NCC232368_FRO Submitted_20230808

For TOWF Use Only Application #:
Project Name:
Date Received: Acres:
Date Approved: Fees Paid:
•- • - __ TOWN o
- ; f
WAKE FOREST
4
LAND DISTURBING (E&SC)
PERMIT APPLICATION, PLAN CHECKLIST, &
FINANCIALLY RESPONSIBLE OWNER (FRO) FORM
NO PERSON MAY INITIATE ANY LAND-DISTURBING ACTIVITY ON 1/2 ACRE OR MORE BEFORE THESE FORMS, FEES,AND AN
EROSION AND SEDIMENTATION CONTROL PLAN SEALED BY A NORTH CAROLINA REGISTERED PROFESSIONAL ENGINEER OR
LANDSCAPE ARCHITECT HAVE BEEN COMPLETED AND APPROVED BY THE TOWN OF WAKE FOREST. MULTIPLE SINGLE
FAMILY LOTS THAT DISTURB MORE THAN 1/2 ACRE ALSO REQUIRE A PERMIT AND SHALL FOLLOW THE STANDARD
PROCEDURES OUTLINED BELOW. SEE THE UNIFIED DEVELOPMENT ORDINANCE FOR ADDITIONAL INFORMATION AND FULL
ORDINANCE REGULATIONS.
NOTE: THE APPLICATION FEE OF$500.00 PER ACRE(ROUNDED UP TO THE NEXT ACRE I.E.:1.1 ACRES = 2 ACRES*
$500=$1,000)IS DUE AT TIME OF SUBMITTAL. IF FEES ARE NOT SUBMITTED THE PLAN WILL AUTOMATICALLY BE
DISAPPROVED.
DISCLAIMER:TOWN OF WAKE FOREST FEES AND CHARGES ARE SUBJECT TO CHANGE WITHOUT NOTICE.
PLEASE CALL 919-435-9443 TO CONFIRM CURRENT FEES AND CHARGES.
PART A: PROJECT INFORMATION
PROJECT NAME Grove 98 Northeast Quadrant Lot 4
1. TAX PIN NUMBER 1830875268
2. ZONING PUD RZ-18-15
3. LOCATION/ADDRESS OF TRACT 11136 Ligon Mill RD Wake Forest, NC 27587

4. SUBDIVISION N/A LOT# 4
5. DEED BOOK 019363 PAGE 02326
*PLEASE PROVIDE A COPY OF THE MOST CURRENT DEED
6. PURPOSE OF DEVELOPMENT Mixed Use
7. TOTAL NUMBER OF UNITS 1
8. PERCENT IMPERVIOUS SURFACE 7 7 • 7
9. TOTAL TRACT ACREAGE: 2 . 36
10. TOTAL ACREAGE DISTURBED(INCLUDING OFF-SITE UTILITIES AND ROADWORK): 2 . 42
11. AMOUNT OF FEE ENCLOSED:
ROUNDED UP ACREAGE 3 * $5OO/ACRE = $ 1, 500
CHECK NUMBER
DATE PAID
DISCLAIMER:Town of Wake Forest fees and charges are subject to change without notice.Please call 919-435-
9443 to confirm current fees and charges.
12. PROPERTY OWNER(S) (PROVIDE LIST OF ADDITIONAL PROPERTY OWNERS ON AN ATTACHED SHEET):
NAME WB Fitness Wake Forest LLC E-MAIL cwilson@wilsonblount . com
ADDRESS 2626 Glenwood Ave, Ste 350 Raleigh NC 27608
PHONE (919) 65 9-32 93 CELL
13. PERSON TO CONTACT SHOULD EROSION AND SEDIMENT CONTROL ISSUES ARISE DURING LAND-DISTURBING ACTIVITY:
NAME Taylor Hollingshead E-MAIL [e-mail]
ADDRESS 418 South Dawson St. Raleigh, NC 27601
PHONE [phone] CELL

