HomeMy WebLinkAboutNCC241974_FRO Submitted_20240628 Check if this project is ARPA-funded ❑
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, including any
activity under a common plan of development of this size as covered by the NCGO1 permit, before this form
and an acceptable erosion and sedimentation control plan have been completed and approved by the Land
Quality Section, N.C. Department of Environmental Quality. Submit the completed form to the appropriate
Regional Office. (Please type or print and, if the question is not applicable or the e-mail address or phone
number is unavailable, place N/A in the blank.)
Part A.
1. Project Name Brick Mills Estates
*If this project involves American Rescue Plan Act (ARPA) funds, list the Project Name below
under which you applied for funding through the Division of Water Infrastructure(DWI).
2. Location of land-disturbing activity: County Harnett City or Township Coats
N. Main St/NC Hwy 210 35.426369 -78.797342
Highway/Street Latltude(decimal degrees) Longltude(decimai degrees)
3. Approximate date land-disturbing activity will commence:July 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):61 .1
6. Amount of fee enclosed: $6,200 (paid) The application fee of$100.00 per acre (rounded
up to the next acre) is assessed without a ceiling amount (Example: 8.10-acre application fee is$900).
Checks should be addressed to NCDEQ.
7. Has an erosion and sediment control plan been filed? Yes ❑x Enclosed ❑ No ❑
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name
Lauren Granger E-mail Address lauren.dowdygranger@ashtonwoods.com
Phone: Office# Mobile# 919-616-5347
9. Landowner(s)of Record (attach accompanied page to list additional owners):
CW-Brick Mill LLC 984-208-2254
Name Phone: Office# Mobile#
7855 S River Parkway, Suite 222
Current Mailing Address Current Street Address
Tempe AZ 85284
City State Zip City State Zip
10. Deed Book No.4238 Page No.2579 Provide a copy of the most current deed.
Part B.
1. Company(ies)who are financially responsible for the land-disturbing activity(Provide a comprehensive list
of all responsible parties on accompanied page.) If the company is a sole proprietorship or if the landowner(s)is
an individual(s), the name(s)of the owner(s)may be listed as the financially responsible party(ies).
Starlight Homes North Carolina, LLC lauren.dowdygranger@ashtonwoods.com
Company Name E-mail Address
4025 Lake Boone Trail 4025 Lake Boone Trail
Current Mailing Address Current Street Address
Raleigh NC 27607 Raleigh NC 27607
City State Zip City State Zip
Phone: Office# 919-616-5347 Mobile#
Note: If the Financially Responsible Party is not the owner of the land to be disturbed, include with this form
the landowner's signed and dated written consent for the applicant to submit a draft erosion and sedimentation
control plan and to conduct the anticipated land disturbing activity.
2. (a) If the Financially Responsible Party is a domestic company registered on the NC Secretary of State
business registry, give name and street address of the Registered Agent:
Corporation Service Company chris.hamrick@starlighthomes.com
Name of Registered Agent E-mail Address
2626 Glenwood Ave, Ste 550 2626 Glenwood Ave, Ste 550
Current Mailing Address Current Street Address
Raleigh NC 27608 Raleigh NC 27608
City State Zip City State Zip
Phone: Office# 984-208-2254 Mobile#
Chris Hamrick
Name of Individual to Contact(if Registered Agent is a company)
(b) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina agent who is registered on the NC Secretary of State business registry:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# Mobile#
Name of Individual to Contact(if Registered Agent is a company)
(c) If the Financially Responsible Party is engaging in business under an assumed name, give name under
which the company is Doing Business As. If the Financially Responsible Party is an individual, General
Partnership, or other company not registered and doing business under an assumed name, attach a copy
of the Certificate of Assumed Name.
Company DBA Name
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(s)
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 Party). I agree to provide
corrected information should there be any change in the information provided herein.
Chris Hamrick VP Finance
Type or print name Title or Authority
Signature . Date
I, LCWItrUn �, et i/a,4° e' , a Notary Public of the County of wa
State of North Carolina, hereby certify that C1A_A/t appeared personally
before me this day and being duly sworn acknowledged that the above form was executed by him/her.
