NCG550440_Regional Office Physical File Scan Up To 6/3/2020

PAT MCCRORY
eoa.a,No.
DONALD R.VAN DER VAART
" Se I.,
Water Resources S.JAY ZIMMERMAN
ENVIRONMENTAL QUALITY
Dlrecro.
December 15, 2016
CERTIFIED MAIL7015 0640 0007 9833 9415
RETURN RECEIPT REQUESTED
Mr. Douglas N. Clark
4 Camelfield Road
Weaverville, NC 28787
Subject: Wastewater Disposal at
4 Camelfield Road,Weaverville
Certificate of Coverage(CoC)NCG550440
Buncombe County
Dear Mr. Clark:
An audit of annual fee payments for NPDES permittees has noted unpaid fees for the subject facility.
Payment of annual fees is required by Part II B. (12)of your NPDES permit NCG550000, as well as 15A
NCAC 2H.0105 (b)(2).
The following unpaid invoices are enclosed for the years 2012-2014,totaling$I80 in overdue annual fees:
2015PR003945,2015PR004285, 2015PR004824. Payment instructions are provided on the invoice(s).
Please submit payment by January 30, 2017.
Due to a coding problem within our permit database, annual fee invoices for several CoCs (including yours)
were not sent. Depending on the CoC, there could be only one or 5+unsent invoices. The invoices you are
receiving cover those un-billed years.
If you have questions concerning this matter or would like to discuss payment options,please do not hesitate
to contact me at 919-801-6479 or [e-mail]. If you have any questions about how to
make payments,please contact Teresa Revis at 919-807-6316 or [e-mail].
We appreciate your assistance in this matter.
no ely, (�
John E. Hennessy
D' 'sion� ct+g-D
cc: Asheville Regional Office,DWR WQRO aM&on of Watx REsoulas
NPDES General Permit Piles
Teresa Revis,DWR Budget Office
DEC 1 6 2016
SlaceofNuNh CemluslEmiromnenbl Qualiy Weler e
1611 bail service Cemar IIteloigh,NOM Camtiw 296�951600r"I^r O^Ally Pagonal O(JEreilON9
9197079000

PAT MCCRORY
KCG-QcN,
DONALD R.VAN DER VAART
sc"a"
Water Resources S.JAY ZIMMERMAN
ENVIRONMENTAL QUALITY
Diresfor
October 26,2016
Mr. Douglas N. Clark
4 Camelfield Road
Weaverville, NC 28787
Subject: Wastewater Disposal at
4 Camelfield Road, Weaverville
Certificate of Coverage(CoC)NC0550440
Buncombe County
Dear Mr. Clark:
An audit of annual fee payments for NPDES permittees has noted unpaid fees for the subject facility.
Payment of annual fees is required by Part II B. (12)of your NPDES permit NCG550000, as well as 15A
NCAC 2H.0105 (b)(2).
The following unpaid invoices are enclosed for the years 2012-2014,totaling$180 in overdue annual fees:
2015PR003945,2015PR004285,2015PR004824. Payment instructions are provided on the invoice(s).
Please submit payment by December 12,2016.
Due to a coding problem within our permit database(BIMS), annual fee invoices for several CoCs
(including yours)were not sent. Depending on the CoC, there could be only one or 5+unsent invoices. The
invoices you are receiving cover those un-billed years.
If you have questions conceming this matter or would like to discuss payment options,please do not hesitate
to contact me at 919-807-6479 or [e-mail]. If you have any questions about how to
make payments,please contact Teresa Revis at 919-807-6316 or [e-mail].
We appreciate your assistance in this matter.
Sincerely,
Meredith We',. ._._0
Division fWat� „ Q
cc: fi_`tvuleate844 1a9,ldEA18t61�YR IaW
DES General Peamil Flies
Teresa aevls,DwR Budget office NOV - 1 2016 ,
water oaemr Reglonei operedone
sNmotrvonn camlmalna�troemooml Qaaliryla'u"ae—.' Ashevifle Be Tonal Office
1611 Mail aervloe Caemv I Raldgh,NOM Camllua 27699-1611
9197079000

