WQ0018416_Owner (Name Change)_20240104

601 N.TRADE STREET,SUITE 200
st i m m e I
WINSTON SALEM,NC 27101
www.stimmelpa.com 336.723.1067
January 2, 2024
North Carolina Department of Environmental Quality
Division of Water Resources
Water Quality Permitting Section, Floor 9
512 North Salisbury Street
Raleigh, NC 27604
Attn: Mr. Matthew Nevills, Environmental Specialist
Re: Application for Sewer System Permit Ownership/Name Change
Kinderton Village Pump Station
Permit No: WQ0018416
Dear Mr. Nevills,
Attached you will two copies (one original and one copy) of the above referenced Ownership/Name Change application
with supporting information that was e-mailed to you on December 19, 2023. Attached items include the following:
- Signed Ownership/Name Change Application
- NCSOS Search showing dissolution of Adams Egloff Avant Properties, LLC
- The most recent permit for the pump station #WQ0018416
- Original Engineer's Certification for the pump station
- Deed transferring pump station property from Adams Egloff Avant Properties, LLC to Davie County
Please notify me at ntuckerstimmelpa.com or(336) 723-1067 if you need additional information.
Sincerely,
444°QjlAdVI ,,,, C..A.
•
.••Q- •. -
J. Neal Tucker, PE - ••
SEAL
14985
Vice President/ Director of Civil Engineering •
Stimmel Associates, PA •
41.
Attachments �i'�,/�/�A L TUG,`<<
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Cc: Johnny Lambert
John Grey
Lee Rollins
Sally McGuire
Ken Bingham
LANDSCAPE ARCHITECTURE CIVIL ENGINEERING LAND PLANNING

State of North Carolina
DWR Department of Environmental Quality
Division of Water Resources
SEWER SYSTEM PERMIT OWNERSHIP/NAME CHANGE
Division of Water Resources INSTRUCTIONS FOR FORM: PNOCF 01-16
This form is for ownership changes or name changes of a sewer system permit. Please note that"Permittee" references the
existing permit holder,and that"Applicant" references the entity applying for the ownership/name change.
Sewer permits start with a WQ or WQCS and contain the terms sewer extension or collection system in the subject field. This
form should not be used for permits with NC,NCG,SW or other types of non-sewer permits beginning with WQ.
For more information, visit the Division's Water Quality Permitting's website:
A. Sewer System Permit Ownership/Name Change(FORM: PNOCF 01-16)Application(All Applications):
® Submit an original completed and appropriately executed application(PNOCF 01-16).
❑ The Existing Permittee's Certification shall be signed in accordance with I5A NCAC 02T .0106(b). Per I5A NCAC 02T
.0106(c), an alternate person may be designated as the signing official if a delegation letter is provided from a person who
meets the criteria in 15A NCAC 02T.0106(b).
• The Applicant's Certification shall be signed in accordance with 15A NCAC 02T.0106(b). Per 15A NCAC 02T.0106(c),an
alternate person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria
in 15A NCAC 02T .0106(b).
B. Existing Permit(All Applications):
® Submit a copy of the most recently issued permit and certification.
C. Property Ownership Documentation(All Applications):
➢ The Applicant shall demonstrate they are the owner of all property containing the sewer system facilities:
❑ Legal documentation of ownership(i.e., GIS,deed,article of incorporation,or contract),or
❑ Written notarized intent to purchase agreement signed by both parties with a plat or survey map,or
❑ Approved board minutes
D. Certificate of Public Convenience and Necessity(All Applications where the Applicant is a Privately-Owned Public Utility):
❑ Per 15A NCAC 02T .0115(a)(I), provide one copy of the Certificate of Public Convenience and Necessity from the North
Carolina Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served
by the non-discharge system.
E. Operational Agreements(Applications where the Applicant is a Home/Property Owners'Association or Developer of lots to be
sold):
➢ Home/Property Owners' Associations
❑ Per 15A NCAC 02T.0115(c),submit an original properly executed Operational Agreement(FORM: HOA).
❑ Per 15A NCAC 02T .0115(c), submit an original proposed or approved Articles of Incorporation, Declarations and By-
laws that contain the language required by the Operational Agreement.
➢ Developers of lots to be sold
❑ Per 15A NCAC 02T.0115(b),submit an original of the properly executed Operational Agreement(FORM: DEV).
F. Package Submitted in Duplicate
• Submit a copy of all required documents in Instructions A-E as required
THE COMPLETED APPLICATION AND SUPPORTING DOCUMENTATION SHALL BE SUBMITTED IN DUPLICATE
TO:
NCDEQ-DWR
Water Quality Permitting Section
PERCS Unit
By U.S.Postal Service: By Courier/Special Delivery:
1617 MAIL SERVICE CENTER 512 N. SALISBURY ST.
RALEIGH,NORTH CAROLINA 27699-1636 SUITE 925
RALEIGH,NORTH CAROLINA 27604
TELEPHONE NUMBER: [phone]
INSTRUCTIONS FOR APPLICATION PNOCF 01-16 Page 1 of 1

