670029_Application_20220915

Notification of Change of Ownership
Animal Waste Management Facility
(Please type or print all information that does not require a signature)
In accordance with the requirements of 15A NCAC 2T .1304(c) and 15A NCAC 2T .1305(d) this form is official notification
to the Division of Water Resources (DWR) of the transfer of ownership of an Animal Waste Management Facility. This
form must be submitted to DWR no later than 60 days following the transfer of ownership.
General Information:
Previous Name of Farm: NO( WO d Q v t S rc r ► n5 Facility No: (.e - 02 5
Previous Owner(s) Name: Nor vJ Oe`) d 170.+) S Phone No: clip - 59 31Sa
New Owner(s) Name: N\kOr4n)c c cl L. , S P0.r r LL(.. Phone No: q )t) Sc le(p(p
New Farm Name (if applicable): KOrv40Csd +S �tctfrnS. 1-LC
Mailing Address: 3B 5 Dcty is 2d 1� �t_k ck IJC c285 `1 Lt
E-mail Address: --i etr rrin r• dad 'ES $ ®'C lot 1 1 .COtrrl
Farm Location: Latitude and Longitude: 31 45 rja 1 /1 3Cit 4I
County: Cr}SIOv.)
Please attach a copy of a county road map with location identified, and provide the location address and driving directions
below (Be specific: road names, directions, milepost, etc.): -foal SwCUE Ror, USa't59, !� Lori ICI i -iJj Lon feibanler-
R or, mufrtll 6iravr Qd Orrc66 ` enWLIharn5 '> a at,tic, +?d , -rev,y' an Le ® 3% t J:s Rd,
Operation Description:
Type of Swine No. of Animals Type of Swine No. of Animals Type of Cattle No. of Animals
❑ Wean to Feeder ❑ Gilts 0 Dairy
0 Wean to Finish 0 Boars EtBeef 50
DI Feeder to Finish o? 4 4p
❑ Farrow to Wean Type of Poultry No. of Animals
0 Farrow to Feeder 0 Layer
❑ Farrow to Finish ❑ Pullets
Other Type of Livestock: Number of Animals:
Acreage Available for Application: c 5. 5 Required Acreage:
/8.14
Number of Lagoons / Storage Ponds: t Total Capacity: (0q'7 5D Cubic Feet (ft3)
Owner / Manager Agreement
I (we) verify that all the above information is correct and will be updated upon changing. 1 (we) understand the operation and
maintenance procedures established in the Certified Animal Waste Management Plan (CAWMP) for the farm named above
and will implement these procedures. I (we) know that any modification or expansion to the existing design capacity of the
waste treatment and storage system or construction of new facilities will require a permit modification before the new
animals are stocked. I (we) understand that there must be no discharge of animal waste from the storage or application
system to surface waters of the state either directly through a man-made conveyance or from a storm event less severe than
the 25-year, 24-hour storm and there must not be run-off from the application of animal waste. I (we) understand that this
facility may be covered by a State Non -Discharge Permit or a NPDES Permit and completion of this form authorizes the
Division of Water Resources to issue the required permit to the new land owner.
Name of Previous Land Owner: NOrl�ppd � tS
Signature: DeCesz. d 3/078/2242a / Date: — z
Name of New Land Owner: j\lr)r\ c d
Signature:
Name of Man
Signature:
t_ S L-L
nt from owner): Ary4 ( Da.0 S
Please sign and rrn this form to:
Animal Feeding Operations
N. C. Division of Water Resources
Water Quality Permitting Section
1636 Mail Service Center
Raleigh, NC 27699-1636
Date:
Date:
1 6- Z.Z
March 25, 2022