n
t
MUNR ..�
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R.van der Vast
Governor Secretary
January 29,2015
Ms. Katbleene Clark
4 Camelfield Road
Weaverville,NC 28787
SUBJECT: Compliance Evaluation Inspection
Clark Residence
Permit No: NCG550440
Buncombe County
Dear Ms. Clark:
Enclosed please find a copy of the Compliance Evaluation Inspection Report for the
inspection conducted on January 27, 2015. The facility appeared to'be in compliance )vith
permit NCG550440.
According to our records, the system is currently permitted to a previous homeowner. I
have enclosed an Ownership Change Form with this letter. Please complete the form and mail to
the address indicated.
Please refer to the enclosed inspection report for additional observations and comments.
If you have any questions,please call me at 828-296-4500.
Sincerely,
Andrew Moore
Environmental Senior Technician
Enclosure
cc: MSC 1617-Central Files-Basement
WQ Asheville Files
G:\WR\WQ\Buncombe\Wastewater\General\NCG55 Single Family Residence\550440 Douglas Clark\550440 CEI
01-15.doc
2090 U.S.Hwy.70,North Carolina 28778
Phone:[phone]Internet:v Wocdenr.gov
An Equl Opportunity l Alfirmstiva Action Empiwer—Made In pan by recycled paper

n n
United$raise Environmental PmrecOon Agency Form Approved.
EPA Washington,D.C.DMW OMB No.2040 0057
Water Compliance Inspection Report Approvalaxpo-mMl- yl
Sector,A:National Date System Coding(i.e.,PCS)
Transectlon Code NPDES yrlmolday Ina,molon Type Inspector Fac Type
1 U 215 3 I NCG55D440 111 12 1",27 17 181,.1 19I .5l 201 I
211 1 I I I I I I I I I I I I I I I I I I I I I I I I L I 1 I I I I I 1 1Lll l l I I �6
Inspection Work Days Facility Self-MonitoMg Evaluation Rating Bi CIA ---Reserved--
67 701 LJ I 71 Lj 72..i .IJ j 731 I I74 751 1 1 1 1 1 1 80 LJ Section B:Facility Data I I I
Name and Location of Faclllty Inspected(For Industrial Users discharging to PO P V,also include Entry Time(Oate Permit Effadve Date
POTW name and NPDES permit Number) 01:45PM 15101I27 '13I08101
4 Camelfleld Drive
4 Camellleld Or EAt TlmelDate Permit Expireticn Data
Weavervllle NO 28787 02:00PM 16/0127 18/07131
Humble)of Onem,RepresentativepsyTitles(syPhone and Fax Numbers) Other Facility Data
111
Name,Address of Responsible OMcIeI?IIIelPhone and Fax Number
Contacted
Douglas N Clark,4 Camaltield On Weaverville NC 28787/8284i58-85821
No
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
Operations&Maintenance M Facility Site Review Efiluent/Receiving Waters
Section D:Summery of Finding/Comments(Attach additional sheets of narrefive and checkllsts as necessary)
(See attachment summary)
°II
Name(s)and Signature(s)of lnspector(s) Agency(OfowPhone and Fax Numbers /// Data
Timothy H Heim ARO WOl1828-2964666/ 8%
Andrew W Moore ARM WO//028-290A0841
Signature of anagemeLil O A Reviewer Agency/OffcelPhona and Fax Numbers Data
P -
EPA Form 35603(Rev 9-94)Previous editions are obsolete.
a
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Page# 1
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NPDES yrlmolday In ,p .n Type (Copt.) 1
3I NCG55a44p I11 12 15IOi14] 17 18I ni Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
On January 27,2015,Andrew Moore and Tim Heim of the Asheville Regional Office conducted a -
compliance evaluation inspection of the facility.The homeowner was not present at time of Inspection.
According to Buncombe County tax records the current properly owner Is not the permittee.A Change
of Ownership Form should be completed and submitted.
The inspectors were not able to locate the effluent pipe at the time of the inspection.The permittee ..
should locate and maintain access to the effluent pipe. No other infrastructure associated with the
system was located or observed at the time of the inspection. -
It is recommended that the septic tank be pumped every 3-5 years.Records of the septic tank
pumping events should be kept for future compliance Inspections. '..
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Page# 2