• State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
SEWER SYSTEM PERMIT OWNERSHIP/NAME CHANGE
INSTRUCTIONS FOR FORM: PNOCF 01-16
Division of Water Resources
I. EXISTING PERMITTEE INFORMATION:
1. Permittee's name:Adams Egloff Avant Propertyes,LLC -Dissolved
2. Signature authority's name:NA per 15A NCAC 02T.0106(b)
3. Signature authority's title:NA
4. Permittee's mailing address:N/A
City: State: Zip:5. Permittee's contact information: Phone number: ( ) - Fax Number( ) -
Email Address:
H. APPLICANT INFORMATION:
1. Applicant's name: Davie County
2. Signature authority's name: Brian Barnett per 15A NCAC 02T.0106(b)
3. Signature authority's title: County Manager
4. Applicant's mailing address: 123 S.Main Street
City: Mocksville State: NC Zip:27028-
5. Applicant's contact information: Phone number:[phone] Fax Number( )_-
Email Address:[e-mail]
6. Representative's name: Johnny Lambert
7. Representative's title: Utilities Director
8. Representative's contact information Phone number: [phone] Fax Number( )_-
Email Address: [e-mail]
III. PERMIT INFORMATION:
1. Existing permit number: WQ0018416 and most recent issuance date:April 26,2007
2. Reason for the permit application: Change of Ownership If other, attach detailed explanation
3. Has the facility been constructed? ®Yes or❑No
4. Has the facility been certified per 15A NCAC 02T.0116? ® Yes or❑ No
FORM:PNOCF 01-16 Page 1 of 2

•
IV. CERTIFICATIONS:
Existing Permittee's Certification per 15A NCAC 02T.0106(b):
I,N/A attest that this application
(Signature Authority's name&title from Application Item I.2&3)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that prior to reissuance of the permit
into the Applicant's name, I will continue to be responsible for compliance with the current permit and any discharge of wastewater
from this system to surface waters or the land may result in an enforcement action that may include civil penalties, injunctive relief,
and/or criminal prosecution. I will also make no claim against the Division of Water Resources should a condition of the existing permit
be violated. I also understand that if all required parts of this application are note completed and that if all required supporting
information and attachments are not included,this application will be returned to me as incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement,
representation, or certification in any application package shall be guilty of a Class 2 misdemeanor,which may include a fine not to
exceed$10,000 as well as civil penalties up to$25,000 per violation.
Signature: Date:
Applicant's Certification per 15A NCAC 02T.0106(b):
I,Brian Barnett,Davie County Manager attest that this application
(Signature Authority's name&title from Application Item II.2&3.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that after issuance of the permit into
the Applicant's name, I will be responsible for compliance with the issued permit and any discharge of wastewater from this non-
discharge system to surface waters or the land may result in an enforcement action that may include civil penalties, injunctive relief,
and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition of this permit be violated.
I also understand that if all required parts of this application package are not completed and that if all required supporting information
and attachments are not included,this application package will be returned to me as incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement,
representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed$10,000 as well as civil penalties up to$25,000 per violation.
Signature Date: I Z� / 26 Z3
FORM: PNOCF 01-16 Page 2 of 2
L

