WQ0001926_Application_20230530

DWR
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .0600 — SINGLE-FAMILY RESIDENCE
WASTEWATER IRRIGATION SYSTEM — CHANGE OF OWNERSHIP
FORM: SFRWWIS-CO 03-21
Pursuant to 15A NCAC 02T .0107(b), if the application does not include all required information and the necessary supporting
documentation, the application shall be returned. The application and attachments shall be prepared in accordance with 15A
NCAC 02T .0100, 15A NCAC 02T .0600, and Division Policies. For more information, visit the Water Quality Permitting
Section's Non -Discharge Branch website. The Applicant shall submit an electronic copy of the application and attachments
uploaded as a single Portable Document Format (PDF) file to httt)s:Hedocs.deci.nc.2ov/Forms/NonDischar2e-Branch-Submittal-
Form-Vert, or entailed to Non-Discharge.Ret)orts(a)ncdenr.gov if less than 20 megabytes (MB).
MUSECTION I — APPLICANT INFORMATION
1.
Applicant: ANIA ONN, LLC
2.
Permit No.: WQ0001926
3.
Signature authority: Vinita Mittal, Member and Manager
Title: Member and Manager
4.
Mailing address: 104 Green Park Ln
City: Cary
State: NC Zip: 27518-
5.
Contact person: Vinita Mittal
Primary phone number: [phone] Cell
Email: vinitagmjmreg.com
Secondary phone number: [phone] Office
6.
Secondary Contact person: Nicolle Volpe
Primary phone number: [phone] Cell
Email: [e-mail]
Secondary phone number: [phone] Office
SECTION II — FACILITY INFORMATION
1. Physical address: 151 Green Level Road County: Chatham
City: Apex
State: NC Zip: 27523-
SECTION III — BILLING INFORMATION
1. Billing address: 104 Green Park Ln
City: Cary State: NC Zip: 27518-
SECTION IV — DEED INFORMATION
Ha7adeed been executed and recorded in the County Register of Deeds pursuant to 15A NCAC 02T .0604(e)(1)?
® Complete Items 1 through 4 below.
❑ o — See Attachment B on Page 3.
1. Parcel No.: 0067226 / PIN 0714-00-30-8450
2. Date of Purchase: April 27, 2023
3. Deed Book: 2358
4. Deed Page Nos.: 1048 - 1052
FORM: SFRWWIS-CO 03-21 Page 1 of 3

SECTION V — OPERATION AND MAINTENANCE AGREEMENT
Permit No.: WQ0001926 County: Chatham
Permittee: ANIA ONN, LLC (i.e., all deeded property owners)
The Permittee agrees to operate and maintain the single-family residence wastewater treatment and irrigation system as
follows:
I. Inspect the septic tank annually, and pump out solids as needed.
2. Inspect and clean the septic tank effluent filter annually. (if applicable)
3. Inspect the tablet chlorinator weekly. Add wastewater grade chlorine tablets (e.g., calcium hypochlorite) as needed.
Swimming pool grade chlorine tablets are not acceptable. (if applicable)
4. Inspect the ultraviolet disinfection unit weekly. Clean or replace the lamps and quartz sleeves as needed. (if
applicable)
5. Inspect all storage tanks, pumps, and alarms monthly. Remove the floating scum layer in all pump/storage tanks
when pumping the septic tank solids out.
6. Inspect the spray irrigation system monthly to verify: proper operation of the spray heads; that there are no leaks;
that vegetative growth does not obstruct the spray heads; that the irrigated wastewater is not ponding in or running
off the designated irrigation area; and that there are no objectionable odors. (if applicable)
7. Inspect the drip irrigation system monthly to verify: proper operation of the drip lines; that there are no leaks; that
vegetative growth does not obstruct the drip emitters; that the irrigated wastewater is not ponding in or running off
the designated irrigation area; and that there are no objectionable odors. (if applicable)
8. Maintain a set of Division -approved engineering plans and specifications.
9. Pay the required annual fee.
10. Request renewal of this permit on Division -approved forms no later than 180 days prior to expiration.
11. Sign and provide a Change of Ownership application to any future owner of the single-family residence wastewater
treatment and irrigation system for their completion and submission to the Division of Water Resources.
I/We understand the o Veq em is anzl gee to these terms as part of the issued permit.
Signature: Date: 05/30/2023
Signature:
Signature:
Signature:
Date:
Date:
Date:
All deeded property owners shall sign this Operation and Maintenance Agreement
FORM: SFRWWIS-CO 03-21 Page 2 of 3

