIGNAGE
The Municipality shall provide and maintain adequate signage and other warning devices for the
protection of the public in accordance with the approved traffic control plans for the Project and
the current edition of the Manual on Uniform Traffic Control Devices (MUTCD)for Streets and
Highways, or any subsequent revision of the same, published by the Federal Highway
Administration and effective at the time of award of the contract.
SITE LAYOUT
The Municipality shall be responsible for ensuring that all site layout, construction work, and
Project documentation are in compliance with applicable city, state and federal permits,
guidelines, and regulations, including American Association of State Highway and Transportation
Officials (AASHTO) guidelines and Americans with Disabilities Act(ADA) Standards for
Accessible Design (www.usdoj.gov/crt/ada/stdspdf.htm).
RIGHT TO INSPECT
The Department and representatives of the Federal Highway Administration shall have the right
to inspect, sample or test, and approve or reject, any portion of the work being performed by the
Municipality or the Municipality's contractor to ensure compliance with the provisions of this
Agreement. Prior to any payment by the Department, any deficiencies inconsistent with approved
plans and specifications found during an inspection must be corrected.
Agreement ID# 11026 13

CONTRACTOR COMPLIANCE
The Municipality will be responsible for ensuring that the contractor complies with all of the terms
of the contract and any instructions issued by the Department or FHWA as a result of any review
or inspection made by said representatives.
CHANGE ORDERS
If any changes in the Project plans are necessary, the Department must approve such changes
prior to the work being performed.
SHOP DRAWINGS
Shop Drawings shall be submitted in accordance with the approved plans and specifications and
may require review by the Designer.
17.CLOSE-OUT
Upon completion of the Project, the Municipality shall be responsible for the following:
FINAL INSPECTION
The Municipality shall arrange for a final inspection by the Department. Any deficiencies
determined during the final field inspection must be corrected prior to final payment being made
by the Department to the Municipality. Additional inspection by other entities may be necessary
in accordance with the Department's guidelines and procedures. The Municipality shall provide
the Department with written evidence of approval of completed project prior to requesting final
reimbursement.
FINAL PROJECT CERTIFICATION
The Municipality will provide a certification to the Department that all work performed for this
Project is in accordance with all applicable standards, guidelines, and regulations.
18.MAINTENANCE
The Municipality, at no expense or liability to the Department, shall assume all maintenance
responsibilities for the South Judd Parkway and Main Street intersection, or as required by an
executed encroachment agreement.
Agreement ID# 11026 14

19.REIMBURSEMENT
SCOPE OF REIMBURSEMENT
Activities eligible for funding reimbursement for this Project shall include:
■ Design
■ Environmental Documentation
■ ROW Acquisition
■ Utility Relocation
■ Construction
REIMBURSEMENT GUIDANCE
The Municipality shall adhere to applicable administrative requirements of Title 2 Code of Federal
Regulations, Part 200 (www.fhwa.dot.gov/legsregs/directives/fapgtoc.htm) "Uniform
Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards."
Reimbursement to the Municipality shall be subject to the policies and procedures contained in
Title 23 Code of Federal Regulations, Part 140 and Part 172, which is being incorporated into this
Agreement by reference at www.fhwa.dot.gov/legsregs/directives/fapgtoc.htm. Reimbursement
to the Municipality shall be subject to the guidance contained in Title 2 Code of Federal
Regulations, Part 170 (http://edocket.access.qpo.qov/2010/pdf/2010-22705.pdf)and Office of
Management and Budget(OMB)"Federal Funding Accountability and Transparency Act"
(FFATA). Said reimbursement shall also be subject to the Department being reimbursed by the
Federal Highway Administration and subject to compliance by the Municipality with all applicable
federal policy and procedures.
REIMBURSEMENT LIMITS
■ WORK PERFORMED BEFORE NOTIFICATION
Any costs incurred by the Municipality prior to written notification by the Department to
proceed with the work shall not be eligible for reimbursement.
■ NO REIMBURSEMENT IN EXCESS OF APPROVED FUNDING
Agreement ID# 11026 15

At no time shall the Department reimburse the Municipality costs that exceed the total
funding per this Agreement and any Supplemental Agreements.
■ UNSUBSTANTIATED COSTS
The Municipality agrees that it shall bear all costs for which it is unable to substantiate
actual costs or any costs that have been deemed unallowable by the Federal Highway
Administration and/or the Department's Financial Management Division.
■ WORK PERFORMED BY NCDOT
All work performed by the Department on this Project, including, but not limited to,
reviews, inspections, and Project oversight, shall reduce the maximum award amount of
$494,610 available to the Municipality under this Agreement. The Department will bill the
Municipality for the non-federal match of any costs that the Department incurs on the
Project and for any costs that exceed the Total Estimated Cost.
■ CONSTRUCTION ADMINISTRATION
Reimbursement for construction contract administration will be made as governed by
Departmental policy that limits reimbursement for construction contract administration to
no more than fifteen (15%) percent of the actual construction contract of the Project.
These costs will also include any cost overruns and charges to the Project by the
Department during the Construction Phase.
■ CONSTRUCTION CONTRACT UNIT PRICES
Reimbursement for construction contract work will be made on the basis of contract unit
prices in the construction contract and any approved change orders.
■ RIGHT OF WAY
Reimbursement will be limited to the value as approved by the Department. Eligible
costs for reimbursement of Right of Way Acquisition include: realty appraisals, surveys,
closing costs, and the agreed upon just compensation for the property, at the
reimbursement rate as shown in the FUNDING TABLE.
■ FORCE ACCOUNT
Invoices for force account work shall show a summary of labor, labor additives,
equipment, materials and other qualifying costs in conformance with the standards for
Agreement ID# 11026 16

allowable costs set forth in 2 CFR 200 "Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards." Reimbursement shall be based
on actual eligible costs incurred with the exception of equipment owned by the
Municipality or its Project partners. Reimbursement rates for equipment owned by the
Municipality or its Project partners cannot exceed the Department's rates in effect for the
time period in which the work is performed.
BILLING THE DEPARTMENT
■ PROCEDURE
The Municipality may bill the Department for eligible Project costs in accordance with the
Department's guidelines and procedures. Proper supporting documentation shall
accompany each invoice as may be required by the Department. By submittal of each
invoice, the Municipality certifies that it has adhered to all applicable state and federal
laws and regulations as set forth in this Agreement.
Along with each invoice, the Municipality is responsible for submitting the FFATA
Subrecipient Information Form, which is available at
https://connect.ncdot.gov/municipalities/Funding/Pages/default.aspx.
■ INTERNAL APPROVALS
Reimbursement to the Municipality shall be made upon approval of the invoice by the
Department's Financial Management Division.
■ TIMELY SUBMITTAL OF INVOICES
The Municipality may invoice the Department monthly for work accomplished, but no less
than once every six (6) months to keep the Project funds active and available. If the
Municipality is unable to invoice the Department, then they must provide an explanation.
Failure to submit invoices or explanation may result in de-obligation of funds.
■ FINAL INVOICE
All invoices associated with the Project must be submitted within six (6) months of the
completion of construction and acceptance of the Project to be eligible for reimbursement
by the Department. Any invoices submitted after this time will not be eligible for
reimbursement.
Agreement ID# 11026 17

20.REPORTING REQUIREMENTS AND RECORDS RETENTION
PROJECT EVALUATION REPORTS
The Municipality is responsible for submitting quarterly Project evaluation reports, in accordance
with the Department's guidelines and procedures, that detail the progress achieved to date for the
Project.
PROJECT RECORDS
The Municipality and its agents shall maintain all books, documents, papers, accounting records,
Project records and such other evidence as may be appropriate to substantiate costs incurred
under this Agreement. Further, the Municipality shall make such materials available at its office
and shall require its agent to make such materials available at its office at all reasonable times
during the contract period, and for five (5)years from the date of payment of the final voucher by
the Federal Highway Administration, for inspection and audit by the Department's Financial
Management Section, the Federal Highway Administration, or any authorized representatives of
the Federal Government.
21.OTHER PROVISIONS
REFERENCES
It will be the responsibility of the Municipality to follow the current and/or most recent edition of
references, websites, specifications, standards, guidelines, recommendations, regulations and/or
general statutes, as stated in this Agreement.
INDEMNIFICATION OF DEPARTMENT
The Municipality agrees to indemnify and hold harmless the Department, FHWA and the State of
North Carolina, to the extent allowed by law, for any and all claim for payment, damages and/or
liabilities of any nature, asserted against the Department in connection with this Project. The
Department shall not be responsible for any damages or claims, which may be initiated by third
parties.
Agreement ID# 11026 18

