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HomeMy WebLinkAboutNCC240010_FRO Submitted_20240104 •Fon 3c10o Tunc+1oA Blvd. [ Parcel 1 of 2 ] WAKE COUNTY 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 Wake County Unified Development Ordinance before this form and an acceptable erosion and TY WAKE sedimentation control plan have been completed and approved by Wake County Department of Environmental Services, Water Quality Division (Please type or print and, if the question is not applicable, place N/A in the blank.) Part A. 1 Project Name Tesler. collision Cer+er — Caarncr 2 Location of land-disturbing activity Jurisdiction IOWrr 0-c Cilthek , NC (Wake Co or Municipality) Highway/Street ZotriefriDA Blvd Latitude 1g.(O5g86b Longitude 35.125I'11 3 Approximate date land-disturbing activity will commence �//G/ 4_ Type of development (residential, commercial;industrial, institutional, etc.). ComrnerCAt 5. Total acreage disturbed or uncovered (including off-site utilities and borrow/waste areas) 3.30 Acres 6 Person to contact should erosion and sediment control issues arise during land-disturbing activity- Name Sam Moore E-mail Address sam@6sdev.com Telephone Cell# 817 505 8117 Fax# 7 Landowner(s)of Record (attach accompanied page to list additional owners)• Ziej Verrtureg,ut, 911- 961-2046 r+no:ewslti S► tynail•Cont fii* atrce.I --' Name(s) Telephone Fax or E-mail address OS6o25$ 2.61‘ 13ceocield D++• TQmc AS (Haling Current Mailing Address Current Street Address R t.e.igh N 0 2740 b City State Zip City State Zip 8 Deed Book No. 012612 Page No 02692-02694 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 Include requested information) 6S T Raleigh NC,LLC sam@6sdev.com Name E-mail Address 18333 Preston Rd Suite 500 18333 Preston Rd Suite 500 Current Mailing Address Current Street Address Dallas TX 75252 Dallas TX 75252 City State Zip City State Zip Telephone 817-505-8117 Fax Number 2. (a) If the Financially Responsible Party is not a resident of Wake County, identify a designated agent in Wake County to receive any notice, process, pleading in any action or legal proceeding arising out of any matter relating to the Wake County Erosion and Sedimentation Control Ordinance and/or Land Disturbance Permit: 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: James J.Amyx jamyx@6sdev.com Name of Registered Agent E-mail Address 18333 Preston Rd Suite 500 18333 Preston Rd Suite 500 Current Mailing Address Current Street Address Dallas TX 75252 Dallas TX 75252 City State Zip City State Zip Telephone 817-505-8117 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. James J. A yx Manager Type or print nam Title or Authority 10/16/23 Signature Date I, �lioo�E- , a Notary Public of the County of ��44,75 T�9S State of Nlalh--earettria, hereby certify that j"tES ST/7,1-1*yx appeared personally before me this day and being duly sworn acknowledged that the above form was executed by him. Witness my hand and notarial seal, this !lo ` day of �GToQEiL , 20 Z?j Notary Seal /./Z My commission expires l �7 """'e', SAM MOORE �,Grp•n`6� __: -,-Notary Public,State of Texas ;': .�� Comm.Expires 04-11-2027 '' ,.;3i. +°. Notary ID 134299784 BK012612PG02692 WAKE COUNTY, NC 438 LAURA N RIDDICK REGISTER OF DEEDS PRESENTED & RECORDED OH 06/2112007 AT 14:10:10 STATE OF NORTH CAROLINA REAL ESTATE EXCISE TAX: sees BOOK:012612 PAGE:02692 - 02694 NORTH CAROLINA SPECIAL WARRANTY DEED Excise Tax: $ 8(:ri Tax Lot No. Parcel Identifier No. out of REID 0341261 Verified by County on the_ day of ,20� By Mail/Box to: _Xkc&C&J icP Lcf This instrument was prepared by:_Leslee Roth Sharp,without benefit of title search Brief description for the Index: Lot 6 Book of Maps 2007 Page 1332 Lincoln Park South THIS DEED made this_day of ,2007,by and between GRANTOR GRANTEE JACK PARKER PROPERTIES NC,LLC ZIGGY VENTURES,LLC a Delaware limited liability company a North Carolina limited liability company 1700 Broadway,34th Floor 2816 Brenfield Drive New York,NY 10019 Raleigh,NC 27606 Enter in appropriate block for each party: name,address,and,if a3propriate,character of entity,e.g.corporation or partnership. 