NCG551019_Owner (Name Change)_20221101

,4 ` 'C�J~ ,.
ROY COOPER `
,may .
Governor fi t
ELIZABETH S.BISER
Secretary a '"rrir f ,
S.DANIEL SMITH NORTH CAROLINA
Director Environmental Quality
I NPDES Certificate of Coverage (CoC) �1
N_CG550000 OWNERSHIP CHANGE FORM _
I. Please enter the CoC number for which the change is requested.
Certificate of Coverage
N 0 G 5 5 j Q / 9
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
0 Name change of the facility or owner
If other please explain:
b. CoC will be issued to(person's name r i
or company name,if applicable): ��", ? ( 1(.1)5 F pi 5C0p a ( C,V l Ltioh
c. Owner:person legally responsible for ' h-d04-0 JJ
CoC: Co '1dv- G S e A 0 riA( le`la
First MI Last
$(Yor hicur en / Jac it '-Wad
Title
qD3 e M d v ,-
Permit Holder Mailing Address
17wr kall NC 27-7DI
City State Zip
(qt ) b52-5 70 son iarwardoyi@�f phi[irsd tAekami,1
Phone E-mail Address
d. Facility name(if applicable): J. re•2.$ .
•
e. Facility address: 170 1 I C1k.5L.,V1-F- G--re9 r g
r�lain
Address
C Z 7?o F
City State Zip
f. Facility contact person: ZD(�,{T* l�(J�(l )UU�-�0V)
[if different from Owner] First MI t
( qIc )730•—K 7 robe,%i-a hall t�-�n(� 16166.cowl
Phone E-mail Ad s
III. Contact person fI'"r>[;� from the person legally responsible for the CoC)
7019e r- :1-r-I1 y(oLty;pi
First MI Last
The- '&6s ei l i lli Czordii 0,7 r-
Title
3(05 Z IPoevew Clrde
Mailing Address
-)M kI ,4 N Ci
City State Zip
( q 19 ) 7? -(o401 rob€xf IIllcu il�1-�g`vu tair5-c b M
Phone E-mail Addr ss
DE � North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11617 Mail Service Center I Raleigh,North Carolina 27699-1617
NORIN CAROLINA
owmwn m cnrnovamnal amour 919.707.9000

NCG550000 OWNERSHIP CHANGE FORM
' Page 2 of 2
WM this permitted facility continue to discharge the same.volume and type of wastewater as
prior to this ownership or name change?
El Yes '� y t .,T
❑ No(please explain)
V Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR,MISSING:
1 This completed application isrequired'for both facility-name change'and/or';'facility ownership
. 'changerequests. . ;..
IF
[2c Legal documentation of the transfer'cif ownershfip(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'applicantin the'case Of'an ownership
change request._ _ .. . - _ . ..
APPLI TCERTIFICATION
I, attest that this application for a name/ownership change has been reviewed and is accurate and
comp e te to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if allirequiredr supporting information is not included,this application package will be
returned as incomplete.
. - -- ' (O • •20a,9--
Date
P -. -:- ( ::--,-,: „,,;.= ,,.i k..,,," .
f PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
- . -- _ Mr. Charles H.Weaver
NC DEQ/DWR/NPDES
- _. - _. _. 1617 Mail Service Center
z
' Raleigh,'NC 27699-1617 : ' ` . :' ;,-`'-'' . -
- . - - [e-mail]
:;I.-
.

StPhilip's
episcopal church
worship• love •action
a church for all people
MOTION
At its regularly scheduled meeting of October 24, 2022, the Vestry of St. Philip's
Episcopal Church, Durham, NC adopted the following upon motion made by
Rebecca Hix and seconded by Shamieka Rhinehart.
BE IT RESOLVED that St. Philip's agrees with provisions concerning its real
property known as The Trees and located at 1701 Pleasant Green Road, Durham,
North Carolina which are contained in the attached NCG55000 Ownership
Change Form. The Vestry further directs its Senior Warden, Condict G. Semans,
and Junior Warden, Adam J. McClellan to execute the said document on behalf of
St. Philip's Episcopal Church all as authorized by Canon 23 of the Canons of the
Episcopal Diocese of North Carolina.
This the 24th day of October, 2022.
Wes Newman, Secretary of the Vestry

