NCG551562_Owner (Name Change)_20211130

STATE4ti
,A
ROYCOOPER � .. o, I ECE V
Governor �. vii_ .{;;,���' C �®
ELIZABETH S.BISER N O V 3 0 2021
Secretary Y�'k Qu AN Nis
S.DANIEL SMITH NORTH CAROLINA
Director Environmental Quality NCDEQIDWRIN PD ES
PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
Permit Number: NCO() / / / / or NCG5 c// /,;/6 / 0
1. Facility Name: 77/ I4// A E.L ) / G /.7 //i�sv7c. /VC
II. NEW OWNER/NAME INFORMATION:
1. This request for a name change is a result of:
xa. Change in ownership of property/company
b. Name change only
c. Other(please explain):
2. New owner's name(name to be put on permit):
./V/1/ 77/ T/V
3. New owner's or signing official's name and title:
( •s gully responsible for permit)
(Title)
4. Mailing address: 7Z 0 X/e/9G/9/7' /n City: // / 7?/ //vim
State: Zip Code: 3275/ Phone: (407 ) 9Z5 - 9�-�
E-mail address: L -,,,97-7"dd /9OG de)/Y2
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]
D_E -j North Carolina Department of Environmental Quality I Division of Water Resources
Q Asheville Regional Office 12090 U.S.Highway 70 I Swannanoa.North Carolina 28778
NORTH ci i w a av o� r4.'!!// 828.296.4500

Page 2 of 2
Applicant's Certificatio .
I ci 6;7704ttest that this application for a name/
ownerslup ch ge has been reviewed and is accurate and complete to the best of my knowledge. I
understand t at 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: /A/ Z/
THE COMPLETED APPLICATION PACKAGE,INCLUDING ALL SUPPORTING
INFORMATION & MATERIALS, SHOULD BE SENT TO THE FOLLOWING ADDDRESS:
NCDEQ/DWR/NPDES
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
Version 11/2020

Instrrunent# 2020004824 Book 998 Page 1358
DATE 2 i2e o5-29 BY HW 2020004824
HAYWOODCOUNTYTAXCERTIFICATION HAYWOOD COUNTY NC FEE$26.00
'Gregor West,Haywood Cody Tax Collector STATE OF NC REAL ESTATE EXTX
Date; 22020-05-29 By: CANDY $482.00
Them are aodd>IqueMt xesduelhatrealienagaiustparcel[s) PRESENTED &RECORDED
05/29/2020 08:47:53 AM
SHERRI C.ROGERS
REGISTER OF DEEDS
BY: HAVEN MUSE
DEPUTY
BK: RB 998
PG: 1358 -1361
NORTH CAROLINA=GENERAL WARRANTY DEED
Excise Tax: $482.00
Parcel Identifier No.7684-64-0794 Verified by County on the day of ,20__,
By:
Mail/Box to:J.0l R.Weaver,PAJalicensed NC attorney141 Woodland.Drivg,Waynesvtlle.NC 28786
This instrument was prepared by: Jnet,R.Weaver,PA,(a lirsgagstlic attorney)4 LjUopd4hnd )rivejVaynesville,NC 28786
Brief description for the Index:
THIS DEED made this 1-7 day of 4-t.i ,202%,by and between
GRANTOR { GRANTEE
Doris S.Mergner;unmarried, Kenneth J.Gallon and wife,
Life Estate Interest and LinneaA.Gatton
Steven Alexander Mergaer;unmarried, 720 Arapaho Tsai
Remainder Interest Maitland,FL 32751
771 WallaerRoad
Waynesville,NC 28786
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 avaluable considerationpaid by the Grantee,the receipt of which is hereby acknowledged,has andby
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 , *Waynesville Township, Haywood County,
North Carolina and more particularly described as follows:
See Attached Exhibit"A"
Page I of 2
NC Bar Association Form No. 3 01976,Revised 01977,2002,2013 This standard form has been approved by:
Printed by Agreement with the NC Bar Association—1981 North Carolina Bar Association—NC Bar Form No.3
submitted electronically by "39e1 R Weaver PA"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Haywood county Register of Deeds.

