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HomeMy WebLinkAboutNCC221790_FRO Submitted_20220518FINANCIAL 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 Land Quality Section, N.C. Department of Environment and Natural Resources. (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 Lachlan Village 2. Location of land -disturbing activity: County Catawba City or Township Hickory Highway/Street 4 8 th Ave. NE Latitude 3 5. 7966 Longitude - 81 . 2 5 7 7 3. Approximate date land -disturbing activity will commence: 5 / 0 9 / 2 2 4. Purpose of development (residential, commercial, industrial, institutional, etc.): Residential 5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 10 . 31 6. Amount of fee enclosed: $ 910 . 00 . The application fee of $65.00 per acre (rounded up to the next acre) is assessed without a ceiling amount (Example: a 9-acre application fee is $585). 7. Has an erosion and sediment control plan been filed? Yes X No Enclosed 8. Person to contact should erosion and sediment control issues arise during land -disturbing activity: Name Jarred Blanton E-mail Address jarredthomascompany@qmail.com Telephone 828-639-0157 Cell# 828-639-0157 Fax# 9. Landowner(s) of Record (attach accompanied page to list additional owners): D&J Properties of North Carolina LLC . 8 2 8- 3 0 8- 319 3 Name Telephone Fax Number 2008 46th AVE. DR NE 2008 46th AVE. DR NE Current Mailing Address Current Street Address Hickory NC 28601 Hickory NC 28601 City State Zip City State Zip 10. Deed Book No. 0 3 6 5 6 Page No. 0 2 4 0- 0 2 4 7 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): DJT Development, LLC jarredthomascompany@gmail.com Name E-mail Address 2088 46th Ave. Drive NE 2088 46th Ave. Drive NE Current Mailing Address Hickory, NC 28601 City State Telephone 828-639-0157 Current Street Address Hickory, NC 28601 Zip City State Zip Fax Number 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 Current Mailing Address City Telephone, E-mail Address Current Street Address State Zip City State Zip 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: Jarred Blanton Name of Registered Agent 2033 10th St LN Current Mailing Address Hickory, NC 28601 City State Zip Telephone 828-639-0157 jarredthomascompany@gmail.com E-mail Address 2033 loth St LN Current Street Address Hickory, NC 28601 City State Zip 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. Jarred Blanton Type or print name ignature Member Title or Authority 5/5/22 Date I, Cdr'r�q SL(,r 1Qhn err a Notary Public of the County of CJCttc� ire State of North Carolina, hereby certify that 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 J day of , 20 ,9a� Gf._ORIA BURKHA�.Tf=R Notary Public Otary Caldwuniy, North Carolina My _ om[risswon Expires September 11, 284 My commission expires FILED C118Wba COUntY On May 11, 2021 at 10:42:00 am Excise Tar $320-00 (CH) iNST. # 11138 DONNA HICKS SPENCER, Re gater Of Cis lw 03656 Pg 02'40-0241 GENERAL WARRANTY DEED REVENUE: $320.00 Tax Parcel ID No. 3735-13-02-2954 Verified by County on the day of , 20 By: V/Mail/Box to: Thomas N. Hannah, Attorney at Law, P.O. Drawer 1989, Hickory, NC 28603 This instrument was prepared by: Thomas N. Hannah, Attorney at Law, P.O. Drawer 1989, Hickory, NC 28603 Brief description for the Index: THIS DEED, made this the 29th day of April 2021, by and between GRANTOR: CLOYD H. PROPST, JR. and wife, PAMELA S. PROPST and CATHERINE ELAINE PROPST and spouse, JANET M. MCGOLDRICK and AMBER ELISE CRUZ (sole heir of Judy P. Stevens) and husband, NICHOLAS CRUZ BENITEZ LEIGH ANN P. BLODGETT and husband, HARLEY H. BLODGETT whose mailing address is: 4205 61' St NW, Hickory, NC 28601 (herein referred to collectively as Grantor) and GRANTEE: D K J PROPERTIES NORTH CAROLINA, LLC whose mailing address is: 2008 46'" Ave Drive NE, Hickory, NC 28601 (herein referred to collectively as Grantee) [include mailing address foreach Grantorand Grantee; marital status of each individual Grantorand Grantee; and type of entity, e.g., corporation, limited liability company, for each non -individual Grantor and Grantee.] WITNESSETH: For valuable consideration from Grantee to Grantor, the receipt and sufficiency of which is hereby acknowledged, Grantor hereby gives, grants, bargains, sells and conveys unto Grantee in fee simple, subject to the Exceptions and Reservations hereinafter provided, if any, the following described property located in City of , Clines Township, County of Catawba, State of North Carolina, more particularly described as follows: BEGINNING at a stone in M.L. Deal's line and comer, and runs with his line North 84° 30' West 591.8 feet to a stake; thence North 40 55' East450 feet to a stake, comer of tract#5; thence with the line of tract#5, South 810 30' East 680 feet to a stake; thence South 360 30' East 840 feet, passing a stake on