Jordan Petersen
14. PLANS PREPARED BY
ADDRESS 418 South Dawson St . Raleigh, NC 27601
EMAIL [e-mail]
PHONE [phone] CELL
15. DOCUMENTS SUBMITTED (SUBMITTER TO PLACE A CHECK MARK IN THE BOX):
FEES ($500 per acre rounded up, due upon 1" review) X
FINANCIAL RESPONSIBILITY OWNER FORM X
COMPLETED PLAN CHECKLIST X
PLANS (to be submitted with construction set) X
E&SC CALCULATIONS (1 copy) X
STORM WATER CALCULATIONS (1 copy) X
MAINTENANCE AND OPERATION AGREEMENT X
NCDOT Encroachment/Driveway Permit n/a
DWQ 401 Permit
USACOE 404 Permit
NCG010000 Permit COC
EROSION & SEDIMENT CONTROL SURETY
APPROXIMATE DATE LAND-DISTURBING ACTIVITY WILL COMMENCE: 11/01/2022
THE SOIL EROSION AND SEDIMENTATION CONTROL PLAN, supporting documents, maps and
computations submitted for the above tract conform to the requirements of all applicable
sections of the Town of Wake Forest Erosion & Sedimentation Control Ordinance outlined in
the UDO.
Senior Project Manager 12/8/2021
SJNATURE TITLE DATE

PART B. FINANCIALLY RESPONSIBLE OWNER(FRO)/PERSONS INFORMATION
1. PERSON(S)OR FIRMS WHO ARE FINANCIALLY RESPONSIBLE FOR THE LAND-DISTURBING ACTIVITY(PROVIDE A
COMPREHENSIVE LIST OF ALL RESPONSIBLE PARTIES ON AN ATTACHED SHEET):
WB Fitness Wake Forest LLC cwilson@wilsonblount . com
NAME EMAIL
2626 Glenwood Ave, Ste 350
ADDRESS
Raleigh NC 27608
CITY STATE ZIP CODE
(919) 659-3293
PHONE CELL
2. IF THE FINANCIALLY RESPONSIBLE PARTY IS NOT A RESIDENT OF NORTH CAROLINA,GIVE NAME AND STREET ADDRESS OF
THE DESIGNATED NORTH CAROLINA AGENT:
X
NAME EMAIL
ADDRESS
CITY STATE ZIP CODE
PHONE CELL
IF THE FINANCIALLY RESPONSIBLE PARTY IS A PARTNERSHIP OR OTHER PERSON ENGAGING IN BUSINESS UNDER AN
ASSUMED NAME,ATTACH A COPY OF THE CERTIFICATE OF ASSUMED NAME. IF THE FINANCIALLY
RESPONSIBLE PARTY IS A CORPORATION, GIVE NAME AND STREET ADDRESS OF THE REGISTERED AGENT:
NAME OF REGISTERED AGENT E-MAIL ADDRESS
ADDRESS
CITY STATE ZIP