Witness my hand and notarial seal, this I I day of J fait , 20 24
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Continued from Items 9 & 10 in Part A of the Financial Responsibility/Ownership Form for multiple
owners. Attach copies of this page as needed to list all landowners.
Landowner 2 of Record:
Name Phone: Office# Mobile#
Current Mailing Address Current Street Address
City State Zip City State Zip
Deed Book No. Page No. Provide a copy of the most current deed.
Landowner 3 of Record:
Name Phone: Office# Mobile#
Current Mailing Address Current Street Address
City State Zip City State Zip
Deed Book No. Page No. Provide a copy of the most current deed.
Landowner 4 of Record:
Name Phone: Office# Mobile#
Current Mailing Address Current Street Address
City State Zip City State Zip
Deed Book No. Page No. Provide a copy of the most current deed.
Landowner 5 of Record:
Name Phone: Office# Mobile#
Current Mailing Address Current Street Address
City State Zip City State Zip
Deed Book No. Page No. Provide a copy of the most current deed.
Continued from Item 1 in Part B of the Financial Responsibility/Ownership Form for multiple parties.
Attach copies of this page as needed to list all financially responsible parties.
Company 2 Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# Mobile#
Company 3 Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# Mobile#
Company 4 Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# Mobile#
Company 5 Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office# Mobile#
Matthew S. Willis Register of Deeds
Harnett County, NC
Electronically Recorded
06/11/2024 03:00:47 PM NC Rev Stamp: $0.00
Book: 4238 Page: 2579 - 2581 (3) Fee: $26.00
Instrument Number: 2024009956
HARNETT COUNTY TAX ID #
070599 0130
06-11-2024 BY: MMC
NORTH CAROLINA NON-WARRANTY DEED
Excise Tax: $0.00 Parcel ID: 070599 0130
Prepared by: StephensonLaw, LLP (WITHOUT TITLE EXAM)
Return to: Grantee
Brief Description for Index:78.21 acres,MB2022/201
THIS DEED is made this I 1 day of Sin. , 2024,by and between:
GRANTOR: OLIVE BRANCH RESERVE LLC,
a North Carolina limited liability company
GRANTOR ADDRESS: 5448 Apex Peakway, Ste 196,Apex,NC, 27502
GRANTEE: CW-Brick Mill,LLC,
a Delaware limited liability company
GRANTEE'S ADDRESS: 7855 S. River Parkway, Suite 222,Tempe,AZ 85284
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 real property in Harnett County,North Carolina described as follows:
SEE EXHIBIT A ATTACHED HERETO AND INCORPORATED HEREIN BY REFERENCE.
The property hereinabove described was acquired by Grantor by instrument recorded in
Book 4180, Page 340, Harnett County Registry.
TO HAVE AND TO HOLD the real property and all privileges and appurtenances thereto belonging to
the Grantee in fee simple.
The Grantor makes no warranty, express or implied, as to title to the property hereinabove described.
Submitted electronically by "Schell Bray PLLC"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Harnett County Register of Deeds.
BK 4238 PG 2580 DOC# 2024009956
IN WITNESS WHEREOF,the Grantor has caused this instrument to be duly executed and delivered.
OLIVE BRANCH RESERVE LLC,
a North Carolina limited liability company
By: MF Development,LLC,
a North Carolina limit liability company, its Manager
By: (SEAL)
Michael oley,Manager
STATE OF NORTH CAROLINA
COUNTY OF WAKE
I,Melody Armsworthy, a Notary Public of the County and State aforesaid, certify that Michael Foley,
Manager of MF Development LLC,a North Carolina limited liability company,personally appeared before me
this day and acknowledged the due execution of the foregoing instrument. on belnwtf oc' Sal A. 4*
th
Witness my hand and official stamp or seal,this I day of v(4 ii , 2024.