the bank of the highway, to a point in the center of Highway #16; thence with the highway toward Hickory, South 420 30' West and South 46° 40' West about 464 feet, more or less, to the BEGINNING. This tract lies on the Northwest side of the said highway, contains about 12.8 acres, and is fully shown on the aforesaid map by G.S. Rowe, C.E., March 20, 1937 which is duly recorded in Catawba County. This being Lot Number 4 of the T.E. Bowman Property; for reference to title, see Book 284, Page 148 and Plat recorded in Plat Book 7, at Page 90, Catawba County Registry. Revised December 17, 2009 I Said property having been previously conveyed to Grantor by instrument(s) recorded in Book 1788, Page 1102, and being reflected on plat(s) recorded in Map/Plat Book 7 Page/Slide 90. Ail or a portion of the property herein conveyed [ ] includes or j X ] does not include the primary residence of a 0241 Grantor. TO HAVE AND TO HOLD unto Grantee, together with all privileges and appurtenances thereunto belonging, in fee simple, subject to the Exceptions and Reservations hereinafter and hereinabove provided, if any. And Grantor hereby warrants that Grantor is seized of the premises in fee and has the right to convey same in fee simple, that title is marketable and is free and clear of encumbrances other than as set forth herein, and that Grantor will forever warrant and defend the title against the lawful claims of all persons or entities whomsoever. This conveyance is made subject to the following Exceptions and Reservations: This conveyance is made subject to restrictive covenants and encumbrances of record, and to any and all easements and rights of way on location on the above described property heretofore granted or existing in favor of any individuals, corporations, public or private associations of individuals, public utilities and governmental agents, commissions or departments for the purpose of constructing, erecting, laying, building or maintaining any streets, roads, highways, signs, service alleys, power lines or poles, gas lines, water lines, lines for pipes or sewer lines and any and all other similar or related public or private utility service facilities or otherwise. All references to Grantor and Grantee as used herein shall include the parties as well as their heirs, successors and assigns, and shall include the singular, plural, masculine, feminine or neuter as required by context. IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written. (SEAL) Amr C Sz pl 1 k (SEAL) as Cruz" Benitez (SEAL) Catherine Elaine ropst (SEAL) Janet M. cGoldrick STATE OF COUNTY OF Cloyd H. Propst, Jr. Pamela S. Leigh ArXf P. Blodgett H. Blodgett 1, G wsc CA , [[prinf/type name of Notary], a Notary Public in and for the aforesaid County and State, certify that the following person (s) personally appeared before me this day, each acknowledging to me that he or she voluntarily signed the going document: Amber Elise Cruz and husgand Nicolas Cruz Be itez, GRAN -TO). gnatur Notary Public ires: VIV;i-Q Revised December 17, 2009 Seal) co pTA/ A G - COv (SEAL) (SEAL) (SEAL) Said property having been previously conveyed to Grantor by instrument(s) recorded in Book 1788, Page 1102, and being reflected on plat(s) recorded in Map/Plat Book 7 Page/Slide 90. 0242 All or a portion of the property herein conveyed [ ] includes or [ X ] does not include the primary residence of a Grantor. TO HAVE AND TO HOLD unto Grantee, togetherwith all privileges and appurtenances thereunto belonging, in fee simple, subject to the Exceptions and Reservations hereinafter and hereinabove provided, if any. And Grantor hereby warrants that Grantor is seized of the premises in fee and has the right to convey same in fee simple, that title is marketable and is free and dear of encumbrances other than as set forth herein, and that Grantor will forever warrant and defend the title against the lawful claims of all persons or entities whomsoever. This conveyance is made subject to the following Exceptions and Reservations: This conveyance is made subject to restrictive covenants and encumbrances of record, and to any and all easements and rights of way on location on the above described property heretofore granted or existing in favor of any individuals, corporations, public or private associations of individuals, public utilities and governmental agents, commissions or departments for the purpose of constructing, erecting, laying, building or maintaining any streets, roads, highways, signs, service alleys, power lines or poles, gas lines, water lines, lines for pipes or sewer lines and any and all other similar or related public or private utility service facilities or otherwise. All references to Grantor and Grantee as used herein shall include the parties as well as their heirs, successors and assigns, and shall