PHONE FAX
The above information is true and correct to the best of my knowledge and belief and was
provided by me under oath (This form must be signed by the Financially Responsible Person if an
individual or his attorney-in-fact, or if not an individual, by an officer, director, partner, or
registered agent with the authority to execute instruments for the Financially Responsible
Person). I agree to provide corrected information should there be any change in the information
provided herein.
Charles Wilson Manager
NAME TITLE OR AUTHORITY
.0) e/eq
SIGNATURE DATE
I, R C lougk , a Notary Public of the County of
GJoce_ , State of North Carolina, hereby certify that
C liv4Aes 1s©v\ appeared personally before me this day and being
duly sworn acknowledged that the above form was executed by him.
Witness my hand and notarial seal, this day of ,,sk , 20 c3
Notar _ ;� `�4� ti-
140TARy Ni
A1/B L I G
My commission expires fola3la'i -,'9 bey 2-14-
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y f, ti
t; R TOWN of
WAKE FOREST
LAND DISTURBING (E&SC) PERMIT PLAN SUBMITTAL CHECKLIST
(SUBMITTER TO PLACE A CHECK MARK NEXT TO EACH ITEM)
X L LOCATION/VICINITY MAP
X 2
EXISTING AND PROPOSED COUNTOURS, INCLUDING OFFSITE
X 3• CLEARLY DELINEATED BOUNDARIES OF LAND DISTURBANCE WITH ACREAGE
X 4. SOILS AREA MAP
X 5. DRAINAGE AREA MAP
X 6. EXISTING UTILITY EASEMENTS,STORM DRAINAGE, BASINS, LEVEL SPREADERS
X 7. EXISTING LOT LINES, LOT NUMBERS,SURROUNDING PROPERTY OWNERS
X 8, STREAM CENTERLINES,STREAM BUFFERS,WETLANDS, FLOODPLAINS
X 9 TEMPORARY EROSION CONTROLS TO BE SHOWN ON PLANS:
X 1. EROSION CONTROL CALCULATIONS(SEDIMENT BASIN,SEDIMENT TRAP,
SKIMMER, DITCH, ETC...)
X 2. SKIMMER BASINS REQUIRED FOR DRAINAGE AREA OVER 5 ACRES
x 3. IF PAM IS TO BE USED ONSITE FOR ANY APPLICATIONS, CALCULATIONS FOR
APPLICATION RATES AND SPECIFICATIONS MUST BE SHOWN. IN ADDITION,
SOIL TESTS MUST BE TAKEN TO DETERMINE CORRECT SOIL CHARGE AND
PRODUCT TYPE PRIOR TO USE.
X 4. CONSTRUCTION ENTRANCE 50 FOOT MINIMUM WITH WOVEN 20#
TENSILE STRENGTH FABRIC UNDERNEATH
X 5. SILT FENCE-METAL POSTS WITH WIRE SPACED AT 6 FEET
X 6. HARDWARE CLOTH OUTLETS(SPECIAL SEDIMENT CONTROL FENCE)
X 7. TREE PROTETION FENCE WITH "DO NOT ENTER TREE PROTECTION AREA"
SIGN IN ENGLISH AND SPANISH
i. REQUIRED AROUND PERIMETER OF
PROPERTY

ii. REQUIRED AT BUFFER ZONES
iii. REQUIRED IN TREE SAVE AREAS(AROUND
DRIP LINE)
X 8. DIVERSION DITCHES
X 9. INLET PROTECTION
X 10. EROSION
X 11. PERMANENT EROSION/STORMWATER CONTROLS
i. STORMWATER CALCULATIONS,Q PRE,Q POST,%
IMPERVIOUS
ii. PROPOSED STORM WATER EASEMENTS(RECORDED)
iii. MAINTENANCE AND OPERATION AGREEMENT
iv. PROFESSIOANLLY SURVEYED AND ENGINEER STAMPED AS-
BUILTS OF STORM WATER PONDS/BIO CELLS, LEVEL
SPREADERS,STORM DRAINAGE INVERTS,TOPS, GRATES,
SLOPES, LENGTH,SIZE, ETC...
v. PERMANENT DITCHES WITH MATTING
X 10. EROSION PERMIT NOTES: (please add to plans)
1. A LAND DISTURBING (E&SC) PERMIT IS REQUIRED FOR PROJECTS OVER 0.50
ACRE.
IF MULTIPLE LOTS WITH LAND DISTURBANCE OVER 0.50 ACRE TOTAL ARE
EITHER CONTIGUOUS OR NON-CONTIGUOUS IN THE SAME SUBDIVISION, BY
THE SAME BUILDER/OWNER,A LAND DISTURBING PERMIT IS REQUIRED.
THE COST OF THE PLAN REVIEW AND PERMIT IS$500/ACRE ROUNDED UP(1.1
ACRES=2 ACRES @ $500/ACRE=$1,000).THE FEE IS DUE AT TIME OF PLAN
SUBMITTAL. DEVELOPER IS RESPONSIBLE FOR INFORMING BUILDER OF E&SC
PERMIT REQUIREMENTS ON INDIVIDUAL LOTS.
DISCLAIMER:Town of Wake Forest fees and charges are subject to change
without notice. Please call 919-435-9443 to confirm current fees and charges.
2. IF ADDITIONAL ACREAGE IS ADDED TO AN EXISTING PERMIT REVISED FORMS,
PLANS,AND ANY ADDITIONAL FEES MUST BE SUBMITTED.
3. IF OWNERSHIP OF A PROPERTY HAS CHANGED A REVISED FRO MUST BE
SUBMITTED.
4. IF A PROPERTY IS TAKEN OVER BY THE BANK,THE BANK SHALL CONTACT THE
TOWN AND REPAIR ALL EROSION CONTROL MEASURES TO TOWN/NCDENR
STANDARDS.THEY SHALL ALSO SUBMIT A NEW FRO FORM.
5. IF A PROJECT IS NOT COMPLETE WITHIN TWO YEARS,THE PLANS MUST BE
RENEWED AT$250/ACRE.A REVISED SET OF PLANS MAY BE SUBMITTED IF
ACREAGE HAS ALREADY BEEN DEVELOPED AND A CERTIFICATE OF OCCUPANY
HAS BEEN ISSUED.

