NCG551116_Owner (Name Change)_20210617

ROY COOPER
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prz.":„
MICHAEL S. REGAN
Secretory
LINDA CULPEPPER
Water Resources Interim Director
ENVIRONMENTAL QUALITY
NPDES Certificate of Coverage (CoC)
NCG 550000 OWNERSHIP CHANGE FORM_
I. Please enter the CoC number for which the change is requested.
Certificate of Coverage
NI C G, 5, 5
II. Please provide the following for the requested ange(revised permit).
a. Request for change is a result of: Change in ownership of the residence/property
❑ Name change of the facility or owner
If other please explain:
b. Permit will be issued to(company
name, if applicable): Li..r\I
G vte, CO �,,r)ve,S-} +s U
c. Person legally responsible for permit: p,.A - et r ►� 2r
First MI Last
RECEIVED �w r
^� 53 E Title 1 y Y U- & A-
R
M -
j 17 ZUzt Permit Holder Mailing Address
UVRINPD 1,- 1
�#5
ODE f City State Zip
4� (e37-0) 2Zly b eobo Lave-Fakn-er e
Phone E-mail Address
d. Facility name(discharge): �� - ?co?�4-9
e. Facility address: SS S D (yet te_A
_ Address
-r r4 ln.►Ll. ;n NZ -3(1
City State Zip
f. Facility contact person: �anx-
[if different from Owner] First MI Last
( )
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
pLioirto this ownership or name change?
Yes
❑ No(please explain) l
Revised 11/2017

NCG550000 OWNERSHIP CHANGE FORM
Page 2 of 2
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.
El/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, Y ,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 mplete.
(clre)
gnature Date
PLEASE SEND TILE COMPLETE APPLICATION PACKAGE TO:
NC DEQ/DWR/NPDES
1617 Mail Service Center
Raleigh,NC 27699-1617
Revised 1112017

VMS. £I U CQCjC JYV
BK: CRP N-40 I Ulll)IIIlfl111111II1I1Il1II
PG: 540-544 2020010635
RECORDED: NC FEE$26.00
12-30-2020 MACON COUNTY,NC STATE OF NC
03:21:16 PM TODD RABY REAL ESTATE
BY:TODD RABY REGISTER OF DEEDS EXTX$750.00
REGISTER
Revenue$750.00
THIS INSTRUMENT PREPARED BY: PLEASE RETURN TO:
ORVILLE D. COWARD, JR., a licensed Kenneth W. Fromknecht,II
North Carolina Attorney. Delinquent taxes, P.O. Drawer 1146
if any,to be paid by the closing attorney to Franklin,NC 28744
the county tax collector upon disbursement
of closing proceeds.
COWARD, HICKS & SILER, P.A.
43 WEST MAIN STREET P/N�
FRANKLIN,NORTH CAROLINA 28734 N
PIN: 6581983247& 6581984069
20F776T
NORTH CAROLINA GENERAL WARRANTY DEED
THIS DEED, made this the 14th day of December, 2020, by and between STEVEN
KOSTER and wife, KASEY KOSTER, Grantors; and CANE POLE INVESTMENTS, LLC,
a North Carolina limited liability company of 10 Caleb's Way,Franklin,North Carolina, 28734,
Grantee.(The designation Grantors 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 Grantors, in consideration of Ten Dollars and Other Valuable Consideration

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($10.00 OVC),the receipt of which is hereby acknowledged,have bargained and sold,and by these
presents do bargain,sell, and convey unto the Grantee, in fee simple,all that certain lot or parcel of
land situated in Smithbridge Township, Macon County, State of North Carolina, and being more
particularly described as follows:
See attached Exhibit A for full description.
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, subject to the exceptions herein
enumerated.
AND,subject to the exceptions herein enumerated,the Grantors covenant with the Grantee,
that Grantors are seized of the premises in fee simple, have the right to convey the same in fee
simple, that the property is free and clear of all encumbrances, and that Grantors will warrant and
defend the title against the lawful claims of all persons whomsoever.