12/11/23,8:31 AM North Carolina Secretary of State Search Results
• Upload a PDF Filing • Order a Document Online • Add Entity to My Email Notification List
• View Filings • Print a Pre-Populated Annual Report form
Limited Liability Company
Legal Name
Adams Egloff Avant Properties, L.L.C.
Prey Legal Name
Salem Development Venture, L.L.C.
Information
Sosld: 0393830
Status: Admin. Dissolved O
Date Formed: 4/17/1996
Citizenship: Domestic
Annual Report Due Date: April 15th
Registered Agent: Avant, Kerry
Addresses
Mailing Principal Office
1338 Ashley Square 1338 Ashley Square
Winston-Salem, NC 27103 Winston-Salem, NC 27103
Reg Office Reg Mailing
1338 Ashley Square 1338 Ashley Square
Winston-Salem, NC 27103 Winston-Salem, NC 27103
Company Officials
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
https://www.sosnc.gov/online_services/search/Business_Registration_Results 1/2

12/11/23,8:31 AM North Carolina Secretary of State Search Results
Manager Manager Manager
Trent C. Adams Kerry L. Avant Richard C. Egloff
1533 Boxthorne Lane 3105 Buena Vista Road 537 Arbor Road
Winston Salem NC 27106 Winston Salem NC 27106 Winston Salem NC 27104
https://www.sosnc.gov/online_services/search/Business_Registration_Results 2/2

17A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
April 26, 2007
Mr. Kerry Avant
Adams, Egloff, Avant Properties, LLC
1645 Westbrook Plaza Drive
Winston-Salem, NC 27103
Subject: Permit No. WQ0018416 (3' Modification)
Adams, Egloff, Avant Properties, LLC
Kinderton Village Phase 3D
Wastewater Collection System Extension
Davie County
Dear Mr. Avant:
In accordance with your application received April 13, 2007, and additional information received
on April 24, 2007, we are forwarding herewith modified Permit No. WQ0018416, dated April 26, 2007, to
Adams, Egloff, Avant Properties, LLC for the construction and operation of the subject wastewater
collection system extension. This permit shall be effective from the date of issuance until rescinded, shall
void Permit No W00018416 issued 11/13/2006 and shall be subject to the conditions and limitations as
specified therein. This cover letter shall be considered a part of this permit and is therefore incorporated
therein by reference. This permit modification is for the addition of Phase 3D to Kinderton Village with a
flow of 10,220 GPD.
Please pay particular attention to Permit Condition 3 which requires that the wastewater collection
facilities be properly operated and maintained in accordance with 15A NCAC 2T .0403 or any individual
system-wide collection system permit issued to the Permittee.
Permitting of this project does not constitute an acceptance of any part of the project that does
not meet 1)15A NCAC 2T; 2) the Division of Water Quality's (Division) Gravity Sewer Minimum Design
Criteria adopted February 12, 1996, as applicable; 3) and the Division's Minimum Design Criteria for the
Fast-Track Permitting of Pump Stations and Force Mains adopted June 1, 2000, as applicable, unless
specifically mentioned herein. Division approval is based on acceptance of the certification provided by
a North Carolina-licensed Professional Engineer in the application. It shall be the Permittee's
responsibility to ensure that the as-constructed project meets the appropriate design criteria and rules.
Failure to comply may result in penalties in accordance with North Carolina General Statute§143-215.6A
through §143-215.6C, construction of additional or replacement wastewater collection facilities, and/or
referral of the North Carolina-licensed Professional Engineer to the licensing board.
Winston-Salem Regional Office One
585 Waughtown Street,Winston-Salem,North Carolina 27107 North Carolina
Phone: [phone]/Fax: [phone]/Internet: www.ncwaterquality.orq tUrallJ
An Equal Opportunity/Affirmative Action Employer—50%Recycled/10%Post Consumer Paper

