HomeMy WebLinkAboutNCG140182 Ownership Change FormYp
Division of Energy, Mineral & Land Resources FOR AGENCY USE ONLY
Date Received
Land Quality Section/Stormwater Permitting Year Month Da
National Pollutant Discharge Elimination System
NCDENR
W� C--D-W-
DmKomm� Aw"� PZe PERMIT NAMEIOWNERSHIP CHANGE FORM
1. Please enter the permit number for which the change is requested.
NPDES Permit (or) Certificate of Coverage
1 14 0 1 1 8 2
H. Permit status prior to requested change.
a. Permit issued to (company name): _ Southern Equipment Company
b. Person legally responsible for permit: Steve Simonsen
First MI Last
ENED
SAN 29 IZ13
DENR-LAND QIlALIN
SIORMWAJER PfrRM1i i1N0
c. Facility name (discharge):
Environmental Manager
Title
3015 Windward Plaza Suite 300
Permit Holder Mailing Address
Alpharetta GA 30005
City State Zip
(678) 392-2130 ) -_
Phone Fax
Ready Mixed Concrete Company - Sprung Lake, Plant
117
d. Facility address: Hwy 210 N
Address _—
Spring Lake NC 28390
City State Zip
e. Facility contact person: (704) 872-5901 Ext.
Andy Stankwytch 10290
First / Ml /Last Phone
III. Please provide the following for the requested change (revised permit).
a. Request for change is a result of- ® Change in ownership of the facility
❑ Name change of the facility or owner
If other please explain:
b. Permit issued to (company name): Concrete Service Co, Inc.
a Person legally responsible for permit: Richard R Allen
First MI Last
President
d. Facility name (discharge):
e. Facility address:
f. Facility contact person:
Revised Jan. 27, 2014
Title
PO Box 1867
Permit Holder Mailing Address
Fayetteville NC_ 28302
City State Zip
910 483-0396 boballen"r fa blockcom /
Phone E-mail Address
Concrete Service - Spring Lake
Hwv 210 N
Address
Spring Lake NC 28390
City State Zip
Winnie Jenkins
First MI Last
(9101323-9198 313
NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
Phone E-mail Address
IV. Permit contact information (if different from the person legally responsible for the permit)
Permit contact:
First MI Last
Title
Mailing Address
City state Zip
Phone E-mail Address
V Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
® Yes
❑ No (please explain)
VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
❑ This completed application is required for both name change and/or ownership change
requests.
❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change.
......................................................................................... .........................
The certifications below must be completed and signed by both the permit holder prior to the change, and
the new applicant in the case of an ownership change request. For a name change request, the signed
Applicant's Certification is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
I, 4 attest that this application for a name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
returned as incomplete.
1'..jhitik.' Signature 6e�L1 Cr s11 -'1A Date
APPLICANT CERTIFICATION
1, Richard R. Allen, attest that this application for a name/ownership change has been reviewed and is
accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information is not included, this application
package will be returned as incomplete.
Z&2 VL
1 a��siE�
Signature Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, Noah Carolina 27699-1612
Revised Jan. 27, 2014
BK 10221 PG 0827
NORTH CAROLINA NON -WARRANTY DEED
Lxcise Tax: $0.00
FILED ELECTRONICALLY
Co -b ERLAND COUNTY NC
J. LEF, WAMMIST, JR.
FILED Dec 18, 2017
AT 12:59:37 P4
noox 10221
START PAGE 0627
END PAGE 0.681
INSTRUMENT 3934.4
RnCORD ING: $26.00
EXCISE TAX $0.00
Parcel identifier -No. 0512-2,M880
Mail/Box to, Grantee
This instrument was prepared by: Kilpatrick Townsend & Stocicton LLP (BFR) (without title examination)
Brief description for the Index: 1100 00 Cottagoville Drive
THIS 'DEED made this �_ day of December, 2017, by and between
GRANTOR
ARGOS IDSA LLC,
a Delaware limited liability company, successor
by merger with Southern Equipment -Company,
Inc.
3015 Windward plaza, State 300,
Alpharetta, GA 30005
GRANTEE
Allen of Fayetteville W, LLC,
a North Carolina limited liability company
103 Builders Blvd
Fayetteville, NC 2.8301
Suter in appropriate block for each party: naive, address, and, if appropriate, character of entity, e.g. corporation or putn.ership,
The designation Grantor and Granteeas used herein shall include said parties, their heirs;successors, and assigns, and shall
include singular, plural, roasotiline, feininine or neuter as required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby
aolmowl.edged, has and by these presents does grant, bargain, sell and convey imto the. Grantee in feesimple, allthat certain
lot or parcel of laud situated in Cumberland. County, North Carolina and more particularly described as Mows:
SEE EX MIT A. ATTACHED HERETO AND INCORPORATED I MEM BY REFERENCE..
IM — Cumberiand Co. — Spdns Take
'submi.tted electronically by "wyatt Early Harris wheeler LLP"
U4008 [:.in compliance with North Carolina statutes governing recordable documents
and the terms. of the submitter agreement with the Cumberland county Register of Deeds.
MEMORANDUM OF LEASE
THIS MEMORANDUM OF LEASE ("Memorandum") is signed as of December 15,
2017, by ALLEN OF FAYETTEVILLE IV, LLC, a North Carolina limited liability company,
with its principal offices in Cumberland County, North Carolina ("Landlord"), and
CONCRETE SERVICE CO., INC., a North Carolina corporation, with its principal offices in
Cumberland County, North Carolina ("Tenant").