6. AN EROSION PRECONSTRUCTION MEETING MUST BE HELD WITH THE TOWN OF
WAKE FOREST PRIOR TO START OF ANY WORK, INCLUDING INSTALLATION OF
EROSION CONTROL MEASURES, DEMOLITION, CUTTING TREES,AND
GRUBBING.
CALL ENGINEERING AT(919)435-9443 TO SET UP A MEETING.ALL PLANS MUST
BE SIGNED AND COPIES RETURNED TO THE TOWN 1 WEEK PRIOR TO
PRECONSTRUCTION MEETING.
7. THE OWNER,GENERAL CONTRACTOR, GRADING COMPANY,AND EROSION
CONTROL INSTALLER MSUT BE PRESENT AT THE PRECONSTRUCITON MEETING.
8. THE E&SC PERMIT WILL BE DISTRIBUTED AT THIS MEETING.
X it. E&SC CONSTRUCTION SEQUENCE NOTES: (please add to plans)
1. PRIOR TO SCHEDULING THE PRECONSTRUCTION MEETING,THE EROSION AND
SEDIMENT CONTROL SURETY MUST BE SUBMITTED TO THE TOWN OF WAKE
FOREST.THE NCG010000 CERTIFICATE OF COVERAGE MUST BE OBTAINIED BY
THE PERMITTEE,WHEN APPLICABLE.A COPY OF THE COC MUST BE SUBMITTED
TO THE TOWN.
2. AFTER THE PRECONSTRUCITON MEETING IS HELD,THE CONTRACTOR CAN
INSTALL INITIAL EROSION CONTROL MEASURES ONLY.THIS INCLUDES BUT IS
NOT LIMITED TO CONSTRUCTION ENTRANCE,SILT FENCE, PERIMETER
DIVERSION DITCH, CHECK DAMS(ROCK OR WADDLE TYPE),TREE PROTECTION
FENCE, EXISITNG INLET PROTECTION,SKIMMER SEDIMENT BASINS,AND
SEDIMENT TRAPS. CLEAR ONLY AS NECESSARY TO INSTALL THESE MEASURES.
3. CONTRACTOR IS RESPONSIBLE FOR E&SC WEEKLY INSTALLATION AND
MAINTENANCE LOG INCLUDING DATES OF TEMPORARY/PERMANENT
GROUND COVER,A RAIN GAUGE, COPY OF TOWF SIGNED PLANS ONSITE,
REVISED SIGNED PLANS, NPDES LOG,AND CONSTRUCTION BOX MUST BE
PRESENT AND EASILY ACCESSABLE ONSITE.
4. ONCE MEASURES ARE INSTALLED,CONTRACTOR/FRO TO CALL TOWF FOR AN
INITIAL INSPECTION. IF SITE PASSES INSPECTION,A CERTIFICATE OF
COMPLIANCE WILL BE ISSUED. CONTRACTOR CAN NOW BEING CLEARING,
GRUBBING,AND GRADING.
5. CONTRACTOR TO MAINTAIN ACCESS ROAD FOR EMERGENCIES AT ALL TIMES.
6. PHASE PROJECT TO LEAVE AS LITTLE GROUND OPEN AS POSSIBLE.
7. TEMPORARILY SEED,STRAW AND TACK OR HYDROSEED WITHIN 14 DAYS OF
ANY PHASE OF GRADING, INCLUDING SLOPES.SEED BASINS AND DITCHES
IMMEDITEALY AFTER CONSTRUCTION.
8. PRIOR TO REMOVAL OF TEMPORARY MEASURES,TOWN MUST APPROVE
REMOVAL.ALL AREAS ABOVE TEMPORARY MEASURE MUST HAVE 85%
GROUND COVER.
9. THE TOWN OF WAKE FOREST CONSTRUCTION INSPECTOR WILL EVAULATE THE
SITE ATLEAST ONCE A MONTH.A COPY OF THE INSPECTION FORM WILL BE
EMAILED TO THE FRO.THE WEEKLY EROSION LOG AND NPDES LOG MUST BE
ONSITE AND AVAILABLE FOR REVIEW.
10. IF THE SITE IS FOUND OUT OF COMPLIANCE A NOTICE OF VIOLATION WILL BE
ISSUED GIVING THE CONTRACTOR/FRO 7 WORKING DAYS TO REMEDY THE
PROBLEM. IF THE SITUATION IS NOT RESOLVED WITHIN THE TIME PERIOD A
FINE MAY BE ISSUED.
11. IF SEDIMENT LEAVES THE SITE A FINE MAY BE ISSUED UP TO$5,000 PER DAY