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. WITNESSETH,that the Grantor,for a valuable consideration paid by the Grantee,the receipt ofwhich 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 the Town of Gamer.Swift Creek Township.Wake County North Carolina and more particularly described as follows: BEING all of Lot 6, as same is shown on that certain plat entitled "Subdivision Map of Lincoln Park South,Lots 6&7,"prepared by Withers &Ravenel Kenneth Close Surveying,recorded in Book of Maps 2007,Page 1332,Wake County Registry. (00054462.DOC)NC Bar Association Form No.6 01977,2002 Printed by Agreement with the NC Bar Association-1981 BK012612PG02693 Tice property hereinabove described was acquired by Grantor by instrument recorded in Book 11858 Page 2440. A map showing the above described property is recorded in Book of Maps 2007,Page 1332,Wake County Registry. TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee simple. And the Grantor covenants with the Grantee,that Grantor has done nothing to impair such title as Grantor received,and Grantor will warrant and defend the title against the lawful claims of all persons claiming by,under or through Grantor,other than the following exceptions: 1. Ad valorem taxes for the 2007and subsequent years. 2. Restrictions,easements and covenants of record,including,but not limited to, those recorded in Book 11777 Page 438,Wake County Registry. 3. Easements of record for public/private utilities and rights of way,including,but not limited to, those for sanitary sewer and access for the benefit of Lot 7. 4. Existing utilities. IN WITNESS WHEREOF,the Grantor has duly executed the foregoing as of the day and year first above written. CRAP JACK PARKER PROPERTIES NC,LLC (Entity Name) a Delaware limited liability company By. /``el (A-) Kenneth M.Fuller Title: Operating Manager State of NORTH CAROLINA -County of WAKE I,the undersigned Notary Public of the County and State aforesaid,certify that KENNETH M. FULLER either being personally known to me or proven by satisfactory evidence(said evidence being ),personally appeared before me this day and acknowledged that he is OPERATING MANAGER of JACK PARKER PROPERTIES NC,LLC,a Delaware limited liability company,and that he as OPERATING MANAG>�stM y 'If uthoriaed,voluntarily executed the foregoing instrument for and behalf of the limited liability company for the p ��5 i y,y3,^a ged. ROSARY IP ,� Witness my hand and Notarial stamp or seal g = ••a c this 19 ti day of SuIt4.,,2007. My Commission Expires: .n7:3,oZ at y•.q attOnspRACANp G}2C *•.•' '' rcOtjK ``���` Notary Public �C,�,��� Name: Le5/ee.�rt�h `-")&fl The foregoingCertificate(s)of Ware certified to be correct.This instrument and this certificate are duly registered at the date and time and in the Book and Page shown on the first page hereof. Register of Deeds for County By: Deputy/Assistant-Register of Deeds (00054462.DOC)NC Bar Association Form No.6 01977,2002 Printed by Agreement with the NC Bar Association-1981 BK012612PG02694 i1IIlIIM1U BOOK:012612 PAGE:02692 - 02694 Yellow probate sheet is a vital part of your recorded document. Please retain with original document and submit for rerecording. Wake County Register of Deeds WAKE Laura M.Riddick COUNTY Register of Deeds NORTH CAROLINA This Customer Group This Document #of Time Stamps Needed New Time Stamp #of Pages 22.0041/20/06 l4ii�S DEPARTMENT OF THE TREASURY 6��f� llINTERNAL REVENUE SERVICE CINCINNATI OH 45999-0023 Date of this notice: 02-13-2023 Employer Identification Number: 92-2300323 Form: SS-4 Number of this notice: CP 575 G 6S T RALEIGH NC LLC JAMES J AMYX SOLE MBR 427 N TATNALL ST STE 47933 For assistance you may call us at: WILMINGTON, DE 19801 1-800-829-4933 IF YOU WRITE, ATTACH THE STUB AT THE END OF THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER Thank you for applying for an Employer Identification Number (EIN) . We assigned you EIN 92-2300323. This EIN will identify you, your business accounts, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records. Taxpayers request an EIN for their business. Some taxpayers receive CP575 notices when another person has stolen their identity and are opening a business using their information. If you did not apply for this EIN, please contact us at the phone number or address listed on the top of this notice. When filing tax documents, making payments, or replying to any related correspondence, it is very important that you use your EIN and complete name and address exactly as shown above. Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the information is not correct as shown above, please make the correction using the attached tear-off stub and return it to us. A limited liability company (LLC) may file Form 8832, Entity Classification Election, and elect to be classified as an association taxable as a corporation. If the LLC is eligible to be treated as a corporation that meets certain tests and it will be electing S corporation status, it must timely file Form 2553, Election by a Small Business Corporation. The LLC will be treated as a corporation as of the effective date of the S corporation election and does not need to file Form 8832. To obtain tax forms and publications, including those referenced in this notice, visit our Web site at www.irs.gov. If you do not have access to the Internet, call 1-800-829-3676 (TTY/TDD 1-800-829-4059) or visit your local IRS office. (IRS USE ONLY) 575G 02-13-2023 6STR 0 9999999999 SS-4 IMPORTANT REMINDERS: * Keep a copy of this notice in your permanent records. This notice is issued only one time and the IRS will not be able to generate a duplicate copy for you. You may give a copy of this document to anyone asking for proof of your EIN. * Use this EIN and your name exactly as they appear at the top of this notice on all your federal tax forms. * Refer to this EIN on your tax-related correspondence and documents. * Provide future officers of your organization with a copy of this notice. Your name control associated with this EIN is 6STR. You will need to provide this information along with your EIN, if you file your returns electronically. Safeguard your EIN by referring to Publication 4557, Safeguarding Taxpayer Data: A Guide for Your Business. You can get any of the forms or publications mentioned in this letter by visiting our website at www.irs.gov/forms-pubs or by calling 800-TAX-FORM (800-829-3676) . If you have questions about your EIN, you can contact us at the phone number or address listed at the top of this notice. If you write, please tear off the stub at the bottom of this notice and include it with your letter. Thank you for your cooperation. Keep this part for your records. CP 575 G (Rev. 7-2007) Return this part with any correspondence so we may identify your account. Please CP 575 G correct any errors in your name or address. 9999999999 Your Telephone Number Best Time to Call DATE OF THIS NOTICE: 02-13-2023 ( ) - EMPLOYER IDENTIFICATION NUMBER: 92-2300323 FORM: SS-4 NOBOD INTERNAL REVENUE SERVICE 6S T RALEIGH NC LLC CINCINNATI OH 45999-0023 JAMES J AMYX SOLE MBR lllll 427 N TATNALL ST STE 47933 WILMINGTON, DE 19801 Ton 39 5o Stott-ha n 81vd• C Pored L °4 21 Landowner(s)of Record (attach accompanied page to list additional owners) 6H Para! DkS fact u.`, H ton f+oldingt,Uc 17o-zb2-464o Si onavelwws ®grail •coM Name(s) Telephone Fax or E-mail address 0340 s-41 1y Apo+I t.cary 6t. Some. ay Moulin Current Mailing Address Current Street Address garner NC 21529 City State Zip City State Zip Deed Book No. 017581 Page No 01079-01082 Provide a copy of the most current deed BK017581 PG01079 WAKE COUNTY, NC 117 CHARLES P. GILLIAN • REGISTER OF DEEDS PRESENTED & RECORDED ON 09/19/2019 1S:40:40 STATE OF NC REAL ESTATE EXCISE TAX: $660.00 BOOK:017581 PAGE:01079 - 01082 NORTH CAROLINA SPECIAL WARRANTY DEED Excise Tax: $660.00 Parcel.:Identifier No.: 1701192089 REM: 0360259 Verified by County on the_day of ,20 By: MaiUBox to_HOLD FOR LYNDA R HERRING PA (BOX #101) This instrument was prepared by: Leslee Ruth Sharp,without benefit of title Brief description for the Index: Lot 7,Lincoln Park South Book of Maps 2007,Page 1332 THIS DEED made this 18th day of September,2019,by and between GRANTOR GRANTEE JACK PARKER PROPERTIES NC,LLC D&S East,LLC a Delaware limited liability company a North Carolina limited liability company 118 W.57th St. and Helton Holdings,LLC New York,NY 10019-3318 a North Carolina limited liability company MAILING ADDRESS: 14 APOTHECARY COURT, GARNER NC 27529 Enter in appropriate block for each Grantor and Grantee: name,mailing address,and,if appropriate,character of entity,e.g. corporation or partnership. 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. 