Landlord and Tenant have entered into a lease ("Lease") dated as of the date of this
Memorandum for valuable consideration with respect to certain "Premises" in Cumberland
County, North Carolina, more fully described and/or depicted on attached Exhibit A.
The term of the Lease is scheduled to commence on December 15, 2017, and expire on
December 14, 2022, unless sooner terminated as provided in the Lease. Tenant shall have the
five (5) options to extend the term of the Lease for periods of five (5) years each as specified in
the Lease.
This Memorandum is executed for the purpose of giving record notice of the existence of
the Lease for the term provided above. All terms and conditions of the Lease are incorporated
into this Memorandum by reference.
[SIGNATURES APPEAR ON THE FOLLOWING PAGES.]
1
72147753
Landlord and Tenant have executed this Memorandum as of the date set forth above.
La=�N O A TTEVILLE IV, LLC
Name: Richard R. Allen, Jr.
Title: Manager
Tenant: CONCRETE SERVICE CO., INC.
hlwn L
Nam�
Title: Cotp �x {-/
STATE OF NOR C OLINA�
COUNTY OF
I, the undersigned, a Notary Public of the County and State aforesaid, certify that the following person(s)
personally appeared before me this day, and
Y I have personal knowledge of the identity of the principal(s)
❑ I have seen satisfactory evidence of the principal's identity, by a current state or federal
identification with the principal's photograph in the form of a
❑ A credible witness has sworn to the identity of the principal(s);
each acknowledging to me that he or she voluntarily signed the foregoing document for the purpose stated
therein and in the capacity indicated: Richard R. Allen, Jr., Manager of Allen, of Fayetteville IV
LLC.
Date: �� ���7
P6F�r�f, 1' r�
�otary Public
(print name)
N0TWycial sed) My commission expires:_
m
PUBO
STAT NORTH CA LII�AA
OF (.
rij�tl'i� undersigned, a Notary Public of the County and State aforesaid, certify that the following person(s)
personally appeared before me this day, and
[+ I have personal knowledge of the identity of the principal(s)
❑ I have seen satisfactory evidence of the principal's identity, by a current state or federal
identification with the principal's photograph in the form of a
❑ A credible witness has sworn to the identity of the principal(s);
each acknowledging to me that he or she voluntarily signed the foregoing document for the purpose
stated therein and in the capacity indicated:: 2n (name) as
OurAD 5g c, title of Concrete ServicCo. Inc.
Date: /;Z-15-17 _
i--
���` ary Public
GARY �o (print name)
:w
'(official seal) = My commission expires:_
v'� rij0YxK 2
' � a
EXHIBIT A
STATE OF NORTH CAROLINA
COUNTY OF CUMBERLAND
BEGINNING at a point in the western margin of N.C. highway #210 (100' right -of way), said point
being North 25 degrees 39 minutes 29 seconds East 327.86 feet from the southeast corner of a 20.13
acre tract of land belonging to Roney W. Bailey and his wife, Sallie P. Bailey as recorded in Deed
Book 2558, Page 305 Cumberland County Registry; and running thence with the western margin of
said N.C. Highway #210 South 24 degrees 57 minutes 22 seconds West 49.62 feet to a point; thence
North 64 degrees 00 minutes 00 seconds West 200.24 feet to a point; thence along the are of a curve
to the right in a northerly direction having a radius of 466.94 feet an are distance of 97.59 feet to a
point; thence South 37 degrees 58 minutes 31 seconds West 253.23 feet to a point in the southern
margin of the tract of which this is a part; thence with the southern margin of the tract of which this is
a part North 57 degrees 23 minutes 00 seconds West 1379.93 feet to the southwest corner of the tract
of which this is a part, said point also being in the eastern edge of the tract of the Lower Little River;
thence with the western margin of the tract of which this is a part and the eastern edge of said Lower
Little River the following courses and distances: North 49 degrees 28 minutes 06 seconds East 66.35
feet; North 51 degrees 53 minutes 26 seconds East 100.08 feet; North 55 degrees 31 minutes 32 feet;
North 50 degrees 03 minutes 38 seconds East 100.60 feet; North 40 degrees 02 minutes 29 seconds
East 45.97 feet; North 63 degrees 06 minutes 00 seconds East 56.71 feet to the northwest corner of
the tract of which this is a part; thence with the northern margin of the tract of which this is a part
South 48 degrees 32 minutes 00 seconds East 1231.98 feet to the northeast corner of the tract of
which this is a part; thence with the eastern margin of the tract of which this is a part South 25
degrees 50 minutes 00 seconds West 200.00 feet to the point and place of BEGINNING and
containing 18.53 acres more or less.
LESS AND EXCEPT from the above described property is that certain portion thereof described in
the Fee Simple Deed from Metro Products and Construction company, Inc. to the Department of
Transportation dated May 7, 1996 and recorded in Book 4501, Page 189, Cumberland County
Registry.
And also being all of the property conveyed to Allen of Fayetteville IV, LLC by deeds recorded in Book
10221, Page 818, and Book 10221, Page 827, Cumberland County Registry.
u:laevanslargosllease documentslcumberland - spring lakelcumberland - spring lake
memorandum of lease.docx
72147753
3