NCG551414_owner name change_20210915

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
S. DANIEL SMITH
Director
Rebecca L. Whittlesey
3421 Coley Rd
Durham, NC 27703
Dear Permittee:
NORTH CAROLINA
Environmental Quality
September 15, 2021
Subject: General Permit NCG550000
Certificate of Coverage (CoC) NCG551414
3421 Coley Rd
Durham County
The Division has approved your request to transfer coverage under the subject General Permit.
Accordingly, the Division hereby issues you a revised version of NCG551414, along with a copy of
NCG550000. Discard any earlier versions of the permit and use this version until further notice. This CoC
is issued pursuant to the requirements of North Carolina General Statue 143-215.1 and the Memorandum
of Agreement between North Carolina and the US Environmental Protection agency dated October 15, 2007
[or as subsequently amended].
PLEASE NOTE: Your facility discharges to a class WS-IV NSW waterbody. Therefore, you will use
the limits and monitoring frequencies found in Part I, section C. (3.) of NCG550000.
If any parts, measurement frequencies or sampling requirements contained in this General Permit
are unacceptable to you, you have the right to request an individual permit by submitting an individual
permit application. Unless such demand is made, the certificate of coverage shall be final and binding.
This CoC is not transferable except after notice to the Division. The Division may require
modification or revocation and reissuance of the CoC. Contact the Raleigh Regional Office prior to any
sale or transfer of the permitted facility. Regional Office staff will assist you in documenting the
transfer of this CoC.
This permit does not affect the legal requirements to obtain any other State, Federal, or Local
governmental permit that may be required. If you have any questions concerning the requirements of the
General Permit, please contact Derek Denard of the NPDES staff [[e-mail]].
cc: NPDES file
NORT
Department of Environmental Dual
Sincerely,
li V.7)7
.
for S. Daniel Smith
Director, Division of Water Resources
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11617 Mail Service Center I Raleigh, North Carolina 27699-1617
919.707.9000

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG551414
DISCHARGE OF DOMESTIC WASTEWATER FROM SINGLE FAMILY RESIDENCES AND
OTHER 100% DOMESTIC DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and
the Federal Water Pollution Control Act, as amended,
Rebecca L. Whittlesey
is hereby authorized to discharge <1000 gallons per day of domestic wastewater from a
facility located at
3421 Coley Rd
Durham
Durham County
to receiving waters designated as Laurel Creek, currently a class WS-IV NSW stream in subbasin
03-04-01 of the Neuse River Basin in accordance with the effluent limitations, monitoring
requirements, and other conditions set forth in Parts I, II, and III hereof.
This certificate of coverage takes effect 9/15/2021.
This Certificate of Coverage shall remain valid for the duration of the General Permit.
Signed this day 9/15/2021
ii 144
for S. Daniel Smith
Director, Division of Water Resources
By Authority of the Environmental Management Commission

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
S. DANIEL SMITH
OWNIOr
NORTH CAROLINA
Environmental Quality
NPDES Certificate of Coverage (CoC)
NCG550000 OWNERSHIP CHANGE FORM
I. Please enter the CoC number for which the change is requested.
Certificate of Coverage
N
G
5
5
4 1
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/property
❑ Name change of the facility or owner
If other please explain:
b. CoC will be issued to (person's name
or company name, if applicable):
c. Owner: person legally responsible for
CoC:
d. Facility name (if applicable):
e. Facility address:
f Facility contact person:
[if different from Owner]
ebecca_ Whi Ifiesee�
First MI Last
Title
36121 CG}e� 2
Permit Holder Mailing Address �� �3
ofhcwh N�
City State Zip
(q[el)wS`l-(o1,s riimg rocs RA4 e er-41,1.cov,-1
Phone E-mail Address
. Li21 Colel P-Ct
Address
DLliklo-n-. IOC. XlO3
City State Zip
First MI Last
Phone E-mail Address
[[[. 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
North Carolina Department of Environmental Quality Division of Water Resources
512 North Salisbury Street 1 1617 Mail Service Center I Raletoh, North Carolina 27699-1617
919.7079000

IV.
V.
NCG550000 OWNERSHIP CHANGE FORM
Page 2 of 2
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)
Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
❑ 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
1, it , 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
SSeP21
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Mr. Charles H. Weaver
NC DEQ / D WR / NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
[e-mail]