Page 1 of 3
Type: CONSOLIDATED REAL PROPERTY
Recorded: 8/12/2022 3:34:05 PM
Fee Amt: $26.00 Page 1 of 3
Revenue Tax: $0.00
Onslow County, NC
Omega K. Jarman Reg. of Deeds
BK 5816 PG 338 - 340
***NO TITLE SEARCH REQUESTED***
Mail after Recording to: Norwood Davis Farms, LLC, 398 Davis Road, Richlands, NC 28574
Prepared by: Lanier Fountain, Ceruzzi & Sabbah, 114 Old Bridge Street, Jacksonville, NC 28540/KEF/ap
Tax Parcel ID # 005938
Stamps - S0.00
STATE OF NORTH CAROLINA
COUNTY OF ONSLOW
NORTH CAROLINA GENERAL WARRANTY DEED
THIS DEED made and entered into this the / .clay of Litt/8- , 2022 by and between:
GRANTORS
GRANTEES
ELEANOR DAVIS ,
398 Davis Road
Richlands, NC 28574
widow
NORWOOD DAVLS FARMS, LLC, A North
Carolina Limited Liability Company
398 Davis Road
Richlands, NC 28574
The designation Grantor and Grantee as used herein shall include said parties, their heirs,
successors, assigns, and shall include singular, plural, masculine, feminine, or neuter as required by
context.
WTTNESSETH:
That said Grantors for a valuable consideration paid by Grantees, the receipt of which is hereby
acknowledged, has and by these presents does grant, bargain, sell, and convey unto the Grantees in fee
simple, all that certain lot or parcel of land situated in Jacksonville Township, Onslow County, North
Carolina, and more particularly described as follows:
BEING all of Lot as shown on that map of the Norwood and Eleanor Davis
property, dated February 14, 1994, prepared by John L. Pierce Surveying,
and recorded in Map Book 30, Page 133, Onslow County Registry.
BEING the same property described hi a Deed, dated September 17, 1970,
from Minnie M. Davis to Norwood Davis and wife, recorded in the Office of
the Register of Deeds, Onslow County, North Carolina, in Book 396, Page
393. This property is being conveyed subject to restrictive covenants,
easements and rights of way of record recorded in the Onslow County
Registry.
The above -described property does not include the primary residence of the Grantors.
TO HAVE AND TO HOLD the above -described premises with all appurtenances thereunto belonging
unto Grantees, their heirs, successors, and assigns in fee simple.
The property hereinabove described was acquired by Grantors through instrument recorded in Deed
Book 396, Page 393, Onslow County Registry.
And the Grantor covenants with the Grantee that Grantor is seized of the premises in fee
submitted electronically by "Lanier, Fountain ceruzzi & sabbah"
in compliance with North carulina statutes governing recordable documents
and the terms of the submitter agreement with the onslow county Register of Deeds.
Book: 5816 Page: 338 Page 1 of 3
Book: 5816 Page, 1977-Current: 338 Seq: 1

Page 2of3
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 except for the exceptions hereinafter stated.
Title to the property hereinabove described is subject to the following exceptions:
Subject to restrictions, easements, and rights -of -ways of records, if any.
IN WITNESS WHEREOF, Grantors have hereunto set their hands and seals the day and year
first above written.
ELEANOR't VIS
STATE OF NORTH CAROLINA
ONSLOW COUNTY
I, a Notary Public, certify that ELEANOR DAVIS personally appeared before me this day and
acknowledged the execut'on of the foregoing instrument_ Witness my hand and official stamp or seal,
this the l,**day of 2022.
My Commission Expires: cam.
MORAG A. POLASKI
NOTARY PUBLIC
ONSLOW COUNTY
STATE OF NORTH CAROLINA
Book: 5818 Page: 338 Page 2 of 3
Book: 5816 Page, 1977-Current: 338 Seq: 2