include the singular, plural, masculine, feminine or neuter as required by context. IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written. (SEAL) Amber EI'ise nsz (SEAL) NJIqolas Cruz Begilki (SEAL) Catherine Elaine Propst (SEAL) anet M. McGoldrick STATE COUNTY OF Cloyd H. Propst, Jr, Pamela S. Leigh A96 P. Blodgett H. Blodgett I, f nt/type name of Notary], a Notary Public in and for the aforesaid and State, certify that the following person (s) personally appeared fore me this day, each acknowledging to me that he or she voluntari igned the foregoing document: Amber Elise Cruz and husband Nic Cruz Benitez, GRANTOR(S). Date: Signature of Notary Public Revised December 17, 2009 (OfficiallNotarial Seal) (SEAL) (SEAL) (SEAL) STATE OF COUNTY OF (Official/Notarial Seal) 1, , Vpfinte4g49 me of Notary], a Notary Public in and for the afo d County an e, certify that the following person (s) personally appear be this day, each acknowledging to me that he or she voluntarily si the foregoing document Cloyd H. Propst Jr and Pamela S. P pst, NTOR(S). Date: Sig ture of Notary Public My mission expires: STATE OF I i (Official/Notarial Seal) COUNTY OF 0011"AL)(&_ 1, 1 [[prinbtype name of Notary], a Notary Public in and for the aforesaid Co ty and State, certify that the following person (s) personally appeared re me this day, each acknowledging to me that he or she voluntarily signed the oing document: Catherine Elaine Propst and Janet M. McGold k, GRANT R( Date: vVL�41L/�'�o gnature of Notary Public AMC NOTARY PUBLIC My Commission GG Expires ?� COL) My Commission expiresjo-nA t900i(g STATE OF (Official/Notarial Seal) COUNTY OF 1, , [ jprin name of Notary], a Notary Public in and for the afar id Coun d State, certify that the following person (s) personally appear re me this day, each acknowledging to me that he or she voluntarily ed the foregoing document: Leigh Ann P. Blodgett and Harley H. g GRANTOR(S). Date: ignature of Notary Public My Commission expires: Revised December 17, 2009 Said property having been previously conveyed to Grantor by instrument(s) recorded in Book 1788, Page 1102, and being reflected on plat(s) recorded in Map/Plat Book 7 Page/Slide 90. 0244 All or a portion of the property herein conveyed [ J includes or [ X ] does not include the primary residence of a Grantor. TO HAVE AND TO HOLD unto Grantee, togetherwith all privileges and appurtenances thereunto belonging, in fee simple, subject to the Exceptions and Reservations hereinafter and hereinabove provided, if any. And Grantor hereby warrants that Grantor is seized of the premises in fee and has the right to convey same in fee simple, that title is marketable and is free and clear of encumbrances other than as set forth herein, and that Grantor will forever warrant and defend the title against the lawful claims of all persons or entities whomsoever. This conveyance is made subject to the following Exceptions and Reservations: This conveyance is made subject to restrictive covenants and encumbrances of record, and to any and all easements and rights of way on location on the above described property heretofore granted or existing in favor of any individuals, corporations, public or private associations of individuals, public utilities and governmental agents, commissions or departments for the purpose of constructing, erecting, laying, building or maintaining any streets, roads, highways, signs, service alleys, power lines or poles, gas lines, water lines, lines for pipes or sewer lines and any and all other similar or related public or private utility service facilities or otherwise. All references to Grantor and Grantee as used herein shall include the parties as well as their heirs, successors and assigns, and shall include the singular, plural, masculine, feminine or neuter as required by context. IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written. Amber Elise Cruz Nicolas Cruz nitez Catheriin Elaine Propst Jan M. McGoldrick STATE OF COUNTY OF -YV- /1] t>�� - - (SEAL) Clo d H. Propst, Jr. SEAL Pamela S. Propst (SEAL) (SEAL) Leigh An P. odgett (SEAL) (SEAL) Harley . Blodgett I, , [(prin name of Notary], a Notary Public in and for the aforesaid County I State, certify that the following person (s) personally appeared bef me this day, each acknowledging to me that he or she voluntarily sippA the foregoing document: Amber Elise Cruz and husband Nicola ruz Benitez, GRANTOR(S). Date: December 17, 2009 Signature of Notary Public (Official/Notarial Sea[) 0245 STATE OF K nrfh j larZjl COUNTY OF i%faWbA, (OfficiallNotarial Seal) ,,�111t111���I I, DeniSt.S�ur- C.enho, [fprfnt/fype name of Notary], a Notary f,� V1SF YI� `` �� Public in and for the aforesaid County and State, certify that the following , ���, person (s) personally appeared before me this day, each acknowledging to iC�.0 me that he or she voluntarily signed the foregoing document: Cloyd H. a � r Propst Jr and Pamela S. Propst, GRANTOR(S). S— `r n Date: 'T''9� -Aoai ` � COS 0. 