DEBARMENT POLICY
It is the policy of the Department not to enter into any agreement with parties that have been
debarred by any government agency (Federal or State). By execution of this agreement, the
Municipality certifies that neither it nor its agents or contractors are presently debarred,
suspended, proposed for debarment, declared ineligible or voluntarily excluded from participation
in this transaction by any Federal or State Agency or Department and that it will not enter into
agreements with any entity that is debarred, suspended, proposed for debarment, declared
ineligible or voluntarily excluded from participation in this transaction.
TITLE VI -CIVIL RIGHTS ACT OF 1964
The Municipality shall comply with Title VI of the Civil Rights Act of 1964, (Title 49 CFR, Subtitle
A, Part 21). Title VI prohibits discrimination on the basis of race, color, national origin, disability,
gender, and age in all programs or activities of any recipient of Federal assistance.
OTHER AGREEMENTS
The Municipality is solely responsible for all agreements, contracts, and work orders entered into
or issued by the Municipality for this Project. The Department is not responsible for any
expenses or obligations incurred for the Project except those specifically eligible for the funds and
obligations as approved by the Department under the terms of this Agreement.
AVAILABILITY OF FUNDS
All terms and conditions of this Agreement are dependent upon, and, subject to the allocation of
funds for the purpose set forth in the Agreement and the Agreement shall automatically terminate
if funds cease to be available.
IMPROPER USE OF FUNDS
Where either the Department or the FHWA determines that the funds paid to the Municipality for
this Project are not used in accordance with the terms of this Agreement, the Department will bill
the Municipality.
Agreement ID# 11026 19

TERMINATION OF PROJECT
If the Municipality decides to terminate the Project without the concurrence of the Department, the
Municipality shall reimburse the Department one hundred percent(100%)of all costs expended
by the Department and associated with the Project.
AUDITS
In accordance with 2 CFR 200 "Uniform Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards," Subpart F—Audit Requirements, and the Federal Single
Audit Act Amendments of 1996, the Municipality shall arrange for an annual independent financial
and compliance audit of its fiscal operations. The Municipality shall furnish the Department with a
copy of the annual independent audit report within thirty (30) days of completion of the report, but
not later than nine (9) months after the Municipality's fiscal year ends.
REIMBURSEMENT BY MUNICIPALITY
For all monies due the Department as referenced in this Agreement, reimbursement shall be
made by the Municipality to the Department within sixty (60) days of receiving an invoice. A late
payment penalty and interest shall be charged on any unpaid balance due in accordance with
NCGS 147-86.23.
USE OF POWELL BILL FUNDS
If the other party to this agreement is a Municipality and fails for any reason to reimburse the
Department in accordance with the provisions for payment hereinabove provided, NCGS 136-
41.3 authorizes the Department to withhold so much of the Municipality's share of funds allocated
to Municipality by NCGS 136-41.1, until such time as the Department has received payment in
full.
ENTIRE AGREEMENT
This Agreement contains the entire agreement between the parties and there are no
understandings or agreements, verbal or otherwise, regarding this Agreement except as
expressly set forth herein.
Agreement ID# 11026 20

AUTHORIZATION TO EXECUTE
The parties hereby acknowledge that the individual executing the Agreement on their behalf is
authorized to execute this Agreement on their behalf and to bind the respective entities to the
terms contained herein and that he has read this Agreement, conferred with his attorney, and fully
understands its contents.
FACSIMILE SIGNATURES
A copy or facsimile copy of the signature of any party shall be deemed an original with each fully
executed copy of the Agreement as binding as an original, and the parties agree that this
Agreement can be executed in counterparts, as duplicate originals, with facsimile signatures
sufficient to evidence an agreement to be bound by the terms of the Agreement.
GIFT BAN
By Executive Order 24, issued by Governor Perdue, and NCGS 133-32, it is unlawful for any
vendor or contractor(i.e. architect, bidder, contractor, construction manager, design professional,
engineer, landlord, offeror, seller, subcontractor, supplier, or vendor), to make gifts or to give
favors to any State employee of the Governor's Cabinet Agencies (i.e. Administration,
Commerce, Environmental Quality, Health and Human Services, Information Technology, Military
and Veterans Affairs, Natural and Cultural Resources, Public Safety, Revenue, Transportation,
and the Office of the Governor).
22.SUNSET PROVISION
All terms and conditions of this Agreement are dependent upon, and subject to, the allocation of
funds for the purpose set forth in the Agreement and the Agreement shall automatically terminate
if funds cease to be available.
IT IS UNDERSTOOD AND AGREED that the approval of the Project by the Department is
subject to the conditions of this Agreement, and that no expenditures of funds on the part of the
Department will be made until the terms of this Agreement have been complied with on the part of
the Municipality.
Agreement ID# 11026 21

IN WITNESS WHEREOF, this Agreement has been executed, in duplicate, the day and year
heretofore set out, on the part of the Department and the Municipality by authority duly given.
L.S. ATTEST: TOWN OF FUQUAY-VARINA
f—DocuSigned by:
BY: BY: u --
—2FA7B1ED707E4FA...
TITLE: TITLE: Town Manager
11/17/2021
DATE:
NCGS 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State Employee of
any gift from anyone with a contract with the State, or from any person seeking to do business with
the State. By execution of any response in this procurement, you attest, for your entire organization
and its employees or agents, that you are not aware that any such gift has been offered, accepted, or
promised by any employees of your organization.
This Agreement has been pre-audited in the manner
required by the Local Government Budget and Fiscal
Control Act.
r—DocuSigned by: /�.
awn.o VL rve.e.
(SEAL) .-3111,4ffAM EOFFICER)
Federal Tax Identification Number
56-6001231
Town of Fuquay-Varina
Remittance Address:
Finance Department
134 N Main St
Fuquay-Varina, NC 27526
DEPARTMENT OF TRANSPORTATION
DocuSigned by: DS
BY: °''° °t L. r
r5
( N I Lr 31fttM.
01/27/2022
DATE:
DS
APPROVED BY BOARD OF TRANSPORTATION ITEM 0: 12/8/2021 (Date ll
Agreement ID # 11026 22

r
- _ 1
Hold: Cumalander E. Cumalander , P.A. �b39 i P60935
. Drawn by ur under the direction
F._ of Mark S. Calvert, Attorney
000353 9:i n-, , 8
NORTH CAROLINA .. _ 4'4
WAKE COUNTY VAKE ce!i jY
THIS DEED, made and entered into thisilir4 day of-DrcimrIik, 1994, from CAROLINA
POWER do LIGHT COMPANY, a North Carolina public service corporation, GRANTOR, to the
TOWN OF FUQUAY-VARINA, 1300 Academy St., Fuquay-Varina, N_C., 27526, a municipal body
politic and corporate, GRANTEE;
WITNESETH:
That GRANTOR, for and in consideration of the sure of S10.00 and other valuable
consideration, receipt
of which is hereby duly acknowledged, has bargained and sold, and hereby does
bargain, sell, and convey, unto GRANTEE, its successors and assigns, the following-described parcel
of land: _
Lying and being in Middle Creek Township, Wake County, North
Carolina:
I
BEGINNING at a concrete monument marking the southeastern corner
of, now or formerly, Lydia Tilley, in the western right of way edge of U.S.
Highway No. 401, the location of said concrete monument having North
Carolina Coordinates Y=663,582.960 and X=2,059.186.072;and nuts thence
I
along and with the western right of way edge of said Highway No. 401 South
00 degrees 19 minutes 47 seconds East 300.00 feet to a concrete monument;
•
thence North 88 degrees 00 minutes 19 seconds West 1270.58 feet to a
concrete monument being located in the eastern property line of P_ K.
' Honeycutt, et ux.; thence North 05 degrees 03 minutes 23 seconds East
i 244.06 feet to a concrete monument marking the northeastern corner of
' Vinson O. Jones, et ux., the southeastern corner of P. K. Honeycutt, et ux.,
( - and the southwestern corner of, now or formerly, Lydia Tilley;thence alongand with a southern property line of, now or formerly, Lydia Tilley South 86
"� degrees 58 minutes 47 seconds East 412.50 feet to a concrete monument
marking a southeastern corner of, now or formerly Lydia Tilley;thence along
and with an eastern property line of, now or formerly, Lydia Tilley North 00
•
degrees 43 minutes 31 seconds East 179.98 feet to a concrete monument; and
thence along and with a southern property line of, now or formerly, Lydia
Tilley South 80 degrees 04 minutes 47 seconds East 845.00 feet to the point
of BEGINNING, containing 9.200 acres, more or less, as shown and
described on Carolina Power& Light Company Drawing No. L-D-7034(dated
May, 1984), and being the same land described in a deed from John Aaron

