NCG551215_Owner (Name Change)_20221121

•'gip' > " '9"''' NC DEPARTMENT OF ENVIRONMENTAL QUALITY
!~, -.,,i,A-42 .11 DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
a ,A_ ,," `� NPDES PERMITTING
NORTH CAROLINA
Environmental Quality
PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
Permit Number: NC00___/_J_/_J_ or NCG5/j/./ //1-
1. Facility Name: 339 Y/ke v IPS &mora 4C
II. NEW OWNER/NAME INFORMATION: RECEIVED
1. This request for a name change is a result of: "V 2 i 2022
X a. Change in ownership of property/company
NGDE !D
b. Name change only
R1 PDES
c. Other(please explain):
2. New owner's name(name to be put on permit):
Feder $Irk le c%nn'err oar,Uty
3. New owner's or signing official's name and title: Pc,- r Ze)._AC-le
(Person legally responsible for Sermit)
(Title)
4. Mailing address: Jr�Jr Mi cGle/Soh 'e/ City: Non,b-e ci
State: CA Zip Code: 93`7510 Phone: (35O ) 2o7 4,55Y
E-mail address: e4e✓_ bc..v- k(e yv ( ,(pw-)
III. FACILITY AND DISCHARGE INFORMATION
1. Will the waste stream for the facility remain the same as under the previous owner? Yes CI No 0
2. Will the treatment system and discharge location remain the same? Yes E(No 0
"No Responses"
If either or both of these questions are answered"No"then more information will be needed to review the
request. Please attach documentation to describe and explain the changes to the facility activities, waste
stream, treatment process or outfall location. The Division may not be able to process the Permit
Name/Ownership Change request and may require that the new owner file a new permit application.
�„y North Carolina Department of Environmental Quality I Division of Water Quality
,�r+r>�xcu.
��')) 512 North Salisbury Street 11617 Mail Service Center l Raleigh,North Carolina 276991617
lAcycsnasevci
vam'�Ce'y .# 919.707.9000

NPDES Name and Ownership Change
Page 2 of 2
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)
3. Information to document facility,waste stream,treatment system or outfall changes as noted in
item III above(if appropriate)
Applicant's Certification:
I, Pc,irc r P a.✓'U c 1 ,attest that this application for a
name/ownership change has been revi6wed 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. I understand that Permit Name/Ownership Change can only take place through action
taken by the Division of Water Resources and that no actions on my part or the part of my company
result in the automatic transfer of permit coverage.
Signature: , 4 Date: ?/2 3 (a 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
Version 07/2021

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OFFER TO PURCHASE AND CONTRACT
[Consult"Guidelines"(Form 2G)for guidance in completing this form]
For valuable consideration, the receipt and legal sufficiency of which are hereby acknowledged,Buyer offers to purchase and Seller
upon acceptance agrees to sell and convey the Property on the terms and conditions of this Offer To Purchase and Contract and any
addendum or modification made in accordance with its terms(together the"Contract").
1. TERMS AND DEFINITIONS:The terms listed below shall have the respective meaning given them as set forth adjacent to each
term.
(a)"Seller":Break-A-Way Enterprises,LLC.
(b)"Buyer":Peter David Barkley and Jennifer Lynn Barkley
(c)"Property":The Property shall include all that real estate described below together with all appurtenances thereto including the
improvements located thereon and the fixtures and personal property listed in Paragraphs 2 and 3 below.
NOTE:If the Property will include a manufactured(mobile)home(s),Buyer and Seller should consider including the Manufactured
(Mobile)Home provision in the Additional Provisions Addendum(Standard Form 2A11-T)with this offer.
Street Address:339 Velvet Rd
City_Semora Zip_27343
County:Person ,North Carolina
NOTE:Governmental authority over taxes,zoning,school districts,utilities and mail delivery may differ from address shown.
Legal Description:(Complete ALL applicable)
Plat Reference:Lot/Unit 3 ,Block/Section ,Subdivision/Condominium_Hyco Lake
as shown on Plat Book/Slide at Page(s) _
The PIN/PID or other identification number of the Property is:A4 48
Other description:Lt 3&House Fr RylandDodson ET UX F2000 OFB7"Owner part owner&Lic RE Agent"
Some or all of the Property may be described in Deed Book 1014 at Page 270
(d)"Purchase Price":
$ 1,360,000 paid in U.S.Dollars upon the following terms:
$ 100,000 BY DUE DILIGENCE FEE made payable and delivered to Seller by the Effective
Date by❑cash ❑personal check 0 official bank check ®wire transfer
❑electronic transfer(sped payment service: )
$ BY INITIAL EARNEST MONEY DEPOSIT made payable and delivered to Escrow
Agent named in Paragraph 1(f)by❑cash 0 personal check ❑official bank check
❑wire transfer,❑electronic transfer,EITHER❑by the Effective Date OR El within
five(5)days of the Effective Date of this Contract.
$ BY(ADDITIONAL)EARNEST MONEY DEPOSIT made payable and delivered to
Escrow Agent named in Paragraph 1(f)no later than 5 p.m on ,
TIME BEING OF THE ESSENCE by❑cash ❑official bank check ❑wire transfer
❑electronic transfer
$ BYASSUMPTION of the unpaid principal balance and all obligations of Seller on the
existing loan(s) secured by a deed of trust on the Property in accordance with the
attached Loan Assumption Addendum(Standard Form 2A6-T).
$ BY SELLER FINANCING in accordance with the attached Seller Financing
Addendum(Standard Form 2A5-T).
$ BY BUILDING DEPOSIT in accordance with the attached New Construction
Addendum(Standard Form 2A3-T).
$1,260,000.00 BALANCE of the Purchase Price in cash at Settlement(some or all of which may be
paid with the proceeds of a new loan)
If the parties agree that Buyer will pay any fee or deposit described above by electronic transfer,Seller agrees to cooperate in effecting
such transfer, including the establishment of any necessary account and providing any necessary information to Buyer,provided,
however,Buyer shall be responsible for additional costs,if any,associated with such transfer.
Page 1 of 15
This form jointly approved by: STANDARD FORM 2 T
I ' North Carolina Bar Association , #21 Revised 7/2021
North Carolina Association of REALTORS Inc °S Ds © 7/2021
etAS
Buyer's initials I Seller's initial V` � �J? \�

