NCG550141_Owner (Name Change)_20211209

ROY COOPER 6f:1.,�t( ? `°i1
,
Governor
ELIZABETH S.BISER .0
Secretary
S.DANIEL SMITH NORTH CAROLINA
Director Environmental Quality
TMNPDES Certifeate of`;Coverage;(CoC)t
NCG550000',OWNERSHIP CHANGE EORIVI -t
I. Please enter the CoC number for which the change is requested.
Certificate of Coverage
N C 6, 5; 5 O 1 L1 i
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): j�„ .Lr
c. Owner: person legally responsible for K^ Ls' C'
CoC: -I
First MI Last
RECEIVE®
Title
DEC 0 9 20 ivy fO�3A tree K tce
Permit Holder Mailing Address
NCDEQIDWRINPDES dale 114i ( I A -7 S17
City State Zip
(Gyp) 64a- 3a77 .11-eri'je_mr}-.e I ;l. ��
Phone E-mail Address
d. Facility name (if applicable):
e. Facility address:
Address
City State Zip
f. Facility contact person:
[if different from Owner] First MI Last
( )
Phone E-mail Address
III. 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
wieksm North Carolina Department of Environmental Quality I Division of Water Resources
.✓) 512 North Salisbury Street i 1617 Mail Service Center ( Rhleigh,North Carolina 27699-1617
Do=tmuttatEntni Cue,tY � 919.7079000

BK 6758 PG 1105-1107(3) DOC#30062507
This Document eRecorded: 12/03/2021 03:20:04 PM
Fee:$26.00 Tax:$1,190.00
,e\" Orange County,North Carolina
MARK CHILTON,Register of Deeds by JAMES A.BARTOW
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax:S1,190.00
Parcel Identifier No.9788-40.8171 Verified byjkL" County on the_day of ,20_
This instrument was prepared by Kendall H.Pure(AME1 without title examination
Mall to:Grantee
Brief Description for the Index:Lot 10,Block A,Morgan Creek Development
THIS DEED made this 28h day of October 2021,by and between
GRANTOR GRANTEE
ATARAXIA,LLC HUNTER BEATTiE AND VERONICA BEATTIE
A NORTH CAROLINA LIMITED LIABILITY COMPANY 130 WEST CORBIN STREET
29 CHEMIN DES LARCHES HILLSBOROUGH,NC 27278
LA VERNAZ,FRANCE 74200
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 ORANGE County,North Carolina and more particularly described as follows:
SEE EXHIBIT"A"ATTACHED AND MADE A PART OF THIS DOCUMENT
Above-described property,kwas or was not the primary residence of Grantors}
submitted electronically by"Kendall H. Page, PLLC"
in compliance with north caroling statutes governing recordable documents
and the terms of the submitter agreement with the orange County Register of Deeds.
submitted electronically by"Kendall H. Page, PLLC"
In compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the orange County Register of Deeds.
•
•
I
jr
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1

BK 6758 PG 1106 DOC# 30062507
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 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 claim of all persons whomever.Title to the property hereinabove described is subject to the following exceptions: including,
but not limited to 1)any and all restrictions,easements and/or rights of way of record,if any;2)2021 taxes a lien that is not due and
payable.
IN WITNESS WHEREOF,the Grantor has duly executed the foregoing as of the day and year first above written.By executing this
Deed,the Grantor acknowledges that this document has been prepared solely for the transfer of title from the Grantor to the Grantee.
Furthermore,Glin r acknowledges that it is not being represented by the preparer of this document in the closing of this sale.
AT ,LLC
(SEAL)
JO $ GTON/CHAIRMAN
`£EiIi PAW, State of ter —County of
I, the undersigned Notary Public of the County and State aforesaid, certify that JOHN
HETHERINGTON personally appeared before me this day and acknowledged that he is the
CHAIRMAN of ATARAXIA, LLC, a North Carolina limited liability company and that by
authority duly given and as the act of each entity,he signed the foregoing instrument in its name
on its behalf as its act and deed.Witness my hand and Notarial stamp o seal this 15 day of
�it ..fas 2 2 1:_lni 5ehc ien ply
My Commission Expires: 31�NL��So \1F
No lic /)h
a� __ Nota r d,,.SSp�
The foregoing Certificate(s)of is/are certified to be correct.
This instrument and this certificate are duly registered at the date and time and in the Book and Page shown on the first page hereof.
Register of Deeds for County
By: Deputy/Assistant—Register of Deeds

BK 6758 PG 1107 DOC#30062507
EXHIBIT A
LEGAL DESCRIPTION
All of that certain lot or parcel of land situated,lying and being on the west side of
Morgan Creek Road,a short distance South of the Town of Chapel Hill,North Carolina,
and known and designated as Lot 10,Block A,Morgan Creek Development,as
surveyed and plotted by E.C.Leonard,Registered Surveyor,on July 7, 1952 and more
particularly described as Beginning at a stake in the west property line of said road,the
southeast corner of Lot 9;running thence with the line of said lot South 83°56'West
204.60-feet to a stake;running thence South 3°51'West 298.20-feet to a stake,the
northwest corner of Lot 11;running thence with the line of said lot North 42°23'East
132.00-feet to a stake;thence South 89°03'East 122.30-feet to a stake in the west
property line of said road;running thence along the west property line of said road in a
northern direction and along the arc of a circle with a radius of 955.40-feet for a
distance of 54.90-feet to a stake;running thence along the west property line of said
road North 3°39'East 169.10-feet to the Beginning.
Parcel:9788-40-8171
Property Location:404 Morgan Creek Road Chapel Hill,NC 27517

NCG550000 OWNERSHIP CHANGE FORM
Page 2 of 2
Will this permitted facility continue to discharge the same volume and type of wastewater as
prioMo this ownership or name change?
Yes
❑ No (please explain)
V. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
AREjNCOMPLETE 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.
APs"� ANT CERTIFICATION
I ttest 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.
gcyvAL )a,1 40A )
Signature Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Mr. Charles H. Weaver
NC DEQ/DWR/NPDES
1617 Mail Service Center
Raleigh,NC 27699-1617
[e-mail]