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 the City of Gamer,Swift Creek Township,Wake County,North Carolina and more particularly described as follows: BEING all of Lot 7 as same is shown on that certain plat entitled "Subdivision Map of Lincoln Park South,Lots 6&7"prepared by Withers&Ravenel Kenneth Close Surveying, recorded in Book of Maps 2007,Page 1332,Wake County Registry. NC Bar Association Form No.6©1/1/2010 Special Warranty Deed Printed by Agreement with the NC Bar Association Page 1 of 2 JPPNC to D&S East and Helton Holdings BK017581 PG01080 The property hereinabove described was acquired by Grantor by instrument recorded in Book 11858, Page 2440, Wake County Registry. All or a portion of the property herein conveyed includes or x_does not include the primary residence of a Grantor. A map showing the above described property is recorded in Book of Maps 2007,Page 1332,Wake County Registry. TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee simple. And the Grantor covenants with the Grantee,that Grantor has done nothing to impair such title as Grantor received,and Grantor will warrant and defend the title against the lawful claims of all persons claiming by,under or through Grantor,other than the following exceptions: 1. Matters shown here on Exhibit"A'; 2. Existing utilities. 3. Matters which would be disclosed by an accurate survey and inspection of the property. IN WITNESS WHEREOF,the Grantor has duly executed the foregoing as of the day and year first above written. JACK PARKER PROPERTIES NC,LLC(Entity Name) a Delaware limited liability company /c-®.a•—�. /41 (SEAL) By: ..KENNETH.M..FULLER Operating Manager State of North Carolina County of Wake I,Leslee Ruth Sharp,the undersigned Notary Public of the County and State aforesaid,certify that KENNETH M.FULLER,. personally known to me,personally appeared before me this day and acknowledged that he is an OPERATING MANAGER of.TACK PARKER PROPETIES NC, LLC, a Delaware limited liability company, and that he as OPERATING MANAGER, being duly authorized,voluntarily executed the foregoing instrument for and behalf of the limited liability company for the purposes therein expressed. Witness my hand and Notarial stamp or seal `,���1i11111����1 This 1.8 day of September,2019. � ,A��y 44,l%a. (world Stamp or Sea%M ?'. ' S! gpPAgk Notary Public Pum.0 Printed Name:Leslee Ruth Sharp sy G`� • My Commission Expires:February 3,2024. , ef CoU ;,, NC Bar Association Form No.6 @ 1/1/2010 Special Warranty Deed Printed by Agreement with the NC Bar Association Page 2 of 2 JPPNC to D&S East and Helton Holdings BK017581 PG01081 SHARP LAW OFFICES A Professional Corporation. 316 W.Miltbrook Road, Suite 113 Raleigh,North Carolina 27609 Phone(919)846-656585l+acsinnile919) 846-6586 www.sharplawoffices.com EXHIBIT"A" Exceptions to Title Deed by and between Jack Parker Properties NC,LLC as Grantor and D&S East,LLC and Helton Holdings,LLC as Grantee 1. Taxes for the year 2020,and subsequent years,not yet due and payable. 2. Matters shown on recorded Book of Maps 2007 at Page 1332 including right of way along Junction Blvd, right of way along Gamer Station Blvd,and portion of City of Raleigh 20'utility easement located on the Land. 3. Title to that portion of the Land within the right-of-way of Junction Blvd and Gamer Station Blvd. 4. Access and Utility Easement and Joint Maintenance Agreement recorded In Book 12609 at Page 92. 5. Rights of others for Ingress and egress purposes in and to the use of access easement located on the Land. 6. Declaration and Easements for sanitary sewer and stormwater recorded in Book 12609 at Page 101. 7. Zoning Amendment recorded in Book 8207 at Page 548. 8. Matters shown on recorded Book of Maps 2007 at Page 839,Book of Maps 2008 at Page 2163,Book of Maps 2006 at Page 433,Book of Maps 1998 at Page 716,Book of Maps 1992 at Page 401,Book of Maps 1992 at Page 321,Book of Maps 1990 at Page 503,Book of Maps 1989 at Page 482,and Book of Maps 1990 at Page 140. 9. Easement(s)to Central Carolina Telephone Co.,inc.recorded in Book 601 at Page 417 and Book 640 at . Page 267. 10. Easement(s)to Southern Bell Telephone and Telephone Company,inc.recorded in Book 938 at Page 299,Book 946 at Page 646,and Book 1028 at Page 96 and 100. 11. Easement(s)to Carolina Power and Light Company recorded In Book 4674 at Page 641 and Book 8288 at Page 1020. 12. Declarations of No Build Restrictive Covenants and Easement recorded in Book 6697 at Page 67 and Book 6800 at Page 64. 13. Easement(s)to Raleigh-Durham MBA Limited Partnership recorded in Book 5087 at Page 446. 14. Title to that portion of the Land lying within the bounds of the railroad right of way of Southern Railroad Company Railroad,as shown on plat of survey by Michael D.Goodfred,RLS,dated 02/10/98. 