i
61639 t r O936
Seater,et us.. to Carolina Power & Light Company. dated June 8. 1914. and
recorded in Book 3291. page 651. Wake County Registry.
The above-described parcel of land is subject to any road, highway.
street. or utility easements of record.
i TO HAVE AND TO HOLD,the above described parcel of land.together with all privileges
and app ttesiances tbereunto belonging, to GRANTEE. its successors and assigns. forever.
GRANTOR covenants with GRANTEE. it successors and ssigns. that it is seized of the
above-described parcel of land in fee and has the right to convey the saner in fee simple; that the same
is free and clear from all liens and encumbrances, except for the hen of GRANTOR'S Mortgage and Deed
of Trust with the Bank of New York as Corporate Trustee, dated May 1, 1940, as supplemented, and
GRANTOR is entitled to and will obtain release of said property from such lien by March 15, 1995, and
if no(released by that date.then GRANTOR shall accept title back from GRANTEE and mark paid and
satisfied the promissory
note and deed of trust for the above described parcel of land executed by
GRANTEE; and that it will warrant and forever defend the title thereto against the claims of all persons -
whensoever.
1N WITNESS WHEREOF,GRANTOR has caused this DEED to be signed in its name by
ii
its duly authorized officers, and its corporate seal to be hereto affixed die day and year first above
written.
I
CAROLINA POWER& LIGHT COMPANY
.r,
4 4
44i tiC"6-
`1 It. (BY, L...............4 i .. # - Vice President
W
�rrr Y {LAKE COUNTY oEc2g.�+
. t ' .F- Aili i ^ ., /
. V sty.
l `. i`. ,,. `' :a .W . .
STATE OFTN

�__
1
L ________________________.
BK639 I r&0937
NORTH CAROLINA
WAKE COUNTY
1. Ofre/.7 t(. id. �f c%j Td R- , a Notary Public in and for the State and County
aforesaid, do hereby ccnify that ROBERT M. WILLIAMS personally came before me this day and
acknowledged that he is Assistant Secretary of CAROLINA POWER & LIGHT COMPANY. a
corporation.and that by authority duly given and as the act of the corporation.the foregoing DEED was
signed in its name by its Vice President. sealed with its corporate seal, and attested by humclf as its
Assistant Secretary.
Witness my hand and notarial seal. this / `T day of -DEGe,Adc`it . 1994-
sil?Vjltd ti) ` a '
�l f''' NotaryPublic
«t �;_,
• My commission expires: tke iARp',``� _
I - «s
Yam•• •
1 COUNT
NORTH CAROLINA - -+a.
NORTH CAROliNA—WAKE COUNT r
, \ .
The brego;np ame5hae_of
�V* 1
(are)ceased es be correct TN*immanent and dis arefic a are duty regn�ered at du dam and time
` and in the boost and page mown m the last page hereof.
KENNETH C.WY-MS.Register of Deeds
, La...........J\ 1)/J—)1\:IAD '-"L—i 2._( _IkN-•_\ -{--- '
AasuDepuh Register of Deeds
Register of Deeds k
r DFZtQUAY.liIN
3

BK019128PG01484 WAKE COUNTY, NC
TAMMY L. BRUNNER
REGISTER OF DEEDS
PRESENTED & RECORDED ON
08-25-2022 AT 09:52:01
BOOK: 019128 PAGE: 01484 - 01488
TEMPORARY CONSTRUCTION EASEMENT AGREEMENT
Prepared by: James S.Adcock III
Attorney for Town of Fuquay-Varina
Without benefit of title certification or opinion of title
Mail to: Town of Fuquay-Marina
134 N Main Street,Fuquay-Varina
ID#: Out of 0656935700
STATE OF NORTH CAROLINA
COUNTY OF WAKE
THIS DEED OF EASEMENT AGREEMENT, made this the 24' 'day of AU osr ,
2022, by and between Christopher Veasey of 6009 Burt Road, Fuquay-Varina, NC 27526
(hereinafter referred to as"Grantor")and the Town of Fuquay-Varina,a North Carolina municipal
corporation, with the address of 134 N Main Street, Fuquay-Varina, North Carolina 27526
(hereinafter referred to as "Grantee").
WITNESSETH:
THAT WHEREAS,the Grantee is a municipal corporation organized and existing pursuant
to the laws of the State of North Carolina; and,
WHEREAS, the Grantor is the owner of a certain tract of land lying and being in Middle
Creek Township,Wake County,North Carolina,the same being the land conveyed to it pursuant to
Deed Book 13484,Page 1705,Wake County Registry; and,
Page 1 of 4
submitted electronically by "cumalander Adcock, LLP"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the wake County Register of Deeds.

BK019128PG01485
WHEREAS, the Grantee is in need of and desires to acquire temporary easements herein
described over and across the land of the Grantor in order that it may perform one of its
governmental functions and in order to make right-of-way improvements; and,
WHEREAS,the Grantor has agreed to convey to the Grantee the temporary easements herein
described.
NOW THEREFORE, FOR AND IN CONSIDERATION of the sum of Ten and no/100
dollars (S 10.00) and other good and valuable consideration, receipt and sufficiency of which is
hereby acknowledged,Grantor does hereby grant,bargain,sell,transfer and convey unto Grantee,its
successors and assigns,temporary construction easements, together with the right of ingress,egress
and regress to and from the same and over the adjacent lands of the Grantor, its successors and
assigns, for the purposes aforesaid, and to go over, under, through and across the above described
lands of the Grantor,and said temporary construction easement area is more particularly described as
follows:
Being all of that"Temporary Construction Easement#1 Area—304 Sq.Ft."and
that"Temporary Construction Easement#2 Area—5140 Sq.Ft."as depicted on
that map entitled "Temporary Construction Easement For: Town of Fuquay-
Varina Lapp Project HL-0041 S.Judd/S.Main(U.S.401)"and attached hereto as
Exhibit A.
This conveyance is being made subject to all deeds of trust,liens,encumbrances,judgments,
restrictions, and civil proceedings of record.
TO HAVE AND TO HOLD said easements unto Grantee, it being agreed that the easements
are appurtenant to and run with the land for the benefit of the Grantee, its successors and or assigns
as long as the easements are necessary for construction and installation of said right of way
Page 2 of 4

BK019128PG01486
improvements, and it is understood and agreed that upon completion of all construction the
temporary easements shall cease to exist.
The Grantee covenants to maintain the easements in good repair so that no unreasonable
damage will result from their use to the land of the Grantor, its successors and assigns, and will
restore Grantor's land to its original condition to the extent practicable.
The terms and conditions hereof shall be binding upon and inure to the benefit of the heirs,
executors, administrators, devisees, successors, trustees or assigns of the parties hereto.
The singular as used herein shall include the plural and any reference to gender shall include
masculine, feminine and neuter.
IN WITNESS WHEREOF, the Grantor has hereunto set its hand and seal this the day and
year first above written.
{See following page for signatures}
Page 3 of 4