Pewit: NC0550440 4Came1fa1tl Drive
Inspection Date: 01127aeS inspactlon Typs: Compllanoo Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? 0 ❑ ❑ ❑
Does the facility analyze process control parameters,for ex:MLSS,MCRT,Settleable ❑ ❑. ❑
Solids,pH, DO,Sludge Judge,and other that are applicable?
Comment:
Septic Tank Yes No NA NE
(If pumps are used)Is an audible and visual alarm operational? ❑ ❑ M ❑
Is septic tank pumped on a schedule? ❑ ❑ ❑
Are pumps or syphons operating properly? ❑ ❑ ❑
Are high and low water alarms operating properly? ❑ ❑ ❑
Comment; The septic tank should be pumped out every five years or when the solids level is found to
be more than 1/3 of the liquid depth in any compartment whichever is greater.Records of
the septic tank pumping events should be kept for future compliance inspections.
Effluent Pipe
Yes No NA NE
Is right of way to the outfall properly maintained? ❑ M ❑ ❑
i
Are the receiving water free of foam other than trace amounts and other debris? ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating property? ❑ ❑ ❑
Comment: The effluent pipe was not located.The permfttee should locate and maintain access to the
effluent pipe.
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Page# 3
{

M
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory, Governor John E.Skvarla III,Secretary
I. Please enter the CoC number for which the change is requested.
Certificate of Coverage
5 1 0 1 4 4 0
H. Please provide the following for the requested change(revised permit).
a. Request for change is a result of: ® Change in ownership of the residence/property
Name change of the facility or owner
Ifotherplease explain:
b. Permit will be issued to(company
name, if applicable):
c. Person legally responsible for permit:
First MI Last
Title
Permit Holder Mailing Address
City State Zip
Phone E-mail Address
d. Facility name(discharge): 4 Camelfield Drive
e. Facility address: 4 Camelfield Road
Address
Asheville NC 28787
City State Zip
f. . Facility contact person:
First MI Lan
Phone E-mail Address
III. Permit contact information(if different from the person legally responsible for the permit)
Permit contact:
First MI Last
Title
Mailing Address
City State Zip
Phone E-mail Address
IV Will this permitted facility continue to discharge the same volume and type of wastewater as
prior to this ownership or name change?
® Yes
❑ No(please explain)
Revised 21209

NCG550000.aWNERSHIP CHANGE I
( ) Page 2 o,
VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
❑ This completed application is required for both name change and/or ownership change
requests.
❑ Legal documentation of the transfer of ownership(such as relevant pages of a contract deed,
or a bill of sale)is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change.
......................................................................................................................
The certifications below must be completed and signed by the new applicant in the case of an ownership
change request.
APPLICANT CERTIFICATION
I, ,attest that this application for a name/ownership 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 is not included,this application package will be
returned as incomplete.
Signature Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
NCDENR/DWR/NPDES
1617 Mail Service Center -
Raleigh,North Carolina 27699-1617
I
I
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Revised 712008

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OUITCLAIM DEED
TITL$¢T pacuMMST
R.RCIBR TA%:$0.00
Age,Recordist Mall To: Meg Tao eadenesss,To: "it lm[mment Evepued BY:
Hot American Tits Xatlilffn F.Clark Douglas NeD Clark
1100 Superior Avenue,Suite 2W 4 Camellleld Road 4 Cemelfield Road
Gevdand,Ohio 44114 Weaverv111e,North Cam8na 28989 Weaverv8ls,NoM Ceroene 28989
4% JQn�n0.f O
Dou DEED OF Clark
a made this rJr" day of 20 le by and between
Kathleen
Nag Cam, end !Cathleen F. Clark, husband
call a¢ eRer called GRANTOR, AND
Road, s¢ F.Clark, a maamfi women, hereinafter celled GRANTEE, WHOSE address is: 4 Camelf�eld
. Road,WeavetvUle,North Carolina 28989,
WITNESSETIL
That life GRANTOR,as a DEED OF GIFT, has bargained and sold, end by these presents does bargain,
sell,remise, release,and forever quitcla rn to the GRANTEE,his heirs and/or successors and assigns,
premises N Township of hbmwtTf 110 ,Buncombe County,Borth Groltm,described as fogowa:
BEING ALL OF LOT NUMBER 2 AND 4, SECTION 1, "MEADOWS IN THE WOODS', AS FEE PLAT
RECORDED AT PLAT BOOK 48,PAGE 38,BUNCOMBE COUNTY REGISTRY.
MORE commonly Mown as: 4 CentelNeld Bond
Waavervills,North Carolina 28989
Assessor's Parcel Number:9763.04-61-0748.000
Prior Recorded Daa Ref:Deed:Recorded August 26, 1999;Book No.2166,Page No.462
Subject To: Restrictions, Conditions, Covenants, Rights, Rights of Way, and Easements now of record, if
any.
TO HAVE AND TO HOLD the above described premises with all the appursnances thereunto belonging,or
to any wise appertaining,unto Ne GRANTEE,his heirs end/or successors and assigns Forever.
When reference is made to the GRANTOR or GRANTEE, the singular shall include the plural and
masculine shall include the feminine or the neuter;
�3�e11�e191111011 CLARK NO
WHEN RECORDED,RETURN'TO: FIRST RNERICRN EL6
EQUI WtdiVSFRV'="a QUIT CLAW DEED -
II423UFEglORAYFhT1$SUI9EEPl
LA7701Y LRWOO4d119
NATKINALREG\J.PDINC.TS'I,NE
AommmodeSunFavtdPBParQirnrRM:mI
Book: 4638 Page: 773 Seq: 1

