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HomeMy WebLinkAboutNCG550489_owner (name change)_20230313ROY COOPER Governor ELIZABETH S. BISER Secretory S. DANIEL SMITH Director NORTH CAROLINA Environmental Quality NPDES C&tiificat* c o>F Coverage (Cot) NCG550000 OWNERSHIP CHANGE FORM 1. Please enter the CoC number for which the change is requested. Certificate of Coverage 5 10 19 11. 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): c. Owner: person legally responsible for CDC: d. Facility name (if applicable): e. Facility address: f. Facility contact person: [if different from Ownet) 2 S1C. kle S l e-y D. A 4a_-*n S T r: FirA MI Last r- Titlei (a u/UrSL'1 11 1 #_ 13Qr.V_4 CnAVA ermii Holder Mailing Address T, orsv;t1e_ _..NC arc. S1 l City State Zip (737)776 28'a1 wcl{aJgr1S67Airoaldromh-e9:COl Phone E-mail Address % QS rl rs L" , r_.P.�r� C Address /sirs U�P &C City State Zip First MI Last Phone E-mail Address Ill. Contact person (if different from the person legally responsible for the CoC) First MI Last Title Mailing Address City Phone State E-mail Address Zip North Carolina Department of Environmental Quality I Division of Water Resources /e 512 North Salisbury Street { 1617 Mail Service Center I Raleigh. North Carolina 27699-1617 919.707.9000 NCG550000 OWNERSHIP CHANGE FORM Page 2 of 2 ry Will this permitted facility continue to discharge the same volume and type of wastewater as prior to this ownership or name change? 0 Yes ❑ No (please explain) V. Required Items: THIS APPLICATION WILL HE RETURNED UNPROCESSED IF ITEMS ARE INCOMPLETE OR MISSING: to 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,W b,A, 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. 311, Signature T Date ..................................... PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO: Mr. Charles H. Weaver NC DEQ / DWR / NPDES 1617 Mail Service Center Raleieh. NC 27699-1617 charies.weaver@,ncdenr.gov Type: DEED Recorded: 8/17/2022 4:30:11 PM Fee Antt: $896.00 Pagel of 2 Revenue Tax: $870.00 Alexander, NC Scotto. Hines Register of Deeds File# BK 655 PG 1458 - 1459 ALEXANDER COUNTY TAX COLLECTOR 08/17/2022 NO DELINQUENT TAXES No opinion on title Is expressed or implied by the preparer of this document This Instrument prepared by: Jon averbey, a licensed North Carolina attorney. Delinquent taxes, It any, to be paid by the closing attorney to the county tax collector upon disbursement of closing proceeds. Parcels: 0003122, 0003123 and 0003124 Stamps: $870.00 MWI after recording to: Grantee Brief Description for index: Lots 8, 9 818 Taylorsville Beach Subdivision NORTH CAROLINA GENERAL WARRANTY DEED THIS DEED made the 17th day of August, 2022, by and between i-- -_-- T- - -- GRANTOR ii GRANTEE HAL L. BOND and wife LUCILLE C. I WESLEY DALTON ADAMS, JR. and i BOND wife WENDY YVONNE ADAMS 448 Liledoun Road j Taylorsville, NC 28681 295 Taylorsville Beach Ct Taylorsville, NC 28681 The designation Grantor and Grantee as used herein shop include sold parties. rhefr heirs. successors, and assigns, and shot Include singuhsr. pkaol, mosculine, leminine or neuter as requhed by context. WITNESSETH That the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged. has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of land situated in Wittenberg Township, Alexander County, North Corokna. and more particularly described as follows: BEING all of Lots Nos. 8, 9, & 18 of the TAYLORSVILLE BEACH SUBDIVISION, as shown on map thereof recorded in the Alexander County Registry in Map Book 4, at page 64, to which plat reference is hereby made for greater certainty of description. THIS PROPERTY IS CONVEYED SUBJECT to the rights and easements of Duke Power Company, its successors and assigns, to back and pond water on Lake Hickory. THERE IS ALSO CONVEYED HEREIN TO THE PARTIES OF THE SECOND PART, THEIR HEIRS AND ASSIGNS, a perpetual right and easement to obtain and use water from a well located on Lot No. 21, together with the right to connect said well with pump and underground pipe for the purpose of conveying water from the well to Lot No. 18, above described. THERE IS FURTHER CONVEYED herein to the parties of the second part, their heirs and assigns, a one -twenty-third undivided interest per each of the above three lots in the ".access Lot" THIS INSTRUMENT PREPARED BY NANCE 8 OVERBEY, PLLC, ATTORNEYS AT LAW, SALI$BURY, NORTH CAROLINA Submitted electronically by "Nance 6 Overbey, PLLC" in compliance with North Carolina statutes governing recordable documents and the terms of the submitter agreement With the Alexander County Register of Deeds. as described in Deed from Lester P. Bowman, et ux, to Hail Stafford, Jr., et at, dated May 1, 1980, and recorded in said Registry in Book 219, page 957, for the uscs and purposes therein conveyed, to the extent that the owner of each of the above Lots Nos. 8, 9, and 18 shall own a (1l23rd) undivided interest per lot. THIS PROPERTY IS ALSO CONVEYED SU13JECT to a right of way ofegress and regress reserved by G. W. Stafford in that certain deed from G. W. Stafford to Reins-Sturdivant Corp, dated January 27, 1945, and recorded in Deed Book 37, page 233, Alexander County Registry. Being the property conveyed to Grantor by deed recorded in Book 266, Page 275, Alexander County Registry. TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and opp6rtenance5 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, that title Is marketable and free and clear of oil encumbrances, and that Grantor will warrant and defend the title against the lawful claims of all persons whomsoever except for the exceptions hereafter stated. The property herein described does Include the primary residence of the Grantor. Title to the property hereinabove described is subject to the following exceptions: - Subject to restrictive covenants. easements, and rights of woy of record. IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal, or if corporate, has caused this instrument to be signed in its corporate name by its duly authorized officers and its seal to be hereunto affixed by authority of its Board of Directors, the day and year first above written. (SEAT) Hal L. Bond (SEAL) Lucille C. Bond STATE OF NORTH CAROLINA COUNTY Of ROWAN I, a Notary Public for the County and State aforesaid, do hereby certify that Heal L. Bond and Lucille C. Bond personally appeared before me this day and acknowledged the due execution of the foregoing instrument. Witness my hand and official seal, this the 17th of August, 2022. My Commission Expires: ( lr�dley Na , oCN . • o�isslpn R�: �40TAq> ASO p2 a� CounV`1;��; Two IAWR1tbEEPAREO BY NANCE a OYERBEY, PLLC, ATTORNEYS AT LAW, SALIS URY. NORTH CAROLINA