NCC231520_FRO Submitted_20230518

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 Soil Erosion and
Sedimentation Control Ordinance of the City of Greenville (Title 9, Chapter 8) before this form and an
acceptable erosion and sedimentation control plan have been completed and approved by the City of
Greenville, Engineering Division. (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 SCAM l Po
2. Location of land-disturbing activity: County �1 City or Township r 3U' tl &J I tISL
Highway/Street GYI(Ltr Latitude Longitude
3. Approximate date land-disturbing activity will commence: 5) l a-3
4. Purpose of development (residential, commercial, industrial, institutional, etc.): 1J2SI ct.Q.Ikk1 a
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): - °b.Q5 QcIrQ
6. Amount of fee enclosed: $ . The application fee of $100.00 per acre (rounded
to the tenth of acre) is assessed without a ceiling amount (Example: a 9-acre application fee is $900).
7. Has an erosion and sediment control plan been filed? Yes No Enclosed X
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name lar I I5fl 1 E-mail Address S\1C.tnrrn 1 1 10)(1'1013COM ri)4i , rpm
Telephone Cell#a, -�1�in a �j Fax# `JJ
9. Landowner(s) of Record (attach accompanied page to list additional owners):
sharwLm _) asa. ciao. ab59
Name Telephone Fax Number
?Do) CA-etytas Blvd Ieo1 ClayIns 61vc
Current Mailing Address Current Street Address
ar. anu a sb C-',r. V i 1LL. NC .r,T1e5 ,
City State Zip City State Zip
10. Deed Book No. - L-'1 Page No. SU1-309 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):
Name E-mail Address
I FJU C1rl1Qs Blvol 1(601 Cher1 Blvd
Current Mailing Address Current Street Address
fir-e0nv1 U-Q N aig58 ar.Q. v c tC . MC a bS
City State Zip City State Zip
Telephone oa5 q 1.(D' abSS 1a 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 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:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone 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 by any change in the information ovided herein.
_,ch4 exert
Type or t n Tit a or Authority
qb
Sig r Da
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I, 11,00S.rS ile-toirc y , a Notary Public of the County of JettA(-4-
State of North Carolina, hereby certify thatSfrartram � IPyt-K y appeared
personally before me this day and being duly sworn acknowledged/that the above form was
executed by him.
Witness my hand,f��d notarial seal, this (Ith day of (�,,� , 20�
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+0T'41/41. sNotary
5 Seal
?m t/81.� c�: My commission expires L,t1 t/l I I
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Page 1 of 3
Type: CONSOLIDATED REAL PROPERTY
Recorded:2/22/2022 3:26:32 PM
Fee Amt: $336.00 Page 1 of 3
Revenue Tax: $310.00
Pitt County, NC
Lisa P. Nichols REG OF DEEDS
BK 4247 PG 307 - 309
[SPACE ABOVE THIS LINE RESERVED FOR RECORDING DATA]
STATE OF NORTH CAROLINA Prepared By: HORNE& HORNE, PLLC
COUNTY OF PITT Mail To: GRANTEE
1801 Charles Blvd.
Tax Parcel No:72789, 72790, 72791, 72792 Greenville,NC 27858
Excise Tax: $310.00
GENERAL WARRANTY DEED
The Preparer is informed that all or a portion of the property herein conveyed does not include the principal residence of
the Grantor. This instrument prepared by Stephen F.Horne,Ill,a licensed North Carolina attorney. Delinquent taxes,if
any,to be paid by the closing attorney to the county tax collector upon disbursement of closing proceeds.
THIS DEED,made and entered into this the 18th day of February, 2022,by and between JAMES
L. LANIER, JR. and wife, ANN P.LANIER, whose address is 208 Hampton Circle, Greenville,NC
27858, hereinafter called GRANTOR; and TIERNEY CONSTRUCTION, LLC, whose address is1801
Charles Blvd., Greenville,NC 27858, hereinafter called GRANTEE;
WITNESSETH:
That Grantor, for and in consideration of 1'EN DOLLARS ($10.00) and other good and valuable
consideration to him in hand paid by Grantee,the receipt of which is hereby acknowledged, has given,
granted,bargained, sold and conveyed and by these presents does give, grant,bargain, sell and convey
unto the said Grantee, his heirs and assigns,in fee simple, the following described real property,to-wit:
Being all of Lot Nos. 85, 86, 87 and 88 of South Pointe Subdivision, Sections 2 and 3 as shown
on the plat prepared by Baldwin and Associates and recorded in Map Book 65, Pages 185 and
186, Pitt County Registry.
This conveyance is made subject to those Restrictive Covenants recorded in Book 1993, Page
668 and as amended in Book 2142, Page 4, Pitt County Registry.
Submitted electronically by "Horne & Horne, PLLC"
in compliance with North caroling statutes governing recordable documents
and the terms of the submitter agreement with the Pitt County Register of Deeds.
Book:4247 Page:307 Page 1 of 3

Page 2 of 3
TO HAVE AND TO HOLD the above described real property with all the rights,privileges and
appurtenances thereunto belonging or in anywise appertaining unto the said Grantee,his heirs and
assigns, in fee simple forever.
And the Grantor, for himself,his heirs and assigns, covenants with Grantee, his heirs and assigns,
that he is seized of said premises in fee and has the right to convey the same in fee simple; that the same
is free and clear from all encumbrances except easements and restrictions of record and 2022 ad valorem
taxes which are to be prorated between Grantor and Grantee at the time of closing,noncompliance with
local, county, state or federal governmental laws, ordinances,or regulations relative to zoning,
g,
subdivision, occupancy,use, construction or the development of the property,
p y, p subjectp if any, and that he
will warrant and defend the title to the same against the lawful claims of all persons whomsoever.
When reference is made to the Grantor or Grantee, as used herein, shall include said ,
arties their
pasties,
heirs, successors and assigns,and shall include the singular and plural, and any reference to gender shall
include masculine,feminine and neuter.
IN WITNESS WHEREOF, Grantor has adopted the word "SEAL" as his seal and has hereunto
set his hand and seal on this the day and year first above written.
(SEAL)
.JAMES L.LANIER,JR.
�.�ilrtA� ic)/-734et-11-e-e-, (SEAL)
ANN P.LANIER
Book:4247 Page:307 Page 2 of 3

Page 3 of 3
STATE OF NORTH CAROLINA
COUNTY OF PITT
Gr 10
I,a Notary Public of Pitt County,North Carolina do hereby certify that JAMES L. LANIER,JR.
and,ANN P. LANIER personally appeared before me this day and acknowledged the due execution of
the foregoing deed of conveyance.
lvi
Witness my hand and Notarial Seal,this the 44,day of February, 2022.
FAY DIXON 1/:---Car4 (DAANt...)
,,. � a Notary Public, North Carolina
1 NQTARY PUBLIC
! � '" Greene County
' My Commission Expires Printed/TypedName: fratj DIXeYi
July 07 2023
My Commission Expires:Book:4247 4247 Page:307 Page 3 of 3