20231278 Ver 1_Adisposalform_20230918

DREDGE SPOIL DISPOSAL !FORM
Project Name/address: _ � i1 1;.J ,�,c d ,,, � �'•�c o� � 2e � County: Ate41 1r.1 h4c
Location Address: — 3776 Amity Hill Rd, Statesville NC; 28677
Parcel #; 4751935674
Parcel/lot size 9.83 Acres
Disposal area required (sq ft and/or acreage)
Acknowledgement of Notification
I, 8ra.' i N L I am aware that the site must adhere to all state regulations
and rules regarding sediment and erosion control and water quality. And give permission for
Name of Individual and Company
to dispose of their dredge material at the above stated location
Owner -�r
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Along with form, please provide:
Aerial of parceViot (County GIS)
Photo of proposed spoil site
Identified proposed spoil site
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EXHIBIT A
PROPERTY DESCRIPTION
TRACT 1: Being all of Lot ## 1 containing 9.83 acres +I- as shown on plat recorded in Map Book
66 at page 110 in the Iredell County Public Registn.

State of North Carolina
County of Iredell
1, Wilford V. best, a Notary Public for said County and State, do hereby certify that
Jonathan M. Dillon, Marty A. Tucker, Michael T. Tucker and Jennifer Tucker personally
appeared before me this day and acknowledged that they are the Members of Ozark Avenue,
LLC, a North Carolina Limited Liability Company, and that by authority duly given and as the
act of the Company, they signed the foregoing instrument in its name and as its act and deed.
I certify that the Signatories personally appeared before me this day and
I have personal knowledge of the identity of the Signatory, or
_x I have seen satisfactory evidence of the Signatory's identity, by a current state or federal
identification with the Signatory's photograph in the form of:
x (a) a driver's license, or
(b) a credible witness has sworn to the identity of the Signatory.
The Signatories acknowledged to me that they voluntarily signed the foregoing document
for the purposes stated therein and in the capacity indicated_
Witness my hand and notary stamp/seal this the 21 st day of March, 2019.
4nk�
Notary ublic
My commission expires: 12-21-2019
WILFORD V. WESt, tv
Notary Public. North Cazoirna
Iredeli County
My Cornmias:on Expires
� o®omtaor 21, 2019
SEMI.

TO HAVE AND TO HOLD unto the Grantee, together with all privileges and appurtenances thereunto
belonging, in fee simple, subject to the Exceptions and Reservations hereinafter and hereinabove
provided, if any.
And the Grantor hereby warrants that Grantor is seized of the premises in fee and has the right to convey
the same in fee simple, that title is marketable and is free and clear of encumbrances other than as set
forth herein, and that Grantor will forever warrant and defend the title against the lawful claims of all
persons or entities whomsoever.
Title to the property described herein is subject to the following exceptions:
The current year's ad valorem taxes and subsequent years which are not yet due and payable and all liens,
easements, restrictions, conditions, and other matters appearing upon public record.
All references to Grantor and Grantee as used herein shall include the parties as well as their heirs,
successors and assigns, and shall include the singular, plural, feminine or neuter as required by context.
FN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the 21st day of
March, 2019.
Ozark Avenue, LLC
nathan M. Dillon
Member
���
Marty 4 ucker
Member
Michael T. Tucker
Member
0�w" I '�o 9ucew _
Jifer Tu er
n
tember

Type: CONSOLIDATED REAL PROPERTY
Recorded: 31211201912:53-34 PPA
Fee Amt: S526.00 Page 1 of 4
Revenue Tax. $$500.00
Iredell County, NC
Ronald N. Wyatt Register of Deeds
BBC 2608 PG 671 - 574r
NORTH CA.ROLIN.A GENERAL WARRANTY DEED
Excise tax: $500.00
Tax parcel ID No. 475I-93-5674
Prepared by and return to: Attorney Wilford V. West, IV
116 S. Main Street, Ste 201 Mooresville, NC 28115
THIS DEED is made this 21 st day of March; 2019, by and between:
GRANTOR. Ozark Avenue, LLC, a North Carolina Limited Liability Company
whose mailing address is 203 Sycamore Lane, Hiddenite, NC 28636
GRANTEE: Amity Hill LCID, LLC, a North Carolina Limited Liability Company
whose mailing address is 284 Barfield Road, Mooresville, NC 28115
WITNESSETH:
For valuable consideration from Grantee to Grantor; the receipt and sufficiency of which is hereby
acknowledged, Grantor hereby gives, grants, bargains, sells and conveys unto the Grantee in fee simple,
subject to the exceptions and reservations hereinafter provided, if any, the following described property
located in the County of Iredell, State of ,North Carolina, more particularly described as follows:
See attached Exhibit A
Being all of the property conveyed to the Grantor in Reed Book 2492 at page 2336 in the Iredell
County Register of Deeds.
Pursuant to N_C.G.S_ 105-317.2(2), this certain lot or parcel of land does not include the principal
residence of the Grantor.