ATTACHMENT A — SIGNATURE AUTHORITY DELEGATION
Does the signature authority in Section I, Item 3 meet the requirements pursuant to 15A NCAC 02T .0106(b)?
® Yes — Skip Attachment A.
❑ No — Submit a delegation letter pursuant to 15A NCAC 02T .0106(c) authorizing the signature authority to sign.
ATTACHMENT B — PROPERTY OWNERSHIP DOCUMENTATION
Has a deed been executed and recorded in the County Register of Deeds pursuant to 15A NCAC 02T .0604(f)(1)?
® Yes — Complete Items 1 through 4 in Section IV on Page 1.
❑ No
❑ Submit a written notarized intent to purchase agreement sign by both parties with a plat or survey map pursuant to 15A NCAC
02T .0604(e)(2); or
❑ Submit a written notarized lease agreement that specifically indicates the intended use of the property and has been signed by
both parties, as well as a plat or survey map pursuant to 15A NCAC 02T .0604(e)(3). Lease agreements shall adhere to the
requirements of 15A NCAC 02L .0107.
APPLICANT'S CERTIFICATION
I Vinita J. Mittal attest that this application
(Signature authority's name as noted in Section I, Item 3)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application package are not completed, and that if all required supporting information and attachments are not included, this
application package will be returned as incomplete. I further certify pursuant to 15A NCAC 02T .0120(b), that the applicant, or any
parent, subsidiary, or other affiliate of the applicant has: not been convicted of environmental crimes under; not previously abandoned
a wastewater treatment facility without properly closing the facility; not paid a civil penalty; not been compliant with any compliance
schedule in a permit, settlement agreement, or order; not paid an annual fee.
Note: The Applicant's Certification shall be signed pursuant to 15A NCAC 02T .0106(b). An alternate person may be delegated as
the signing official if a letter is provided pursuant to 15A NCAC 02T .0106(c). Pursuant to § 143-215.6A and § 143-215.6B, any
person who know makes any f lse state e t, representation, or certification in any application package shall be guilty of a Class
2 misdemeanor, vliicl �yri�fineqbyo exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature:
Date: 05/30/2023
THE COMPLETED APPLICATION AND ATTACHMENTS SHALL BE SUBMITTED AS A SINGLE PDF FILE VIA:
Email:
Non-Discharge.Ret)o rts(a,ncdenr.gov
Laserfiche Upload:
httt)s:Hedocs. deci.nc.gov/Form s/NonDischarge-Branch-
Submittal-Form-Ver2
FORM: SFRWWIS-CO 03-21 Page 3 of 3

BK 2358 PG 1048
Excise Tax: $0.00 [This conveyance is exempt
from excise tax as a corporate reorganization
pursuant to NCGS § 105-228.29(7)]
FILED ELECTRONICALLY
CHATHAM COUNTY NC
LUNDAY A. RIGGSBEE
REGISTER OF DEEDS
----------------------
----------------------
FILED Apr 27, 2023
AT 09:00:26 AM
BOOK 02358
START PAGE 1048
END PAGE 1052
INSTRUMENT # 03543
EXCISE TAX $0.00
Recording Time, Book and Page
Tax Lot No. Parcel Identifier No.: 0714-00-30-8450 &
0714-00-40-7207
After recording mail to: Weatherspoon & Voltz LLP, 3700 Glenwood Ave., Suite 250, Raleigh, NC 27612
This instrument prepared by: Nicole S. Loeffler of Weatherspoon & Voltz LLP, a licensed North Carolina
attorney.
Brief description for the Index
NORTH CAROLINA GENERAL WARRANTY DEED
THIS DEED made this 2L+.day of April, 2023, by and between
GRANTOR
Floresta, LLC,
a North Carolina limited liability company
104 Green Park Lane
Cary, NC 27518
GRANTEE
Ania ONN LLC,
a North Carolina limited liability company
104 Green Park Lane
Cary, NC 27518
The property conveyed by this instrument does not include the primary residence of the Grantor.
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, in all that certain lot or parcel of land situated in the County of Chatham, New Hope
Township, State of North Carolina, and more particularly described as follows:
SEE EXIIIBIT A attached hereto and incorporated herein
submitted electronically by "weatherspoon & Voltz LLP"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Chatham county Register of Deeds.

BK 2358 PG 1049
The property hereinabove described was acquired by Grantor by instrument recorded in Book 2313,
Page 849, Chatham County Registry.
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
except for the exceptions hereinafter stated.
Title to the property hereinabove described is subject to the following exceptions:
Covenants, easements and restrictions of record affecting said property and to 2023 ad valorem
taxes.
[Remainder of Page Intentionally Blank, Signature Page to Follow]
2

BK 2358 PG 1050
IN WITNESS WHEREOF, the Grantor has caused this instrument to be duly executed the day and
year first above written.
FLORESTA, LLC,
a North Caro ' a limited liability company
By: (SEAL)
Title: Mf+NA 5ZE52
STATE OF NORTH CAROLINA
COUNTY OF w O V-.P—
I certify that the following person personally appeared before me this day, acknowledging to me that he/she
signed the foregoing document for the purpose stated therein and in the capacity indicated:
P.�
Date: c \ 2S , 2023
AALTON
NOTARY PUBLIC
WAKE COUNTY, N.C.
Notary Public:
Printed Name:
My Commission Expires: C)3/O t Z U 2

