NCC233662_FRO Submitted_20231212

�,ON Cook JACKSON COUNTY PERMITTING & CODE ENFORCEMENT
_ A Land Disturbance: One-Half(1/2) or more Acres/Sto►tntt'alel'Installation
to Financial Responsibility/Ownership Form
Silva Office: 538 Scotts Creek Rd,Salle 205,!'Gone: 828-586-7560/Fax: [phone]
• Tjy WO' Cashiers Office: 357 Frank Allen Road,Phone: [phone]/Far: 828-745-6867
No person may initiate a land-disturbing activity and/or stormwater installation before this form has been completed and
an acceptable erosion and sedimentation control/stormwater plan has been approved by the Jackson County Office of
Permitting&Code Enforcement. If work is started without an approved permit your permit fcc will be doubled.
• !'lease type or print,and if any question is not applicable place N/A in the blank.
• Submit three (3) copies of the plan,a narrative,and the appropriate fcc;please contact our office for
an accurate fcc calculation before submitting paperwork. For fee calculation call 828-745-6850 or e-
mail [e-mail] or jamiebaumgarner lt,jacksonnc.org.
• A surety bond is required for any disturbance of five (5)acres or more
Part A
1. Project Name: SKYLAND PROP SITE AT 281 PIN 7577-08-0432
2. Location of land disturbing activity/stormwater installation: (City or Township) TUCKASEGEF
Highway/Street HWY 107 /CANADA RD Latitude 35.2690 Longitude -83.1220
3. This project will require the review of the following:n Erosion Control n✓ Stormwater
Is this project within a regulated district?nNo nYes—District:
4. Approximate date work will begin onsite: ASAP
5. Purpose of development(residential,commercial,industrial,etc.) COMMERCIAL
6. Total acreage disturbed or uncovered (including off-site borrow and waste areas) 1.52
7. Amount of fee$300 FOR OFFICE USE:Received? (initial/date) 36 / •a3
8. Has an erosion&sedimentation control/stormwater plan been filed?nNo Iy iYes nEnclosed
9. Person to contact should issues arise during land-disturbing activity/stormwater installation:
Name BILLY D SMITH E-mail Address [e-mail]
Phone Cell 828-269-0253 Fax
10. Landowners(s)of Record (Use blank page to list additional owners) Deck Bk/Pg 2348/460 (Provide a copy)
Name Skyland Properties of\VNC Inc Phone Fax
Current Mailing Address 51 Bridge St/ Sylva NC/28779
Part B
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. M od l- 2 J
BILLY D SMITH [e-mail] I C., 4*
Name I?-mail Address 23^ t I
51 BRIDGE ST r_
Mailing Address Street Address R L:C EI V E U
SYLVA NC 28779 NOV 1 5 2023
City State Zip Code City State Zip Code
828-269-0253 PAID
Phone Number Fax Number
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.

1. (a) If the financially Responsible Party is not a resident of North Carolina,please give name and street
address of a North Carolina Agent.
Name E-mail Address
Mailing Address Street Address
City State Zip Code City State Zip Code
Phone Fax Number
(b) If the Financial 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 Financial Responsible
Party is a Corporation,give name and street address of the Registered Agent.
Name of Registered Agent E-mail Address
Mailing Address Street Address
City State Zip Code City State Zip Code
Phone 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 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 authority to execute
instruments for the Financially Responsible Person). I agree to provide corrected information should there
be any changes in the information provided herein.
BILLY D SMITH OFFICER-SKYLAND PROP OF\Y/NC INC
Type or Print Name 'ride or Authority
• kt ti i27
Signature Date
I,C\2D , a Notary Public of the County of c P-!/10-S
State of North Carolina, hereby certify that 111\\ v, Srv\O appeared personally
before me this day and being duly sworn acknowledged that the above form was executed by them.
•
Witness my hand and notarial seal,this 15 day of N()VAN\\Inv' , 20 �3.
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county
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Page 1 of 3
Type: WARRANTY DEED
Recorded: 12/13/2022 1:55:33 PM
Fee Amt: $856.00 Page 1 of 3
Revenue Tax: $830.00
Jackson County, NC
Shandra Sims Register of Deeds
BK 2348 PG 460 - 462
1t).9creek,
MN �q
Dec - 13 2022 LP
PIN; 7567-98-9465 and 7567-98-9221
Revenue; $830.00
THIS INSTRUMENT PREPARED WITHOUT
BENEFIT OF A TITLE EXAMINATION
UNLESS CER1'WIED IN WRITING BY;
Jeffrey Goss of Ridenour&Goss,P,A.
21 Colonial Square, Sylva,NC 28779
STATE OF NORTH CAROLINA
SPECIAL WARRANTY DEED
COUNTY OF JACKSON
THIS SPECIAL WARRANTY DEED ("Deed") is dated this 12th day of December, 2022,
by and between JAMES SEARCY,Executor of The Estate of Hazel Coggins Henderson,hereinafter
referred to as "Grantor," whose address is PO Box 1907, Sylva, NC 28779, and SKYLAND
PROPERTIES OF WNC, INC.,a North Carolina corporation,hereinafter referred to as"Grantee,"
whose address is 51 Bridge Street, Sylva,NC 28779.
The designations Grantor and Grantee include the above parties and their respective heirs,successors, and
assigns, whether singular,plural, masculine,feminine Or neuter, as required by context.
WHEREAS, Hazel Coggins Henderson, a widow, died testate on December 20, 2021 in
Jackson County,North Carolina, being seized and possessed of the below described lands; and,
WHEREAS,Letters Testamentary were issued in the Estate of Hazel Coggins Henderson,
which appears of record in File No 21 E 12 in the Office of the Clerk of Superior Court for Jackson
County, North Carolina, appointing James Searcy as Executor of the Estate of Hazel Coggins
Henderson; and,
WHEREAS, pursuant to Item 4 of the Last Will and Testament of Hazel Coggins
Henderson,admitted to probate in the above referenced Estate,Hazel Coggins Henderson devised
all the rest, residue, and remainder of the Estate, including the below described lands, to the
Executor be sold and the sale proceeds distributed in percentage shares to the beneficiaries listed
in Item 4; and,
submitted electronically by "smith & Morgan Law, PA"
in compliance with North Carolina statutes governing recordable documents •
and the terms of the submitter agreement with the Jackson county Register of Deeds.
Book: 2348 Page: 460 Seq: 1

