NCC230860_FRO Submitted_20230329

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 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.
Project Name Toledo Subdivision
2. Location of land -disturbing activity: County Rockingham City or Township Reidsville
Highway/Street Country Lane (SR 2453) Latitude(decimal degrees) 36.34777 Long itude(decimaldegrees)
79.9788
3. Approximate date land -disturbing activity will commence:
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Residential
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas):3.29
6. Amount of fee enclosed: $400 . 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. (4.0 Acres *$100 =$400)
7. Has an erosion and sediment control plan been filed? Yes ❑ Enclosed 0 No ❑
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Guillermo Toledo
Phone: Office # 336-362-5508
E-mail Address [e-mail]
Mobile # [phone]
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Toledo Homes, LLC
Name
1034 Rierson Road
Current Mailing Address
Madison, NC 27025
City
336-362-5508
336-362-5508
Phone: Office # Mobile #
1034 Rierson Road
Current Street Address
Madison, NC 27025
State Zip City
State
Zip
10. Deed Book No.1592 Page No.2511 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).
Toledo Homes, LLC
Company Name
1034 Rierson Road
Current Mailing Address
Madison, NC 27025
City State
Phone: Office # 336-362-5508
[e-mail]
E-mail Address
1034 Rierson Road
Current Street Address
Madison, NC 27025
Zip City
Mobile # [phone]
State
Zip
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:
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)
(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.
Guillermo Toledo Owner
Type or print name Title or Authority
�JJIVMO 7 '6- I5.2o zz
Signature Date
I, �u2an�e Iyl ThOM01,5500 , a Notary Public of the County of CIO, WD(A
State of North Carolina, hereby certify that 06 kit(-M 1) � ottk 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 day of AU105t , 20 S L
Notary
Seal 12-05- Z Q2Z
My commission expires
SUZANNE M THOMASSON
NOTARY PUBLIC
GUILFORD COUNTY, NC
Myu'm'," eow 11- or, -10

) BOOK 1592 PAGE 2511 (3)
�('"
{ 607088
Unofficial Document Unollpliff Docum
Filed
Rockingham County, NC
Benjamin J. Curtis, Register of Deeds
01 /08/2021 11:46:40 AM
Fee Amt: $26.00 NC Excise Tax: $450.00
BRITTANY P. PRATT
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax $ 450.00 1 Recording $ 26.00 Recording Time, Book and Page
Mail after recording to Grantee
This instrument was prepared by Kevin Berger, Attorney
Brief Description for the index
THIS DEED made the 9 day of January, 2021 by and between
Grantor Grantee
RODNEY DALE SORRELL and wife,
JEANNE RENEE SORRELL
Mailing Address:
1090 Lemons Rd
Stokesdale, NC 27357
TOLEDO HOMES, LLC
Mailing Address:
7303 Horseshoe Bend Trl
Summerfield, NC 27358
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.
The below described property does ( ) does not ( x ) include the primary residence of one or more of the Grantor(s).
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
lot or parcel of land situated in Rockingham County, North Carolina and more particularly described as follows:
See Attached Exhibit "A"

BK 1592 PG 2512 DOC# 607088
UThe
n 0 1� i c 1ve dce-scr ed wcOicred uby metor nby `tnunent recordedn in B000ffi,Pacge
1 -al Docum
A map showing the above described property is recorded in Plat Book _, Page _.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and privileges and appurtenances thereto belonging to the
Grantee in fee simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right convey the
same in fee simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend
the title against the lawful claims of all persons whomsoever except for the exceptions hereinafter stated.
Title to the property hereinabove described is subject to the following exceptions:
1. Ad Valorem Taxes;
2. Easements of record;
3. Covenants and restrictions of record, if any; and
IN WITNESS WHEREOF, the Grantor has hereunto set her hand and seal, or if corporate, has caused this
instrument to be signed in its corporate name by its duly authorized officers and its seal to be hereunto affixed by authority
of its Board of Directors, the day and year first above written.
(SEAL)
Rodney Dale Sorrell
C. 2�u �PII O p Q� )l! AL)
anne Renee Sorrell
STATE OF NORTH CAROLINA
COUNTY OF ROCKINGHAM
I certify that the following person(s) personally appeared before me this day, and I have ( x )
examined satisfactory evidence of their identity or ( ) have personal knowledge of identity and
each acknowledged to me that he or she voluntarily signed the foregoing document for the
purpose stated therein and in the capacity indicated: Rodney Dale Sorrell and Jeanne Renee
Sorrell
WITNESS my hand and official seal or stamp, this the g day of January, 2021.
Notary Public
31 I2S
My Commission Expires: rl Kevin BergerNotary Public
Rockingham County, NC

BK 1592 PG 2513 DOC# 607088
Unofficial Document Unofficial Docum
EXHIBIT "A"
TRACT I:
Being Lot Two, containing 35.32 acres, more or less, as shown on that plat of survey entitled "Subdivision
of Property of Henry Decatur Baker Heirs" prepared by Kenneth A. Vaughn, R.L.S., dated April 1976 and
recorded in the Office of the Register of Deeds of Rockingham County, N. C., in Map Book 16 at Page 3.
Reference to said plat is hereby made for a further and more complete description.
TRACT H:
Being 2.000 acres, more or less, as shown on a plat entitled "Survey Plat for David Brian Baker & Leslie
Baker Moreau' dated December 30, 2016 prepared by Vaughn Surveying Co, Inc., as recorded in Plat
Book 78, Page 20 on January 17, 2017 in the Rockingham County, North Carolina Registry. Reference to
said plat is hereby made for a further and more complete description.
SAVE AND EXCEPT that property conveyed in Deed Book 728, Page 397, Deed Book 813, Page 138,
Deed Book 1034, Page 1893, Deed Book 1527, Page 724 and any other out conveyances.
SAVE AND EXCEPT Lot 1, containing 1.684 acres, Lot 2, containing 1.000 acres, Lot 3, containing
1.000 acres, and Lot 4, containing 1.000 acres, more or less, as shown on a plat of survey for Rodney
Dale Sorrell and wife, Jeanne Renee Sorrell, dated February 14, 2020 prepared Vaughn Surveying Co.,
Inc., as recorded in Plat Book 85, Page 48 on March 27, 2020 in the Rockingham County, North Carolina
Registry. Reference to said Plat is hereby made for a further and more complete description. (BLF 20-
8201)