NCG551010_Owner (Name Change)_20181018

•
1
Wo er Resources
ENViROW-1ENTAL QUALITY
ROY COOPER
Governor
MICHAEL S. REGAN
Secretart,
S. JAY ZIMMERMAN
Director
PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
Permit Number: /� C, i o I L
1. Facility Name: SWA I tJ OLD ( r Ig )vlti�
II. NEW OWNER/NAME INFORMATION:
1. This request for a name change is a result of:
a. Change in ownership of property/company
b. Name change only
c. Other (please explain):
2. New owner's name (name to be put on permit):
QTI (A CeR
3. New owner's or signing official's name and title: Lew.
( son legally responsible for permit)
C)u."L!QR
(Title)
4. Mailin address: o �(ei p � W" Tu % Z;2.- !
g � � � _City. :T� 4 69,
State: Zip Code:201503� Phone: (77o 36 6 2-
E-mail address: C1 NR,4 5 IA Li Ua -- C `% :/YVi-1 i _ 's 66 M
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION UNLESS ALL OF THE
APPLICABLE ITEMS LISTED BELOW ARE INCLUDED WITH THE SUBMITTAL.
REQUIRED ITEMS:
1. This completed application form
2. Legal documentation of the transfer of ownership (such as a property deed, articles of
incorporation, or sales agreement)
[see reverse side of this page for signature requirements]
ptf��y/ State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh, NC 27699-1617
919 807 6300 919-807-6389 FAX
http://portal.ncdenr.org/web/wq

Applicant's Certification:
M /Yl , -5-� L4 (.�.../� , attest that this application for a
name/ow516rship change has been reviewed and is accurate and complete to the best of my
knowledge. I understand that if all required parts of this application are not completed and that
if all required supporting information and attachments are not included, this application
package will be returned as incomplete.
Signature: - Date:
THE COMPLETED` PPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INFORMATION & MATERIALS, SHOULD BE SENT TO THE FOLLOWING ADDDRESS:
NC DEQ / DWR / NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Version 1212015

BK:00459 PG:0886
SWAIN COUNTY TAX OFFICE
Date 7- I g --18
Stampps 0.
PIN a -2
Signatu
FILED
SWAIN COUNTY NC
DIANA WILLIAM•SON KIRKLAND
REGISTER OF DEEDS
FILED Jul 18, 2018
AT 11:53:08 am
BOOK 00459
START PAGE 0886
END PAGE 0888
INSTRUMENT # 01154
(ALL TAXES PAlb'ON THIS PARCEL ONLY.)
EXCISE TAX $80.00
EXCISE TAX: $80.00
PIN: 666206376613
GRANTORS PRIMARY RESIDENCE: No RECORDING TIME, BOOR AND PAGE
Prepared by: Fred H. Moody, Jr., P.O. Box 670, Bryson City, NC 28713
TITLE TO THE WITHIN DESCRIBED LANDS ARE NOT CERTIFIED BY FRED H. MOODY, JR.
UNLESS A WRITTEN TITLE OPINION IS RENDERED.
STATE OF NORTH CAROLINA
GENERAL WARRANTY DEED
COUNTY OF SWAIN
THIS DEED made this -17-11day of
2018, by and between
JAMES R. COLLINS, unmarried
5146 Odum Smallwood Road
Gainesville, GA 30506
hereinafter referred to as Grantor, and
GARY M. SHULER
P.O. Box 1311
Bryson City, NC 28713
hereinafter referred to as Grantee. 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.
W I T N E S S E T H:
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 Charleston Township, Swain County, North Carolina and
more particularly described as follows:

0459 13K:00459 RG:0887
0887
**SEE DESCRIPTION CONTAINED ON EXHIBIT "A" ATTACHED
HERETO AND MADE A PART HEREOF BY EXPRESS REFERENCE**
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 is
seized of the premises in fee simple, has the right to convey the
same in fee simple, that title is marketable and free and clear of
all encumbrances, and that 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 hereinabove described is subject to the
following exceptions:
Exceptions and reservations as set forth herein.
IN WITNESS WHEREOF, the Grantors have hereunto set their hands
and seals, the day and year first above written.
C� (SEAL)
DAMES R. COLLINS
STATE OF NORTH CAROLINA
COUNTY OF SWAIN
if C�C� _ PZr-e I O K , a Notary Public of the County
and State aforesaid, certify that JAMES R. COLLINS personally
appeared before me this day and acknowledged the execution of the
foregoing instrument.
Witless my
hand and official stamp r seal, this I --day of
2018.
My comm ssior} expires:
r
N tary Public
I/, t !�'ktc
P. PC( -
Pr n Notary Name

BK:00459 PG:0888
EXHIBIT "AV'
Being a portion of the Old DeHart Mill Property and being
more particularly described as follows:
BEGINNING at a point near the margin of the Southern
Railway right of way, said point being located N.78-11-40
E. 385.37 feet from a nail and cap set in the centerline
of the bridge across Alarka Creek, and runs thence from
said beginning point, more or less with the margin of
said right of way, 5.86-41-40 E. 152.97 feet; then
leaving the said right of way, S. 6-56-10 W. 134.46 feet,
crossing old U.S. Highway #19 to a point at or near the
south bank of Alarka Creek; then more or less with the
south bank of the creek, N. 87-59-40 W. 152.84 feet; then
leaving the south bank of said creek, N. 6-46-20 E.
137.91 feet, passing iron pins at 31.24 feet and 57.01
feet to the BEGINNING, containing .47 acre, more or less,
as surveyed by Larry M. DeHart, RLS.
Reference is made to a map of the above described
premises recorded in Map Book 42, at page 202, Swain
County Registry.
There is excepted and reserved from the above described
conveyance a right of way for Old U.S. Highway #19 and a
right of way for Southern Railway.
For a source of title see deed book 241, at page 226,
Swain County Registry.