BK019128PG01487
(SEAL)
Christopher easey
Hannah Shaw
NOTARY PUBLIC
_ Wake County NC
State of N 0 �'{ ) s(D)1(\O MNffiffiftion Expires December OZ 2026
County of YA
I certify that the following person(s)personally appeared before me this day,each acknowledging to
me that he or she signed the foregoing document: Christopher Veasey
Date: (DA0vNI)\(6-o2 — oZ a
ell
Notary Public
My commission expires: li)CC . 1 a M R
Page 4 of4

BK019128PG01488
EXHIBIT A
,
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m r- co-- (VARIABLE WIDTH PUBLIC R/W)
m to wn orr z- "
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e
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C7 1f N A 27 Omg0 co==
v _ y`< czvz N
I �? xi 0
Oxi��i1�DU
I
9.4 1 mrxlmK
xr bwmn z-<
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0 U,z zO
mmzo,n� o
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a x�Cmz m
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-I0moD f np,D_,
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,hti
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BKO13298P 01789
WAKE COUNTY, NC 377
LAURA M RIDDICK
REGISTER OF DEEDS
PRESENTED 8 RECORDED ON
11/10/2008 AT 15:32:20
BOOK:013298 PAGE:01789 - 01792
NORTH CAROLINA QUITCLAIM DEED
Excise Tax $ 0.00
Tax Identification No. 0256007 AND 0256006 AND 0127638
Hold/Mail after recording to: Cumalander, Adcock & McCraw, LLP
133 Spring Avenue, Fuquay Varina, NC 27526
This instrument was prepared by: Cumalander, Adcock & McCraw, LLP
John B. Adcock, P.A., a licensed North Carolina attorney,
Without title search, closing, tax advice or domestic law advice
Brief Description for the index 3 Tracts
THIS DEED made this jle day of did , 2008, by and between
GRANTOR GRANTEE
WANDA A. VEASEY CHRISTOPHER S. VEASEY
969 Judd Parkway
Fuquay Varina, NC 27526
•
•
Enter in appropriate block for each party:name,address,and,if appropriate,character of entity,e.g.,corporation or partnership.
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 said Grantors, for and in consideration of the sum of Ten Dollars to them in hand paid, the receipt of
which is hereby acknowledged,have remised and released and by these presents do remise,release,and forever quitclaim unto
the Grantee and his heirs and assigns all right,title,claim and interest of the said Grantors in and to all that certain lot or parcel
of land lying and being in the County of Wake and state of North Carolina, and more particularly described as follows:
SEE EXHIBIT "A" ATTACHED HERETO AND INCORPORATED HEREIN BY REFERENCE.
THE PURPOSE OF THIS CONVEYANCE is made pursuant to N.C.G.S. 39-13.3, N.C.G.S. 52-10
and N.C.G.S. 52-10.1 in order to vest title to the within described property solely
in the Grantee herein, free and clear of any right, title and interest of the Grantor
herein. (For purposes of this provision, the "Grantor" shall mean any Grantor other
than the individual Grantee spouse in whom title is to remain vested herein) .
For this purpose and with regard to the property and any interests and rights
described herein or related thereto, by execution of this deed, the Grantor hereby
waives, releases and quitclaims forever unto the Grantee (1) any and all right to
share in the estate of the Grantee ' upon the Grantee' s death as provided in
N.C.G.S. 29-14, or pursuant to a Last Will and Testament or codicil thereto of the
Grantee, (2) all and every right to elect to take a life estate in said real estate
N.C. Bar Assoc. Form No. 7 8 1977
Printed by Agreement with the N.C. 13ar Assoc. 4003

BK013298P.Q01790
upon the death of the Grantee, (3) all and every right to an elective share in the
estate of the Grantee pursuant to N.C.G.S. 30-3. 1 et seq, (4) any and all rights
arising out of any action for equitable distribution under N.C.G.S. 50-20, (5) any
and all community property laws of any state, and (6) any and all other rights and
interests in said real estate which the Grantor now has or may hereafter have or
acquire arising out of or accruing to said Grantor by reason of past, current or
future marital relationship with the Grantee.
This conveyance is pursuant to that "Contract of Separation and Property Settlement
Agreement" by and between Grantor and Grantee, dated 26 March 2007, which is
incorporated herein by reference as if set forth verbatim.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges thereunto belonging to him the said
Grantee and his heirs and assigns free and discharged from all right, title, claim or interest of the said Grantors or
anyone claiming by, through or under them.
Title to the property hereinabove described is subject to the following exceptions:
l. All restrictions, covenants, easements and right of ways of record;
2. Ad valorem taxes due and payable; .. '
•
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 and its seal to be hereunto affixed by
authority of its Board of Directors, the day and year first ab ve written.
• . LLiiii 0OV (SEAL)
anda A. Veasey
(SEAL)
NORTH CAROLI:N� A
COUNTY OF WaJCZ
I certify that the following person(s) personally appeared before me this day, each acknowledging to me
that he . he voluntarily signed the foregoing document for the purpose stated therein and in ee iap/�city indicated:
Wan i a A. easev, Grantor . Witness my hand and official stamp or seal this 1 4; day of C tVI ie-I , 2008.
i a.. M . lA_i , . - • .t Notary Public ...,
PI1VL1'k1/U14 j (Printed Name) , j M. wy/Td,
My commission expires: [� 1'� 'QP IOTA, is r'•
J f
I.
* * *
`% % ,off G V. t
-may" B 0 r:
•
N.C.Bar Assoc. Form No. 7 8 1977
Printed by Agreement with the N.C. Bar Assoc. #003

BK913298P 01791
EXHIBIT "A"
TRACT 1:
Property Address: 0 S Judd Parkway, Fuquay Varina, NC
Wake Co. REID#: 0256007
BEING all o f Lot I C, as shown on that map entitled "Subdivision Plat for: Billie M. Veasey,"
and recorded in Book of Maps 1999, page 865, Wake County Registry, reference to which is
hereby made for greater certainty of description.
TRACT 2:
Property Address: 969 S. Judd Parkway, Fuquay Varina, NC
Wake Co. REID#: 02560006
BEING all of Lot IB, containing 7595± square feet (0.174± acres) as shown on that map entitled
"Subdivision Plat for: Billie M. Veasey," and recorded in Book of Maps 1999, page 865, Wake
County Registry, reference to which is hereby made for greater certainty of description.
TRACT 3:
Property Address: 5920 O.C. Hester Road, Holly Springs, NC 27540
Wake Co. REID#: 0127638
BEING all of that tract or parcels of property described in those deeds recorded at Deed Book
8772, page 213 and Deed Book 9253, page 809 in the Wake County Registry, which said deeds
are incorporated herein by reference.

BK013298PG01792
BOOK:013298 PAGE:01789 - 81792
Yellow probate sheet is a vital part of your recorded document.
Please retain with original document and submit for rerecording.
BMW
Wake County Register of Deeds
CoWAKE Laura M. Riddick
Register of Deeds
NORTH URO[INA
This Customer Group This Document
#of Time Stamps Needed New Time Stamp
#of Pagescj
22.004-1/20/06

BK019130PG02234 WAKE COUNTY,NC
TAMMY L.BRUNNER
REGISTER OF DEEDS
PRESENTED&RECORDED ON
08-26-2022 AT 13:43:23
BOOK:019130 PAGE:02234-02238
TEMPORARY CONSTRUCTION EASEMENT AGREEMENT
Prepared by. James S.Adcock 111
Attorney for Town ofFuquay-Varina
Without benefit of title certification or opinion oftitle
Mail to: Town ofFuquae-Marina
134 N Main Street,Fuquay-Marina
Ilkt: Out of 0656939469
STATE OF NORTH CAROLINA
COUNTY OF WAKE
THIS DEED OF EASEMENT AGREEMENT,made this th e/ day of us l,
2022,by and between Capps Development,LLC,a North Carolina limited liability company,with
address of 259 Atkins Road,Fuquay-Varina,NC 27526(hereinafter refer ed to as"Grantor")and the
Town of Fuquay-Varina,a North Carolina municipal corporation,with the address of 134 N Main
Street,Fuquay-Varina,North Carolina 27526(hereinafter referred to as"Grantee").
WITNESSETH:
THAT WHEREAS,the Grantee is a municipal corporation organized and existing pursuant
to the laws of the State of North Carolina;and,
WHEREAS,the Grantor is the owner of a certain tract of land lying and being in Middle
Creek Township,Wake County,North Carolina,the same being the land conveyed to itpursuant to
Deed Book 14621,Page 2559,Wake County Registry;and,
Page l of4
submitted electronically by "cumalander Adcock, LLP"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Wake county Register of Deeds.