STATE OF NORTH CAROLINA
In The`General Court Of Justice CERTIFICATE OF TRUE COPY
DURHAM County !
OFFICE OF THE CLERK OF THE SUPERIOR COURT
As a Clerk of the Superior Court of this County, State of North Carolina,,Icertify that the attached copies of the documents described
below are true and accurate copies of the originals now on file in this office.'
Number And Description Of Attached Documents: l
SEVENTEEN(17)PAGES OF THE ESTATE OF JACQUELINE CATO HARRIS,ESTATE FILE# 19-E-371,INCLUDING THE
FOLLOWING:INVENTORY;,APPLICATION FORPROBATE AND LETTERS;CERTIFICATE OF PROBATE;OATH;ORDER
AUTHORIZING ISSUANCE OF LETTERS;THE LAST WILL AND TESTAMENT OF JACQUELINE CATO HARRIS.
•
•
Witness my hand and the seal of the'Superior Court
Date ; -
Clerk Of Superior Court , ' ' '
SEAL • " ARCHIE L:SMITH III '. •
• " ' Name Of Undersigned Clerk(type or print) { '
' JENNIFER'A.'GILL . '
Signatur /� ` �! � /J (J‘444 l/1/"tl L �eW[/ Y",
Deputy CSC Assistant CSC El Clerk Of Superior Court
AOC-G-101,Rev.3/19

STATE OF NORTH CAROLINA
COUNTY OF ORANGE - -~ -
WILL,'OF .
JACQUELINE CATO HARRIS
I,JACQUELINE CATO:HARRIS,•of Orange County,North Carolina, declare'this to be.. •
my will and revoke all earlier wills and codicils.
ARTICLE I
DISPOSITION OF ESTATE
A. Gift of Tangible Personal Property. All my tangible personal property that was not
held by me solely for investment purposes, including, but not limited to, my automobiles,
household furniture and furnishings, clothing,jewelry, collectibles and personal effects, I give to
the trustees acting under that certain trust agreement previously executed by me on January 31,
2017 and known as the Jacqueline Cato Harris Revocable Trust to be added to and disposed of as
part of the trust estate.
B. Gift of Real Property. I give the real property consisting of my residence and all
surrounding land described as follows:
BEGINNING at a stake in the center of Pleasant Green Road at the southeast
corner of the Property of Eugene A. Grimstead, and running thence along and
with the center of said Pleasant Green Road South 12° 17' West 326.67 feet to a
stake; thence continuing with said center of Pleasant Green Road South 5° 28'
East 846.47 feet to a stake, the northeast corner of Lot No. 13 as shown on plat
and survey hereinafter referred to; running thence South 87° 57' West 1843.07
feet to a stake in the line of Eugene A. Grimstead; running thence South 86° 38'
East 1844.79 feet to a stake in the center of Pleasant Green Road the point and
place of BEGINNING and being Tracts Nos. 14 and 15, containing 49.4 acres,
more or less, as shown on plat and survey entitled "ESTATE OF GLEN TYREE
MCARTHUR" dated October 12, 1966 by J. Watts Copley & Associates, of
record in the Office of the Register of Deeds of Orange County in Plat Book 15 at
Pages 175 and 176, to which reference is hereby made for a more particular
description of the same.,, � _ „,, ,
to St. Philip's Episcopal Church, Durham, North'Carolina, upon condition that the property be
- preserved in accordance with the Declaration,_of Restrictive and Protective Covenants on record
with respect to the property and.that the property be used as a conference and,retreat center by
St. Philip's Episcopal Church., .Iri the event the-'operation of a conference and retreat center
becomes impracticable or incapable of fulfillment, then, and in that event, St. Philip's Episcopal
887633 v2.CLS.28392.G47720
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Church may sell the property subject to the Declaration of Restrictive and Protective Covenants,
and may use the proceeds from the sale of the property in the discretion of the Vestry of St.
Philip's Episcopal Church. Any remaining real property owned by me at my death I give to my
Executor, in fee simple, and direct that my Executor sell such property and add the proceeds to
my residuary estate.
C. Gift of Residuary Estate. I give my residuary estate, being all my real and personal
property, wherever located, not'otherwise effectively disposed of, but without exercising any
power of appointment over property which I may have, to the trustees acting under that certain
trust agreement previously executed by ine on January 31, 2017 and known as the Jacqueline
Cato Harris Revocable Trust to be added to and disposed of as part of the trust estate.
ARTICLE II'
PAYMENT OF DEBTS,EXPENSES AND DEATH TAXES
A. Payment of Debts and Expenses. All my debts, health care expenses, funeral and
burial expenses and the administration expenses of my estate shall be paid out of my,residuary
estate. I'authorize my Executor, in its discretion, to spend more than is otherwise allowed by law
for a suitable gravestone and for perpetual care of the lot upon which my grave is located.
B. Payment of Death Taxes. All death taxes (Other than death taxes which are paid from
property passing outside,of this will pursuant to the terms of the governing instrument) shall be
paid out of my residuary estate as an administration expense and shall not be charged against or
recovered'from any recipient or beneficiary of the property taxed, except'that my Executor shall
recover as provided by law any death tax'attributable to property (i) over which I have a power
of appointment, (ii) in which I have a qualifying income interest for life or(iii) in which.I have a
retained interest for life to the extent that any death tax recoverable by law is not otherwise paid
out of Such property.
ARTICLE III . '
THE EXECUTOR
A. Appointment of Executor. I appoint Harriette H. Sturges and Jill Staton Bullard to
be my Co-Executors.` If it becomes necessary for a representative of my'estate to qualify in any
jurisdiction other than the State of North Carolina in which my'Executors shall be unable or
unwilling to qualify as'Executors; then my Executors shall have the right to appoint an individual
or corporate representative'of my estate in such jurisdiction. '
B. Waiver of Bond and Court Supervision. No bond or other security shall be required
from my Executors unless otherwise required bylaw. My Executors may act without qualifying
before any court or filing with any court any inventory, accounting or other report relating to the
administration of my estate unless otherwise required by law to do so.
C. 'Comperisation'of Execut®r. A corporate Executor may receive compensation for its
services in accordance with its regularly adopted schedule Of compensation in effect'at the time
887633 v2.CLS.28392.047720 2