Pao 2 612a
IN WITNESS WHEREOF,the GRANTOR has caused this deed to be executed the day and year first above
written.
roj av- �
Douglas Neil Clark tfethleen F.Clazk
..11 ACNNOWLEDGEMENT
STATE OF 44
nn 11 89
CO[RiTV OF HunCemO— 1
y �r MJG g( Mlas,. Puc do hereby certify that Douglas Neff Clark and Eathleen
F. Gark personally eppemed before me this day and acknowledged the due execution of the foregoing
rearmament. J
NOTARV STAMP/SEAL
WITNESS my hand and official seal this the
05 dayot ,A.D.,2GO3.
OFFlOIAL SEAL. -
Not�ry PINla. Nona Cerollna
Coaaty of eancomEe -
J.ERIC 'tits", NOTARY PU 1
My esmmlesbn Erplree eept.1,2pt0 MY Commission NOTAe O �/p
TU. f iL AA["t'k
1
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Book: 4638 Page: 773 Seq:2

Inspection Data: 1 P.l� p 5 Start Time: 13(4 9 Endriime:. N 6a
SINGLE FAMILY WASTEWATERS STEM CHECKLIST
t�zots
1 Permittee: CIcgk(t T4!55�• . (l�G 'l�eenl Permit: NCC> S501I40�
Address: LI . C4,4e1 aA Vf lvle- E-mail-
Phone:( ) _-9 S 9 a Cell Phone (. )_ County: 0LAct 4kq e- .
The Permidoeas reaponsibie to"ho operation and maintenance of the entire wastewater lreatineotanddls rider sbah.
Doesn't Did Not
Yes. No Apply Investigate
1,Is the current resident in the home the Penalties? t 0—I Li
y
2.If not does the resident rent from the permittee? El Q W2 u
3.Change of Ownership form:needed?(mall the term with the inspection letter). 521 El El 0
4. Is there a inspection and maintenance agreement with a contractor? 0. El Q 0
5. If yes to#4 who is the contractor?
SEPTIC TANK. The slinciank and fitters should be checked aanualry and pumped2leartdas needed.
6. Is all wastewater from the home connected to the septic tank? ❑ El �11
7. Does the permitteetresident know where the:septic tank is located? 0 r��p
8.Has the septic tank been pumped In the last 5.years? 0 L 0 k
9. If yes to#8 date, if known.. If proof,describe
10,Does the septic tank have an:EFFLUENT FILTER or SANITARYT? (clrcleone)
11. If Yes to filter when was the filter cleaned? B whom?
SAND FILTER I TREATMENT PODS YES NNIMME-NO if no proceed to the next section.
A<desaPola send likersadaoss shall be raked and levalad Every sis rnuntho and any vegetativegmmh shall he ra hw d manually,
12.is system something other than asandfilterd Q 0 0 E.
13.If yes,what kind?(examples-Past,.Textile,Other r brand.name Advantex,etc.)
4.Does the permittee know where the sandfliter is located? Q ❑ ❑ El
15. Does the sandfilter require maintenance? ❑. ❑ El
it ma ntenance Is ragwrea ,uwarai the comment ssh,.,
DISINFECTION I UV YES LJ NO if no proceed to the next Section,
The uIsavisa.t end$hall ba checked'weekly.The lamps and sleaveo ahead be aleened orrepla daa needod to metre Met dlslnfachon.
16, Is UV working?
El D
17. Has the UV Unit been serviced and bulbs cleaned? 0 0 171
18,Who completes the weekly check for the i Vg Non-Discha e)
DISINFECTION I TABLETS YES NO If no proceed to the next section.
The tablet eblodnatorunit shall be chocked weekly toensure continuous and proper operation;
10. Does the:permittee have the correct chlorine-tablets?(If none,mark NO) ❑ ❑. Ej Q
20. Does the Permitted know the location of the chlorinator? E El
El ED
21.Were chlonne tablets observed in the chlorinator? 0
22,Are tablets contadin water?it possible poke them to determine. ElDECHLOR(Discharge only) YES LJ NO If no proceed to the next section.
The gechlddnet.,and shall N,thebked waeky to ensure coninuous and propar operation..
23..Does the.permittee know where the deohlcris? 0 0.
El
24. Does the permittee have the correct dechior tablets? El ❑ L
El
25.Were daohior tablets observed in the dechlorination chamber? 0 Q
26..Are tablets contacting water?If possible poke them to d termine. 0 ❑ El
Owvtar o*?C . `av 1(er rs seu W50- py�h-te c vU
creel[, It CA hmne. 0'k'y p kt 10C S �Iti augk� G/Us
A� cCe Pape. was c�,sCon+>ti�:F2 ,