15. Rights of others thereto entitled in and to the continued uninterrupted flow of creek,located on the Land. 16. Restrictions appearing of record in Book 4969,Page 926,Book 8018 at Page 581,Book 8139 at Page 942,and Book 11777 at Page 438,but this policy Insures that a violation thereof will not cause a forfeiture or reversion of Title. BK017581PG01082 jlultlinhi/ ..0.104147,74413, 4:-:181;e: e:082 111.1111 /°1111°.1.11114 WAKE COUNTY NORTH CAROLINA Please retain yellow trailer page It is part of the recorded document and must be submitted with the original for re- recording. Charles P. Gilliam Register of Deeds Wake County Justice Center 300 South Salisbury Street, Suite 1700 Raleigh, NC 27601 ❑ New Time Stamp ❑ $25 Non-Standard Fee ❑ Additional Document Fee ❑ Additional Reference Fee This Customer Group This Document #of Excessive Entities G #of Pages pi #of Time Stamps Needed l4ii�S DEPARTMENT OF THE TREASURY 6��f� llINTERNAL REVENUE SERVICE CINCINNATI OH 45999-0023 Date of this notice: 02-13-2023 Employer Identification Number: 92-2300323 Form: SS-4 Number of this notice: CP 575 G 6S T RALEIGH NC LLC JAMES J AMYX SOLE MBR 427 N TATNALL ST STE 47933 For assistance you may call us at: WILMINGTON, DE 19801 1-800-829-4933 IF YOU WRITE, ATTACH THE STUB AT THE END OF THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER Thank you for applying for an Employer Identification Number (EIN) . We assigned you EIN 92-2300323. This EIN will identify you, your business accounts, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records. Taxpayers request an EIN for their business. Some taxpayers receive CP575 notices when another person has stolen their identity and are opening a business using their information. If you did not apply for this EIN, please contact us at the phone number or address listed on the top of this notice. When filing tax documents, making payments, or replying to any related correspondence, it is very important that you use your EIN and complete name and address exactly as shown above. Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the information is not correct as shown above, please make the correction using the attached tear-off stub and return it to us. A limited liability company (LLC) may file Form 8832, Entity Classification Election, and elect to be classified as an association taxable as a corporation. If the LLC is eligible to be treated as a corporation that meets certain tests and it will be electing S corporation status, it must timely file Form 2553, Election by a Small Business Corporation. The LLC will be treated as a corporation as of the effective date of the S corporation election and does not need to file Form 8832. To obtain tax forms and publications, including those referenced in this notice, visit our Web site at www.irs.gov. If you do not have access to the Internet, call 1-800-829-3676 (TTY/TDD 1-800-829-4059) or visit your local IRS office. (IRS USE ONLY) 575G 02-13-2023 6STR 0 9999999999 SS-4 IMPORTANT REMINDERS: * Keep a copy of this notice in your permanent records. This notice is issued only one time and the IRS will not be able to generate a duplicate copy for you. You may give a copy of this document to anyone asking for proof of your EIN. * Use this EIN and your name exactly as they appear at the top of this notice on all your federal tax forms. * Refer to this EIN on your tax-related correspondence and documents. * Provide future officers of your organization with a copy of this notice. Your name control associated with this EIN is 6STR. You will need to provide this information along with your EIN, if you file your returns electronically. Safeguard your EIN by referring to Publication 4557, Safeguarding Taxpayer Data: A Guide for Your Business. You can get any of the forms or publications mentioned in this letter by visiting our website at www.irs.gov/forms-pubs or by calling 800-TAX-FORM (800-829-3676) . If you have questions about your EIN, you can contact us at the phone number or address listed at the top of this notice. If you write, please tear off the stub at the bottom of this notice and include it with your letter. Thank you for your cooperation. Keep this part for your records. CP 575 G (Rev. 7-2007) Return this part with any correspondence so we may identify your account. Please CP 575 G correct any errors in your name or address. 9999999999 Your Telephone Number Best Time to Call DATE OF THIS NOTICE: 02-13-2023 ( ) - EMPLOYER IDENTIFICATION NUMBER: 92-2300323 FORM: SS-4 NOBOD INTERNAL REVENUE SERVICE 6S T RALEIGH NC LLC CINCINNATI OH 45999-0023 JAMES J AMYX SOLE MBR lllll 427 N TATNALL ST STE 47933 WILMINGTON, DE 19801