NCC241548_NOI Signed Certification_20240521

NCGO1 Notice of Intent (NOI) Certification Form
Directions:
Print this form, complete,scan and upload to the electronic NOI.
Then,mail the original form to the NC DEMLR Stormwater Program (with $120 check if paying by check)
at:
Division of Energy, Mineral & Land Resources Stormwater Program
512 N.Salisbury Street, 6th Floor(Office 640K)
1612 Mail Service Center
Raleigh, NC 27699-1612
THE FORM YOU MAIL MUST BE COMPLETED WITH AN ORIGINAL SIGNATURE(NOT DIGITAL) [40 CFR 122.22]
Per NC General Statute 143-215.68(i),any person who knowingly makes any false statement, representation, or
certification in any application, record, report, plan, or other document filed or required to be maintained under this
Article or a rule implementing this Article. . .shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed ten thousand dollars($10,000).
Under penalty of law, I certify that(check all boxes to indicate your agreement):
[r I am the person responsible for the construction activities of this project,for satisfying the requirements of this
permit,and for any civil or criminal penalties incurred due to violations of this permit.
121 The information submitted in this NOI is,to the best of my knowledge and belief,true, accurate, and complete
based on my inquiry of the person or persons who manage the system,or those persons directly responsible for
gathering the information.
Er I will abide by all conditions of the NCG010000 General Permit and the approved Erosion and Sediment Control
Plan.
[r If the approved Erosion and Sediment Control Plan is not compliant with Part II (Stormwater Pollution
Prevention Plan)of the NCG010000 General Permit, I will nonetheless ensure that all conditions of Part II of the
permit are met on the project at all times.
I hereby request coverage under the NCG010000 General Permit and understand that coverage under this
permit will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
Project Name (must match Ala): Latta Park
Specific Lot Numbers(must match Alb): 0824171992,0824173943,0824173367,0824067951
Permittee(must match B1): Tri Pointe Homes Holdings, Inc.
Legally Responsible Person (must match B2& B3): Bob Davenport
Title of Legally Responsible Person (must match B3b): Division President
Print Name&Title of Signed if Authorized
Individual Differs from Legally Responsible Person:
Phone Number:
S-i7 zy
Signature of Legally Responsible Person or Authorized Individual Date
* IMPORTANT NOTE: This form must be signed by a responsible corporate officer that owns or operates the construction activity,
such as a president,secretary, treasurer,or vice president, or a manager that is authorized in accordance with Part 1V,Section B,
Item(6)of the NCG010000 permit.

Book9683 - Page 270 Page 1 of 4
For Registration Sharon A. Davis
Register of Deeds
Durham County, NC
Electronically Recorded
2022 Apr 29 04:33 PM
Book: 9683 Page: 270
NC Rev Stamp: $ 11924.00 Fee: $ 26.00
Instrument Number: 2022018334
DEED
NORTH CAROLINA SPECIAL WARRANTY DEED
Excise Tax $11,924.00 Tax Parcel Number: All or portions of: 182875, 182878, 182879, 181005,
181006,181013, 182876,181011,181012,181009, 181008,181007,and 182877
Mail after recording to: Grantee
This instrument was prepared by: Alexander Ricks PLLC, 1420 E. 7th Street,Suite 100,Charlotte,NC 28204(JG)
Brief description for the Index: 20.66 acres(+/-)at Latta Road and Guess Road j
THIS DEED made this 29 day of April,2022,by and between:
GRANTOR GRANTEE
C4 LATTA PARK,LLC, KLLB ATV LLC,
a North Carolina limited liability company a Delaware limited liability company
Address: Address:
121 West Trade Street,Suite 2550 c/o KL Servicers LLC
Charlotte,NC 28202 6900 E.Camelback Road,Suite 1090
Scottsdale,AZ 85251
Enter in appropriate block for each party:name,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 good and 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 City of Durham,Durham County,North Carolina,and more
particularly described as follows:
SEE EXHIBIT A ATTACHED HERETO.
submitted electronically by "The Pryzwansky Law Firm"
Oin compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Durham County Register of Deeds.

Book9683 - Page 271 Page 2 of 4
The property hereinabove described was acquired by Grantor by instrument recorded in Book at Page
,Durham County Public Registry.
None of the property herein conveyed includes the primary residence of 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,other than the Permitted Exceptions(as such term is defined below).
This Special Warranty Deed and the conveyance hereinabove set forth is executed by Grantor and accepted
by Grantee subject to the following(hereinafter referred to collectively as the"Permitted Exceptions"):
1. Taxes for calendar year 2022 and subsequent years,not yet due and payable.
2. Flat recorded in Plat Book 206Page(s) 195 ,Durham County Public Registry.
3. Matters disclosed by that certain survey prepared by Coulter Jewell Thames P.A. dated April 27,
2022.
4. Easement to Duke Power Company recorded in Book 199, Page 63, Durham County Public
Registry.
5. Declaration of Easements,Covenants and Restrictions Recorded in Book 206,Page 195,Durham
County Registry
[SIGNATURE PAGE FOLLOWS]
01424-069/00382439-4

Book9683 - Page 272 Page 3 of 4
IN WITNESS WHEREOF,Grantor has caused this instrument to be signed and delivered as of the day and
year first above written.
C4 LATTA PARK,LLC,
a North Carolina limited liability company
By:CSE Latta Park,LLC, its Manager
By: 4..e.„
N e: t 1741 /f e
Title: m
STATE OF NORTH CA ROLINA �,�p
COUNTY OF 1 t c� (- r Cx
I certify that the following persons personally appeared before me this day,each acknowledging to jine t�hatttLthey voluntarily
signed the foregoing document for the purpose stated therein and in the capacity indicated: rtit 3T111 " (t(,{Qins
Date: -4f-t, ,2022 Official Signature of Notary: C:41,
Notary's printed or typed name; &a te I
My commission expires: ]2iO2h!-
(Official Seal) _ ?gam �oTAR y N
PtUBUt' 'U
Coo
'N'++nlu a n1,,,,,,
0(}768-100/00382142-1

Book9683 - Page 273 Page 4 of 4
EXHIBIT A
Legal Description
Lying in the City of Durham,Durham County,North Carolina,and being more particularly described as follows:
BEING ALL of those certain parcels of real property shown as"NEW LOT AREA,792,544.28 SF, 18.1943 ACRES",
"NEW AREA, 64,370.10 SF, 1.4777 ACRES", "NEW LOT AREA, 21,860.4 SF, 0.5018 ACRES", and"LOT 2"
(which is also referred to as"707 LATTA ROAD,AREA 21,343.50 SF, 0.4900 ACRES"),on that certain plat map
recorded in Plat Book ,Pages(s) of the Durham County Register of Deeds.
TOGETHER WITH,the easement rights set forth in that certain Declaration of Easements Covenants and Restrictions
recorded in Book ,Page of the Durham County Register of Deeds.
01424-069/00382439-4