NCG551535_owner (name change)_20230703

ROY COOPER
Governor
ELIZABETH S. BISER
secretary
S. DANIEL SMITH
Director
RECEIVED
Y1I! G- 3.2023
NORTH CAROLINA
Environmental Quality
NCDEO/DWR/NPDES
NPDES Certificate of Coverage (CoC)
NCG550000 OWNERSHIP CHANGE FORM
Please enter the CoC number for which the change is requested.
Certificate of Coverage
N I C I G 1 5 1 5
H. 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 n
CoC: St
First MI Last
Title
Permit Holder Mailing Address
City State Zip
Phone E-mail Address
d. Facility name (if applicable):
e. Facility address:
Address
City State Zip
f. Facility contact person:
[if different from Owner] First MI Last
Phone
E-mail Address
III. Contact person (if different from the person legally responsible for the CoC)
yt>� 1
First MI Last
Title
Mail A ess
ri( z'aq--V3
City State Zip
05- 55`13
Phone E-mail Address
D �rs �.,- North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1617 Mail Service Center I Raleigh. North Carolina 27699-1617

Register of Deeds
Sharon A. Davis
Durham County, NC
04/18/2023 02:50:20PM
BT: OPR B: 9899 P: 925 Pages: 3
DEED -DEED
Fee: $715.00 Excise Tax: $689.00
INSTRUMENT #2023058707
April Carrington
NORTH CAROLINA GENERAL WARRANTY DEED
Excise tax $689.00
Real Estate Tax ID #: 211291
Mail after recording to GRANTEE
This instrument was prepared by: Crosby Law Firm, PA 8490 Honeycutt Rd. #200 Raleiph, NC 27615
Brief description for the Index: Lot 2 Pope Sub
rrira lira" maoe tors day of 4/18/2023 , by and between
GRANTORS GRANTEES
Estate of Charles Edwin Cash
by Leigh Ann Hobgood, Administrator
whose mailing address is
1455 Medlin Rd, Clayton, NC 27527
(herein referred to collectively as Grantor)
All or a portion oighe property herein conveyed
_ does or V does not include the primary
residence of a Grantor. (Seller to check one)
Pah Kue, a married woman, and
Bu Reh, a married man
whose mailing address is
6917 Kemp Rd, Raleigh, NC 27613
(herein referred to collectively as Grantee)
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 reauired
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 pesents does grant, bargain, sell, and convey unro
the Grantee in fee simple, all that certain lot or parcel of land situated in Durham County, North
Carolina and more particularly described as follows:
Being all of Lot 2, Containing 2.0 Acres, more or Less, as per plat and survey thereof entitled
Final Plat Pope Subdivision, Property of Willie E. Pope, Jr. and Emma T. Pope Living Trust,
said plat is njo;. in file i _ lu
183, Page 248, to which plat reference is hereby made for a more particular description of
same.
rroperw Street Address: 6917 Kemp Rd. Raleigh. NC 27713
„ ,miued eiectronicaiiv by Crosbv Law Firm in compliance with North Carolina statutes eovernine recordable documents and

' nlflCQ7n7 DT• ADD Q• 0000 D• 097
V4J30JLVLJ VL:OV:LV t'M rays 3 ui 3
IN WITNESS WHEREOF, the Grantor, having been duly swom, has hereunto set his/her hand
mid seal me day ano year above written.
l n L Estate of Charles Edwin Cash
e / 1l /1 1A
i, the undersigned Notary Public, cerufy max me ianowing person(s) personally appeared before me
1x11s flay, each acknowledging m me mat ne or "e voinntnn. ly si, M tho 4nr ani_na
................................... �...._........ ....... ........... ... ._.. • _ • . A-
i s 11Z
\[ aun Va4HL61 UM11lV Vl UGQI 111 L12111f. ilI1AL.f I �� � _ _ • •' � •' • • -"
' 7
RECEIVED
NCDEQ/DWR/NPDES