V VIt 1V-YV rCLCjC JYL
EXHIBIT A
TRACT ONE:
Being the same lands, easements,privileges and appurtenances as described in
and conveyed by the deed dated March 9, 1999 from Ronnie Franklin and wife,
Kathy Franklin to Steven Koster and wife, Kasey Koster, recorded in book D-23,
Pages 1201-1203, Macon County Public Registry, and described in full therein as
follows:
'Being all the lands, easements,privileges and appurtenances as described in that
deed dated 20 December, 1985, from John S. Courson, Sr. To Billy J. McDaniels
and wife, Barbara L. McDaniels, and recorded in Book S-16, Page 448, Macon
County Land Registry, and being described as follows:
'BEGINNING at a p.k. nail set in the center line of U.S. Highway 441, said point
of beginning being situated South 70 degrees 25 minutes 00 seconds West 53.60
feet from an iron pipe, said point of beginning further being situated the following
two calls from a second PK nail in the center line of U.S. Highway 441, said
reference PK nail being the penultimate and Northwesternmost corner of the lands
described in the Deed from James H. Mason and wife, Maggie Mason to James C.
Carpenter, dated February 17, 1982, and recorded in the Office of Register of
Deeds for Macon County,North Carolina, in Deed Book I-14, Page 223, to wit:
North 10 degrees 29 minutes 42 seconds West 46.77 feet to a PK nail and North
10 degrees 57 minutes 18 seconds West 113.65 feet to said point of beginning,
and runs thence from said point of beginning,North 70 degrees 25 minutes 00
seconds East,passing the aforesaid iron pipe at 53.60 feet, and passing a second
iron pipe at 289.83 feet, whole distance 323.74 feet to a point in the center of the
Little Tennessee River;then down and with the meanders of the river,North 20
degrees 17 minutes 54 seconds East 146.63 feet to a point; and North 3 degrees 30
minutes 36 seconds East 7.58 feet to a point; then leaving the river, South 70
degrees 25 minutes 00 seconds West,passing an iron pipe at 35.05 feet, and
passing a second iron pipe at 348.65 feet, whole distance 402.61 feet to a PK nail
in the center line of U.S. Highway 441; then with the center of the same, South 10
degrees 57 minutes 18 seconds East 120.85 feet to the point of BEGINNING,
containing 1.00 acres, more or less, as surveyed by Ron Kirkland, Registered
Land Surveyor and as shown on his unrecorded map titled James H. Mason, dated
February 8, 1982, as revised on January 10, 1983, drawing No. FB 206270 and
being designated as Tract Number 5.
'The lands hereby conveyed are made subject to the right of way of U.S. Highway
441 and to easements for public utilities.
'The lands hereby conveyed are a portion of the lands described in the deed from
Addie Vanhook to James Mason and wife,Maggie Mason, dated September 29,
1961, and recorded in the Office of Register of Deeds for Macon County,North

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Carolina, in Deed Book W-6, Page 5.
'"The lands hereby conveyed are made subject to the following restrictive
covenants and conditions,which restrictive covenants and conditions shall be
covenants running with the land by whomsoever owned and parties of the first
part further covenant and agree that the restrictions contained herein shall apply to
all that portion of the lands described in the deed from Addie Vanhook to James
Mason and wife, Maggie Mason dated September 29, 1961, and recorded n the
Office of the Register of Deeds for Macon County,North Carolina, in Deed Book
W-6,Page 5, which lie North of the lands hereby conveyed.
'1. No part of said lands shall be used as a junk yard or dumping ground for trash
or rubbish or for any unsightly or obnoxious purpose, and no junk cars shall be
allowed to remain on said lands.
'2. No noxious or offensive activity shall be carried on upon the lands hereby
conveyed nor shall anything be done thereon intending to cause embarrassment,
discomfort, annoyance or a nuisance to the neighborhood.
'3.No automobiles or other motor vehicles shall be parked or allowed to remain
upon the lands hereby conveyed for a continuous period in excess of six months.
'For further source of title, see Deed from Billy J. McDanieIs and wife, Barbara L.
McDaniels,to Ronnie Franklin and wife, Kathy Franklin, dated 15 August, 1997,
recorded in the Office of the Register of Deeds for Macon County,North Carolina
in Book C-22, Pages 1710-1712.'
TRACT TWO:
Being Lot 2 containing 0.65 acres as shown on the survey map by Eric A.
Lorenzen, PLS, Sylvester& Company,PA, dated August 7, 2006, drawing#5082,
recorded on Plat Card#4977,Macon County Public Registry, to which reference
is hereby made for a full and complete description. Provided however, Parcel "C"
containing 0.34 acres, as shown on said recorded survey map, is excepted out of
the provisions of the warranties contained hereinbelow.
Subject to the matters shown on the above referenced recorded survey map,
easements for existing roadways and utility lines and facilities, to restrictions of
record, and to applicable land use laws and ordinances.
W:\Chelsi\Exhibits,Desc,Etc\ExhibitA.KosterToCanePole.wpd

...MAR t"- rClyC :JaY
IN WITNESS WHEREOF, the Grantors have caused this instrument to be properly
executed and sealed.
(SEAL)
VE KOSTER
I vU (SEAL)
KASEY(OSTER
STATE OF NORTH CAROLINA
COUNTY OF MACON
C-NuAs1
ie , L C I k.5 a Notary Public, do hereby certify that
(type or print name of Not
STEVEN KOSTER and wife,KASEY KOSTER,Grantors,each personally appeared before me this
day and acknowledged the execution of the foregoing instrument.
WITNESS my hand and official stamp or seal, this ' t day of December, 2020.
O ary Public //��
Tq/� cZi�' My commission expires: ` ' `70.1
••40 PUBLIC 0
CGOUi�",.��°
W:\Chelsi\Deeds\20F776T.KosterToCanePole.Deed.wpd