Adams.Egloff,Avant Properties,LLC
April 26.2007
Page 2
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina
as amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to Adams,
Egloff, Avant Properties, LLC for the construction and operation of approximately 3,843 linear feet of 8-
inch gravity sewer to serve 43 3-bedroom residences and 30 duplexes as part of the Kinderton Village
Phase 3D project, and the discharge of 10,220 gallons per day of collected domestic wastewater into the
Davie County and City of Winston-Salem's existing sewerage system, pursuant to the application
received .April 13, 2007 and in conformity with 15A NCAC 2T; the Division's Gravity Sewer Minimum
Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the
Fast-Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other
supporting data subsequently filed and approved by the Department of Environment and Natural
Resources and considered a part of this permit, and the continued operation of the following previously
permitted components:
1) Initial permit issued 12/29/2000 for Phase 1 - 11,913 linear feet of 8-inch gravity sewer and a
200-gallon per minute pump station with duplex pumps, on-site audible and visual high water
alarms, an automatically activated on-site generator; as well as approximately 1,731 linear feet of
4-inch force main and 1,058 linear feet of 6-inch force main to serve 200 three-bedroom
residences, 8 three-bedroom townhomes, 36 two-bedroom condominiums,as well as a clubhouse
and pool for 185 bathers per day with the discharge of 36,010 gallons per day of collected
domestic wastewater into the Davie County collection system and then to the City of Winston-
Salem collection system (Note: The Division approved a retroactive flow reduction request for the
Kinderton Development on April 28, 2006 for 140 gallons per day per residential unit and 60
gallons per day per 1,000 square feet for all non-residential/non-food service establishments).
2) Permit modified 12/8/04 for Phase 2—2,352 linear feet of 8-inch gravity sewer to serve 66 three-
bedroom residences with the discharge of 9,240 gallons per day of collected domestic wastewater
into the Davie County and City of Winston-Salem existing sewerage system, pursuant to the
application received September 27, 2004.
3) Permit modified 11/13/06 for Phase 1 additions and Phase 3B — 540 linear feet of 8-inch
gravity sewer to serve eight three-bedroom residences and 60 three-bedroom quads (additions
to Phase 1) and 16 three-bedroom residences (Phase 3B) with the discharge of 11,760 gallons
per day of collected domestic wastewater into the Davie County and City of Winston-Salem
existing sewerage system, pursuant to the application received November 8, 2006.
(To date, the total wastewater flow volume approved for the Kinderton project is 67,230 gallons per day.
The total gravity line length approved is 18,648 linear feet).
The sewage and wastewater collected by this system shall be treated in the City of Winston-
Salem Muddy Creek Wastewater Treatment Facility (Permit No. NC0050342) prior to being discharged
into the receiving stream.
This permit shall become voidable unless the agreement between Adams, Egloff, Avant
Properties, LLC, Davie County and the City of Winston-Salem for the collection and final treatment of
wastewater is in full force and effect.

Adams,Egloff,Avant Properties,LLC
April 26,2007
Page 3
The Operational Agreement between the Permittee and the Environmental Management
Commission is incorporated herein by reference and shall be a condition of this permit. Noncompliance
with the terms of the Operational Agreement shall subject the Permittee to all sanctions provided by North
Carolina General Statutes §143-215.6A to §143-215.6C for violation of or failure to act in accordance
with the terms and conditions of this permit.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing upon written request within 30 days following receipt of this
permit. This request must be in the form of a written petition, conforming to Chapter 150B of North
Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding.
If you need additional information concerning this matter, please contact Mike Mickey at (336)
771-5000.
Sincerely,
for Alan W. Klimek, P.E.
cc: Kelway Howard, PE (Stimmel Associates, PA, 601 N. Trade Street,Winston-Salem, NC 27101)
Davie County Building Inspections
WSRO - WQS (NPDES No. NC0050342)
PERCS Files
SWP - Central Files