TEMPORARY CONSTRUCTION EASEMENT AGREEMENT
Prepared by: James S.Adcock III
Attorney for Town of Fuquay-Marina
Without benefit of title certification or opinion of title
Mail to: Town ofFuquay-Marina
134 NMain Street,Fuquay-Varina
ID#: Out of 0656939469
STATE OF NORTH CAROLINA
COUNTY OF WAKE //ee
THIS DEED OF EASEMENT AGREEMENT, made this thew day of uJ l ,
2022,by and between Capps Development,LLC,a North Carolina limited liability company,with
address of 259 Atkins Road,Fuquay-Varina,NC 27526(hereinafter referred to as"Grantor")and the
Town of Fuquay-Varina,a North Carolina municipal corporation,with the address of 134 N Main
Street, Fuquay-Varina,North Carolina 27526 (hereinafter referred to as "Grantee").
WITNESSETH:
THAT WHEREAS,the Grantee is a municipal corporation organized and existing pursuant
to the laws of the State of North Carolina; and,
WHEREAS, the Grantor is the owner of a certain tract of land lying and being in Middle
Creek Township,Wake County,North Carolina,the same being the land conveyed to it pursuant to
Deed Book 14621, Page 2559,Wake County Registry; and,
Page 1 of 4

WHEREAS, the Grantee is in need of and desires to acquire temporary easements herein
described over and across the land of the Grantor in order that it may perform one of its
governmental functions and in order to make right-of-way improvements; and,
WHEREAS,the Grantor has agreed to convey to the Grantee the temporary easements herein
described.
NOW THEREFORE, FOR AND IN CONSIDERATION of the sum of Ten and no/100
dollars ($10.00) and other good and valuable consideration, receipt and sufficiency of which is
hereby acknowledged,Grantor does hereby grant,bargain,sell,transfer and convey unto Grantee,its
successors and assigns,temporary construction easements, together with the right of ingress,egress
and regress to and from the same and over the adjacent lands of the Grantor, its successors and
assigns, for the purposes aforesaid, and to go over, under, through and across the above described
lands of the Grantor,and said temporary construction easement area is more particularly described as
follows:
Being all of that "Temporary Construction Easement#1 Area—454 Sq. Ft." as
depicted on that map entitled"Temporary Construction Easement For:Town of
Fuquay-Varina Lapp Project HL-0041 S.Judd/S.Main(U.S.401)"and attached
hereto as Exhibit A.
This conveyance is being made subject to all deeds of trust,liens,encumbrances,judgments,
restrictions, and civil proceedings of record.
TO HAVE AND TO HOLD said easements unto Grantee,it being agreed that the easements
are appurtenant to and run with the land for the benefit of the Grantee, its successors and or assigns
as long as the easements are necessary for construction and installation of said right of way
improvements, and it is understood and agreed that upon completion of all construction the
Page 2 of 4

temporary easements shall cease to exist.
The Grantee covenants to maintain the easements in good repair so that no unreasonable
damage will result from their use to the land of the Grantor, its successors and assigns, and will
restore Grantor's land to its original condition to the extent practicable.
The terms and conditions hereof shall be binding upon and inure to the benefit of the heirs,
executors, administrators, devisees, successors, trustees or assigns of the parties hereto.
The singular as used herein shall include the plural and any reference to gender shall include
masculine, feminine and neuter.
IN WITNESS WHEREOF, the Grantor has hereunto set its hand and seal this the day and
year first above written.
{See following page for signatures}
Page 3 of 4

Cap s Development, LLC
(SEAL)
By: Christopher L. apps, Member/Manager
State of PO/A- Ca417.6- r 7�(-
County of MP-4(L
I certify that the following person(s)personally appeared before me this day,each acknowledging to
me that he or she signed the foregoing document: Christopher L. Capps,Member/Manager of Capps
Development,
/LLC.
�,
Date: d 2t7 - oC.(J1-2 ualllui,,,,"
it
4C4j ''''0 TA''''''''02P
z s'''\.4 '9):N1 E , (airs
- �s MY Comm.Ex p to Public
'T
P.
/
x= -2027 _ y commission expires: I
'.,• C/B
, COU''t o`���
Page 4 of 4

JONES RD ARNOLD LN S JUDD PARKWAY SE
i
(VARIABLE WIDTH PUBLIC R/W)
00V)
L1 L2 S 89°05'00"E 197.15'
—� __ _ x 37.13' x 80.01' x ^
S JUDD PKWY SW ING 10' —L8
EXIST �� 80.01
--
UTILITY FASEM N L7 x
L6 L5 1
S JUDD PKWY SE g.0.M.1999,PG2338 -
n1 1 1
TEMPORARY TEMPORARY TEMPORARY I
CONSTRUCTION CONSTRUCTION CONSTRUCTION 1 `V o
VICINITY MAP (NTS) EASEMENT #1 EASEMENT #2 EASEMENT #3 <U'\� I a
AREA - 454 SQ.FT. AREA - 710 SQ.FT. AREA - 887 SQ.FT. 6, I z a_
r.
o 4 in in L6 EN ti 1 ctrn
�r `n �r w mq I z •
w (11;) p
W 14 0 - tic) I
BRYLAND VENTURES LLC ® N 1
D.B.18503, PG.274 - ro�� I �? w
ix
fi B.O.M.2007, PG.1365 o o w l N z
z rn cn
EH o z I
I-1 z W
H
W I VD I
N.
X
W
80.56'
B0.56'
80.56' S g4°50'24'W 241.69'
Course Bearing Distance J&A DEVELOPMENT GROUP LLC LOT 13 OWNER: LOT 14 OWNER:
D.B.16838, PG.1791 CAPPS DEVELOPMENT LLC PIPE DREAM
L1 N 85°24'33" E 9.95' B.O.M.2012, PG.1108 259 ATKINS ROAD INVESTMENTS III LLC
L2 N 85°24'33" E 33.17' FUQUAY-VARINA, N.C. 27526 301 MONTFORD DRIVE
L3 N 27°18'57" W 15.97'
L4 . N 12°42'18" W 19 42' THIS MAP MAY NOT BE A CERTIFIED SURVEY AND LOT 15 OWNER: GARNER, NC 27529
L5 N 89°42'14" W 67.49' HAS NOT BEEN REVIEWED BY A LOCAL GOVERNMENT CHAD W. GASKINS
L6 N 89°42'14" W 80.03' AGENCY FOR COMPLIANCE WITH ANY APPLICABLE
L7 N 89°42'14" W 19 87' LAND DEVELOPMENT REGULATIONS AND HAS NOT 931 S JUDD PKWY SE
L8 N 81°53'27" W 50.56' BEEN REVIEWED FOR COMLIANCE WITH RECORDING FUQUAY—VARINA, N.C. 27526
REQUIREMENTS FOR PLATS.
NOTE: SHOWN IS LOT 13, 14, AND 15 TEMPORARY CONSTRUCTION EASEMENT FOR:
OF THE CALVIN PLACE S/D - PHASE 6
REF: B.O.M. 1999, PG.2338 40 0 40 80 120 TOWN OF FUQUAY- VARINA
MIDDLE CREEK TWSP. , WAKE CO. , N.C. ■■■■■■■■■■ LAPP PROJECT HL-0041
SCALE 1 " = 40' MAY 24, 2022 GRAPHIC SCALE - FEET S. JUDD/S. MAIN (U.S.4 01)

BK014621PG02559
N
WAKE COUNTY, NC 63
LAURA M RIDDICK
REGISTER OF DEEDS
PRESENTED 8 RECORDED ON
01/25/2012 AT 10:07:23
STATE OF NORTH CAROLINA
REAL ESTATE EXCISE TAX: $170
BOOK:014621 PAGE:02559 - 02562
STATE OF NORTH CAROLINA GENERAL WARRANTY DEED
COUNTY OF WAKE
Excise Tax: $ ?o°"�
Parcel ID Number: 0272404
Prepared By & Mail to: Pope & Pope, Attorneys at Law, P.A.
PO Box 790, Angier, NC 27501
File No: 12 . 004
THIS DEED made this day of January, 2012, by and between
GRANTOR GRANTEE
Robert H. Crabtree and wife, Capps Development, LLC
Josephine 0. Crabtree 259 Atkins Road
5528 Stickleback Drive Fuquay-Varina, NC 27526
Fuquay-Varina, NC 27526
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.
WITNESSET H:
THAT said Grantor, for and in consideration of the sum of TEN and
no/hundredths DOLLARS ($10 . 00) and other good and valuable
considerations, receipt of which is hereby acknowledged, has given,
granted, bargained, sold, and conveyed, and by these presents does
hereby give, grant, bargain, sell, and convey unto said Grantee, its
heirs, successors, administrators, and assigns forever, all of that
Page 1 of 3 Pages
Pope & Pope, Attorneys at Law, P.A.

