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Home My WebLink AboutNCG550909_Owner (Affiliation Change)_20200615 ROY COOPER )Of f, MICHAEL S. REGAN See,eta,l S. DANIEL SMITH M+air • NORTH CAROLINA Environmental Quality NPDES Certificate of Coverage (CoC) • NCG550000 OWNERSHIP CHANGE FORM 1. Please enter the CoC number for which the change is requested. Certificate of Coverage N CGS 5 0 9 0 9 II. Please provide the following for the requested change(revised CoC). a. Request for change is a result of: ® Change in ownership of the residence/0�erp}�E I V E D El Name change of the facility or owner l If other please explain: JUN 1 �� b. CoC will be issued to(person's name or company name,if applicable): Erin Howard NCQEC INPQES c. Owner:person legally responsible f9r CoC: Erin W Howard First MI Last Title 225 Brooks Farm Drive Permit Holder Mailing Address Rockwell NC 28138 City State Zip (704)798-6247 e witalisongyahoo.com Phone E-mail Address d. Facility name(if applicable): e. Facility address: 2750 Morgan Road Address Gold Hill NC 28071 City State Zip f. Facility contact person: [if different from Owner] First MI Last ( ) Phone E-mail Address III. Contact person(if different from the person legally responsible for the CoC) First MI Last Title Mailing Address City State Zip ( ) Phone E-mail Address Revised 12/2018 NCG550000 OWNERSHIP CHANGE FORM Page 2 of 2 IV Will this permitted facility continue tgdischarge the same volume and type of wastewater as prior to this ownership or name chan ige? ® Yes 0 No(please explain) V. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE INCOMPLETE OR MISSING: Z This completed application is required for both facility-name change and/or facility ownership change requests. ® Legal documentation of the transfer of ownership(such as a property deed,relevant pages of a contract,or a bill of sale)is required for an ownership change request. The certifications below must be completed and signed by the new applicant in the case of an ownership change request. APPLICANT CERTIFICATION I,Erin Howard,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. C • CM, 06/10/2020 Signature Date PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO: Mr.Charles H.Weaver NC DEQ/DWR/NPDES 1617 Mail Service Center Raleigh,NC 27699-1617 Revised 4/2020 r NT MAN I S/M PAR' S/P I WIN ILAN 1C/CPART ( INT I Rowan County Assessor's Office I1111111 111`NIE IIIIII1 I10IIIINII1uIIII Doc ID: 014258140003 Type: CRP Recorded: 10/23/2019 at 11:45:08 AM This certifies that there are no delinquent ad valorem real estate taxes,w¢ich the Fee Amt: $26.00 Page 1 of 3 Revenue Tax: $0.00 Rowan County Tax Collector is chaff wiLIZAP lectmS.that are a lien on: Rowan. NC Property Identification Number j��j�' (J't') J. E. Brindle Register of Deeds This is not a certification that the owan County Property Identification Number BK 1336 PC I T matches this Deed description. /�F 1D�a -(Q trga(� 2 Tonya Parnell ��f Date/nine Rowan Co.Tax Collections Manager Cleric a4 No opinion on title is expressed or implied by the preparer of this document Tax Map 521 Parcel 041 Stamps: $0 Mail after recording to: Erin W. Howard, 225 Brooks Farm Drive Rockwell,NC 28138 Brief Description for index: 2750 Morgan Rd. Gold Hill,NC 28071 Document Prepared By: R. Darrell Hancock,Attorney at Law, Salisbury,NC NORTH CAROLINA QUITCLAIM DEED THIS DEED made this ( r7 day of October 2019 by and between GRANTOR GRANTEE JONATHAN D. HOWARD ERIN W. HOWARD 225 BROOKS FARM DRIVE 225 BROOKS FARM DRIVE ROCKWELL, NC 28138 ROCKWELL,NC 28138 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 Grantor,for and in consideration of the sum of ten dollars and other valuable consideration,in hand paid,the receipt of which is hereby acknowledged, has remised and by these presents does remise,release,convey and forever quitclaim unto the Grantee, her heirs and/or successors and assigns, all right, title, claim and interest of the Grantor in and to that certain lot or parcel of land lying and being in Morgan Township, Rowan County, North Carolina and more particularly described as follows: SEE ATTACHED EXHIBIT"A" TO HAVE AND TO HOLD the aforesaid tract or parcel of land and all privileges thereto belonging to the Grantee. her heirs andr`or successors acid assigns, free and discharged from all right, title, claim or interest of the Grantor. or anyone claiming by,though, or under him. Title to the property hereinabove described is subject to the following exceptions: Any and all easements.restrictions. rights of way and encumbrances of public record. All or a portion of the land conveyed herein does not include the principal residence of a Grantor IN WITNESS WHEREOF,the Grantor has hereunto set his hand and seal,the day and year first above written. (SEAL) ONATHAN D. HO 'ARD STATE OF NORTH CAROLINA COUNTY OF ROWAN I. Darrell Hancock, a Notary Public of the County and State aforesaid, do hereby certify that JONATHAN D. HOWARD, Grantor, personally appeared before me this day and acknowledged t ecution of the fore oin instrument. Witness my hand and official stamp or seal, this of Qetober 2019. (SEAL) oFFiciAi.st:nt• Notary Public DARREL/ ILA.\COCK PhY1:1RiPtRI.1`..-.'Of ffI('.X-Rt':"l.Vr1 COI.\i OF POW My Commiss112 Expires My Commission Expires: (0 20 Z0 • EXHIBIT "A" DESCRIPTION BEGINNING at a stake in the centerline of Morgan Road, Culp's corner; and runs thence with Culp's line,North 79 degrees 52 minutes 42 seconds West 878.89 feet to a stake in Lowder's corner;thence with Lowder's line,North 83 degrees 11 minutes 08 seconds West 973.50 feet to a stake: thence South 13 degrees 18 minutes 52 seconds West 61.5 feet to a stake, a new corner on David Miller; thence a new line with Miller, South 78 degrees 39 minutes 19 seconds East 1,727.63 feet to a stake in the centerline of Morgan Road: thence with the center line of Morgan Road, North 49 degrees 31 minutes 18 seconds East 200 feet to the BEGINNING, containing 5 acres, and shown on survey of MILLER PROPERTY,dated March 9, 1976,prepared by Douglas M. Clayton. For back title see Book 1308,Page 373 Rowan County Register of Deeds.