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
following specified conditions and limitations:
1. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 2T; the Division of Water Quality's
(Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996, as applicable; the
Division's Minimum Design Criteria for the Fast-Track Permitting of Pump Stations and Force Mains
adopted June 1, 2000, as applicable; and other supporting materials unless specifically mentioned
herein.
2. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
3. The wastewater collection facilities shall be properly maintained and operated at all times. The
Permittee shall maintain compliance with an individual system-wide collection system permit for the
operation and maintenance of these facilities as required by 15A NCAC 2T .0403. If an individual
permit is not required, the following performance criteria shall be met as provided in 15A NCAC 2T
.0403:
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge
to land or surface waters, and any contravention of the groundwater standards in 15A NCAC
2L .0200 or the surface water standards in 15A NCAC 2B .0200.
b. A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenance plan shall be developed and implemented.
d. Pump stations that are not connected to a telemetry system shall be inspected every day (i.e.
365 days per year). Pump stations that are connected to a telemetry system shall be inspected
at least once per week.
e. High-priority sewer lines shall be inspected at least once per every six-month period of time.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Inspection and maintenance records shall be maintained for a period of at least three years.
h. Overflows and bypasses shall be reported to the appropriate Division regional office in
accordance with 15A NCAC 2B .0506(a), and public notice shall be provided as required by
North Carolina General Statute §143-215.1C.

4. This permit shall not be transferable. In the event there is a desire for the wastewater collection
facilities to change ownership, or there is a name change of the Permittee, a formal permit request
shall be submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate. The approval of this request shall be considered
on its merits and may or may not be approved.
5. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater
to the surface waters of the State.
6. Per 15A NCAC 2T. .0116, upon completion of construction and prior to operation of these permitted
facilities, the completed Engineering Certification form attached to this permit shall be submitted with
the required supporting documents to the address provided on the form. A complete certification is
one where the form is fully executed and the supporting documents are provided as applicable.
7. A copy of the construction record drawings shall be maintained on file by the Permittee for the life of
the wastewater collection facilities.
8. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2T; the
Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for the Fast-Track Permitting of Pump Station and Force Mains adopted
June 1, 2000 as applicable; and other supporting materials may subject the Permittee to an
enforcement action by the Division, in accordance with North Carolina General Statutes§143-215.6A
through §143-215.6C.
9. In the event that the wastewater collection facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action, including those as may
be required by this Division, such as the construction of additional or replacement facilities.
10. The issuance of this permit shall not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances that may be imposed by other government agencies (local, state
and federal) which have jurisdiction, including but not limited to applicable river buffer rules in 15A
NCAC 2B .0200, erosion and sedimentation control requirements in 15A NCAC Ch. 4 and under the
Division's General Permit NCG010000, and any requirements pertaining to wetlands under 15A
NCAC 2B .0200 and 15A NCAC 2H .0500.
11. Noncompliance Notification:
The Permittee shall verbally report to a Division of Water Quality employee at the Winston-Salem
Regional Office, telephone number [phone], as soon as possible, but in no case more than
24 hours or on the next working day, following the occurrence or first knowledge of the occurrence
of either of the following:
a. Any process unit failure, due to known or unknown reasons, that renders the facility incapable of
adequate wastewater transport, such as mechanical or electrical failures of pumps, line blockage
or breakage, etc.; or
b. Any failure of a pumping station or sewer line resulting in a by-pass directly to receiving waters
without treatment of all or any portion of the influent to such station or facility.
Voice mail messages or faxed information is permissible, but shall not be considered as the initial
verbal report. Overflows and spills occurring outside normal business hours may also be reported to

the Division of Emergency Management at telephone number [phone] or [phone].
Persons reporting any of the above occurrences shall file a spill report by completing Part I of Form
CS-SSO (or the most current Division approved form), within five days following first knowledge of
the occurrence. This report shall outline the actions taken or proposed to ensure that the problem
does not recur. Part II of Form CS-SSO (or the most current Division approved form) can also be
completed to show that the SSO was beyond control.
Gravity sewers installed greater than ten percent below the minimum required slope per the
Division's Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be certified
until corrected. If there is a unforeseen obstacle in the field where all viable solutions have been
examined, a slope variance can be requested from the Division with firm supporting documentation.
This shall be done through a permit modification with fee. Such variance requests will be evaluated
on a case by case basis. Resolution of such request shall be evident prior to completing and
submitting the construction certification.
Permit issued this the 26th day of April, 2007.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
/i,r Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ00 8416 (3rd Modification)
3

