NCC240559_FRO Submitted_20240228

WAKE COUNTY 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 Wake
WAKE
County Unified Development Ordinance before this form and an acceptable erosion and
COUNTY sedimentation control plan have been completed and approved by Wake County Department of
Environmental Services,Water Quality Division. (Please type or print and. if the question is not
applicable,place N/A in the blank.)
Part A.
1. Project Name GREENWOODS, LOT 15, 139 STELLA CT, MORRISVILLE
2. Location of land-disturbing activity: Jurisdiction WAKE (Wake Co.or Municipality)
Highway/Street Latitude Longitude
3. Approximate date land-disturbing activity will commence: NOVEMBER 14,2023
4. Type of development(residential,commercial,industrial,institutional,etc.):RESIDENTIAL
5. Total acreage disturbed or uncovered (including off-site utilities and borrow/waste
areas): .75
6. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name SUDHA RAJAN E-mail Address [e-mail]
Telephone Cell# 9196074711 Fax#
7. Landowner(s)of Record(attach accompanied page to list additional owners):
THIRUPPATHI RAJAN GOPALAKRISHNAN,SUDHA RAJAN
Name(s) • Telephone Fax or E-mail address
4217 SAUBRANCH HILL ST
Current Mailing Address Current Street Address
RALEIGH, NC 27616
City State Zip City State Zip
8. Deed Book No. 19113 Page No.(3649 Provide a copy of the most current deed.
Part B.
1. Person(s) or firm(s) who are financially responsible for the land-disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet.Include requested information):
SUDHA RAJAN [e-mail]
Name E-mail Address
4217 SAUBRANCH HILL ST 4217 SAUBRANCH HILL ST
Current Mailing Address Current Street Address
RALEIGH NC 27616 RALEIGH NC 27616
City State Zip City State Zip
Telephone [phone] Fax Number

2. (a) If the Financially Responsible Party is not a resident of Wake County, identify a designated agent in
Wake County to receive any notice,process,pleading in any action or legal proceeding arising out of any
matter relating to the Wake County Erosion and Sedimentation Control Ordinance and/or Land
Disturbance Permit:
N/A N/A
Name E-mail Address
N/A
N/A
Current Mailing Address Current Street Address
N/A N/A
City State Zip City State Zip
Telephone N/A Fax Number N/A
(b) If the Financially Responsible Party is a Partnership or other person engaging in business under an
assumed name, attach a copy of the Certificate of Assumed Name. If the Financially Responsible
Party is a Corporation,give name and street address of the Registered Agent:
N/A N/A
Name of Registered Agent E-mail Address
N/A N/A
Current Mailing Address Current Street Address
N/A N/A
City State Zip City State Zip
Telephone N/A Fax Number N/A
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.
Ulf RftRN wN K
Type or print name Title or Authority
1 I O` / 20�
Signature Date
i MbKJ ,a Notary Public of the County of lnla
State of_ NorthN Carolina, hereby certify that St,J h', .. Ci Y\ appeared
personally before me this day and being duly sworn acknowledged that ttSe above form was executed by him.
Witness my hand and notarial seal,this q day of Ni W1b47 ,20 L3 •
otary
Seal 71`�a 17 %
My commission expires �j
Bow JE
NOTARY POLIO
WAKE COUNTY -
commission

BK019113PG00649 WAKE COUNTY, NC
TAMMY L. BRUNNER
REGISTER OF DEEDS
PRESENTED & RECORDED ON
08-09-2022 AT 09:52:08
STATE OF NC REAL ESTATE
EXCISE TAX: $800.00
BOOK: 019113 PAGE: 00649 - 00650
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $800.00
Parcel Identifier No. 0094683 Verified by County on the day of ______ _,20
By:
Mail/Box to: GRAN ILE
This instrument was prepared by: Gwynn,Edwards&Getter.PA,900 Ridgefield Drive,Ste 150,Raleigh.NC 27609
Brief description for the Index: LOT 15, Green Woods
THIS DEED made this 8th day of August ,20 22,by and between
GRANTOR GRANTEE
Douglas Alan Whitehouse and spouse
Barbara Alexander Whitehouse Thimppathi Rajan Gopalakrishnan and spouse
130 Stella Court Sudha Rajan
Morrisville,NC 27560 4217 Saubranch Hill St
Raleigh,NC,27616
Enter in appropriate block for each Grantor and Grantee: name,mailing 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 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,parcel of land or condominium unit
situated in the City of Morrisville _ _Township, Wake _County,
North Carolina and more particularly described as follows:
BEING all of Lot 15,Green Woods,as recorded in Book of Maps 1975,Page 234,Wake County Registry.
parcel#0094683
known as Lot 15,Stella Court,Morrisville,NC 27560
Submitted electronically by "Gwynn, Edwards & Getter, PA"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Wake County Register of Deeds.
Page 1 of 2
NC Bar Association Form No. 3©1976,Revised©1977,2002,2013 This standard form has been approved by:
Printed by Agreement with the NC Bar Association—1981 North Carolina Bar Association—NC Bar Form No.3

BK019113PG00650
The property hereinabove described was acquired by Grantor by instrument recorded in Book 2343 page 277
All or a portion of the property herein conveyed___includes or X does not include the primary residence of a Grantor.
A map showing the above described property is recorded in Plat Book 1975 page 234
TO HAVE AND TO HOLD the aforesaid lot or parcel ofland 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:
Restrictive covenants recorded in Book2342,Page 375,Wake County Registry.
Easements and Restrictions of record.
2022 ad valorem taxes.
IN WITNESS WHEREOF,the Grantor has duly executed the foregoing as of the day and year first above written.
41 /J (SEAL)
(Entity Name) 'nt/*ype Name: Douglas Alan White ouse
By: � Laet-(<244
de2e1;746-*ZildW,/
Print/Type Name&Title: Print/Type Name:' Barbara Alexander Whitehouse
By: (SEAL)
Print/Type Name&Title: Print/Type Name:
By: (SEAL)
Print/Type Name&Title: Print/Type Name:
State of North Carolina -County or City of Wake
I,the undersigned Notary Public of the County or City of Wake and State aforesaid,certify that
Douglas Alan Whitehouse and spouse Barbara Alexander Whitehouse personally appeared before me this day and acknowledged the
due execution of the foregoing instrument for the purposes t errA19Wggssed. Witness my hand and Notarial stamp or seal this $ day of
-- Gaa" ,2022_. ♦e'k a� elf hl S+ ®.eo,
♦ \'
My Commission Expires: _,3/26/25 r, .�► .e• `� f`. (�t� .�J {d`c* Notary Public
(Affix Seal) w ► 49
T �„ • Notary's Printed or Typed Name
State of -County or C d„ �
f �.1d
I,the undersigned Notary Public of the Couf , �84-0 ' and State aforesaid,certify that
1104ff CoU,.rc litrsonally appeared before me this day and acknowledged the
due execution of the foregoing instrument for the purposes tmprAd. Witness my hand and Notarial stamp or seal this day of
,20_ .
My Commission Expires: Notary Public
(Affix Seal) Notary's Printed or Typed Name
State of__ _-County or City of
I,the undersigned Notary Public of the County or City of and State aforesaid,certify 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
(Affix Seal) Notary's Printed or Typed Name
Page 2 of 2
NC Bar Association Form No. 3©1976,Revised©1977,2002,2013 This standard form has been approved by:
Printed by Agreement with the NC Bar Association—1981 • North Carolina Bar Association—NC Bar Form No.3