NCC232592_FRO Submitted_20230829

CA Roe
�oN FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
No person may initiate any land-disturbing activity that disturbs one or more acres as covered by the Town of
Clayton Soil Erosion and Sedimentation Control Ordinance before this form and an acceptable erosion and
sedimentation control plan have been completed and approved by the Town of Clayton. Lots smaller than one
acre that are part of a larger plan of development are also subject to Town of Clayton Soil Erosion and
Sedimentation Control Ordinance and are required to complete this form. (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 Outback/Popeye's Restaurant Development
2. Location of land-disturbing activity: County JOHNSTON City or Township CLAYTON
11756 US Hwy 70 Business West 35.6558° N -78.4754° W
Highway/Street Latitude Longitude
3. Approximate date land-disturbing activity will commence:August 2023
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Commercial
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): 6.93
6. Has an erosion and sediment control plan been filed? Yes ✓ No Enclosed 1
7. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Curtis Little E-mail Address [e-mail]
Telephone [phone] Cell # 843-906-0882 Fax#
8. Landowner(s)of Record (attach accompanied page to list additional owners):
MOC Clayton II, LLC 843-906-0882
Name Telephone Fax Number
500 6th Street Same as Mailing Address
Current Mailing Address Current Street Address
San Antonio TX 78215
City State Zip City State Zip
9. Deed Book No. 6385 Page No. 918 Provide a copy of the most current deed.
Part B.
1. Company(ies)or firm(s)who are financially responsible for the land-disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet.) If the company or firm is a sole
proprietorship the name of the owner or manager may be listed as the financially responsible party.
MOC Clayton II, LLC [e-mail]
Name E-mail Address
500 6th Street Same as Mailing Address
Current Mailing Address Current Street Address
San Antonio TX 78215
City State Zip City State Zip
Telephone [phone] 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:
Chris Clayton - Mount Oak Capital [e-mail]
Name E-mail Address
12908 Baybriar Drive Same as Mailing Address
Current Mailing Address Current Street Address
Raleigh NC 27613
City State Zip City State Zip
Telephone [phone] 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 be any change in the information provided herein.
(,../ I,'5 ZA /44-17.,&„,--
Type or pri ame Title or Auth ty
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Signature Date
I, 1Q. 'C- (Qc , a Notary Public of the County of t AC ,
t_j,-•
State of North Carolina, hereby certify that (�) 1 t \ 'M-�.- appeared
personally before me this day and being duly sworn acknowledged that the above form was executed
by him.
je 9L—
Witness my hand and notarial seal, this 9�f day of d� 20 ' '
e l—.ow
it. I , My commission expires p- — it--/�—rk-t\
iii

Filed in JOHNSTON COUNTY, NC CRAIG OLIVE, Register of Deeds Filed 11/28/2022 03:23:44 PM
DEED BOOK: 6385 PAGE: 918-928 INSTRUMENT#2022836071
Real Estate Excise Tax: $0.00 Deputy/Assistant Register of Deeds: LaWanda Neal
in
*THIS DEED IS BEING RE-RECORDED TO CORRECT A TYPOGRAPHICAL ERROR IN THE GRANTEE THE
SPECIAL WARRANTY DEED ORIGINALLY RECORDED IN BOOK 6380, PAGE. 790-800,.INSTRUMENT#
2022835069
SPECIAL WARRANTY DEED
NO TITLE EXAMINATION BY PREPARER
Excise Tax: $2,160.00(paid on previous Deed)
Tax Parcel ID No.: 05026073 LJ
Verified by County on the day of ,2022
Prepared by: Richard A. Galt,PLLC,2533 Raeford Road,Fayetteville,NC 28305
Return alter recording to: Graybill,Lansche& Vinzani,LLC
Brief Description for the Index: Lot 2 of Minor Subdivision and Recombination plat for Capps &
Marvel Properties—Map 89/42
THIS SPECIAL WARRANTY DEED is made effective as of the 16th clay of November, 2022,by
and between MARY ELLIS CAPPS, IN HER CAPACITY AS EXECUTRIX OF THE ESTATE OF
SHERRILL CAPPS; LON ALAN FINER,IN HIS CAPACITY AS EXECUTOR OF THE ESTATE
OF RAYMOND CAPPS; MARY ELLIS CAPPS, unmarried; MARY SMITH CAPPS, unmarried;
JOSEPH E. CAPPS, unmarried; GRACE CAPPS HAMILTON, unmarried; JERRY W. CAPPS and
spouse, MARY N. CAPPS; TILLIE CAPPS WOOD and spouse, STEPHEN G. WOOD; having an
address of 430 Southwick Drive Fayetteville,NC 28303(collectively,the"Grantor"),and MOC CLAYTON
H LLC,a Delaware limited liability company*having an address 500 6th Street, San Antonio,Texas 78215
(the"Grantee").
WITNES SET H:
WITNESSETH,that Grantor, for a valuable consideration paid by Grantee,the receipt and sufficiency
of which is hereby acknowledged,has and by these presents does grant,bargain,sell and convey unto Grantee
in fee simple,all those certain lots or parcels of land situated in Johnston County,North Carolina,and more
particularly described as follows:
See attached Exhibit A.
The Property was acquired by Grantor's predecessor-in-title by instrument recorded
in Book 470,Page 621 of the Johnston County Registry. See Johnston County Estate File Nos. 10-E-836
(Stella Puckett Capps),21-E-4913 (Sherrill M. Capps)and 21-E-2077(Raymond I.Capps).
The Property referenced herein does not include the primary residence of a Grantor.
TO IIAVE AND TO HOLD the aforesaid lots or parcels of land and all privileges and appurtenances
thereto belonging to the Grantee in fee simple.
And Grantor covenants with Grantee, that Grantor is seized of the Property in fee simple and has
done nothing to impair such title as Grantor received, and Grantor will warrant and defend the title against
submitted electronically by "Stewart Title Guaranty Company - Commercial services Charlotte"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Johnston County Register of Deeds.