BK014621PG02660
•
• certain piece, parcel, or tract of land situate, lying, and being in
Middle Creek Township of said County and State, and more particularly
described as follows :
BEING all of Lot 13 of Calvin Place Subdivision, said lot
containing 12 ,329 sq. ft. , more or less, as shown upon that map
entitled, "Lot Recombination Survey For: Gary Matthews Builders"
prepared by Stancil & Associates, Professional Land Surveyor, P.A. ,
dated 08-27-04 and recorded in Book of Maps 2004, Page 1625, Wake
• County Registry, reference to which map is hereby made for greater
certainty of description.
The above-described lot is the greater portion of that lot conveyed
by Edythe W. Holleman to Robert H. Crabtree and wife, Josephine 0.
Crabtree by deed dated April 25, 2000 and recorded in Book 8569,
Page 1172 , Wake County Registry. For further reference, see Deed
from Robert H. Crabtree and wife, Josephine 0. Crabtree to
Christopher B. Wrenn dated August 9, 2005 and recorded in Book
11624, Page 2307, Wake County Registry.
Pursuant to NCGS §105-317 . 2 the Grantor herein acknowledges that
the real property conveyed herein ❑ does / ® does not include the
primary residence of the grantor.
The herein described lands are conveyed to and accepted by the
Grantees subject to all other easements, rights-of-way and
restrictions shown on said map and listed on the public record.
This conveyance is expressly made subject to the lien created by
Grantor' s real 2012, Wake County ad valorem taxes .
TO HAVE AND TO HOLD the above-described lands and premises, together
with all appurtenances thereunto belonging, or in any wise
appertaining, unto the Grantee, its heirs, successors, administrators,
and assigns forever, but subject, however, to the limitations set out
above.
AND the said Grantor covenants to and with said Grantees, its heirs,
successors, administrators, and assigns that it is lawfully seized in
fee simple of said lands and premises, and has full right and power to
convey all said interest in the same to the Grantee (but subject,
however, to the limitations set out above) and that said lands and
premises are free from any and all encumbrances, except as set forth
above, and that it will (and its heirs, successors, administrators,
and assigns shall) forever warrant and defend the title to the same
lands and premises, together with the appurtenances thereunto
appertaining, unto the Grantee, its heirs, successors, administrators,
and assigns against the lawful claims of all persons whomsoever.
Page 2 of 3 Pages
Pope & Pope, Attorneys at Law, P.A.

BK414621PG42661
•
• IN WITNESS WHEREOF, the Grantors have hereunto set their hand and seal
and do adopt the printed word "SEAL" beside their name as their lawful
seal as of the day and year first above written.
(Seal)
d
Robert H. Crabtree
(Seal)
Josephine 0. Crabtree
STATE OF NORTH CAROLINA
COUNTY OF HARNETT
I 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 for the purpose stated therein and in the
capacity indicated: Robert H. Crabtree and Josephine O. Crabtree
Date: January , 2012 .
0111110
kasillAJO. N/fQ4U4uft-ti)-
(Offi .�L_'�; Notary Public
Ci WARY.
005-
LPUBUC
. • �\ te-i6ra. S,'vn a,oms
NN���n�\\\\ Notary' s Printed or Typed Name
My commission expires : ao1ci4
Page 3 of 3 Pages
Pope & Pope, Attorneys at Law, P.A.

BK414621PG42562
\MIN
BOOK:014621 PAGE:02559 - 02562
Yellow probate sheet is a vital part of your recorded document.
Please retain with original document and submit for rerecording.
1111,111
Wake County Register of Deeds
Laura M. Riddick
COUNTY Register of Deeds
NVFTH CAROLINA
This Customer Group This Docume
#of Time Stamps Needed New Time Stamp
#of Pages
zzaaw-vzaob

BK019130PG02188 WAKE COUNTY,NC
TAMMY L.BRUNNER
REGISTER OF DEEDS
PRESENTED&RECORDED ON
08-26-2022 AT 13:37:13
BOOK:019130 PAGE:02188-02192
TEMPORARY CONSTRUCTION EASEMENT AGREEMENT
Prepared by: James S.Adcock III '..
Attorney for Town of Fuquay-Variva
Without benefit of title certification or opinion of title
Mail to: Town ofFuquay-Marina
134 NMain Street.Fuquap-Marina
ID#: Out of 0666030560
STATE OF NORTH CAROLINA
COUNTY OF WAKE
THIS DEED OF EASEMENT AGREEMENT,made this the)6 r14 day of AU6UST
2022,by and between Pipe Bream HI Investments,LLC of 301 Montford Drive,Gamer NC
27529(hereinafter referred to as"Grantor")and the Town of Fuquay-Varina,a North Carolina
municipal corporation,with the address of 134 N Main Street,Fuquay-Varina,North Carolina 27526
(hereinafter referred to as"Grantee").
WITNESSETH:
THAT WHEREAS,the Grantee is a municipal corporation organized and existing pursuant
to the laws of the State of North Carolina;and,
WHEREAS;the Grantor is the owner of a certain tract of land lying and being in Middle
Creek Township,Wake County,North Carolina,the same being the land conveyed to it pursuant to
Deed Book 19038,Page 1953,Wake County Registry;and,
Pagel of4
submitted electronically by "cumalander Adcock, LLP"
in compliance with North carolina statutes governing recordable documents
and the terms of the submitter agreement with the Wake county Register of Deeds.

TEMPORARY CONSTRUCTION EASEMENT AGREEMENT
Prepared by: James S.Adcock III
Attorney for Town of Fuquay-Marina
Without benefit of title certification or opinion of title
Mail to: Town ofFuquay-Marina
134 NMain Street,Fuquay-Varina
ID#: Out of 0666030560
STATE OF NORTH CAROLINA
COUNTY OF WAKE
THIS DEED OF EASEMENT AGREEMENT, made this the,2 6 TH day of AUGUST ,
2022, by and between Pipe Dream III Investments, LLC of 301 Montford Drive, Garner NC
27529 (hereinafter referred to as "Grantor") and the Town of Fuquay-Varina, a North Carolina
municipal corporation,with the address of 134 N Main Street,Fuquay-Varina,North Carolina 27526
(hereinafter referred to as "Grantee").
WITNES SETH:
THAT WHEREAS,the Grantee is a municipal corporation organized and existing pursuant
to the laws of the State of North Carolina; and,
WHEREAS, the Grantor is the owner of a certain tract of land lying and being in Middle
Creek Township,Wake County,North Carolina,the same being the land conveyed to it pursuant to
Deed Book 19038,Page 1953,Wake County Registry; and,
Page 1 of 4