BK 2358 PG 1051
EXHIBIT A
Legal Description
Tract One
Lying and situated in New Hope Township, Chatham County, North Carolina Lying East of Green Level
Road and being more particularly described as follows:
Starting from an existing PK Nail and control corner in the center of Green Level Road and the North
Western property corner of Sameh K. Toma. Thence, continuing along the centerline of said road, N 34'
37' 45" W, 163.03 feet to the Point of BEGINNING; Thence, leaving said road centerline N 82' 26' 49" E,
29.49 feet to an existing iron pipe at the intersection of the Eastern Right of Way of Green Level Road and
the center of a 60' Private Road. Thence, leaving said Right of Way, and along the 60' Private Road N 82'
26' 49" E, 187. 73 feet to an existing iron pipe and beginning of a curve. Thence, along a curve to the right
with a length of 65.90 feet, a radius of 392.75 feet, a delta angle of 09' 36' 48", and a chord bearing and
distance of N 77' 51' 55" E, 65.82 feet to an existing iron pipe. Thence, N 73' 03' 3 1 " E, 369.13 feet to an
existing iron pipe and the beginning of a curve. Thence, along a curve to the right with a length of 47.27
feet, a radius of 167.76 feet, a delta angle of 16' 08' 40", and a chord bearing and distance of N 81 ° 07' 51"
E, 47. 11 feet to an existing iron pipe. Thence, leaving said 60' Private Road, N 53' 18' 2 1 " E, 143.76 feet
to a point. Thence, N 30" 21' 34" W, 368.18 feet to an existing iron pipe and South Eastern property corner
of Curtis Davis & Amanda Hockney. Thence, N 88' 24' 37" W, 600.28 feet to an existing concrete
monument and point along the Eastern line of the property of Josephine B. Sears. Thence, S 00" 19' 06" W,
145.30 feet to an existing iron pipe Thence S 84' 58' 43" W, 256.54 feet to a point on the centerline of
Green Level Road. Thence, continuing on said road centerline, S 24 ° 23' 49" E, 99.23 feet to a point.
Thence, S 29' 50' 53" E, 100.19 feet to a point. Thence, S 33' 32' 29" E, 100.14 feet to a point. Thence,
North 34' 19' 03" West. 180.37 feet to the Point of BEGINNING, and containing 9.37 acres total, with -
0.81 acres in road Right of Way for a net area of 8.56 acres more or less.
Tract Two
Lying and situated in New Hope Township, Chatham County, North Carolina Lying East of Green Level
Road and being more particularly described as follows:
Starting from an existing PK Nail and control corner in the center of Green Level Road, and the North
Western property corner of Sameh K. Toma. Being the Point of BEGINNING. Thence, continuing along
the centerline of said road, N 34' 37' 45" W, 163.03 feet to a point; Thence, leaving said road centerline N
82° 26' 49" E, 29.49 feet to an existing iron pipe at the intersection of the Eastern Right of Way of Green
Level Road and the center of a 60' Private Road. Thence, leaving said Right of Way, and along the 60'
Private Road N 82' 26' 49" E, 187.73 feet to an existing iron pipe and beginning of a curve. Thence, along
a curve to the right with a length of 65.90 feet, a radius of 392.75 feet, a delta angle of 09' 36' 48", and a
chord bearing and distance of 77' 51' 55" E, 65.82 feet to an existing iron pipe. Thence, N 73' 03' 3 1 " E,
369.13 feet to an existing iron pipe and the beginning of a curve. Thence. along a curve to the right with a
length of 47.27 feet, a radius of 167. 76 feet, a delta angle of 16' 08' 40", and a chord bearing and distance
of N 81' 07' 5 V E, 47.11 feet to an existing iron pipe. Thence. leaving said 60' Private Road N 53' 18' 21"
E. 143.76 feet to a point. Thence, N 30' 21' 34" W, 368.18 feet to an existing iron pipe and South Eastern
properly corner of Curtis Davis & Amanda Hockney. Thence, with the southern property line of Donald &
Janice Parry S 88' 26' 55" E, 910.83 feet to an existing iron pipe and South Western corner of the property
of Bettie W Toma. Thence, with said property, S 88' 30' 14" E, 381.28 feet to an existing iron pipe Thence,
S 88° 42' 59" E, 28.36 feet to a point along a creek centerline. Thence, along said creek centerline. S 27'
0

BK 2358 PG 1052
05' 52" E, 80.78 feet to a point. Thence, S 10' 25' 55" E, 136.09 feet to a point. Thence S 77' 38' 24" E,
98.41 feet to a point. Thence, S 24' 55' 21" W, 167.78 feet to a point. Thence, S 76' 37' 59" E, 200.59 feet
to a point Thence, S 25°58' 49" E, 137.43 feet to a point. Thence, S 40' 26' 31" E, 111. 75 feet to a point
Thence, S 46" 50' 17" W. 133.01 feet to an existing iron pipe along a creek centerline. Thence. leaving said
creek centerline and point along the Northern property line of Charles & Cecilia Gabriel, N 88' 15' 56" W,
435. 94 feet to an existing iron pipe and North Eastern corner of the property of Sameh K. Toma. Thence,
N 88.15' 56" W, 477.72 feet to an existing iron pipe. Thence, N 88' 15' 56" W, 1240.91 feet to the Point
of BEGINNING, containing 26.51 total, with -0.57 acres in road Right of Way for a net area of 25. 94
acres, more or less.
5