NCG551442_Owner (Name Change)_20220629

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Sarah Elizabeth Bowes
217 Breedlove Avenue
Durham, NC 27703
Dear Permittee:
NORTH CAROLINA
Environmental Quality
June 29, 2022
Subject: General Permit NCG550000
Certificate of Coverage (CoC) NCG551442
217 Breedlove Avenue
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 NCG551442, 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
Sincerely,
li V.7)7
.
for Richard E. Rogers, Jr.
Director, Division of Water Resources
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11611 Mail Service Center I Raleigh, North Carolina 27699-1611
919.707.9000

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG551442
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,
Sarah Elizabeth Bowes
is hereby authorized to discharge <1000 gallons per day of domestic wastewater from a
facility located at
217 Breedlove Avenue
Durham
Durham County
to receiving waters designated as an unnamed tributary to Little Lick 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 6/29/2022.
This Certificate of Coverage shall remain valid for the duration of the General Permit.
Signed this day 6/29/2022
ii 144
for Richard E. Rogers, Jr.
Director, Division of Water Resources
By Authority of the Environmental Management Commission

Water Resources
ENVIRONMENTAL ou ALirr
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
Permit Number: NC00 / / / / or NCG5/1/A/1 //
1. Facility Name:
11 \00- o4t- -WAK Z113
II. NEW OWNER/NAME INFORMATION:
This request for a name change is a result of:
a. Change in ownership of property/company
b. Name change only
c. Other (please explain):
title:
2. New owners name (name to be put on permit):
6O
3. New owners or signing official's name and
SA/1%k' cirtkki-k
(Person legally responsible for permit)

(Title)
4. Mailing
address: 7,14. ( Lf it4e, pc,re_ City: y4Ilm
State: A I ` Zip Code: ' 1, 3
Phone
110 3 SZ 6V1
E-mail address: Sb 4 e. t: 1 , ,
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]
Applicant's Certification:
I, 41,L 1 , , attest that this application for a
name wnership 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: I w' I/ Y Z Z
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
Statc of North Carolina I Environmental Quality I Watcr Resources
1617 Mail Service Center I Raleigh, NC 27699-1617

LOAN 0:7188149283
AFFIDAVIT OF OCCUPANCY
STATE OF NORTH CAROLINA
COUNTY OF Durham
217 Breedlove Ave
Durham, NC 27703 and administer oaths personalty
appeared: Sarah Elizabeth Bowes
Before me, the undersigned authority duly authorized to take acknowledgments
}
} SS.
('Affiants") who, upon being duly sworn, depose and say as follows: status
1. Affiants hereby certify that, upon taking title to the real property described above, their occupancy
will be as follows:
[ K ] 1.1 Primary Residence: At least one borrower will occupy, establish, and use the Property identified
aboveent and
hllas my/our toprincipaloccupy
the Property as my/our principal ncipalafter the residence ion of the for at least Security
erlyearsafter1the date
shall continue to occupy
of occupancy, unless Lender otherwise agrees in writing.
1.2 Second Home: At least one borrower will occupy the property as a second home (vacation, etc) while
[ ] maintaining a principal residence elsewhere.
[ ]
1.3 Investment Property: Not owner occupied. Purchased as an investment to be held or rented.
[ ] 1.4 REFINANCES ONLY that the property referenced above is NOT currently listed for sale or under
I/We the undersigned certify
contract to be listed for sale.
Me the undersigned acquired the property on
2. Affiants acknowledge that this Affidavit of Occupancy is given as a material inducement to cause:
Ameris Bank
to make a mortgage loan to Affiants and that any false statements, misrepresentations or material
omissions shall constitute a breach of the Affiant's obligation to:
Ameris Bank
and that all the provisions of the mortgage indenture concerning detault on the Promissory Note will
thereupon be in full force and effect.
3. Affiants further acknowledge that they have read and understand the following.
18 United States Code Section 1014:
"Whoever knowingly makes any false statement or report,...for the purpose of influencing in any way the
action decal hiomeution loanthe bank, thets of which are Federal Housing insured
F nanceeBoard, Federal
Deposit Insurance thhe Federal Deposit Insurance
any
Corporation, the Farm
System
nsuCorporation, National Credit
Union Administration
Board,...upon anapplcatonor tonshall be fined not more than $1,000000 or imprisoned not more
than 30 years or both."
The agreements and covenants contained herein shall survive the closing of the mortgage loantransaction.
SARAN ELIZABETH BOWES
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