WHEREAS, the Grantee is in need of and desires to acquire temporary easements herein
described over and across the land of the Grantor in order that it may perform one of its
governmental functions and in order to make right-of-way improvements; and,
WHEREAS,the Grantor has agreed to convey to the Grantee the temporary easements herein
described.
NOW THEREFORE, FOR AND IN CONSIDERATION of the sum of Ten and no/100
dollars ($10.00) and other good and valuable consideration, receipt and sufficiency of which is
hereby acknowledged,Grantor does hereby grant,bargain,sell,transfer and convey unto Grantee,its
successors and assigns,temporary construction easements, together with the right of ingress,egress
and regress to and from the same and over the adjacent lands of the Grantor, its successors and
assigns, for the purposes aforesaid, and to go over, under, through and across the above described
lands of the Grantor,and said temporary construction easement area is more particularly described as
follows:
Being all of that "Temporary Construction Easement#2 Area—710 Sq. Ft." as
depicted on that map entitled"Temporary Construction Easement For: Town of
Fuquay-Varina Lapp Project HL-0041 S.Judd/S.Main(U.S.401)"and attached
hereto as Exhibit A.
This conveyance is being made subject to all deeds of trust,liens,encumbrances,judgments,
restrictions, and civil proceedings of record.
TO HAVE AND TO HOLD said easements unto Grantee,it being agreed that the easements
are appurtenant to and run with the land for the benefit of the Grantee, its successors and or assigns
as long as the easements are necessary for construction and installation of said right of way
improvements, and it is understood and agreed that upon completion of all construction the
Page2of4

temporary easements shall cease to exist.
The Grantee covenants to maintain the easements in good repair so that no unreasonable
damage will result from their use to the land of the Grantor, its successors and assigns, and will
restore Grantor's land to its original condition to the extent practicable.
The terms and conditions hereof shall be binding upon and inure to the benefit of the heirs,
executors, administrators, devisees, successors, trustees or assigns of the parties hereto.
The singular as used herein shall include the plural and any reference to gender shall include
masculine, feminine and neuter.
IN WITNESS WHEREOF, the Grantor has hereunto set its hand and seal this the day and
year first above written.
{See following page for signatures}
Page 3 of 4

I-PE DREAM I ON ‘I4ENT , C
B : (SEAL)
Name: Debra it o
Title: President
State of No h C C Occ,
County of
I certify that the following person(s)personally appeared before me this day,each acknowledging to
me that he or she signed the foregoing document: Debra Dillo in her capacity as President of Pipe
Dream III Investments,, LLC
Date: 8—
�`��w4;••'°�OT'�9 T Notary Public •
�rn
• .
My27
Comm.Exp
Page 4 of 4

JONES RD ARNOLD LN S JUDD PARKWAY SE
i
(VARIABLE WIDTH PUBLIC R/W)
00V)
L1 L2 S 89°05'00"E 197.15'
—� __ _ x 37.13' x 80.01' x ^
S JUDD PKWY SW ING 10' —L8
EXIST �� 80.01
--
UTILITY FASEM N L7 x
L6 L5 1
S JUDD PKWY SE g.0.M.1999,PG2338 -
n1 1 1
TEMPORARY TEMPORARY TEMPORARY I
CONSTRUCTION CONSTRUCTION CONSTRUCTION 1 `V o
VICINITY MAP (NTS) EASEMENT #1 EASEMENT #2 EASEMENT #3 <U'\� I a
AREA - 454 SQ.FT. AREA - 710 SQ.FT. AREA - 887 SQ.FT. 6, I z a_
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o 4 in in L6 EN ti 1 ctrn
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BRYLAND VENTURES LLC ® N 1
D.B.18503, PG.274 - ro�� I �? w
ix
fi B.O.M.2007, PG.1365 o o w l N z
z rn cn
EH o z I
I-1 z W
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80.56'
B0.56'
80.56' S g4°50'24'W 241.69'
Course Bearing Distance J&A DEVELOPMENT GROUP LLC LOT 13 OWNER: LOT 14 OWNER:
D.B.16838, PG.1791 CAPPS DEVELOPMENT LLC PIPE DREAM
L1 N 85°24'33" E 9.95' B.O.M.2012, PG.1108 259 ATKINS ROAD INVESTMENTS III LLC
L2 N 85°24'33" E 33.17' FUQUAY-VARINA, N.C. 27526 301 MONTFORD DRIVE
L3 N 27°18'57" W 15.97'
L4 . N 12°42'18" W 19 42' THIS MAP MAY NOT BE A CERTIFIED SURVEY AND LOT 15 OWNER: GARNER, NC 27529
L5 N 89°42'14" W 67.49' HAS NOT BEEN REVIEWED BY A LOCAL GOVERNMENT CHAD W. GASKINS
L6 N 89°42'14" W 80.03' AGENCY FOR COMPLIANCE WITH ANY APPLICABLE
L7 N 89°42'14" W 19 87' LAND DEVELOPMENT REGULATIONS AND HAS NOT 931 S JUDD PKWY SE
L8 N 81°53'27" W 50.56' BEEN REVIEWED FOR COMLIANCE WITH RECORDING FUQUAY—VARINA, N.C. 27526
REQUIREMENTS FOR PLATS.
NOTE: SHOWN IS LOT 13, 14, AND 15 TEMPORARY CONSTRUCTION EASEMENT FOR:
OF THE CALVIN PLACE S/D - PHASE 6
REF: B.O.M. 1999, PG.2338 40 0 40 80 120 TOWN OF FUQUAY- VARINA
MIDDLE CREEK TWSP. , WAKE CO. , N.C. ■■■■■■■■■■ LAPP PROJECT HL-0041
SCALE 1 " = 40' MAY 24, 2022 GRAPHIC SCALE - FEET S. JUDD/S. MAIN (U.S.4 01)

BK019038PG01953 WAKE COUNTY, NC
TAMMY L. BRUNNER
REGISTER OF DEEDS
PRESENTED & RECORDED ON
05-26-2022 AT 12:36:13
STATE OF NC REAL ESTATE
EXCISE TAX: $550.00
BOOK: 019038 PAGE: 01953 - 01954
STATE OF NORTH CAROLINA GENERAL
COUNTY OF WAKE WARRANTY DEED
Excise Tax: $550.00
REID: 0272405
Prepared by: Mercogliano&Associates, PA,P.O. Box 1381,Fuquay-Varina,NC 27526
Mail to: Grantee
THIS DEED made this 25'' day of May, 2022 by and between
GRANTOR GRANTEE
Peggy C. Johnson, Divorced Pipe Dream III Investments, LLC
137 Beacon Woods Drive 301 Montford Drive
Holly Ridge, NC 28445 Garner, NC 27529
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 more particularly described as follows:
Being all of Lot 14 of Calvin Place Subdivision, Phase 6, as shown in Book of Maps 1999, Page 2338,
Wake County Registry.
Subject to all easements, rights of way,protective covenants, and other matters of public record.
Subject to 2022 Ad Valorem taxes.
All or a portion of the property hereinabove described was acquired by Grantor by instrument recorded in
Book 17477, Page 1566, Wake County Registry.
TO HAVE AND TO HOLD the above-described lot or parcel of land and all privileges and appurtenances thereto
belonging to the Grantee in fee simple.
submitted electronically by "Mercogliano & Associates, PA"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the wake County Register of Deeds.

BK019038PG01954
AND the Grantor covenants with the Grantee, that Grantor is lawfully seized of the premises in fee simple, has the
right and power to convey the same in fee simple, that title is marketable and free from any and all encumbrances
and that Grantor will forever warrant and defend the title against the lawful claims of all persons whomsoever.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written.
j . � (SEAL)
eggy C. on
STATE OF NORTH CAROLINA
COUNTY OF WAKE
I, Kathy A. Mercogliano, a Notary Public of Harnett County, North
Carolina, certify that Peggy C. Johnson, personally appeared before me
this day and acknowledged the due execution of the foregoing instrument.
WITNESS my hand and notarial stamp or seal this 25'''day of
May, 2022.
Kath A. Merco liano,N tary Publ.c
My Co tmission Ex es: August 30, 2025
KATHY A. MERCOGLIANO I
NOTARY PUBLIC
HARNETT COUNTY
NORTH CAROLINA

BK019190PG00333 WAKE COUNTY, NC
TAMMY L. BRUNNER
REGISTER OF DEEDS
PRESENTED & RECORDED ON
11-02-2022 AT 15:24:42
BOOK: 019190 PAGE: 00333 - 00337
Prepared by/Return to:James S.Adcock III
James S.Adcock III,PA(Attorneys for the Town of Fuquay-Varina)
P.O.Box 1055,Fuquay-Varina,NC 27526
NORTH CAROLINA IN THE GENERAL COURT OF JUSTICE
SUPERIOR COURT DIVISION
22 CVS 0,$-
WAKE COUNTY
Town of Fuquay-Varina, )
)
Plaintiff, )
) MEMORANDUM OF ACTION
v )
)
Chad W. Gaskins and )
Bank of America Corporation, )
)
Defendants. )
TA E NOTICE:
1. That on the , , day of evtyil,l+. , 2022, the Town of Fuquay-Varina, under
the provisions of Section 4-1 of the Charter of the Town of Fuquay-Varina and Article 9, Chapter
136 of the General Statutes, instituted the above-captioned civil action in the Superior Court of
Wake County by the filing of a Complaint and Declaration of Taking and by the issuance of
summonses; that pursuant to G.S. 136-104, the interests in the areas specified in said Complaint
and Declaration of Taking vested in the Town of Fuquay-Varina on said date.
submitted electronically by "Cumalander Adcock, LLP"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the wake County Register of Deeds.