Page 2 of 3
WHEREAS, the said James Searcy, Executor, being empowered by the Last Will and
Testament of Hazel Coggins Henderson, has contracted to sell and convey the below described
lands to the Grantee upon such terms and conditions as he deems just and for the advantage of the
Estate,
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 lot,parcel of land,or condominium unit in River Township,
Jackson County,North Carolina and more particularly described as follows (the"Property"):
SEE LEGAL DESCRIPTION
ATTACHED AS EXHIBIT"A"
The property herein described 0 is or 0 is not the primary residence of the Grantors,
TO HAVE AND TO HOLD the Property and all privileges and appurtenances thereto
belonging to Grantee in fee simple. Grantor covenants with Grantee that Grantor has done •
nothing to impair such title as Grantor received, and Grantor shall warrant and defend the title
against the lawful claims of all persons claiming by, under or through Grantor,other than the
following exceptions: '
Easement(s) and right(s)-of-way for public utilities of record, if any.
Ad valorem taxes due for the current year. 1
IN WITNESS WHEREOF, Grantor has duly executed this Warranty Deed, if an entity by •
its duly authorized representative, the day and year first above written. '
The Estate of Hazel oggins Henderson .
By: e--(SEAL)
J es Searcy,Executo
STATE OF NORTH CAROLINA
CO TY OF JA KCI
I, k(-e, 2tteEy\ ,Notary Public,do hereby certify that James Searcy, Executor
of The Estate f Hazel Coggins Henderson personally appeared before me this day and
acknowledged the due execution of the foregoing instrument.
Witn e: hand and • c'. •-al this f 2. day of December,2022.
i,L ,,i,'I I . l' (Official Seal)
Official Signa i• of Notary auECN
ASHLEY A.
/ 414.11-1,10:r.
NolarYPubllo,NorthCurollneMy Commission Expires: (( I g a02`� Commlaslon Eplies•
MY o2a Plovo►nbec 19,2
•
Race Rile 22-2465
Book: 2348 Page: 480 .Seq: 2

Page 3 of 3
EXHIBIT A
BEING AND COMPREHENDING all of Tract"A"containing 3.029 acres as shown on a survey
entitled "Skyland Properties of WNC, Inc," dated November 5, 2022, Drawing # J-2163, as
surveyed by Davenport&Assoc,,Inc.,and recorded in Nat Cabinet 25 at Slide 838 of the Jackson
County Registry (the "Survey"), to which specific reference is made for a more complete
description.
The Property is conveyed TOGETHER WITH all appurtenances and SUBJECT TO all restrictions,
reservations and exceptions shown on the Survey and contained in the below-referenced deeds and
the instruments referenced therein.
The Property is conveyed SUBJECT TO the joint right of the owners of Tract "C" shown on the
Survey to take water from the well, pump,and water system located on Tract"A" the location of
which is designated as "WELL HOUSE" on the Survey and further SUBJECT TO an easement
for the purposes of ingress and egress for going upon Tract "A" to inspect, service, maintain,
repair, and replace the well, pump, and water system. The Property is further conveyed
TOGETHER WITH and SUBJECT TO the obligation to pay a pro rata share of the costs of
maintenance and upkeep of the well, pump, and water system, such costs to be equally divided
among the number of buildings connected to the water system.
The Property is further conveyed SUBJECT TO an easement for existing water lines, in their
• present location, leading from the Well House across Tract"A"for the benefit of Tract"C,"said
easement to be ten feet(10')in width and for the purpose of repairing,maintaining,and inspecting
the existing pipelines and installing new water lines from the water system to Tract"C."
The Property is conveyed SUBJECT TO the terms and conditions of a Consent Judgment entitled
"Department of Transportation vs. Hazel Henderson," which appears of record in File# 10 CVS
767 in the Office of the Clerk of Superior Court for Jackson County and as recorded in Book 1925
at Page 62 of the Jackson County Registry.
Also being a portion of the lands described by deeds recorded in Book 1098 at Page 350, Book
1078 at Page 202 and Book 246 at Page 39, both of the Jackson County Registry.
Book: 2348 Page: 460 Seq: 3

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Business Corporation
Legal Name
Skyland Properties of WNC, Inc.
Information
Sosld: 1132178
Status: Current-Active 0
Date Formed: 1/19/2010
Citizenship: Domestic
Fiscal Month: December
Annual Report Due Date: April 15th
CurrentAnnual Report Status:
Registered Agent: Smith, Michele D,
Addresses
Reg Office Mailing Principal Office Reg Mailing
240 Skyland Drive 51 Bridge Street 51 Bridge Street PO Box 1905
Sylva, NC 28779 Sylva, NC 28779 Sylva, NC 28779 Sylva, NC 28779
Officers
President
Billy D Smith
51 Bridge Street
Sylva NC 28779
Stock