Page 3 of 3
DEPARTMENT OF TAX ADMINISTRATION
Tax Certification Form
(Check One Box)
❑f This certifies that there are no delinquent ad valorem taxes, or other
taxes which the Onslow County Tax Collector is charged with
collecting, that are a lien on:
Parcel Identification Number:
005938 GRANTEE(S): NORWOOD DAVIS FARMS, LLC
This is not a certification that this Onslow County Parcel
Identification Number matches the deed description.
- No certification required, as attorney statement that any delinquent
taxes will be paid from closing proceeds is included on first page of
deed, and the assessor has obtained the desired information from the
conveyance (G.S. 105-303).
❑ Balance due on account It must be paid to Onslow County Tax Collector.
Please make payment within 5 days of closing.
KAREN D LEE cT 2022. 812141228 Q b0 08/12/2022
Tax Collections Staff Signature Date
nThis parcel may have deferred taxes which become due upon transfer of the
property_ Ca11 the Tax Office, Land Records Division at 910-989-2204 for
more information.
234 NW Corridor Blvd • Jacksonville, North Carolina • 28540 • Phone: [phone] • Fax: [phone].On5lowCountyNC.gov/tax
Book: 5816 Page: 338 Page 3 of 3
Book: 5816 Page, 1977-Current: 338 Seq: 3

Facility/Farm Name:
Animal Waste Management System Operator Designation Form
WPCSOCC
NCAC 15A 8F .0201
Ixl4r wOod+ Oct.%S Fctrnns
Permit #: AWs (61009
Facility ID#: CQ1 - aq County:
Onsk) vJ
Operator In Charge (OIC)
Name: A (ley
First
Middle
Dal/ is
Lust .Jr, Sr, etc-
Cert Type / Number: A I LAI a39
Signature.
Work Phone: (Q l a
%�►-tL,.1, Date:
"I certify that 1 agr to my designation as the Operator in Charge for the facility noted. I understand and will abide by the rules and regulations
pertaining to the responsibilities set forth in 15A NCAC 08F .0203 and failing to do so can result in Disciplinary Actions by the Water
Pollution Control System Operators Certification Commission."
Back-up Operator In Charge(Optional)
` (Back-up OIC)
Name: Ar, Ong I/V4�t/ is
First (! Middle Last
Cert Type / Number: A, vJ l La i'
Signature:
Jr, Sr, etc.
Work Phone: (q-1 IO ) `-1 Ca 7- 1 f 3
Date: G
I certify that I agree to my designation as Back-up Operator in Charge for the facility noted. 1 understand and will abide by the rules and
regulations pertaining to the responsibilities set forth in 15A NCAC 08F .0203 and failing to do so can result in Disciplinary Actions by the
Water Pollution Control System Operators Certification Commission."
OwneriPermittee Name:
Phone #: A to
Signature:
Nor -Woad bcio s R (r \
`-1 S q-(Q(06) %
(Owner or auftlorized agent)
Fax#: ( ) q
Date. ! - G- Z ^�
Mail, fax or email the
original to:
Mail or fax a copy to the
appropriate Regional Office:
WPCSOCC, 1618 Mail Service Center, Raleigh, NC 27699-1618
Email: certadmin(a�ncdenr.gov
Asheville
2090 US Hwy 70
Swannanoa 28778
Fax: [phone]
Phone: [phone]
Washington
943 Washington Sq Mall
Washington 27889
Fax: [phone]
Phone: [phone]
Fayetteville
225 Green St
Suite 714
Fayetteville 28301-5043
Fax: [phone]
Phoen: 910.433.3300
Wilmington
127 Cardinal Dr
Wilmington 28405-2845
Fax: [phone]
Phone: [phone]
Fax: [phone]
Mooresville
610 E Center Ave
Suite 301
Mooresville 28115
Fax: [phone]
Phone: [phone]
Winston-Salem
450 W. Hanes Mall Rd
Winston-Salem 27105
Fax: [phone]
Phone: [phone]
Raleigh
3800 Barrett Dr
Raleigh 27609
Fax: [phone]
Phone:[phone]
Revised 05-2015
(Retain a copy of this form for your records)