BK019190PG00334
2. That the above-named Defendants are the persons who the Town of Fuquay-Varina
is informed and believes may have or claim to have an interest in said lands and who are parties to
the above action.
3. That the tract or tracts of land affected by the said taking are described as follows:
Those certain lands lying and being in Middle Creek Township,Wake County,North Carolina and
being more particularly described as follows:
BEING all of Lot 15,Phase 6, Calvin Place Subdivision,as shown on plat recorded
in Book of Maps 1999, Page 2338, Wake County Registry.
These lands are designated as PIN# 0666031541 by the Wake County Revenue Department.
4. The property which is subject of this action, the interest or estate acquired and the
areas appropriated are all described in Exhibit B. Exhibit A is intentionally omitted from this
instrument.
This is the 2 day of , 2022.
JAMES S. ADCOCK- P
By: _
James S. A o I
N.C.S.B. 0. 44161
Attorney for Plaintiff
P.O. Box 1055
Fuquay-Varina, NC 27526
Tel: [phone]
Fax: [phone]
2

BK019190PG00335
EXHIBIT B
DESCRIPTION OF SUBJECT PROPERTY AFFECTED BY THIS ACTION:
Those certain lands lying and being in Middle Creek Township, Wake County,North Carolina and
being more particularly described as follows:
BEING all of Lot 15,Phase 6, Calvin Place Subdivision, as shown on plat recorded
in Book of Maps 1999, Page 2338, Wake County Registry.
These lands are designated as PIN# 0666031541 by the Wake County Revenue Department.
INTEREST OR ESTATE AND AREA TAKEN:
TEMPORARY CONSTRUCTION EASEMENT(S):
BEING all of that area depicted as "Temporary Construction Easement #3",
containing 887 square feet, as shown on that survey entitled "Temporary Construction
Easement For: Town of Fuquay-Varina," prepared by Mauldin-Watkins Surveying, P.A.,
dated May 24,2022,bearing Project Number HL-0041,which is attached hereto as Exhibit
B-1, and incorporated herein by reference for greater certainty of description.
The Town shall have the right to construct and maintain the cut and/or fill slopes in
the above-described temporary easement area(s) until such time that the property owners
alter the adjacent lands in such a manner that the cut and/or fill slopes are no longer needed
for the lateral support of the roadway. Any additional construction areas lying beyond the
cut and/or fill slopes and extending beyond the right of way limits and beyond any
permanent easement areas will terminate upon completion and acceptance of the project.
The underlying fee owner shall have the right to continue to use the Temporary Easement

BK019190PG00336
area(s) in arty manner and for any purpose, including but not limited to the use of said area
for access, ingress, egress, and parking, that does not, in the determination of the Town,
obstruct or materially impair the actual use of the easement area(s)by the Town,its agents,
assigns, and contractors.

BK019190PG00337
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N
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THIS MAP MAY NOT BE A CERTIFIED SURVEY AND HAS NOT BEEN REVIEWED
BY A LOCAL GOVERNMENT AGENCY FOR COMPLIANCE WITH ANY APPLICABLE
LAND DEVELOPMENT REGULATIONS AND HAS NOT BEEN REVIEWED FOR
COMPLIANCE WITH RECORDING REQUIREMENTS FOR PLATS

BK012153PG01060
WAKE COUNTY, NC 592
LAURA M RIDDICK
REGISTER OF DEEDS
PRESENTED 8 RECORDED ON
09/05/200G AT 13:25:18
STATE OF NORTH CAROLINA
REAL ESTATE EXCISE TAX: $250
BOOK:012153 PAGE:01060 — 01062
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $250.00
Parcel Identifier No.0272406 _ Verified by County on the day of ,20_
By:
Mail/Box to: Grantee _
This instrument was prepared by:Janak Law Firm,PA, 7404-D Chapel Hill Road,Raleigh,NC 27607
Brief description for the Index:
THIS DEED made this 31 st day of August ,20 06,by and between
GRANTOR GRANTEE
Charles Brantley Barnes and wife, Chad W.Gaskins
Connie L. Barnes 931 S.Judd Parkway
Fuquay-Varina,NC 27526
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 City of Fuquay-Varina , Middle Creek Township, Wake County,North Carolina and
more particularly described as follows:
BEING all of Lot 15,Phase 6,Calvin Place Subdivision,as shown on plat recorded in Book of Maps 1999,Page 2338, Wake
County Registry.
The property hereinabove described was acquired by Grantor by instrument recorded in Book 8754 page 1602
A map showing the above described property is recorded in Plat Book 1999 page 2338
NC Bar Association Form No.L-3© 1976,Revised© 1977,2002
Printed by Agreement with the NC Bar Association—1981 SoftPro Corporation,333 E.Six Forks Rd.,Raleigh,NC 27609

BK012153PG01061
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,other than the following exceptions: Easements,restrictions and covenants on
record. 2006 ad valorem taxes.
IN WITNESS WHEREOF,the Grantor has duly executed the forego' gas f the day and e first above written
(Entity Name) Charles Brantley Barnes
By: dAt414‘ /eaAint&-- (SEAL)
Title: Connie I.. Barnes
By: (SEAL)
Title:
By: (SEAL)
Title:
State of North Carolina-County of Wake
I, the undersigned Notary Public of the County and State aforesaid,certify that Charles Brantley Barnes and wife,
Connie L.Barnes personally appeared before me this day and
acknowledged the due execution of the foregoing instrument for the purposes therein expressed. Witness my hand and Notarial
stamp or seal this 31st 'day of August ,20 06 _
My Commission Expires: •
MONICA S.SMITH Notary Public
NOTARY PUBLIC
Wake County
State of North Carolina-County of North Carolina
I,the undersigned Notary Pi lay ist iaori t Setpta7d,2@1ty that
personally came before me this day and acknowledged that_he is the _ of
, a North Carolina or
corporation/limited liability company/general partnership/limited partnership(strike through the inapplicable),and
that by authority duly given and as the act of such entity,_he signed the foregoing instrument in its name on its behalf as its act and
deed. Witness my hand and Notarial stamp or seal,this day of ,20_.
My Commission Expires:
Notary Public
State of North Carolina-County of
I,the undersigned Notary Public of the County and State aforesaid,certify that
Witness my hand and Notarial stamp or seal,this day of ,20`.
My Commission Expires:
Notary Public
The foregoing Certificate(s)of
is/are certified to be correct This instrument and this certificate arc duly registered at the date and time and in the Book and Page shown
on the first page hereof.
Register of Deeds for County
By: Deputy/Assistant-Register of Deeds
NC Bar Association Form No.L-3© 1976,Revised© 1977,2002
Printed by Agreement with the NC Bar Association— 1981 SoftPro Corporation,333 E. Six Forks Rd.,Raleigh,NC 27609

BK012153PG01062
It glum
BOOK:012153 PAGE:01060 - 01062
Yellow probate sheet is a vital part of your recorded document.
Please retain with original document and submit for rerecording.
Wake County Register of Deeds
�� Laura M. Riddick
COUNTY Register of Deeds
NO.7TN CAAOI[NA
This Customer Group This Document
#of Time Stamps Needed New Time Stamp
3 #of Pages
22.004-1/2O/06