(
the services under this will are.performed. An individual Executor may receive reasonable,
coinpenSation for such Executor's services.
. ,
ARTICLE rst
ADMINISTRATIVE POWERS OF EXECUTOR
It is my intention that my Executors shall have all the powers,and authority conferred upon
personal,representatives by,Article 13.of Chapter 28A,of the;general Statutes of North Carolina...
in addition all other powers conferred bylaw or elsewhere in this will. To the extent they may::
•
not be conferred by'law, I grant to my,Executor the discretionary powers set,forth below to,be
exercised without court order for any purpose that my Executor May cdeem advisable.'
A. Powers Incorporated.by Reference. .Subject to Section 32-26 of the General Statutes
of North Carolina, all of the powers set fortb-„iri.:Section 32727. of the General Statutes of North
Carolina as they exist at the time that 1 sign tiliS will, and such powers are incorporated by
reference with the same effect as though set putverbatim in it.
B. 'Possession,and'Disposition of Real Properti. The pOWer.to take poSsession,:Custody
.•. . ,
and control Of real property OWned:by,ine at the time Of my death even though title to such real,,•
••
property is not devised to my aecutor, and to sell, exchange, give options upon,partition, lease,
mortgage,or otherwise dispose of any,such,real property. , , -
•
.
C. Distributions- to. or for the -Benefit of a Beneficiary Whenever authorized or
directed to-distribute property to a beneficiary, whether or not under a,legal disability, the power
to diStribtitefsuch property, unless otherwise directed, (i) directly to,such beneficiary, including
the transfer of property ,into such beneficiary's name.as by: depositing cash or registering
securities:in his or her name,;(ii).to a.Custodjan.or custodial trustee for such beneficiary Under a ,
uniform gifts or transfers to minors act or ninfOrni custodial trust act, including a custodian or.
custodial trustee designated by my Executor, which may be my Executor, (iii)tO the guardian or
conservator of such beneficiary's estate or (iv)to,any,other peisOn, firm or institution for the
benefit of such beneficiary, and the receipt of.anyL.Of the foregoing shall constitute a full
acquittance of my Executor to the extent of the distribUtion so made.
Retention and Acquisition of Bank Secnrities. The power. (i) to retaiti-for any
period or periods of time securities which are securities of any,corporate,Executor,acting Under.,
this will or of any,corporation owning•stock of the.corporate Executor or,of any subsidiary;or
affiliate of oi successor to stiCit'corpOration and (ii) to, acquire sUCh'SeetiritieS by. purchase,
exchange or otherwise.
ARTICLE V '
PRESUMPTION OF SURVIVORSHIP
For purposes of this will, if beneficiary tinder this will and I should die under such
circumstances ;4at there is uncertainty as,.to w1:1411,person.predeceased,the, fpAer,,,it-shall be
conclusively presumed for the purposes of this will that such beneficiary precieceaSed me. _
887633 v2.CLS.28392.047720 3