0, Signature of N My Commission expires: '7- -0?0 '- `ryi1NG,��.� (Official/Notarial Seal) STAT F COUNTY OF I, pe name of Notary], a Notary Public in and for the afore 'd Cou and State, certify that the following person (s) personally appear Wore me this day, each acknowledging to me that he or she voluntar' sign the foregoing document: Catherine Elaine Propst and Ja M. McGo "ck, GRANTOR(S). Date: Signa of Notary Public My mmission expires: (Official/Notarial Seal) STATE COUNTY OF 1, , [fpri pe name of Notary], a Notary Public in and for the afore Coun nd State, certify that the following person (s) personally appeare re me this day, each acknowledging to me that he or she voluntan ign the foregoing document: Leigh Ann P. Blodgett and Harley . lodgett, NTOR(S). Date: SignhtZ of Notary Public My ommission expires: Revised December 17, 2009 Said property having been previously conveyed to Grantor by instrument(s) recorded in Book 1788, Page 1102, and being reflected on plat(s) recorded in Map/Plat Book 7 Page/Slide 90. 0246 All or a portion of the property herein conveyed [ ] includes or [ X ] does not include the primary residence of a Grantor. TO HAVE AND TO HOLD unto Grantee, togetherwith all privileges and appurtenances thereunto belonging, in fee simple, subject to the Exceptions and Reservations hereinafter and hereinabove provided, if any. And Grantor hereby warrants that Grantor is seized of the premises in fee and has the right to convey same in fee simple, that title is marketable and is free and clear of encumbrances other than as set forth herein, and that Grantor will forever warrant and defend the title against the lawful claims of all persons or entities whomsoever. This conveyance is made subject to the following Exceptions and Reservations: This conveyance is made subject to restrictive covenants and encumbrances of record, and to any and all easements and rights of way on location on the above described property heretofore granted or existing in favor of any individuals, corporations, public or private associations of individuals, public utilities and governmental agents, commissions or departments for the purpose of constructing, erecting, laying, building or maintaining any streets, roads, highways, signs, service alleys, power lines or poles, gas lines, water lines, lines for pipes or sewer lines and any and all other similar or related public or private utility service facilities or otherwise. All references to Grantor and Grantee as used herein shall include the parties as well as their heirs, successors and assigns, and shall include the singular, plural, masculine, feminine or neuter as required by context. IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written. Amber Elise Cruz Nicolas Cruz enitez Catherin laine Propst Jane M. McGoldrick STATE OF COUNTY OF (SEAL) (SEAL) Cloyd H. Pro t, Jr. (SEAL) Pamela S. Propst I. , ((p ' name of Notary], a Notary Public in and for the aforesaid Coun and State, certify that the following person (s) personally appeared b re me this day, each acknowledging to me that he or she voluntarily s' ned the foregoing document: Amber Elise Cruz and husband Nicol Cruz Benitez, GRANTOR(S). Date: December 17, 2009 Signature of Notary Public (Official/Notarial Seal) (SEAL) M W7 (Official/Notarial Sea[} STATE OF COUNTY OF I, , I(prin pe name of Notary], a Notary Public in and for the aforesaid C n d State, certify that the following person (s) personally appeared b e me this day, each acknowledging to me that he or she voluntarily ' ned th foregoing document: Cloyd H. Propst Jr and Pamela S ropst, GRA OR(S). Date: Signatu of Notary Public My Commission expires: (Official/Notarial Seal) STATE OF COUNTY OF I , nn Pe name of Notary], a Notary Public in and for the aforesaid Coun d State, certify that the following person (s) personally appeared re m this day, each acknowledging to me that he or she voluntani gned the for oing document: Catherine Elaine Propst and Jane . McGoldrick, G NTOR(S). Date: Signature of Notary Public My Commission expires: STATE OF N0Y -1'h C'aY 0\%.1&, (Official/Notarial Seal) COUNTY OF I-if\aXy-0 J I, LOY%04NA CAYIQ.AVl \0 ([pririnNypename ofNotary],allotary Public in and for the aforesaid County and State, certify that the following person (s) personally appeared before me this day, each acknowledging to me that he or she voluntarily signed the foregoing document: Leigh Ann P. Blodgett and Harley H. Blodgett, GRANTOR(S).' LORIANN OANAPINNO NOTARY PUBLIC Mecklenburg County North Carolina My Commission Expires June 10, 2023 Date: 'it 29\ Z) 2_ w Signature of Notary Public My Commission expires: lob tO t 2.62-'J Revised December 17, 2009