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Home My WebLink AboutNCC241290_FRO Submitted_20240426 JOHNSTON 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 Act before this form and an acceptable erosion and sedimentation control plan have been completed and approved by the Johnston County Department of Public Utilities. (Please type or print and, if the question is not applicable or the e-mail and/or fax information unavailable, place N/A in the blank.) Part A. 1. Project Name Country Store Meadows Subdivision 2. Location of land-disturbing activity: City or Township Pine Level Highway/Street Country Store Road Latitude 35.50328 _ Longitude-78.23419 3. Approximate date land-disturbing activity will commence:May 1, 2024 4. Purpose of development(residential, commercial, industrial, institutional, etc.) Residential 5. Total acreage disturbed or uncovered (including off-site borrow and waste areas):23.18 6. Amount of fee enclosed: $PAID The application fee of$400.00 per acre (rounded up to the next acre) is assessed for the first 10 acres and an additional $125 per acre for each additional acre(rounded up to the next acre). Individual residential lots plans are$100 per lot. 7. Has an erosion and sediment control plan been filed? Yes I V I No 17 Enclosed 8. Person to contact should erosion and sediment control issues arise during land-disturbing activity: Name Nick Larson E-mail Address Nick@StayWild.com Telephone(530)906-2413 Cell# (530)906-2413 Fax# N/A 9. Landowner(s)of Record (attach accompanied page to list additional owners): Brantley Joy, LLC Name Telephone Fax Number 276 Benning Circle 276 Benning Circle Current Mailing Address Current Street Address Clayton NC 27527 Clayton NC 27527 City State Zip City State Zip 10 Deed Book No.6138 Page No.228 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): Brantley Joy, LLC Name E-mail Address 276 Benning Circle 276 Benning Circle Current Mailing Address Current Street Address Clayton NC 27520 Clayton NC 27520 City State Zip City State Zip Telephone N/A Fax Number N/A 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 be any change in the information provided herein. e_ha yh�' '� f rurdael Type or print name Title or Authority Signature Date I, ( a Notary Public of the County of S hxS State of North Carolina, hereby certify that C.r.(�. ��S . G c�(Mn 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 .>L1 day of `�� 20 aL\ R TNAktSt V.-(WA kij-4-611' .21'4; -q Niotary ►�TAp , % �� S10N pry T�= My commission expires C vec S EXPIRES s` I qrI W2on U'e 4 Pi LIC ti • r,rnH„ a Additional Landowners of Record: Little River JoCo Properties, LLC WA N/A Name Telephone Fax Number 402 C Bluegrass Road 402 C Bluegrass Road Current Mailing Address Current Street Address Selma NC 27526 Selma NC 27526 City State Zip City State Zip Deed Book No. 6138 Page No. 228 Filed in JOHNSTON COUNTY, NC CRAIG OLIVE, Register of Deeds Filed 12/17/2021 09:28:21 AM DEED BOOK:6138 PAGE: 228-231 INSTRUMENT#2021787294 Real Estate Excise Tax:$837.00 Deputy/Assistant Register of Deeds: Marilyn Moore Excise Tax:$837.00 Recording Time,Book and Page Parcel Identification Number: 12N11005 Mail after recording to:Grantee This instrument was prepared by:Jason W.Wenzel,P.O.Box 1567,Smithfield,NC 27577[no title exam] Brief Description for the Index:36-91 A+/-,PB 93,PG 307 NORTH CAROLINA SPECIAL WARRANTY DEED THIS DEED MADE THIS THE 10 DAY OF DECEMBER 2021,BY AND BETWEEN GRANTOR: BD&T PROPERTIES,LLC, A North Carolina limited liability company Post Office Box 511 Pine Level,North Carolina 27568 GRANTEE: BrantleyJoy,LLC, A North Carolina limited liability company 276 Beginning Circle Clayton,North Carolina 27527 Little River JoCo Properties,LLC, A North Carolina limited liability company 402 C Bluegrass Road Selma,North Carolina 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 Johnston County,North Carolina and more particularly described on Exhibit A attached hereto and incorporated herein by reference. Submitted electronically by "Hewett Law Group, PA" in compliance with North Carolina statutes governing recordable documents and the terms of the submitter agreement with the Johnston County Register of Deeds. {N0301611.DOC; 1} DEED B:6138 P:229 This is not the primary residence of the Grantor. 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 has done nothing to impair such title as Grantor received,and Grantor will warrant and defend the title against the lawful claims of all persons claiming by,under or through Grantor,except for the exceptions hereinafter stated. Title to the property hereinabove described is subject to the exceptions listed on Exhibit B,such exhibit being attached hereto and incorporated herein by reference. IN WITNESS WHEREOF,the Grantor has caused this instrument to be signed the day and year first above written. BD&T PROPERTIES,LLC A North Carolina limited liability company _ bia 4ocGakii avev, , tin a BY: Debra Godwin Avery,Manager STATE OF NORTH CAROLINA COUNTY OF —30a-+ troy‘ It t,lkL'f ,a Notary Public,in and for said County and State,do hereby certify that Debra Godwin Avery,Manager of BIT&T PROPERTIES,LTC,a North Carolina limited liability company, personally appeared before me this day and acknowledged the due execution of the foregoing instrument on behalf of the company. Witness my hand and official stamp or seal,this ILI day of December 2021 ,A``•%. ttl STq,, My commission expires: 4—>irOD, � OTA/ <�N Notary Public — • • •map • ','iOt'CO3'.' {N0301611.DOC; I} DEED B:6138 P:230 EXHIBIT A Property Description PARCEL ONE:PIN: 12N11005 Being all of that 36.91 acres, more or less, as shown on a plat entitled"Boundary Survey for BD&T, LLC, Johnston County Parcel#12N11005",prepared by Willie G.Miller, Jr.,Professional Land Surveyor,and recorded in Plat Book 93,page 307,Johnston County Registry, to which such plat is referenced for a more particularly description. For chain of title, see Book 5591,page 768; Book 5591,page 772; Book 5593,page 600;Book 3082,page 596; Book 3294,page 125;Book 1664,page 296;Book 249,page 389; and Book 485,page 518,all of the Johnston County Registry. See also Estate of Madeline Godwin Sanders,file number 86-E-436; Estate of Annie E. Godwin,file number 80-E-53; and Estate of Leslie Earl Godwin, file number 70-E-355, all of the Office of the Clerk of Superior Court of Johnston County. {N0301611.DOC; 1 DEED B:6138 P:231 END OF DOCUMENT EXHIBIT B Permitted Exceptions 1.Ad valorem taxes for 2022 and future years. 2. Matters shown on recorded Plat Book 93,page 307, Johnston County Registry. 3. Easement(s) and right(s)-of-way for roads and public utilities. 4. Easement(s)and rights)-of-way in favor of Carolina Power and Light Company recorded in Book 435,page 605,Johnston County Registry. 5. Easement(s) and right(s)-of-way in favor of State Highway Commission recorded in Book 670,page 179, Johnston County Registry. 6.Title to that portion of the Property within the bounds of any public streets,roads,or highways. 7.Terms and conditions of deed recorded in Book 3294,page 125,Johnston County Registry. {N0301611.DOC; 1}