ARTICLE VI
DEFINITIONS
For purposes of this will,
A. "Executor". The term "Executor" or "Executors" includes any personal
representative or representatives of my estate acting under this will such as a successor Executor
or Executors and any Administrator with the will annexed. It also includes the term "Executrix"
whenever the context requires it.
•
B. "Death Taxes". The term "death taxes" means inheritance, estate, transfer and
succession taxes; and any interest and penalties on these taxes, imposed by reason of my death
by.any jurisdiction with respect to property passing under or outside of the provisions of this will
or any codicil to it which is includable in my estate for the purpose of determining,such tax,
including, but not limited to, any tax on property includable under section 2036 (relating to
transfers with retained life estate), section 2041 (relating to powers of appointment), section
2042 (relating to life insurance proceeds) or section 2044 (relating to qualified terminable
interest property) of the Internal Revenue Code of 1986, as amended, or any comparable
provision of state law, but excluding, however, any tax imposed by section 2032A(c) (relating to
qualified real property), or chapter 13 (relating to generation-skipping transfers) of the Code, or
any comparable provision of state law.
I, JACQUELINE CATO HARRIS, the testatrix, sign my name to this instrument this 31st
day of January, 2017, and being first duly sworn, do hereby declare to the undersigned authority
that I sign and execute this instrument as my last will and that I sign it willingly (or willingly
direct another to sign it for me), that I execute it as my free and voluntary act for the purposes
therein expressed, and that I am eighteen years of age or older, of sound mind, and under no
constraint or undue influence.
oz,( "'s •
' CQLINE CATO HARRIS
We, L(5ce_ in ( l i c e, / and %ar7, 6Z• S?/ , the witnesses, sign
our names to this instrument, being first duly sworn, and do hereby declare to the undersigned
authority that the testatrix signs and executes this instrument as her last will in our presence and
that she signs it willingly (or willingly directs another to sign it for her), and that each of us, at
the request of the testatrix, and in the presence and hearing of the testatrix, and in the presence
and hearing of each other, hereby signs this last will as witness to the testatrix's signing, and to
the best of our knowledge the testatrix is eighteen years of age or older, of sound mind, and
under no constraint or undue influence.
•
887633 v2.CLS.28392.G47720 4

. . ; .
Oame ift4-610- / ii) (
, Residence
/0c.A.A-6_ i ,,:c7").C_
Name Residence
STATE OF NORTH CAROLINA
COUNTY OF ORANGE
,Subscribed, sworn to and acknowledged before me by JACQUELINE CATO HARRIS,.the,
testatrix, and, subscribed and :sworn to .before me, by, ,Zi Set n-) riJc / H and
,witnesses;this 31'day ofJanuary,2017: -
' 1 i' ' ' '
(SEALk0TN i e1/4/ ' ' ' V
• _ . SIGNED .e.-g4t
' • Notary Public - . , 1 i
-
= C 4../1/ ' r‘0771 11
.:i•1-
-3,..% ....•-
. V Notary's Printed Name.
My ea*" :fibaii,,Y;s:
; , ; , , , •
887633 v2.CLS.28392.G47720 ' 5