DEED B: 6385 P: 919
the lawful claims of all persons claiming by,under or through Grantor, subject to all easements, covenants,
conditions,restrictions, and rights-of-way of record, the lien of ad valorem taxes for the current year which
will be prorated at closing, all applicable zoning ordinances, all matters shown on the recorded plat, all
matters which would be revealed by a current and accurate survey,and all other matters shown on the attached
Exhibit B.
[Balance of Page Left Intentionally Blank—Signature Appears on Following Page]

DEED B: 6385 P: 920
IN WITNESS WHEREOF, the Grantor has hereunto set his 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, effective the day and year first above written.
•
Lon Alan Piner, ' OP
r
State of No rG ��e4
County of ,o, ct
I certify that the following person(s)personally appeared before me this day,each acknowledging
to me that they voluntarily signed the foregoing document for the purpose stated therein and in the
capacity indicated: Lon Alan Piner,Executrix.
Dated: 111 .1\ i�; _� LLsS ev
Notary Public <)
Printed Name: v a e1
My commission expires: ()La

DEED B: 6385 P: 921
IN WITNESS WHEREOF, the Grantor has hereunto set his 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,effective the day and year first above written.
"tf/A T( �f�`Pre (SEAL)
Wary Ellis Capps,Executr
eVey r/ ,d " (SEAL)
1 Ellis Capps ��
State of d- •
County or-TV) L.- - A/ i
I certify that the following person(s)personally appeared before me this day,each acknowledging
to me that they voluntarily signed the foregoing document for the purpose stated therein and in the
capacity indicated:Mary Ellis Capps. _p
Dated: , 2,C) `
Notary Public
•
Printed Name: Li-) t f(/+ 1 , S U f i V za_r)
y "" n V w My commission expires:.S t) {
Willa1,Moo
NOTARY PUBLIC
Madden NC
MyCnmmdseton Explvartuaryzace4

DEED B: 6385 P: 922
IN WITNESS WHEREOF, the Grantor has hereunto set his 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,effective the day and year first above written.
(SEAL)
Mary Smith Capps
by and through her attorney-hi-fact,
Lon Alan Piner
State of Q &\.c
County of C-0-A0,:e_\
I, ,Tht c, , ,a notary public in and for said county and state,do hereby certify that Lon
Alan Piner, attorney-in-fact for Mary Smith Capps,personally appeared before me this day, and being by
me duly sworn, says that he executed the foregoing and annexed instrument for and in behalf of Mary
Smith Capps, and that his authority to execute and acknowledge said instrument is contained in an
instrument duly executed, acknowledged, and recorded in the office of the Johnston County Register of
Deeds,and that this instrument was executed under and by virtue of the authority given by said instrument
granting him power of attorney; that the said Lon Alan Piner acknowledged the due execution of the
foregoing and annexed instrument for the purposes therein expressed for and in behalf of the said Mary
Smith Capps.
WITNESS my hand and official seal,this I day of November,2022.
. . ..... 1 gyp0. Notary Pu61ic
co
My Comm. xplres
Printed Name:
November 17,2023 U
' My commission expires: 11 / I )1 a3

DEED B: 6385 P: 923
IN WITNESS WHEREOF, the Grantor has hereunto set his 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, effective the day and year first above written.
N t (SEAL)
Grace Capps Ham 1 on
State of N DAL Cal-6 ►�.�
County of t.. 01-
. .5 sue,
I certify that the following person(s)personally appeared before me this day,each acknowledging
to me that they voluntarily signed the foregoing document for the purpose stated therein and in the
capacity indicated: Grace Capps Hamilton
,t4 Dated: NC 0V r7 Ali
tart'Pu is
Printed Name: W ( I +n
My commission expires: 9 /224r)
,,,ow 11qurrrPfil J�
0.1/4/\40 TA 14.\%:-A
r.
!fp
Of� N+Coy,
CO'

