NCC231299_FRO Submitted_20230503

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.
1. Project Name Herlocker Mechanical Systems Outdoor Storage Area
2. Location of land-disturbing activity: County Mecklenburg City or Township Charlotte
10925 WESTLAKE DR 35.0136 -80.9700
Highway/Street Latltude(decimal degrees) LOngltUde(decimal degrees)
3. Approximate date land-disturbing activity will commence:5/8/2023
4. Purpose of development(residential, commercial, industrial, institutional, etc.):commercial
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas):2.0
6. Amount of fee enclosed: $200'00 . 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 Tom Herlocker E-mail Address [e-mail]
Phone: Office# 704.962.3760 Mobile# 704'574'0035
9. Landowner(s)of Record (attach accompanied page to list additional owners):
HH WESTLAKE LLC
Name Phone: Office# Mobile#
4230 OLDFIELD RD 4230 OLDFIELD RD
Current Mailing Address Current Street Address
Charlotte,NC, 28226 Charlotte,NC, 28226
City State Zip City State Zip
10. Deed Book No.37870 Page No.480 Provide a copy of the most current deed.

vvI v,v - ■ Tvv
•
• For Registration
• •Fredrick Smith
Register of Deeds
Mecklenburg County, NC
Electronically Recorded
2023 Jan 05 12:21 PM RE Excise Tax: $ 0.00
Book: 37870 Page: 480 - 482 Fee: $ 26.00
•
Instrument Number: 2023000985
• liyak
NORTH CAROLINA NON-WARRANTY DEED
Excise Tax: - 0.00
Parcel ID: 201.271.16
Mail/Box to: Grantee
Prepared by: John W.Beddow;James,McElroy&Diehl,P.A.;626 N.Tryon St., Ste. 700, Charlotte.NC 28202
Brief 10925 Westlake Drive
description
for the Index:
THIS NON•WARR.ANTY DEED("Deed")is made on the..,�_day of January 2023,by and between:
GRANTOR GRANTEE _
ULLMAN GROUP PROPERTIES LLC, HH WESTLAKE,LLC,
a North Carolina limited liability company a North Carolina limited liability company
10926 Westlake Drive 4230 Oldheld Road •
Charlotte,NC 28273 I Charlotte,NC 28228-7039
•
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 parcel of land in the
City of Charlotte, Mecklenburg County, North Carolina and more particularly described as follows(the"Property"):
See BXJIIBIT A attached hereto and made a part hereof
All or a portion of the Property 0 includes or ® does not include the primary residence of a Grantor.
TO HAVE AND TO HOLD the Property and all privileges and appurtenances thereto belonging to Grantee in fee
simple. Grantor makes no warranty of'title to the Property.
Page 1 of 3
NC Bar Association Real Property Section Form No. 7 0 Revised 02/2021
Printed by Agreement with the NC Bar Association 5122417
submitted electronically by "Richard L. Robertson & Associates, P.A."
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Mecklenburg County Register of Deeds.

VV, V■ V - ■ TV,
IN WITNESS WHEREOF,Grantor has duly executed this Deed,if an entity by its duly authorized representative.
ULLMAN o C P P PERTIES LLC
Br_
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Name:Luke Ullman
r } Title:Manager
STATE OF E421. �1 1iF 121,11ACOUNfY of elAeCil b
I Q t--#tl V fir t,ti , a Notary of the above state and county,certify that the following
person(s)personally appeared before me on the_ c day of January 2023 each acknowledging to me that he or she signed
the foregoing document,in the capacity represented and identified therein(if any):Luke Ullman,Manager
Affix N(( i'Yi igealiStamp ( // f/ü/
��pY. tN1�t nq Notary Public(Offici i S gnature,
ray o�.ac1+s My commission exp�e 1NI RI
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Page 2 of 3
NC Bar Association Real Property Section Form No. 7®Revised 02/2021
Printed by Agreement with the NC Bar Association 5122417