Book9384 - Page 339 Page 1 of 3
For Registration Sharon A. Davis
Register of Deeds
Durham County, NC
Electronically Recorded
2021 Jul 01 02:38 PM
Book: 9384 Page: 339
NC Rev Stamp: $ 776.00 Fee: $ 26.00
Instrument Number: 2021033546
DEED
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $776.00
Parcel Identifier No. 194876 Verified by
County on the day of , 20
By:
Mail/Box to: Mann, McGibney & Jordan, PLLC, 621 W. Jones Street, Raleigh, NC 27603
This instrument was prepared by: Mann, McGibney & Jordan, PLLC, 621 W. Jones Street, Raleigh, NC 27603
Brief description for the Index: 3421 Coley Road
THIS DEED made this / I day of
, 20 7 (, by and between
GRANTOR
Derek Edwards and Jennifer Edwards, a married couple
2504 Sunnystone Way
Raleigh, NC 27613
GRANTEE
Rebecca Lynn Whittlesey, unmarried and
Travis Nathaniel Varner, unmarried
3421 Coley Road
Durham, NC 27703
Enter in appropriate block for each Grantor and Grantee: name, mailing address, and, if appropriate, character of entity, e.g.
corporation or partnership.
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 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, parcel of land or
condominium unit situated in the City of Durham, Durham County, North Carolina and more particularly described as follows:
SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF.
The property hereinabove described was acquired by Grantor by instrument recorded in Book 7833 page 539.
All or a portion of the property herein conveyed
includes or does not include the primary residence of a Grantor.
A map showing the above described property is recorded in Plat Book page
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.
NC Bar Association Form No. 3 © Revised 7/ 2013 North Carolina Bar Association - NC Bar Foim No. 3
Printed by Agreement with the NC Bar Association North Carolina Association of Realtors, Inc. - Standard Form 3
submitted electronically by "Mann, McGibney & Jordan, PLLC"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Durham County Register of Deeds.

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, other than the following exceptions:
1. Ad valorem property taxes for the current year and subsequent years.
2. All easements, restrictions and rights -of -way of record, if any.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing of the da1and yea first above written.
(Entity Name) Prn
By:
Print/Type Name & Title: Priype Name: Jennifer Edwards
pe
Name: Derek Edwards
(SEAL)
(SEAL)
By: (SEAL)
Print/Type Name & Title: Print/Type Name:
By:
Print/Type Name & Title: Print/Type Name:
State of Ai6 r - County of tA Lk
I, the undersigned Notary Public of the County and State aforesaid, certify that Derek Edwards and Jennifer Edwards
personally appeared before me this day and acknowledged the due execution of the forego'. tg instrument for the purposes therein
expressed. Witness my hand and Notarial stamp or seal this % day of , � 20
My Commission Expires: 01... ,, rt.
(SEAL)
an
Notary Public
2
NC Bar Association Form No. 3 © 1976, Revised © 1/1/2010, 2013 This standard form has been approved by:
Printed by Agreement with the NC Bar Association North Carolina Bar Association - NC Bar Form No. 3

EXHIBIT A
Legal Description
Being all that certain lot or parcel of land lying in Durham County, North Carolina and being more particularly
described as follows:
Beginning at a stake in the center of State Road No. 1900, also known as the Union Grove Road said stake being
at the Northwestern corner of all land lying on the Eastern side of said Union Grove Road which was acquired by
J.C. Ransdell by deed dated November 18, 1965, from D.B. Hoyle and wife, Edna Hoyle, recorded in Book 316,
Page 635, Durham County Registry; running thence South 64° 25 minutes East 215 feet to an iron stake; running
thence South 5° 15 minutes West 451 feet to an iron stake; running thence North 86° 35 minutes West 99 feet to
an iron stake; continuing thence North 86 degrees 35 minutes West 181.5 feet to an iron stake in the center of
state Road No, 1900, also known as Union Grove Road; running thence along the center of said road North 13°
40 minutes East 542 feet to the point and place of Beginning, and containing 2.762 acres, more or less, including
the right of way of said Union Grove Road, and being the Northern portion of the land owned by J.C. Ransdell
lying on the Eastern side of said Union Grove Road, all of said land acquired by J.C. Ransdell from D.B. Hoyle
being shown on map entitled "Property of J.C. Ransdell" prepared by C.W. Russum, RLS, dated November 1965.
Exhibit A (Legal Description)
Page 1 of 1 21-06-3232-P/50