Doesn't Did Not
Yes No Apply Investigate.
PUMP TANK YES NO LJ If no proceed to the next section:
All PUMP and Eland sylems shall be inspected monthly.(non4sc68ri
27. Is the pump working? ❑ ❑:
28.Are the:audible and visual.high water alarms operational? ❑ ❑
29_Does:the committee know now to check the.pump&high water alarm? ❑ ❑ ❑
30. Last functional test. PUMP_ AUDIBLE&VISUAL.
DISCHARGE ONLY YES NO 7f no proceed to the next section.
A visual review of the outtail location shall be executed twice each year(one at the time of sampling to ensure no Visible solids oteuidence of a mahunetlon.
31,Does the permittee know,where the dutfaltis located? ❑ ❑ ❑ )0
32_Wore you able to locate the anthill? ❑ ❑ M
33. Is the end of the discharge pipe visible and accessible? ❑ ❑ ❑
34, Is outlet discharging? 1:1 ❑ ❑
35. Is right of way maintained around the discharge point? ❑ ❑ ❑
36.Any Lab.Results available?
37.Is there evidence of solids around the dice harge point? ❑ ❑
DRIP or SPRAY YES NO ISO If no proceed to the next section.
The initiation system shall be respected monthly to ensure the syatem is free of leaks and equipment is operating.as designed.
38. Is the system DRIP or IRRIGATION(circle cane)? If irrigation number of sprinkler heads.
39.Are the buffers adequate? ❑ ❑ 11
40.Is the site free of pending and runoff? Q ❑ ❑ ❑-
41, Does the application equipment appear to be working properly? 0 ❑ El El
42. is there a minimum two wire fence surrounding entire irrigation area? ❑ ❑ El El
GENERAL . .
43,Are the treatment units lacked and or secured? ❑ ❑. ❑, 2X3
44.Has resident had any sewage problems? If yes ondain in:the comment section. ❑ ❑
45. Does the system match the permit description?if no explain in the comment section. El ❑- ❑'
46,Is the system compliant? ❑ ❑ El
47,Is the system failing? if yes,;takeptcturasl(.ppsaina. ❑' ❑ ❑
48,If system Is failing any sign of children.or animals contacting sewage? ❑ ❑ ❑
NOD Sent Yii_^ Novsent*.
Comments: 'Photos Taken? Y S NO
er ma4 wjed or
lbc4vOAl 12
INSPECTOR: r t'"f SIGNATURE.

