NC0068918_Owner (Name Change)_20210716

ROY COOPER
:..�- ' MICHAEL S. REGAN
a.,. Secrerary
LINDA CULPEPPER
Water Resources
Fc:JV4 eONC.EN;=3:_QU4L•7e
PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
Permit Number: NCO() 6 /1/ r I I / 8 or NCG5 / / / /
1. Facility Name: C.�:, : f i�-� ►.ti1.�2 ►r�11�9 'f / . ,, 1 b- r L L
II. NEW OWNER/NAME INFORMATION:
1. This request for a name change is a result of: RECEIVED
X a. Change in ownership of property/company JUL 6_2021
b. Name change only NCDEQ/DWRNPDES
c. Other(please explain):
2. New owner's name(name to be put on permit):
k.fA'. j-I01.L (Rq Psi-Jt-r) Oto AI; , y 4ToOA-TRW
3. New owner's or signing official's name and title: 4 i !` t,�l 3L.iVAdj
(Person legally responsible for permit)
R& ► ``i 10 14
(Title)
4. Mailing address: P 6 SS 0 City: AR M
Stater„ Zip Code: a1 8-To Phone: ( 'a8) (.41 c4 $'
E-mail address: in Li'_► e' ^.le.0
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]
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
https://deq.nc.gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/npdes-wastewater-permits

NPDES Name&Ownership Change
Page 2 of 2
Applicant's Certification:
I, cl-S, 4 ,u;,1 iirA , 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 and attachments are not included, this application
package will be returned as incomplete.
Signature:
Date:
THE COMPL ED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INFORMATION & MATERIALS, SHOULD BE SENT TO THE FOLLOWING ADDDRESS:
NC DEQ 1 DWR/ NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Version 7/2016

Type: WARRANTY DEED
Recorded:7/12/2021 1:23:54 PM
Fee Amt: $26.00 Page 1 of 7
Revenue Tax: $0.00
Jackson County, NC
Joe Hamilton Register of Deeds
BK 2307 PG 961 - 967
9C',� mPp1 �v.
s4N cosh'
Jul - 12 2021 LP
This instrument prepared by:
Kimberly R. Coward,a licensed
North Carolina Attorney TITLE TO LAND DESCRIBED HEREIN
Coward,Hicks & Siler,P.A. NOT CERTIFIED UNLESS WRITTEN
Post Office Box 1918 OPINION IS RENDERED
Cashiers,NC 28717
Rev. $0.00; unimproved; not primary residence
PIN: 7582-25-2915; whole transfer
STATE OF NORTH CAROLINA
COUNTY OF JACKSON
SPECIAL WARRANTY DEED
THIS SPECIAL WARRANTY DEED is made this !cL 'day ofj l/2021,by and
between CEDAR HILL WASTE WATER TREATMENT,LLC, a North Carolina limited
liability company, of 605 Ledgeview Road, Cashiers,NC 28717,hereinafter referred to as
"Grantor," and CEDAR HILL PROPERTY OWNERS' ASSOCIATION,INC_, a North Carolina
non-profit corporation, of P.O.Box-Z4n, C AINC 17r,hereinafter referred to as
"Grantee." The terms grantor and grantee sligr6giused afn u singular designation of the
parties hereto,their personal representatives,heirs, successors and assigns.
WITNESSETH:
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 Cashiers Township,Jackson
County,North Carolina, and more particularly described as follows:
1
submitted electronically by "coward Hicks & siler"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the ]ackson county Register of Deeds.

BEING ALL of Lot 73B, Phase I, Cedar Hill (formerly Sleepy Valley), containing 2.26
acres, as shown on a plat thereof recorded in Plat Cabinet 5, Slide 735, Jackson County
Registry, to which reference is specifically made.
ALSO BEING all of the same lands as described in that certain deed recorded in Book
2241, Page 1678, Jackson County Registry,to which reference is specifically made.
TOGETHER WITH a non-exclusive right-of-way over the existing access road shown on
the above-referenced plat, together with continuations thereof, for purposes of ingress and
egress between U.S. Highway 64 and subject property and TOGETHER WITH rights-of-
way within the existing Cedar Hill Road System to install, maintain, repair and/or replace
future and/or existing elements (waterlines,pumps, and any other elements thereof) of the
Cedar Hill Wastewater Treatment System (NC DENR Number NC 0068918).
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 has done nothing to impair
such title as Grantor received and Grantor will warrant and defend the title against the lawful
claims of all persons claiming by, under or through Grantor, except for the exceptions hereinafter
stated.
Title to the property hereinabove described is conveyed subject to the following
exceptions:
Exceptions and reservations contained in this deed and/or in instruments referenced
herein.
Easements and rights-of-way for public and private roads and utilities, of public record.
Lien of ad valorem taxes for the current year and subsequent years, not yet due and
payable.
SIGNATURE AND NOTARY ACKNOWLEDGMENTS ON FOLLOWING PAGES
2