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BK 4238 PG 2581 DOC# 2024009956
EXHIBIT A
Legal Description
Commencing at the EIP with NC Grid Coordinates of N: 601029.1722,E: 2095118.2984, said point being
the POINT OF BEGINNING; runs thence across the R/W of Brick Mill Road (NCSR 2005) South
36°32'33"West,a distance of 374.44 feet to an EIP in said R/W;thence South 3°05'25"East,a distance of
14.27 feet to an EIS;thence South 3°05'25"East, a distance of 881.83 feet to an EIS;thence South 3°05'25"
East, a distance of 413.76 feet to an EIS;thence South 59°07'00"West, a distance of 430.09 feet to an NIS;
thence South 89°04'41"West,a distance of 848.88 feet to an EIS;thence North 8°26'48"West, a distance of
167.40 feet to a MS set along an existing Ditch;thence North 0°06'18"East, a distance of 346.05 feet to an
ESDP in the centerline of Brick Mill Road;thence along said centerline North 52°49'33"East, a distance of
199.03 feet to an ESPD;thence leaving said centerline North 2°37'14"East,a distance of 1813.40 feet to an
EIS;thence North 5°54'O1"East, a distance of 600.39 feet to an EIP at an Old Fence;thence South
88°52'28"East, a distance of 799.32 feet to an EIS at an Existing Lightwood Stake;thence South 87°48'15"
East, a distance of 433.79 feet to an EIS;thence South 6°55'38"West,a distance of 1168.09 feet to an EIS at
the R/W of Brick Mill Road;thence South 8°13'28"West, a distance of 5.58 feet to an EIP,the said POINT
OF BEGINNING, containing 78.21 acres,more or less, as shown on that survey entitled"Annexation
Boundary Survey for Carolina Strategic Land Fund,LLC,"prepared by On the Level Land Surveying,
PLLC, dated December 16,2021, and recorded in Map Book 2022 at Page 201,a revision of Map Book
2000 at Page 234,Harnett County Registry.
As also described as:
Commencing at the EIP with NC Grid Coordinates of N: 601029.1722,E: 2095118.2984,said point being
the POINT OF BEGINNING ;thence across the R/W of Brick Mill Road(NCSR 2005) South 36°32'33"
West, a distance of 374.44' to an EIP in said R/W;thence South 3°05'25"East,a distance of 14.27' to an
EIS;thence South 3°05'25"East,a distance of 881.83' to an EIS;thence South 3°05'25"East, a distance of
413.76' to an EIS; thence South 59°07'00"West, a distance of 430.09' to a NIS;thence South 89°04'41"
West, a distance of 848.88' to an EIS;thence North 8°26'48"West,a distance of 167.40' to a MS set along
an existing Ditch;thence North 0°06'18"East, a distance of 346.05' to an ESDP in the centerline of Brick
Mill Road;thence along said centerline North 52°49'33"East,a distance of 199.03' to an ESPD; thence
leaving said centerline North 2°37'14"East, a distance of 1813.40' to an EIS;thence North 5°54'01"East, a
distance of 600.39' to an EIP at an Old Fence;thence South 88°52'28"East, a distance of 799.32' to an EIS
at an Existing Lightwood Stake;thence South 87°48'15"East,a distance of 433.79' to an EIS;thence South
6°55'38"West, a distance of 1168.09' to an EIS at the R/W of Brick Mill Road;thence South 8°13'28"
West, a distance of 5.58' to an EIP the said POINT OF BEGINNING; said described tract containing 78.21
Acres,more or less.