Mmheel J' EaU ,cover!
(i
William G.Russ Jc,Secretary
> r North Carolina Department of Environment and Natural Resources
O ~
Alan W.Klimek,P.E.Director
Division of Water Quality
SURFACE WATER PROTECTION SECTION
February 17, 2005
Douglas N. Clark
4 Toad Frog Bottom
Weaverville, North Carolina 28787-9811
Subject: Certificate of Coverage No! NCG5502611
Sewage Treatment System
Residence at 4 Camelfield Road
Buncombe County
Dear Mr. Clark:
The sewage treatment system serving your Residence at 4 Camelfield Road (Buncombe
County Parcel Identification Number 9763.04-61-1840.000) was constructed under the provisions of
Certificate of Coverage Number NCG550440. This permit has now expired. Attached is a copy of
your partially completed RENEWAL FORM, which is to be used to request renewal of your Certificate
of Coverage. Please return the completed form to the Raleigh address indicated.
Please understand that such a discharge without a valid permit constitutes a violation of North
Carolina General Statute (NCGS) 143-215.1; enforceable under provisions of NCGS 143-215.6A as
administered by this Agency.
I am sure you will have questions regarding this matter so please do not hesitate to call me at
[phone].
Sincerely,
Larr rp8t
E iron mental Chemist
Enclosure
xc: Charles Weaver
�hcuo'na
utum Y
North Carolina Division of Water Quality 209D U.S.Highway 70 Swannanoa,NC28778 Phone[phone] Customer Service
Internet h2o.emslate,no.te PAN [phone] I-877-623.6748
An Equal OppoduutylAHlrmative Anion Employer-50%Recycled110%Pot Consumer Paper

State of North Carolina e.�
Department of Environment AL � � A
and Natural Resources
Division of Water Quality
Michael F. Easley Governor
NCDENR
William G. Ross, Jr., Secretary NORTH CAROLMA DEPARTMEM OF
I
Alan W. Klimek, P.E., Director ENVIRONMENT AND NMURAL RESOURCES
1
GENERAL PERMIT Certificate of Coverage RENEWAL FORM
I. CURRENT PERMIT INFORMATION:
Certificate of Coverage (CoC) Number: NCG5 550440
Owner's name (name to be put on permit):
Owner's or signing official's name and title:
(Person legally responsible for permit)
(Title)
Mailing address:
City: State: Zip Code:
Phone: ( )
E-mail address:
Applicant's Certification:
I, attest that [to the best of my
knowledge] the property previously covered by the Certificate of Coverage (CoC) listed above
'i is under my ownership/control. I hereby request renewal of the CoC listed above and assume
responsibility for wastewater discharge[s]from the site.
Signature: Date:
Send this completed form and a copy of the property deed to:
Mr. Charles H. Weaver, Jr.
NC DENR/ DWQ/ NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
1617 Mall Service Center,Raleigh,North Carolina 27699-1617 Telephone[phone] FAX[phone]
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Page 1 of 3
BAT * * * * * * * -
****** PARCEL AND OWNERSHIP DATA ****** --------
PARCEL ID. . . . . . . . . . : 9763.04-61-1840.000 ACCOUNT # 008138383
ROUTING #. . . . . . . . . . : 08100 OWNER NAME . . . . . : DOUGLAS NEIL CLARK 6 KATHLEEN F
PREVIOUS PARCEL ID. : 22048048.00
PARCEL STATUS A AC'
SITUS ADORE SS. . . . . . !. . . . . . : 004 CAMELFIELD RD MAILING ADDRESS 4 TOAD FROG BTM
SR/CITY/WARD/TSHP. / /2 CREEK WEAVERVILLE , NC 28787-9811
ASSESSED ACRES. . . . . :
PROPERTY CLASS. . . . . : 111 RES/1-FAMILY CNTY CODE . . . . . : BUN BUNCOMBE COUNTY
CITY CODE . . . . . .
FIRE CODE . . . . . : PRO REEMS CREEK
SANI CODE . . . . . .
SCHL CODE . . . . . .
DEED DATE. . . . . . . . . . : 08-26-1999
DEED BOOK/PAGE/INST: 2156/0462-WDT
PLAT BOOK/PAGE. . . . . : 0048/0038
SUBDIVISION NAME. . . : MEADOWS IN THE WOODS
SUBDIV BLK/SECT/LOT: /1 /2
WATERSHED. . . . . . . . . . : 0 NONE
****** FINAL APPRAISED/ASSESSED VALUE ****** ________________________________________________________________
SYSTEM SYSTEM ASSESSED VALUE ADJ EXEMPTED AMOUNT * FINAL
APPRAISED ASSESSED * ASSESSED
VALUE VALUE * VALUE
LAND - > 29,400 29,400 * 29,400
BUILDING(S) ----> 108,500 108,500 108,500
STRUCTURE(S) ---> 4, 600 4,600 * 4, 600
___________ ___________ ___________ ----------- * ___________ +
TOTAL ----------> 142,500 142,500 0 0 * 142,500
****** ASSESSEMENT HISTORY ******
___________________________________________________________
TAX YR ACCOUNT # ACRES LAND BUILDINGS STRUCTURES EXEMPTION DEFERRED TAXABLE
2004 008138383 1.18 29,400 108,500 4, 600 142,500
2003 008138383 1.18 29,400 108,500 4, 600 142,500
v .bmcombegis.org/propeads/9763/976304611840000.txt 2/15/2005