IN WITNESS WHEREOF, Grantor has caused these presents to be executed by its
Managers,the day and year first above-written.
CEDAR HILL WASTE WATER TREATMENT,
LLC, a North Carolina limtexited liability company
By: (SEAL)
DONALD T.POLE,Manager
By: (SEAL)
JOHN A. QUINLIVAN,Manager
By: (SEAL)
BRUCE F.VORSANGER,Manager
STATE OF NQ'ttA
COUNTY OF /144/Ao'W/(
I,a Notary Public of/1 €0.//41410PVt' County and State aforesaid, do
hereby certify that DONALD T.POLE,Manager of CEDAR HILL WASTE
WATER TREATMENT,LLC, a North Carolina limited liability company
personally appeared before me this day and acknowledged the due execution of
the foregoing instrument on behalf of said limited liability company.
'WITNESS my hand and official stamp or seal,this the Z? day off ,2021.
Notary Public NotaryPublic
New Hanover Co.,North Carolina
My Commission Expires Oct.27,2023
Printed Name of Notary
My Commission Expires:/0 "27`z023
ADDITIONAL NOTARY ACKNOWLEDGMENTS ON FOLLOWING PAGE
3

IN WITNESS WHEREOF,Grantor has caused these presents to be executed by its
Managers,the day and year first above-written.
CEDAR HILL WASTE WATER TREATMENT,
LLC,a North Carolina limited liability company
By: (SEAL)
DONALD .POLE,M er
By: SEAL)
OHN A. QUINLIVAN,Manager
By: (SEAL)
BRUCE F.VORSANGER,Manager
STATE OF
COUNTY OF
I,a Notary Public of County and State aforesaid, do
hereby certify that DONALD T.POLE,Manager of CEDAR HILL WASTE
WATER TREATMENT,LLC, a North Carolina limited liability company
personally appeared before me this day and acknowledged the due execution of
the foregoing instrument on behalf of said limited liability company.
WITNESS my hand and official stamp or seal,this the day of ,2021.
(OFFICIAL SEAL)
Notary Public
Printed Name of Notary
My Commission Expires:
ADDITIONAL NOTARY ACKNOWLEDGMENTS ON FOLLOWING PAGE
3

IN WITNESS WHEREOF, Grantor has caused these presents to be executed by its
Managers, the day and year first above-written.
CEDAR HILL WASTE WATER TREATMENT,
LLC, a North Carolina limited liability company
By: (SEAL)
DONALD T. POLE, Manager
By: (SEAL)
JOHN A. QUINLIVAN, Manager
By ^ ' (SEAL)
BRUCE F. VO AN R, Manager
STATE OF
COUNTY OF
I, a Notary Public of County and State aforesaid, do
hereby certify that DONALD T. POLE, Manager of CEDAR HILL WASTE
WATER TREATMENT, LLC, a North Carolina limited liability company
personally appeared before me this day and acknowledged the due execution of
the foregoing instrument on behalf of said limited liability company.
WITNESS my hand and official stamp or seal, this the day of , 2021.
(OFFICIAL SEAL)
Notary Public
Printed Name of Notary
My Commission Expires:
ADDITIONAL NOTARY ACKNOWLEDGMENTS ON FOLLOWING PAGE
3

)
STATE OF kolrrL Qroli (�
COUNTY OFV O,- cJSo Y�
I, a Notary Public of 1/lA co rl County and State aforesaid,do
hereby certify that JOHN A. QUINLNAN,Manager of CEDAR HILL WASTE
WATER TREATMENT,LLC, a North Carolina limited liability company
personally appeared before me this day and ackno ledged the due execution of
the foregoing instrument on behalf of said limited li ility com y.
WITNESS my hand and official stamp or seal,this the of JGt Y1 ' ,.2021.
(OFFICIAL SEAL)
Teresa L.Fritz
NOTARY PUBLIC tary Pu lic
Macon County,NC
My Commission Expires July 10,2024
a a Printed Name of Notary
My Commission Expi s:
STATE OF
COUNTY OF
I, a Notary Public of County and State aforesaid,do
hereby certify that BRUCE F.VORSANGER,Manager of CEDAR HILL
WASTE WATER TREATMENT,LLC,a North Carolina limited liability
company personally appeared before me this day and acknowledged the due
execution of the foregoing instrument on behalf of said limited liability company.
WITNESS my hand and official stamp or seal, this the day of ,2021.
(OFFICIAL SEAL)
Notary Public
Printed Name of Notary
My Commission Expires:
21-1056/eb
4

•
STATE OF
COUNTY OF
I, a Notary Public of County and State aforesaid, do
hereby certify that JOHN A. QUINLIVAN, Manager of CEDAR HILL WASTE
WATER TREATMENT, LLC, a North Carolina limited liability company
personally appeared before me this day and acknowledged the due execution of
the foregoing instrument on behalf of said limited liability company.
WITNESS my hand and official stamp or seal,this the day of , 2021.
(OFFICIAL SEAL)
Notary Public
Printed Name of Notary
My Commission Expires:
STATE OF NO) aft l4l
COUNTY OF cJ C LV D r\
I, a Notary Public of MAG V County and State aforesaid, do
hereby certify that BRUCE F. VORSANGER, Manager of CEDAR HILL
WASTE WATER TREATMENT, LLC, a North Carolina limited liability
company personally appeared before me this day and acknowledged the due
execution of the foregoing instrument on behalf of said limited liability company.
WITNESS my hand and official stamp or seal, this the day of J(it �� , 2021.
_EFICIALSEA -
(=11c�t�@h R. Gordon - 7.6,01 ( G-8q(r)
NOTARY PUBLIC Notary Public
Nitgetgl County
N Carolina _
My Cornffiis§4on€kpiPes October 20,2025 61Z(k ,'")
Printed Name of Notary
My Commission Expires: (4ph,Q/ 3 } �6�
21-1056/eb
4