NC0066249_Owner (Affiliation Change)_20211201

Country Acres Renters Leisa&Frank Reusch,
25 Keith Memorial Drive 109 Redwater Way,Greer,SC 29651
Mills River NC 28�59 [e-mail]
828-606-5823
RECEIVED'
DECO-1 2021
To:
NCDEQ—Division of Water Resources NCDEQ/DWR/NPDES
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, NC 27699-1617
Greer, 11/29/2021
Permit Number: NC0066249, Henderson County, Country Acres MHP WWTP
Subject: Change of Name and Address
Dear Ladies and Gentlemen,
We would like to request the change of the name and address for permit#NC0066249.
Attached the requested form and the transfer deed from 06/08/2020.
If you need any more information, please do not hesitate to get in touch with us.
Respectfully
eisch %eusc

ROY COOPER
Governor
N
`�a MICHAEL S. REGAN
Secretory
LINDA CULPEPPER
Water Resources Director
ENVIRONMENTAL QUALITY
PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION: RECEIVED
Permit Number: NCO() C"l / 2/ 7 / ✓ or NCG5 I / / / DEC.0 1 2021
1. Facility Name: COGCk2/1 y 4ec' 'l#P NCDEQ/DWRINPDES
IL NEW OWNER/NAME INFORMATION:
1. This request for a name change is a result of:
X a. Change in ownership of property/company
b. Name change only
c. Other(please explain):
2. New owner's name(name to be putn on permit):
Lei sce I%C� G 1 6—.c2JcI7
3. New owner's or signing official's name and title: LAGS ce
(Person legally responsible for permit)
• r,� (Title)
4. Mailing address: /0 1C Q Ce/�6 672' l!/4 y City:
State: SG Zip Code: 23 GS 1 Phone: ( 'P) U476 got'2g
E-mail address: /14 f p GAP'ee C C . C-C2
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BYTHE 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 l Water Resources
1617 Mail Service Center I Raleigh,NC 27699-1617
919 807 6300 919-807-6389 FAX
httpsJ/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, 'et:fcc ecreca RecescJ-' , 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:L' Date: ///2 /2c.)2
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INFORMATION & MATERIALS, SHOULD BE SENT TO THE FOLLOWING ADDDRESS:
NC DEQ/ DWR/ NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Version 7/2016

BOOK 3503 PAGE 314 (3)
926324
This document presented and filed:
06/08/2020 02:08:19 PM
WILLIAM LEE KING, Henderson COUNTY, NC
Transfer Tax:$0.00
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax:$0.00
Parcel Identifier No.802312
By:
Mail/Box to: C.Page Collie—1645 Asheville Highway,Hendersonville,NC 28791
This instrument was prepared by: C.Page Collie(Deed Preparation Only—No Title Search Performed)
Brief description for the Index: Acreage off Pennsylvania Road along Keith Memorial Drive
THIS DEED made this 5th day of June,2020,by and between
GRANTOR GRANTEE
LEISA CAROL REUSCH
f/k/a LEISA CAROL EDMUNDSON STACK
and husband,FRANK THOMAS REUSCH LEISA CAROL REUSCH and husband,
FRANK THOMAS REUSCH
JOHN L.EDMUNDSON,un-remarried widower
Address: 109 Redwater Way Address: 109 Redwater Way
Greer,SC 29651 Greer,SC 29651
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 or parcel of land
situated in the Town of Mills River,Mills River Township,Henderson County,North Carolina and more particularly described
as follows:
BEGINNING at a locust stake standing at the Southwest corner of that tract as sold
to Ralph J. Guthrie by deed recorded in Deed Book 415 at Page 199,Henderson
County Registry,and running from said BEGINNING point and with the Southern
NC Bar Association Form No.3 © 1976,Revised© 1977,2002 Page 1 of 3 -Reusch
Printed by Agreement with the NC Bar Association—1981 -Chicago Title Insurance Company