Page 2 of 3
2002 008138383 1.18 29,400 108,500 4, 600 142,500
2001 008138383 1.18 19,800 86,000 2,200 108,000 -
2000 008138383 1.18 19,800 86,000 2,200 108,000
****** SALES HISTORY ****** ONLY QUALIFIED SALES ARE USED FOR VALUATION PURPOSES
DATE OF DEED DEED DEED QUALIFIED DISQUALIFY DATA VACANT @ TIME
SALE BOOK PAGE INST SALE (Y/N) CODE SOURCE OF SALE . (Y/N) SALE PRICE SALE NOTE
08 26 1999 2156 0462 WIT N UO3 SIR N 136,000 PEND. QUALIFICATION
CONT. PARCEL ID: 9763.04-61-1840.000 PAGE 2 09/15/2004
****** LAND DATA ******
REC REC FF OR UNIT APPRAISED APPRAISED
NO TYPE UNITS TYPE VALUE/MRK USE VALUE
001 M 1.18 AT 29,358 0
----------- ------------ ------------
TOTAL ACRES -----> 1.18 LAND VALUE -> 29,358 0
****** MISCELLANEOUS STRUCTURE(S) ******
STR STRUCTURE CONST UN RATE RCN NOTE YRLF PHY RCNLD
# CIE DESCRIPTION YEAR UNITS TY GRAD PER UNIT VALUE TAB DPR VALUE
01 PL SWIMMING POOL 1987 648 SF C 35.25 22,842 IRR 10 80% 4,568
------------
TOTAL RCNLD VALUE --------> 4,568
CONT. PARCEL ID: 9763.04-61-1840.000 PAGE 3 09/15/2004
****** BUILDING CHARACTERISTICS ******
BLDG # . : 01 YEAR BUILT. : 1987 ADJUST. . :
STYLE. . . : 1CN 1.0-STY CONVENTIONAL YR-LIFE TAB: 85 YRS FUNC REP:
GRADE. . . : C AVG PRY DEP. . . . : 78 16 YRS SOON DEP:
COND. . . . : N NORMAL BLDG SIZE. . : C10 SOFT ADJ 1000-1099 FACTOR. : 1.05
****** BUILDING SECTIONS/BUILDING REFINEMENTS/BUILDING SKETCH/BUILDING VALUATION SUMMARY ******
BLDG -- BLDG SECTION(S) DESCRIPTION -- ROLL STORY BASE SQ FT L/F --------- VALUATION ----------
SECT# CDE YEAR HEIGHT SECT AREA PERM UNITS RATE VALUE
01 SEC TY -> BAR BASE AREA 1987 1.00 YES 1,008 128 1,008 SF 49.50 49,896
WALL TYP 100 FR OR EQUAL/FR LB 1,008 SF .00 0
http://w .bmcombegis.org/propcuds/9763/976304611840000.txt 2/1`