DEED B: 6385 P: 924
IN WITNESS WHEREOF, the Grantor has hereunto set his 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,effective the day and year first above written.
(SEAL)
J V . Ca
/l (SEAL)
Mary'i . Ca s
State of I V 61 h' I (tiro
County of 6.irn lei Li
I certify that the following person(s)personally appeared before me this day,each acknowledging
to me that they voluntarily signed the foregoing document for the purpose stated therein and in the
capacity Iindicated: Jerry W. Capps and Mary N. Capps. `' ,A
Dated: 17 / aOa a L.f� iUQ L1 th - 1. 1
No Iublic
owl I !I!001 `J, f r�
`,�e�*P�y11.L1111yg, r Printed Name: `IL r,1�`ndg�6 e /� kA/I I i�C MS H y�i/F
�awy``'�' �'°`� '� °'°�'�a "'"IM l.J�'II VI �� JY� 1Di/'ll-1
Cr: :in w My commission expires: (14_Cili h )6a 3
5_
a
•ti � 2
fi 'P fANiDc"' ‘`.,�

DEED B: 6385 P: 925
IN WITNESS WHEREOF, the Grantor has hereunto set his 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, effective the day and year first above written.
r (SEAL)
Tillie Capps Wood
Cerj-L- CL-1/0 (SEAL)Stephen G.Wood
State of '
County of w
I certify that the following person(s)personally appeared before me this day, each acknowledging
to me that they voluntarily signed the foregoing document for the purpose stated therein and in the
capacity indicated: Tillie Capps Wood and Stephen G. Wood.
Dated: `/_ r E" '
Notary Public
Printed Nam F
e
7-4.,, tea
C
My commission expires: ( / v

DEED B: 6385 P: 926
IN WITNESS WHEREOF, the Grantor has hereunto set his 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, effective the day and year first:above written.
WML
,l
i
;- 9 t l I{11� (SEAL)
Joseph E.lt apps
State of
County of Jo
aV\ 1t
I certify that the following person(s) personally appeared before me this day,each acknowledging
to me that they voluntarily signed the foregoing document for the purpose stated therein and in the
capacity indicated: Joseph E. Capps.
Dated: i 1 a 0*d*�.Ueeisuo-r®ooa, .- —�—. t C
A,m ®F. ( s.r No ary Public
am TA 'a P •
rinted Name: 1NC1.0-V-t_ i'\7
BL O = 1 My commission expires: f '
``..,,_,......ate••

DEED B: 6385 P: 927
EXHIBIT A
Being known and designated as New Lot 2 as shown and described on that Plat entitled, "Minor
Subdivision and Recombination Plat for CAPPS & MARVEL PROPERTIES," recorded May 28,
2019,in Plat Book 89,Page 42,Johnston County Registry.

DEED B: 6385 P: 928 END OF DOCUMENT
EXHIBIT B
1. Rights of tenants in possession under unrecorded leases.
2. Any inaccuracy in the area, square footage or acreage of the Property or on the plat recorded in Plat
Book 89,Page 42,Johnston County Registry.
3. Rights of the public, county, state or municipality in and to that portion of the land taken or used for
road purposes.
4. Any trust, right, interest or claim that may exist, arise or be asserted against the Title under or
pursuant to the Perishable Agricultural Commodities Act of 1930, as amended, 7 U.S.C. §499a, et
seq., or any similar state or federal law.
5. Any trust, right, interest or claim that may exist, arise, or be asserted against the Title under or
pursuant to the Packers and Stockyard Act of 1921,as amended,7 U.S.C. §181,et seq.,or any similar
state or federal law.
6. Minerals of whatsoever kind, subsurface and surface substances, including but not limited to coal,
lignite, oil, gas, uranium, clay, rock, sand and gravel in, on, under and that may be produced from
the Property, together with all rights, privileges, and immunities relating thereto, whether or not
appearing in the Public Records or listed in herein.
7. Easements, setback lines, and any other matters shown on plat recorded in Plat Book 89, Page 42,
Johnston County Registry.
8. Easement(s) in favor of Carolina Power and Light Company recorded in Book 503, Page 19; Book
539,Page 220, Johnston County Registry.
9. Book 737,Page 110; and Book 958,Page 400,Johnston County Registry.
10. Right of Way Agreement in favor of the State Highway Commission recorded in Book 637, Page
269, Johnston County Registry.
11. Subject to the right of way of U.S.Highway 70 Business.