Fast Track Engineering Certification
Permit No. WQ0018416 (3rd Modification)
Adams, Egloff, Avant Properties, LLC
April 26, 2007
Complete and submit this form to the permit issuing regional office with the following:
• One copy of the project record drawings(plan&profile views of sewer lines)of the wastewater collection system
extension
• supporting design calculations (selected pumps, system curve, operating point, available storage if portable
generator(s) or storage greater than longest past three year outage reliability option selected) for any pump
stations permitted as part of this project
• Changes to the project should be clearly identified on the record drawings or in written summary form. Permit
modifications are required for any changes resulting in non-compliance with this permit, regulations or minimum
design criteria.
This project shall not be considered complete nor allowed to operate until this Engineer's Certification and all
required supporting documentation have been received by the Division. Therefore, it is highly recommended
that this certification be sent in a manner that provides proof of receipt by the Division.
ENGINEER'S CERTIFICATION
Il Partial n Final
, as a duly registered Professional Engineer in the State of North Carolina, having
been authorized to observe(❑ periodically, ❑ weekly, ❑full time)the construction of the Kinderton Village Phase
3D project in Davie County for the Permittee hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the construction such that the construction was observed to be built within substantial
compliance of this permit; 15A NCAC 2T;the Division of Water Quality's (Division) Gravity Sewer Minimum Design
Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast-Track
Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting materials.
North Carolina Professional Engineer's
seal, signature, and date:
•
SEND THIS FORM & SUPPORTING DOCUMENTATION WITH
REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS:
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107
Attn: Steve Tedder
•
The Permittee is responsible for tracking all partial certifications up until a final certification is received. Any
wastewater flow made tributary to the wastewater collection system extension prior to completion of this Engineer's
Certification shall be considered a violation of the permit and shall subject the Permittee to appropriate enforcement
actions.

State of North Carolina0 pr.
Department of Environment
and Natural Resources A
Division of Water Quality
Michael F.Easley, Governor
William G. Ross Jr.,Secretary NCDENR
Gregory J.Thorpe,Ph D.,Acting Director NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
November 14, 2001
Adams Egloff Avant Prop LLC
Kerry Avant
150 Charlois Blvd Ste 224
Winston Salem NC 27103
Subject: Permit No. WQ0018416
Adams Egloff Avant Property11c
Davie County
Dear Mr.Avant: -
The Division's Non-Discharge Permitting Unit has received your signed and sealed certification with record
drawings. The Division hereby accepts this certification based upon its execution and submittal by a North
Carolina Professional Engineer. Please note that the record drawings will be forwarded to the Winston-Salem
Regional Office and have not been reviewed. If a review is conducted, you will be notified of any non-
conformity with the Minimum Design Criteria.
If it would be helpful to discuss this matter further, I would suggest that you contact the Water Quality
Regional Supervisor at the Winston-Salem Regional Office at(336)771-4600.
Sincerely, 1(1'
U (�!
Thelma Williams
cc: Winston-Salem Regional Office,Water Quality Section
Central Files
Stimmel Associates
1617 Mail Service Center,Raleigh,NC 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post-consumer paper