PER VIOLATION. IF SEDIMENT ENTERS A BUFFER,STREAM,OR WETLAND
NCDWQ WILL BE NOTIFIED.THEY MAY ISSUE FINES UP TO$25,000 PER DAY PER
VIOLATION.
12. CALL THE TOWN UPON COMPLETION FOR A FINAL EROSION INSPECTION.A
PUNCHLIST MAY BE GENEREATED ADDRESSING ANY REMAINING ITEMS.
THERE MUST BE 85%GROUNDCOVER ON THE ENTIRE SITE PRIOR TO A
CERTIFICATE OF OCCUPANCY. IF THE SITE IS FOUND TO BE IN COMPLIANCE
AN EROSION CERTIFICATE OF COMPLETION WILL BE ISSUED. AFTER THE
COMPLETION OF THE PROJECT,SUBMIT A NOTICE OF TERMINATION TO END
COVERAGE UNDER THE NCG01000 PERMIT.

BK019363PG02326 WAKE COUNTY, NC
TAMMY L. BRUNNER
REGISTER OF DEEDS
PRESENTED & RECORDED ON
06-20-2023 AT 14:00:01
STATE OF NC REAL ESTATE
EXCISE TAX: $3,500.00
BOOK: 019363 PAGE: 02326 -02328
Excise Tax:$3,500.00 REID:0497112
Instrument Prepared By&Hold For:Burns,Day&Presnell,P.A. (JMD)-Box 35
Short Description for Index:Lot 4,BOM 2022/1117-1120
The property does not include the primary residence of Grantor.
NORTH CAROLINA NORTH CAROLINA
WAKE COUNTY SPECIAL WARRANTY DEED
THIS DEED is made this JuneaL, 2023, by and between G98 Commercial, LLC, a Florida
limited liability company, 201 E Las Olas Blvd., Suite 1200, Fort Lauderdale, FL 33301 ("Grantor"), and
WB Fitness Wake Forest, LLC, a North Carolina limited liability company, do Wilson Blount
Development, Inc., 2626 Glenwood Ave. -Suite 350, Raleigh, North Carolina 27608, ("Grantee"). (As
used in this instrument, the designation of Grantor and Grantee shall include the named parties, and their
heirs, successors, and assigns, and shall include the singular or plural number, and the masculine,
feminine, or neuter gender, both as the context requires.)
WITNESSETH:
Grantor,for a valuable consideration paid by Grantee, the sufficiency and receipt of which is
hereby acknowledged, has and by these presents does grant, bargain, sell, and convey unto Grantee, in
fee simple, all that certain real property (the"Property') lying in Wake County and described as follows:
Being all of Lot 4, containing approximately 2.3553 acres, as shown on
Book of Maps 2022, Pages 1117-1120, Wake County Registry.
The Property was acquired by Grantor by that instrument recorded in Book 18600, Page 2301,
Wake County Registry.
TO HAVE AND TO HOLD the Property and all privileges and appurtenances thereto belonging to
Grantee in fee simple.
Grantor covenants with Grantee that Grantor has done nothing to impair such title as Grantor
received, and that Grantor will warrant and defend the title to the Property against the lawful claims of all
persons claiming by, under, or through Grantor, except for the following exceptions:
• Taxes for the year 2023 and subsequent years, not yet due and payable.
• All easements, rights-of-way, restrictive covenants, and other matters of record.
Submitted electronically by Burns,Day and Presnell,PA in compliance with North Carolina statutes governing recordable
documents and the terms of the submitter agreement with the Wake County Register of Deeds.