Page 3 of 3
UNFINISHED BASEMENT - 504 SF 12.98 6,542
FINISHED BASEMENT 504 SF 27.63 13, 926
02 SEC TY -> OR OPEN PORCH 1987 1.00 NO 100 SF 18.25 1,925
03 SEC TY -> UDK WD DECK @ UPPER LVL 1987 1.00 NO 648 SF 12.80 8,294
SUM OF ALL BASE AREAS OF STRUCTURE -> 1, 008
BUILDING REFINEMENTS DESCRIPTION AND VALUATION
+10------+ FOUNDATION 100 CONVENTIONAL 1,008 SF .00 0
1 ROOF TY/MT 100 GABLE W/ COMP. SHGL 1, 008 SF .00 0
0 ROOF STRUC 100 WOOD JOIST 1, 008 SF .00 0
OP FLOOR FIN 100 W/W CARPET 1,008 SF .00 0
TNT FINISH 100 DRYWALL/SHEETROCK 1,008 SF .00 0
1 HEATING -- 102 FORCED AIR 1,008 SF 2.38 2,399
0 AIR COND - 110 NONE(NO CENTRAL A/C 1, 008 SF .00 0
+36 -----+------10-----*10------+ FULL BATH(S) --> 2 3612.00 7,224
3 HALF BATH(S) --> 1 2383.00 2,383
6 HOT TUB(S) ----> 0 .00 0
1 SAUNA(S) ------> 0 .00 0
1 WASH/DRY HKUP 0 .00 0
1 DISHWASHER 0 .00 0
FIREPLACE/GASLOG 1 2575.00 2,575
WOODSTOVE 1 .00 0
LIVING RM(S) --> 0 .00 0
HAS DINING RM(S) --> 0 .00 0
FAMILY RM(S) --> 0 .00 0
# BEDROOMS ----> 2 .00 0
UDK BSMT GR # CARS > 1 1525.00 1,525
IN-DR SWIM PL -> 0 .00 0
ADD'L LV UT (S) > 0 .00 0
ELEVATOR 0 .00 0
I I I
2 2 BUILDING VALUATION SUMMARY
8 8 UNADJ. COST NEW --> 1,008 SF 95.82 96,589
+36 + X C10 SQFT ADJ 1000-1099 1.05
RCN > 101,418
- PHYSICAL DEPREC 7 % 7,099
UNADJ APPRAISED VAL 93.57 94,319
X NEIGHBORHOOD ADJ. 15 8
8 APPRAISED VALUE --> 108,467
+--------- 46+
v .bmeombegis.org/propcards/9763/976304611840000.tst 2/15/2005

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NCDENR !!' , s 2001
North Carolina Department of Environment and Natur I Resources
Division of Water Quality t' r '
Michael F. Easley, Governor 'William:G'.Ross,Jr.,Secretary
Asti Klimek P E Director,.
February 2, 2007
CERTIFIED MAIL-RETURN RECEIPT REQUESTED
Douglas & Kathleen Clark
4 Camelfield Road
Weaverville, NC 28787
Subject: Renewal Notice/General Permit NCG550000
Certificate of CoverageNCG550440j
Buncombe County
Dear Sir or Madam:
You.are receiving this notice because Buncombe County tax records indicate that you own
the property at: .
4 Camelfield Rd
Weaverville, NC 28787
The property was previously covered under General Permit NCG550000 for the discharge
of domestic wastewater. That coverage expired on July 31,2002;the owner who obtained
coverage did not respond to renewal notices from the Division. If this property is still
discharging wastewater,you must renew coverage under NCG550000.
The Certificate of Coverage (CoC) specific to your property [NCG550440] was last issued
on July 21, 1997. The Division needs information from you to determine if coverage under
NCG550000 is still necessary.
➢. If your property still has a wastewater system like the ones described in the
enclosed Technical Bulletin, you must renew the subject CoC. Complete the
enclosed form and submit it to the address on the form.
➢ If you are not sure what type of system your property has, contact Larry Frost in
the NC DENR Asheville Regional Office at(828) 296-4500. That person [or other
staff members] can help you determine if you should renew your CoC.
➢ If you know that your property no longer discharges wastewater, contact me at
the address or phone number listed below to request rescission of the CoC.
➢ If you have already mailed a renewal request,you may disregard this
notice.
1617 Mail Service Center,Raleigh,North Carolina 27699-1617
512 North Salisbury Street,Raleigh,North Carolina 27604 NOne`ffi Carolina
Phone: [phone],extension 511/FAX [phone]/charles.weaver®ncmail.nef (v V�
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NCG550440 renewal notice
Page 2
The attached application form shows the information the Division has on file for your
property. Please verify that the provided information is correct, or make corrections on the
'i form. Complete the additional questions, then sign and date the form.
The completed form should be submitted to the address listed below the signature block.
If you have any questions concerning this matter, please contact me at the telephone
number ore-mail address listed below. Please reference CoC number NCG550440 when
'I you make contact. (If it is difficult to reach me, please be aware that your facility is one of
over1100 that I am contacting regarding the renewal of NCG550000.)
Thanks for your attention to this matter.
Sincerely, �//
uV /
Charles H. Weaver, Jr.
NPDES Unit
cc: Central Files
[Asheville Regional Office/Larry Frost
NPDES file
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