NCG550606_Owner (Name Change)_20220808

•
ROY COOPER
• ELIZABETH S. BISER
�`}m Srri'rrun:r
r RICHARD E. ROGERS,JR.
,.� 1>irrcrnr
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
5 0 6 0 6
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): Rabih Younes
c. Owner: person legally responsible for
CoC: Rabih Younes
First MI Last
Mr.
REC�IVED Title
723 Hurley Rd
AUG 0 8 NU Durham
Holder Mailing Address
Durham NC 27704
NPDES City State Zip
NCDEQIDWR ( 540 )449-8385 [e-mail]
Phone E-mail Address
d. Facility name(if applicable):
e. Facility address: 723 Hurley Rd
Address
Durham NC 27704
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
Revised 12/2018

NCG550000 OWNERSHIP CHANGE FORM
Page 2 of 2
IV. 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)
V. 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
I, Rabih , 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.
July 25,2022
Si LIr tore Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Mr. Charles H. Weaver
NC DEQ/DWR/NPDES
1617 Mail Service Center
Raleigh,NC 27699-1617
Revised 4/2020

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For Registration Sharon A. Davis
Register of Deeds
Durham County, NC
Electronically Recorded
2020 Jun 26 02:03 PM
Book: 8987 Page: 486
NC Rev Stamp: $ 480.00 Fee. $ 26.00.
Instrument Number: 2020024812
DEED
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $480.00
Parcel Identifier No. 168192 Verified by County on the day of ,20
By:
Mail/Box to: Mann,McGibney&Jordan,PLLC,7751 Brier Creek Parkway,Ste. 103,Raleigh,NC 27617
This instrument was prepared by: Mann,McGibney&Jordan,PLLC,7751 Brier Creek Parkway,Ste. 103,Raleigh,NC 27617
Brief description for the Index: Lots 44-47,Hurley Acres
THIS DEED made this a(o day of 3 u ne ,20 20,by and between
GRANTOR GRANTEE
Carpaz Ven LLC Rabih Younes,a free trader
3950 Fairsted Drive 723 Hurley Rd.
Apt 505 Durham,NC 27704
Raleigh,NC 27612
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, Township, Durham County, North Carolina and more
particularly described as follows:
Being Lots 44,45,46,and 47 of the plat and survey entitled"Hurley Acres"as surveyed by R.A.Jones,R.A.dated December 5&6,
1958 as recorded in Plat Book 35,page 47,Durham County Registry.
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.
1
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

The property hereinabove described was acquired by Grantor by instrument recorded in Book 8875 page 804.
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 35 page 47.
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

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 claims of all persons whomsoever,other than the following exceptions:
l. Ad valorem property taxes for the current year and subsequent years.
All easements,restrictions and rights-of-way of record,if any.
IN WITNESS WHEREOF,the Grantor has duly executed the foregoing as of the day and year first above written.
Carpaz Ven LLC (SEAL)
iti a Print/Type Name:
By: (SEAL)
Print/Type Name&Title: icardo Paz,Member/Manager Print/Type Name:
By:
Print/Type Name&Title:' (SEAL)
Print/Type Name:
By:
Print/Type Name&Title: - (SEAL)
Print/Type Name:
State of North Carolina—County of WO k e
I,the undersigned Notary Public of the County and State aforesaid,certify that Ricardo Paz,personally appeared before me
this day and acknowledged that he is the Member/Manager of Carpaz Ven LLC,a North Carolina or corporation/limited liability
company/general partnership/limited partnership(strike through the inapplicable),and that by authority duly given and as the act of
such entity, he signed the foregoing instrument in its name on its behalf as its act and deed. Witness my hand and Notarial
stamp or seal,this 2.4 day of ,vie ,20 2 O
My Commission Expires:
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3
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