NCC240886_FRO Submitted_20240327

FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
EROSION & SEDIMENTATION CONTROL
LNo person may initiate any land-disturbing activity on one or more acres, '/2 acre or more inside a
watershed, as covered by the Sedimentation Pollution Control Act and the Iredell County Land
Development Code, before an acceptable erosion and sedimentation control plan has been submitted
and approved by the Iredell County Planning & Development, Erosion Control Section.
(Please type or print)
Part A.
1. Project Name Marble Road Building 1
2. Location of land-disturbing activity: County Iredell City or Township Statesville
Highway/Street Marble Road Latitude 35D/47'56" N Longitude 80D/56'53" W
3. Approximate date land-disturbing activity will commence: 3/1/24
4. Purpose of development(residential,commercial,industrial,institutional,etc.): Light Industrial
5. Total acreage disturbed or uncovered(including off-site borrow and waste areas): 7.00
6. Amount of fee enclosed: $ 1225.00 . An application fee of$175.00 per acre(rounded up to the next acre)is
assessed without a ceiling amount (Example: a 8.10-acre application fee is $1575). For projects > than 0.5 acres but no
greater than 0.99 acres in a water supply watershed,a flat fee of$100.00 is assessed.
7. Has an erosion and sediment control plan been filed? Yes No Enclosed XX
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Joe Hyde E-mail Address [e-mail]
Telephone [phone] Cell# Same Fax#
9. Landowner(s)of Record (attach accompanied page to list additional owners):
1 Source Properties, LLC 704-201-9935
Name Telephone Fax Number
387 Wood Bridge Same
Current Mailing Address Current Street Address
Statesville, NC 28625
City State Zip City State Zip
10. Deed Book No. 3011 Page No. 1387 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):
1 Source Properties, LLC [e-mail]
Name E-mail Address
387 Wood Bridge Same
Current Mailing Address Current Street Address
Statesville, NC 28625
City State Zip City State Zip
Telephone [phone] Fax Number
Page 1 of 2

2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address of the designated
North Carolina Agent:
Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone Fax Number
(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:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone Fax Number
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 by any change in the informajon provided herein.
Type or p / Title or Authority
e�� _LIJI 3/2/ oui
Sign Date
Ol 411
I, a Notary Public of the County of
State of North Carolina, hereby certify that de 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 1 OSCA) ,20 aiA
?O oPALf n dw 'ad
Notary
Seal OD
-My commission expires -
z0°A•t oft
��°'e,$L t CO.,```4�
/1i11� Page 2 of 2

Type: CONSOLIDATED REAL PROPERTY
Recorded: 8/22/2023 2:17:10 PM
Fee Amt: $626.00 Page 1 of 3
Revenue Tax: $600.00
Iredell County, NC
Renee L. Holland Register of Deeds
BK 3011 PG 1387 - 1389
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $600.00
Parcel Identifier No.4725-21-2483.000 Verified by County on the_day of ,20__
By:
Mail/Box to: Benbow,Davidson and Martin,P.C.,309 Davie Avenue,Statesville,NC 28677
This instrument was prepared by: Luke S.Mattin,Attomey at Law
Brief description for the Index:
THIS DEED made this 1st day of September ,2023,by and between
GRANTOR GRANTEE
Stanley L.Bost,single 1 SourcePropetties,LLC
528 E.Acadia Point 387 Wood Bridge Rd
Aurora,OH 44202 Statesville,NC 28625
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 Concord Township, Iredell County.
North Carolina and more particularly described as follows:
Parcel if:4725-21-2483.000
PropertyAddress:12.785 acres Marble Road,Statesville,NC 28625
See ExhibitA
The property hereinabove described was acquired by Grantor by instrument recorded in Book 1807 page 670
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 page
Page I of 2
NC Bar Association Form No. 3®1976,Revised CI 1977,2002,2013 This standard form has been approved by:
Printed by Agreement with the NC Bar Association-1981 North Carolina Bar Association-NC Bat Form No.3
Submitted electronically by "Benbow & Martin, PC"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Iredell County Register of Deeds.
Book:3011 Page: 1387 Page 1 of 3

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:
IN WITNESS WHEREOF,the Grantor has duly executed the foregoing as of today d year first• ye written. (SEAL)
(Entity Name) Print/Type : Stanley L.Bost
By:
(SEAL)
Print/Type Name&Title: Print/Type Name:
By: (SEAL1
Print/Type Name&Title: Print/Type Name:
By: (SEAL)
Print/Type Name&Title: Print/Type Name:
State of County or City of
I,the undersigned Nora r Public of the County or City of fra. Tr%and State aforesaid,certify that t
Stanley L.Bost personally appeared before me this day and acknowledged ctu
S .ZL-
execution Augustof the foregoing instrument for the purposes therein expressed. Witness my hand and Notarial stamp or seal this � y of
20
JJ Brooke Swortzentru
•
My Commission Expires: Ord-I 7'2 n •; -A Notary fit,Blatt
mY Do
(Affix Seat) _/,; commissionLazy Public
may 1r 2026 o ry'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 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 clay 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 ,20V.
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 0 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
Book:3011 Page:1387 Page 2 of 3

EXHIBIT A
Parcel#: 4725-21-2483.000
Property Address: 12.785 acres Marble Road, Statesville, NC 28625
BEGINNING at a point in the center of the right of way of SR 1515, commonly referred to
as Marble Road, said point being located North 06 deg 28 min 47 sec East 30.00 feet from
an existing iron pin in the Southern margin of said road and in the line of Harold A.
Anderson (see deed book 833, page 603 ICR); and running thence from the point of
Beginning with the centerline of Marble Road, South 60 deg 57 min 14 sec East 31.20 feet
to a point; South 70 deg 05 min 54 sec East 50.88 feet to a point; South 76 deg 46 min 59 sec
East 52.17 feet to a point; South 80 deg 11 min 55 sec East 77.96 feet to a point; South 82
deg 12 min 32 sec East 126.91 feet to a point; South 83 deg 55 min 46 sec East 184.70 feet
to a point and South 84 deg 54 min 08 sec East 107.58 feet to a point and the new common
corner with Patricia Bost Moore; running thence with the new line of Patricia Bost Moore,
South 06 deg 28 min 46 sec West(passing through an iron pin set at 30.00 feet) 760.28 feet
to an iron pin set in the line of Nora Woods Daniels(see deed book 1147 at page 445 ICR);
thence with the line of Daniels, South 74 deg 31 min 31 sec West 676.09 feet to an existing
iron pin in the common corner with Harold A. Anderson(see deed book 833 at page 603
ICR); running thence with the line of Anderson, North 06 deg 28 min 47 sec East(passing
through an existing iron pin at 1006.64 feet) 1046.46 feet to the point and place of
BEGINNING, containing 12.785 acres, more or less, all according to a survey prepared by
Joseph W. Raymer, RLS L-3298.
The above described property being the identical property conveyed to Stanley L. Bost by
general warranty deed recorded in Deed Book 1807, Page 670, Iredell County Registry.
Book:3011 Page: 1387 Page 3 of 3