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HomeMy WebLinkAboutNCC243078_FRO Submitted_20241009 BPI WAKE COUNTY FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
j , No person may initiate any land-disturbing activity on one or more acres as covered by the Wake
W'�/AKE 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
.,sH c.,xoi d,;., 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 C,-1 nrt (CH -( [�j )33 ! CD
2. Location of land-disturbing activity: Jurisdiction )kQ ,KAth (Wake Co. or Municipality)
Highway/Street/8 (iQ;foi J0 Latitude:3'57(5 2 . Longitude - 7 e 36 3
3. Approximate date land-disturbing activity will commence: 10 CJC1O — Zr,,1E 1
4. Type of development(residential, commercial, industrial, institutional, etc.): i ,S 6 sc„-
5. Total acreage disturbed or uncovered (including off-site utilities and borrow/waste
areas): O. r!,`7
6. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Namerj e,1. E-mail Address c LATc.1\- -fittin`t : sc\e, C ur d •C C ,�
Telephone \\C\ c\ i;\'13 Cell# j\cl •io°i cj( 73 Fax#
7. Landowner(s) of Record (attach accompanied page to list additional owners):
dirk+ to LC_ c 15 `7O '1/ '7 `� 3 07fs 1"i)c1
Name(s) Telephone Fax or E-mail addre s
z"" -rrs.i. cam:
5 Lk
Current Mailing Addresj Current Street Addres
2-e C.e '4S .7 L:krs Nc_
City State Zip City State Zip
8. Deed Book No. ._ Page No._ 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):
L 1`2- Ev>E (1 t�rl c:
Name E-mail Address f
`\\(1,, ZA‘\.e- \c.. °?LV `a `a•-k)
Current Mailing Addss Current Street Address
`"15S 2.47. -,
City State Zip City State Zip
Telephone Cri i 9 6 l L/J 7 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:
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:
��z-1-c\\-c c ' c'1.\�.�.� -4\Q .. L�.L Ft�:>Vcx` 'gy m\L ` c�-1 1 :,,\,C N
Name of Registered Agent
" E-mail
y(Address
`\� \ \\ g lam` J {
L- .5 A\4_ 7- .,. ` -c �3
Current Mailing Address) Current Street Address
City State Zip City State Zip
Telephone 9 ‘ 9 90 e-t i `)' 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.
its <:\ , \- N'cX - z -EQ _ c�„ :.\>`QZ '-s-�;<`_,\-\ 'e s\A r
Type or ri t name Title or Authority
17,1(--6-6 Z, 56? Zd (--t
gnature Date
11
I, ( d S 1—I S , a Notary Public of the County of W ke
State of North Carolina, hereby certify that h v 1#i n F -t hie appeared
personally before me this day and being duly sworn acknowledged that the above form was executed by him.
Witness my hand a%13,91,01 seal, this 2.3 day of (( -rn ''r- , 20 Z,ti
JQ�0. IA,• s
U' ©TARS'N Notary
_ Seal --•-- f
\ PUB V-\G ;Q My commission expires I vi ZO I
f llljU111111NII,,`
btkU"IUlD4Ll-qaUL//S 1011,41.1.- I 1 , 1 .,
TAMMY L. BRUNNER
REGISTER OF DEEDS
PRESENTED & RECORDED ON
06-21-2024 AT 15:12:38
STATE OF NC REAL ESTATE
EXCISE TAX: $850.00
BOOK: 019642 PAGE: 02773 - 02774
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $850.00
Parcel ID: 0284399(5013),0284398(5017,0284397(5021)and 0284395(5033)
Mail/Box to: Fritchle Family Farms,LLC,5416 Pulley Town Road,Zebulon,NC 27597
Prepared by: Dale L.Thomas,Jr.,Gray Newell Thomas,LLP,4112 Blue Ridge Road,Suite 200,Raleigh,NC 27612
Brief description Lots 2,4,5 and 6,C.E.Duke Jr.,Heirs Subdivision
for the index:
THIS GENERAL WARRANTY DEED("Deed")is made on the 2i day of JlJt ,20 2.4 ,by and between:
GRANTOR GRANTEE
Clifford G.Revoir and spouse,Carol S.Revoir Fritchle Family Farms,LLC,a North Carolina limited
liability company
Mailing Address: 177 Lake Royale
Louisburg,NC 27549 Mailing Address:5416 Pulley Town Road
Zebulon,NC 27597
Property Addresses:5013,5017,5021 &5033 Mitchell Town
Road,Youngsville,NC 27596
FOR VALUABLE CONSIDERATION paid by Grantee,the receipt and legal sufficiency of which is acknowledged, Grantor by this
Deed does hereby grant, bargain, sell and convey to Grantee,in fee simple,all that certain lot,parcel of land or condominium unit in
the City of YoungsviIle,Wake County,North Carolina and more particularly described as follows(the"Property"):
BEING all of Lots 2,4,5 and 6 of the C.E.Duke,Jr.,Heirs Subdivision,as shown by map and survey recorded in Book of
Maps 2001,Page 58,Wake County Registry.
All or a portion of the Property was acquired by Grantor by instrument recorded in Book 8928 Page 974-976,Wake County Registry.
All or a portion of the Property 0 includes or Q does not include the primary residence of a Grantor.
A map showing the Property is recorded in Book of Maps 2001 Page 58,Wake County Registry.
NC Bar Association Real Property Section Form No.3©Revised 02/2021
Printed by Agreement with the NC Bar Association
Submitted electronically by Gray Newell Thomas,LLP in compliance with North Carolina statutes governing recordable
documents and the terms of the submitter agreement with the Wake County Register of Deeds.
tit�U l JtD4LF1.7UL/14
TO HAVE AND TO HOLD the Property and all privileges and appurtenances thereto belonging to Grantee in fee simple. Grantor
covenants with Grantee that Grantor is seized of the Property in fee simple,Grantor has the right to convey the Property in fee simple,
title to the Property is marketable and free and clear of all encumbrances, and Grantor shall wan-ant and defend the title against the
lawful claims of all persons whomsoever,other than the following exceptions:
1. Title to the property hereinbefore described is subject to the following exceptions:
Ad Valorem taxes for the current year.
Utility easements and unviolated covenants,conditions or restrictions that do not materially affect the value of the
property.
IN WITNESS WHEREOF, the Grantor has duly executed this North Carolina General Warranty Deed, if an entity by its duly
authorized representative.
N . Clifford G.Revoir Entity Name
�j�ie,47,1 By:
Name: Carol S.Revoir Name:
Title:
Name:
By:
Name:
Name:
Title:
STATE OF JCr COUNTY OF WA r""
I' bA t.E. L.. ' ,a Notary of the above state and county,certify that the following person(s)
personally appeared before me on the 2.t 11- day of TO r►€ ,20 2.4 each acknowledging to
me that he/she/they signed the foregoing document,in the capacity represented and identified therein(if any):
Clifford G.Revoir and Carol S.Revoir
Affix Notary Seal/Stamp r
dam----
t Noary Public(Official
DALE L THOMAS JR Signature)
Notary Public My commission expires: T.
North Carolina
Chatham County
2
NC Bar Association Real Property Section Form NOV 3 CO Revised 02/2021
Printed by Agreement with the NC Bar Association