V I WI V - I TVr
F iIBIT A
•
LEGAL DE RYpJION
LYING IN THE CITY OF CHARLOTTE, MECKLENBURG COUNTY, NORTH CAROLINA, AND MORE
PARTICULARLY DESCRIBED AS FOLLOWS:
•
BEING ALL OF PARCEL "E" LOT 12A, OF WESTLAKE BUSINESS PARK AS SHOWN ON A MAP THEREOF
RECORDED IN MAP BOOK 26 AT PAGE 872 IN THE OFFICE OF THE REGISTER OF DEEDS FOR MECKLENBURG
COUNTY, NORTH CAROLINA,AND MORE PARTICULARLY DESCRIBED AS FOLLOWS:
BEGINNING AT AN EXISTING#4 REBAR WITH CAP LOCATED ON THE SOUTHERN RIGHT-OF-WAY OF
WESTLAKE DRIVE(VARIABLE R/W)AND BEING THE COMMON FRONT CORNER OF LOTS 12A AND 11 OF MAP BOOK
26 AT PAGE 872AND HAVING NC GRID COORDINATES N510,6.45.8230 E1,411,527.8700;THENCE RUNNING WITH THE
COMMON LINE OF LOT 11 S 60-36-29 E 678.83 FEET TO A SET #4 REBAR, HAVING NC GRID COORDINATES
N510,312.7153 E1,412,119.2334;THENCE WITH THE COMMON LINES OF LOT 3 OF MAP BOOK 26 PAGE 444 AND LOT
lA OF MAP BOOK 24 PAGE 311 S 26-52-13 W 328.78 FEET TO A FOUND#5 REBAR;THENCE WITH THE COMMON LINE
OF AVERT PROPERTIES(DEED BOOK 6812 PAGE 469)N 63.40.24 W-640.48 FEET TO A FOUND#5 REBAR WITH CAP;
THENCE WITH TWO COMMON LINES OF LOT 12 MAP BOOK 26 PAGE 872 N 27-11-60 E 59.83 FEET TO FOUND#6
REBAR; THENCE N 17-54-49 W 214.30 FEET TO A FOUND #5 REBAR ON THE SOUTHERN RIGHT-OF-WAY OF
WESTLAKE DRIVE(60'PUBLIC R/W);THENCE WITH SAID RIGHT-OF-WAY A CIRCULAR CURVE TO THE LEFT WITH
A RADIUS OF 704.07 FEET, ARC LENGTH 190.56 FEET, CHORD BEARING N 63-19-47 E 189.98 FEET AND DELTA
ANGLE OF 15.80-27 TO POINT AND PLACE OF BEGINNING.
CONTAINING 246,506 SQUARE FEET OR 5.659D ACRES,MORE OR LESS,AS SHOWN ON SURVEY PREPARED
BY ARTHUR F. FORMViAN, NORTH CAROLINA PROFESSIONAL LAND SURVEYOR NO. L-3141 OF LUCAS•FORMAN
INCORPORATED, TITLED "PHYSICAL SURVEY OF 10925 WESTLAKE DRIVE", DATED DECEMBER 16, 2022 AND
DESIGNATED AS JOB NUMBER 22194.
Page 3 of 3
NC Bar Association Real Property Section Fotm No, 7®Revised 02/2021
Printed by Agreement with the NC Bar Association 5122417

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).
HH WESTLAKE LLC. [e-mail]
' Company Name E-mail Address
4230 OLDFIELD RD 4230 OLDFIELD RD
Current Mailing Address Current Street Address
Charlotte,NC, 28226 Charlotte,NC, 28226
City State Zip City State Zip
Phone: Office# 704.962.3760 Mobile# [phone]
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.
1-4-6"1/as5 —1 MAZ-t-AZr L', FA52-T37,-
Typee or print name Title or Authority
Signature Date
Lori L To MSc- , a Notary Public of the County of Unio n
State of North Carolina, hereby certify that -rr,or ob i 1 11oc.K.or 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 tree , 20
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O9 L. Tp',., Notary
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NO74 7 My commission expires
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