r " C .
Permit No.WQ0018416
December 29,2000
•
ENGINEER'S CERTIFICATION
Partial ,��} X Final
I, NICKIE .1-). AlILLS , as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe(peLp
iodically, weekly,full time)ZAW
the cons(oUJJ7)
ruction of the/
project, f /NDE�2TO1J j/LL4GE r�QN C A/C-for the
Project Name Location and County
Permittee hereby state that, to the best of my abilities, due care and diligence was used in the observation of the
construction such that the construction was observed to be built within substantial compliance of this permit;
15A NCAC 2H .0200; the Division of Water Quality's (Division) Gravity Sewer Minimum Design Criteria
adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast-Track Permitting
of Pump Stations and Force Mains adopted June 1,2000 as applicable; and other supporting materials.
North Carolina Professional Engineer's seal,signature,and date:
,4 -
® • RECEIVED
' , <J/f alit herby
-ir • 'j' 'Ihe Division of Water Qu Y sera WATFP ni Jai ITY SECTION
- 6 F.• _ acknowledgesreceiptandacceptance ofthis 8�E 0 = Ceruficauon fC'l U
s %,... 46.. /t),Iti..' ,i.• 1
%�$j 11 -°��,�o• Non-Discharge Permitting
t+�Ek go
D.
The above Engineer's Certification shall be completed and submitted to the address below with one copy of the
"Construction Record Drawings" of the wastewater collection system extension as well as supporting design
calculations for any pump stations permitted as part of this project.This project shall not be considered complete
nor allowed to operate until this Engineer's Certification and all required supporting documentation have been
received by the Division. Any wastewater flow made tributary to the wastewater collection system extension
prior to completion of this Engineer's Certification shall be considered a violation of the permit and shall subject
the Permittee to appropriate enforcement actions. -
•
NORTH CAROLINA DIVISION OF WATER QUALITY
WATER QUALITY SECTION
NON-DISCHARGE PERMITTING UNIT
1617 MAIL SERVICE CENTER
RALEIGH,NORTH CAROLINA 27699-1617 .
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0163
01977
FILED FOR REGISTRATION
APRIL 18. 2011 9:27 AM
DATE TIME
AND RECORDED IN BOOK 857 PAGE 163
M.B ENT SHOAF,REGISTER OF DEEDS
NO TAXABLE CONSIDERATION 57AT:J DANE ,NC
BY
ASSI
DEED TRANSFER CHECKED
DATE 4'--I aaI BY
TAX A 1INISTPATOR
Excise Tax:S-0- Recording Information
Drafted by:Tamara A.Fleming,Attorney at Law,Ten Court Square,Mocksville,NC 27028
Mail to:Grantees(a. County of Davie,123 S.Main St.,Mocksville,NC 27028
Property Address: 155 lakeside Crossing,Advance,NC 27006
TAX MAP: C-8,Pcl.116
WARRANTY DEED
THIS DEED made this 54k day of April, 201 I, by and between ADAMS EGLOFF
AVANT PROPERTIES,L.L.C.,a North Carolina Limited Liability Company,(Grantor Address:
1338 Ashley Square,Winston-Salem,NC 27103);hereinafter referred to as the GRANTOR,to
COUNTY OF DAVIE(Grantee Address:123 S.Main St.,Mocksville,NC 27028); hereinafter
referred to as the GRANTEE:
WITNESSETH:
THE GRANTOR,for valuable consideration paid by the GRANTEE,receipt of which is
acknowledged,has and by these presents does convey unto the GRANTEE in fee simple,all that
certain parcel of land situated (the "property") in Farmington Township, Davie County, North
Carolina,and more particularly described on attached"Exhibit A."
TO HAVE AND TO HOLD the property and all privileges and appurtenances thereto
belonging to the GRANTEE in fee simple.
THE GRANTOR COVENANTS with the GRANTEE,that the GRANTOR is seized of the
property in fee simple,has the right to convey the property in fee simple,that title is marketable and
free and clear of al l encumbrances,and that the GRANTOR will warrant and defend the title against
the lawful claims of all persons whomsoever except for the exceptions hereinafter stated.
Title to the property is subject to the following exceptions:
Easements and restrictions of record.