BKO19363PGO2327
Pursuant to that unrecorded"Agreement for Purchase and Sale of Real Property', dated August 11,
2022, between Grantor and Grantee's predecessor in interest, (as subsequently amended, the
"Agreement', which is incorporated into this instrument by this reference), Grantor reserved a Right of
First Refusal and a Repurchase Right(both as more particularly described in the Agreement). Following
the Purchaser's Construction Commencement Date (as defined in the Agreement), upon Grantor's receipt
of Grantee's written request for such, Grantor shall promptly execute and deliver to Grantee a
commercially reasonable termination of both the Right of First Refusal and the Repurchase Right, in
recordable form, (a"Termination"), which Grantee may record with the Wake County Registry. If Grantor
fails to deliver a duly executed Termination to Grantee within ten (10) days after Grantor's receipt of
Grantee's request for such, Grantee shall send a second written request to Grantor for such, and if
Grantor fails to deliver a Termination to Grantee within five (5) days, Grantee shall be entitled to record a
Termination on its own signature, which shall be deemed to be just as enforceable as if Grantor signed
the Termination. In any event, the Repurchase Right terminates on its own terms if Grantor or its assigns
have failed to exercise that right within eighteen (18) months from the date this Deed is recorded. The
foregoing Right of First Refusal and Repurchase Right, and any other rights Grantor may have with
respect to the Property or under the Agreement, shall be subject and subordinate in all respects to the
deed of trust and the assignment of rents granted to Providence Bank which encumber the Property and
are recorded on or about the date hereof, as well as all other rights of Providence Bank may have under
all other loan documents executed by Grantee in connection therewith.
[signatures on following page]

BK019363PG02328
IN WITNESS WHEREOF, the undersigned has caused this instrument to be signed, sealed, and
delivered the date first above written.
GRANTOR:
G98 Commercial, LLC
a Florida limited liability company
By Its Manage :
S-G98 Commercial LC,
loci ility company,
By: •
Name: Rocco Perrera
Title: VP
STATE OF FLORIDA )
) ss.:
COUNTY OF r)ix_10_(� )
This instrument was acknowledged before me this 14 day of:i r? , 2023, by [X]
means of physical presence or[] online notarization, by Rocco Ferrera, as Vice President of S-G98
Commercial, LLC, a Florida limited liability company, as the manager of G98 Commercial PH II, LLC, a
Florida limited liability company, on behalf of the company, and [X] is:personaWy known to me or [ ] has
produced as identification.
/ 1j, ,
/ ,
Notary Seal Notary Pu ic, State,of Florida
1 oNdodrla LvrAla A,Vvatkoilb y1(VA �. .t �}/1.0
995
20T ed, Printed of Stamped Name of Notary
(9);: Eires:March 19,20 YPNotary Public-State of Florida
i 1 B011\\\