Matthew S. Willis Register of Deeds
Harnett County, NC
Electronically Recorded
06/11/2024 03:23:59 PM NC Rev Stamp: $0.00
Book: 4238 Page: 2625 -2627 (3) Fee: $26.00
Instrument Number: 2024009962
SPECIAL POWER OF ATTORNEY
AND LIMITED AGENCY AUTHORIZATION
THE STATE OF NORTH CAROLINA §
COUNTY OF HARNETT §
KNOW ALL PERSONS BY THESE PRESENTS
The undersigned, as the owner of approximately 78.21 acres of real property located in
Harnett County North Carolina,as described on Exhibit"A" attached hereto and a part hereof for all
purposes (the "Property"), does hereby make, constitute, and appoint STARLIGHT HOMES
NORTH CAROLINA L.L.C., a Delaware limited liability company ("Builder"), as the
undersigned's true and lawful attorney,to act for and in the name,place and stead of the undersigned
to execute and deliver in the name of and on behalf of the undersigned in connection with the
development of the Property as a subdivision, including applications, plans, plats, permits,
declarations(of covenants,conditions and restrictions),easements,requests,utility commitments and
agreements, any amendments thereto, and similar development approvals and agreements relating to
the Property and any amendments thereto that are required to be executed by the undersigned as fee
simple owner of the Property and are compliant with the provisions of the Option Agreement dated
of even date herewith,between the undersigned and Builder.
This special power of attorney and limited agency authorization is irrevocable until,and shall
automatically expire upon,the acquisition of all of the Property by Builder.
The undersigned agrees and represents to those dealing with Builder that Builder is the
undersigned's true and lawful agent and may be dealt with as such until the expiration of this special
power of attorney and limited agency authorization or until written revocation of it by written
instrument executed by the undersigned and Builder. The undersigned does hereby ratify and confirm
whatsoever said attorney shall or may do by virtue of this special power of attorney and limited agency
authorization.
[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]
Submitted electronically by "Schell Bray PLLC"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Harnett County Register of Deeds.
BK 4238 PG 2626 DOC# 2024009962 '.
Executed to be effective as of .)ry` 7 ,2024.
[NOTARIAL SEAL] CW-BRICK MILL,LLC, a Delaware limited liability
company
By: CO• ! • ADO WEST,LLC,a Delaware limited
lia• •ompany—its sole Manager
By: ! /'ohn E ••rk, its President
Man:Co P County, -NY-? 0(\C\
I certify that the following person personally appeared before me this day and
acknowledged to me that he or she voluntarily signed the foregoing gocument for the purpose
stated therein and in the capacity indicated: ,off,v' E (10( Fres t(Ann H.
[print name of signatory in space above]
Date: ( _e\--1 V ok
My Commission Expires:
No a Public 1/
2 10:i Print Name: A- V L,< L V 1-6
[Affix Notary Stamp or Seal below]
ALICE L VIETZE
` �i Notary Public.State of Arizona
4 y� .� Maricopa County
rt' �''=� Commission#644332
fir ,"- My Commission Expires
• February 22,2027
BK 4238 PG 2627 DOC# 2024009962
EXHIBIT "A"
LEGAL DESCRIPTION OF PROPERTY
Commencing at the EIP with NC Grid Coordinates of N: 601029.1722, E: 2095118.2984, said
point being the POINT OF BEGINNING ; thence across the R/W of Brick Mill Road (NCSR
2005) South 36°32'33" West, a distance of 374.44' to an EIP in said R/W; thence South 3°05'25"
East, a distance of 14.27' to an EIS; thence South 3°05'25" East, a distance of 881.83' to an EIS;
thence South 3°05'25" East, a distance of 413.76' to an EIS; thence South 59°07'00" West, a
distance of 430.09'to a NIS; thence South 89°04'41" West, a distance of 848.88'to an EIS; thence
North 8°26'48" West, a distance of 167.40' to a NIS set along an existing Ditch; thence North
0°06'18" East, a distance of 346.05'to an ESDP in the centerline of Brick Mill Road;thence along
said centerline North 52°49'33" East, a distance of 199.03' to an ESPD; thence leaving said
centerline North 2°37'14" East, a distance of 1813.40' to an EIS; thence North 5°54'01" East, a
distance of 600.39' to an EIP at an Old Fence; thence South 88°52'28" East, a distance of 799.32'
to an EIS at an Existing Lightwood Stake; thence South 87°48'15" East, a distance of 433.79' to
and EIS; thence South 6°55'38" West, a distance of 1168.09' to an EIS at the R/W of Brick Mill
Road;thence South 8°13'28"West,a distance of 5.58'to an EIP the said POINT OF BEGINNING;
said described tract containing 78.21 Acres,more or less.