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0164
All or a portion of the property herein conveyed includes or X does not include
the primary residence of Grantor.
The terms GRANTORS and GRANTEES as used herein include the masculine and the I
feminine,the singular and the plural.as the context requires,and the heirs,successors,and assigns
of the parties hereto.
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 the Board of Directors,the day and year
first above written.
ADAMS EGLOFF AVANT ROPERTIES,L.L.C.
a No ( /-17444i
rth C olina Limite Liab ity Company
By: �""
Kerry/L.Avant, Member, imager
**********************
NORTH CAROLINA
COUNTY OF Fna.$,..4-(1)
I certify that the following persons) personally appeared before me this day, each
acknowledging to me that he or she voluntarily signed the foregoing document for the purpose stated
therein and in the capacity indicated: Kerry L. Avant, Member/Manager of ADAMS EGLOFF
AVANT PROPERTIES,L.L.C.,a North Carolina Limited Liability Company
Witness my hand and Notarial stamp or seal,this day of April,2011.
Nota Stamp or Seal:
v OFFICIAL SEAL L
�•Y;�, VIptIE R.31SSON Lt��nq
Not
Pudic
-/ oRsrrrlo°'a : Signature of Notary Public
�--'"9 hly 3 / _on Expires 1/
iLk,e ?. Si s01V
Printed Name of Notary Public
/My Commission Expires: 34 /5

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0165
EXHIBIT A
BEGINNING at an iron(N=826049.31;E=1575986.95),being the southwest corner of the herein
described tract, being in the eastern right of way margin of Lakeside Crossing, said iron being
located North 07 deg.07 min.46 sec. West 137.53 feet from an iron;thence continuing with the
eastern right of way margin of Lakeside Crossing North 07 deg.07 min 46 sec.West 22.92 feet to
a point;thence with a curve to the left North 05 deg.46 min.03 sec.West having an arc of 15.53
feet,a chord distance of 15.53 feet,and a radius of 325.91 feet to an iron;thence North 73 deg.03
min. 11 sec.East 50.02 feet to an iron;thence continuing North 00 deg.01 min.46 sec.West 177.40
feet to an iron;thence continuing North 10 deg.30 min.32 sec.West 15.58 feet to an iron;thence
with the line of the Hillsdale Group,LLC(DB 186,Pgs.303-309)North 81 deg.50 min.57 sec.East
76.89 feet to an iron;thence continuing North 71 deg.02 min.05 sec.East 291.06 feet to an iron;
thence continuing North 81 deg.35 min.01 sec. East 142.62 feet to an iron in the northeast corner
of the herein described tract(N=826421.18;E=1576519.91);thence continuing with the eastern line
of the hereinafter described tract South 02 deg. 49 min. 02 sec. East 290.46 feet to an iron
(N=826131.07;E=1576534.19)in the southeast corner of the herein described tract,said iron being
located North 85 deg.29 min.03 sec.West 1064.71 feet from NCGS Monument"Log Barn"(N=
826,047.24;E=2,577,595.60);thence North 72 deg.57 min.28 sec.West 102.09 feet to a point;
thence continuing North 83 deg. 19 min. 43 sec. West 115.26 feet to a point;thence continuing
South 77 deg.06 min.47 sec.West 52.10 feet to a point;thence continuing South 64 deg. 18 min.
22 sec.West 122.26 feet to a point;thence continuing South 40 sec.51 min.23 sec.West 67.83 feet
to a point;thence continuing South 85 deg.58 min.17 sec.West 130.14 feet TO THE POINT AND
PLACE OF BEGINNING,containing 2.699 acres,as set forth on a survey prepared by Grady L.
Tutterow,Professional Land Surveyor,on March II,2011,Drawing No.2411-3.
TOGETHER WITH the right of ingress and egress across Lakeside Crossing which abuts the
above-described property and other streets of Kinderton Village as access to Yadkin Valley Road.
(SR 1452).
SUBJECT TO easements and restrictions of record.
FOR BACK TITLE,see Tract 2 in Deed Book 686.Page 835,Davie County Registry. Sec also
Tax Map C-8,Parcel 116,located in Farmington Township,Davie County,North Carolina.
N1 EiTAF
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