�oOD—eoG HAYWOOD COUNTY PROPERTY TAX NOTICE '
co HAYWOOD COUNTY TAX COLLECTIONS ��2,
m 215 N MAIN STREET#224 t M� v. `• PAYMENT PLANS:Please call 828-452-6643,If you need to make
WAYNESVILLE NC 28786-3899 yal,�_�5i.• payments or other arrangements,please do so immediately.Once
o �\- , - /` taxes are delinquent,the plan is more costly per month.
m ADDRESS SERVICE REQUESTED \ F r80gcV *See back of tax bill for more information.
ESCROW/MORTGAGE ACCOUNTS:Tax notices are forwarded
to the mortgage companies.The property owner is responsible for
ensuring full payment of this obligation.If funds are held in escrow
**********AUTO**ALL FOR AADC 328 to pay this notice,forward to the appropriate mortgage holder.
9250591 2811-PTN 304781 1 3
ga PERSONAL PROPERTY:If this is the first notice of value,a
GATTON, KENNETH J taxpayer may appeal the value,situs or taxability of the personal
ElGATTON, LINNEA A property in writing within 30 days from the 1st day of September.
720 ARAPAHO TRL FAILURE TO PAY:Delinquent taxes are subject to garnishment of
MAITLAND FL 32751-3804 wages,attachment of monies on deposit or rents received,levy on
personal property and foreclosure proceedings.
t 1I ollI 11 I1 rIC 1 I I11 1OII ��111I rIIIIOIII INTEREST accrues at the rate of 2%for January&3/4 of 1%each
following month.
ACCOUNT NUMBER. BILL NUMBER DUE DATE ' BILL YEAR DELINQUENT AFTER
_
717
261895 20A13337 09/01/2020 2020 01/05/2021
OFFICE INFORMATION PARCEL IDENTIFICATION NUMBER: 7684-64-0794 Z
_ . _.. -. _ --._ _ -- -- -DESCRIPTION: - -- - _- - -771 WALKER RD- - - - -- --------- - - — _- .N_
Tax Collections [phone] ACREAGE: 0.3680 N
OFFICE INFORMATION a
Questions Concerning Value: REAL ESTATE VALUE: 134,400 m
Real Property [phone] DEFERRED REAL VALUE: m
Personal Property [phone] PERSONAL PROPERTY VALUE: co
EXEMPTION VALUE:
Business Property [phone] TOTAL VALUE:. 134,400
PAY BY CREDIT CARD-Real Estate, 11
TAXING DISTRICT„ ALUE&,FETES._ AMOUNT DUE` -11
Personal Property&Motor Vehicle Taxes - p ,' 0 GENERAL COUNTY 0.585000000 786.24 c"
- },r_r - SAUNOOK FIRE DIST 0.050000000 67.20
Master L! D►SC�VER VISA •4-• oi LANDFILL FEE 159.000000000 159.00
rly Novas= E"x 31 0 +:
-
VISIT US ONLINE - -
www.haywoodcountvnc,gov Smart Phone users LATE LIST 0.00
or call 1-877-729-8290 scan QR code to
CURRENT TAX 1,012.44
After authorization of your payment, you will be given a visit us Online
confirmation number to keep for your records.Provider charges www,haywood PREPAID 0.00
a fee for this service.The county only receives the tax amount. . countync.gov
PRIOR TAX 0.00
NORTH CAROLINA GENERAL STATUTE 105-357 PROVIDES A PENALTY OF TEN PERCENT(10%)OR$25.00 ON THANK YOU TOTAL DUE 1,012.44
CHECKS RETURNED BY THE BANK BECAUSE OF INSUFFICIENT FUNDS OR NONEXISTENCE OF AN ACCOUNT.
DUE TO BANKING PROCEDURES IMPLEMENTED BY THE COUNTY,YOUR PAYMENT SHOULD BE MAILED TO THE CHARLOTTE ADDRESS-' -
WHERE IT IS DIRECT DEPOSITED INTO THE COUNTY'S BANK ACCOUNT.THIS WILL BETTER SERVE YOU AND BE MORE COST EFFECTIVE.
YOU MAY USE THE ADDRESS PRINTED ON THE BILL OR OUR PERMANENT ADDRESS OF 215 N.MAIN STREET SUITE 224 WAYNESVILLE,NC 28786