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THE NORTH CAROLINA ASSOCIATION OF REALTORS®,INC.AND THE NORTH CAROLINA BAR ASSOCIATION MAKE
NO REPRESENTATION AS TO THE LEGAL VALIDITY OR ADEQUACY OF ANY PROVISION OF THIS FORM IN ANY
SPECIFIC TRANSACTION. IF YOU DO NOT UNDERSTAND THIS FORM OR FEEL THAT IT DOES NOT PROVIDE FOR
. YOUR LEGAL NEEDS,YOU SHOULD CONSULT A NORTH CAROLINA REAL ESTATE ATTORNEY BEFORE YOU SIGN
IT.
This offer shall become a binding contract on the Effective Date. Unless specifically provided otherwise, Buyer's failure to timely
deliver any fee,deposit or other payment provided for herein shall not prevent this offer from becoming a binding contract,provided
that any such failure shall give Seller certain rights to terminate the contract as described herein or as otherwise permitted by law.
Date: Date:
dotloo d
Buyer: 9eror72"4'6B.v!(' M*4
O46
:7"M Seller:
Date: Date:
dodoo0 vented
o'Buyer: r ���y"&sq UBSP.BEGBSOU OM% Seller:
Entity Buyer: EllV'a 'Way LLC
(Name of LLC/Corporation/Partnership/Trust/etc.) (Name of LLC/Corporation/Partnership/Trust/etc.)
By By:
Name: Name; Sharon Kowitz
Print Name Print Name
Title: Title: Partner Break-A-Way LLC
06/25/2022
Date: Date: 11LJocuSignedby:
yaw#�
F5OCE1892E2C4FF._.
r—DocuSi�by:
WIRE FRAUD WARNING `-5226F7A92F2F439
Docuregned by:
TO BUYERS: BEFORE SENDING ANY WIRE,YOU SHOULD CALL THE CLOSING ATTORNEY'S OFFICE T �i" n
VERIFY THE INSTRUCTIONS. IF YOU RECEIVE WIRING INSTRUCTIONS FOR A DIFFERENT BANK,B 14724C4A101440E...
LOCATION,ACCOUNT NAME OR ACCOUNT NUMBER,THEY SHOULD BE PRESUMED FRAUDULENT. DO NOT
SEND ANY FUNDS AND CONTACT THE CLOSING ATTORNEY'S OFFICE IMMEDIATELY. „----DocuSigned
TO SELLERS:IF YOUR PROCEEDS WILL BE WIRED,IT IS RECOMMENDED THAT YOU PROVIDE WIRINC� =,
INSTRUCTIONS AT CLOSING IN WRITING IN THE PRESENCE OF THE ATTORNEY. IF YOU ARE UNABLE TO
ATTEND CLOSING,YOU MAY BE REQUIRED TO SEND AN ORIGINAL NOTARIZED DIRECTIVE TO THE CLOSING
ATTORNEY'S OFFICE CONTAINING THE WIRING INSTRUCTIONS. THIS MAY BE SENT WITH THE DEED,LIEN
WAIVER AND TAX FORMS IF THOSE DOCUMENTS ARE BEING PREPARED FOR YOU BY THE CLOSING
ATTORNEY. AT A MINIMUM,YOU SHOULD CALL THE CLOSING ATTORNEY'S OFFICE TO PROVIDE THE WIRE
INSTRUCTIONS. THE WIRE INSTRUCTIONS SHOULD BE VERIFIED OVER THE TELEPHONE VIA A CALL TO YOU
INTTIATED BY THE CLOSING ATTORNEY'S OFFICE TO ENSURE THAT THEY ARE NOT FROM A FRAUDULENT
SOURCE.
WHETHER YOU ARE A BUYER OR A SELLER,YOU SHOULD CALL THE CLOSING ATTORNEY'S OFFICE AT A
NUMBER THAT IS INDEPENDENTLY OBTAINED. TO ENSURE THAT YOUR CONTACT IS LEGITIMATE,YOU
SHOULD NOT RELY ON A PHONE NUMBER IN AN EMAIL FROM THE CLOSING ATTORNEY'S OFFICE,YOUR
REAL ESTATE AGENT OR ANYONE ELSE.
Page 13 of 15
vs ns os !r STANDARD FORM 2-T
Revised 7/2021
Buyer's initials Seller's initial © 7/2021