NCG551176_Owner (Name Change)_20240517

s'imw
=` "`-y:, RECEIVED
ROY COOPER i n,.
Governor ,,
\ r MAY 1
ELIZABETH S.RISER
~""° ; 72024
Secretory ..Frs,a,..v�"°' ..
RICHARD E.ROGERS,JR. NORTH CAROLINA
Director Environmental Quality
k a a a ,
NPDES Certificate of Coverage (CoC) ,v fi,:',-,,,,'-c- ' {' ,
M i ° f Y
NCG550000'OWNERSHIP CHANGE FO `I. Please enter the CoC number for which the change is requested.
Certificate of Coverage
N C G 5 5 / / 7 &
II. Please provide the following for the requested change(revised CoC).
a. Request for change is a result of: X 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
CoC: S'i A of G phi lloo-r
First MILast
DaY1 ell
Title
a6.49 /c&RReLL. /?c+
Permit Holder Mailing Address
-Dia ty..imA N, C. 2.77041
City State Zip
(9i9 ) sw-/ofs 5p9401650rahoo,com
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)
/9-A/e c C7`, A,-/ri°First MI Last
PO44
Title
a639 Fekee_Le_ M,
Mailing Address
ddress
Dat Ht C pZ?'7a51
City State Zip
(q/q ) 5 eR to et/i ce.h./ tker 76 @rm.,1.cool
Phone E-mail Address
DE
- North
512No CarorthlinaSalisb Department o1 f1617 Environmental
Service QualityCenter I Division ofNo Watertch Resources
, Carolina 27699-1617
xo m a Environmental anm� /� 919.707.9000

Page 2 of 2
IV Will this permitted facility continue to discharge the same volume and type of wastewater as
prior to this ownership or name change?
Ej Yes
❑ No(please explain)
Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
V. ARE INCOMPLETE OR MISSING:
❑ 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, , 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.
Nctu,,, C P Q„01�' .� 1 t- a`I
Signature_" Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Mr. Charles H. Weaver
NC DEQ/DWR/NPDES
1617 Mail Service Center
Raleigh,NC 27699-1617
[e-mail]

Book9607 - Page 801 Page 1 of 3
For Registration Sharon A. Davis
Register of Deeds
Durham County, NC
Electronically Recorded
2022 Feb 04 03:48 PM
Book: 9607 Page: 801
NC Rev Stamp:$ 0.00 Fee:$ 26.00
Instrument Number: 2022005212
DEED
Prepared By: Walker Kiger,PLLC
After Recording Mail To: Grantees
Excise Tax$0.00
Tax Lot No.8679037
Brief Property Description:
PROP-PHILPOT GERALD&LLLLIE H
No title examination
No Opinion on Title Expressed or Implied by the Preparation of this Deed
EXECUTOR DEED
This deed made this day of February,2022,by and between:
Grantors: Grantees:
The Estate of Lillie H.Philpot Shawn Gerald Philpot,an unmarried man
by Alice Parker,Executor and Personal
Representative
Grantor Address: Grantee Address:
2639 Ferrell Road 2639 Ferrell Road
Durham, NC 27704 Durham,NC 27704
Property Address:
2639 Ferrell Road
Durham, NC 27704
The property being conveyed was the principal residence of at least one Grantor,now deceased.
That Alice Parker, Executor and Personal Representative of the Estate of Lillie H.Philpot,has and
does herby give,grant,bargain,sell,and convey to Grantee,heirs,successors,and assigns, in fee
simple forever all of Grantor's interest in said lot or parcel of land that is situated in Durham
County,North Carolina,being more particularly described in EXHIBIT A of this Deed,below.
Deed Page I
submitted electronically by "walker Kiger, PLLC"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Durham County Register of Deeds.

r �
Book9607 - Page 802 Page 2 of 3
This conveyance made subject to any unpaid Ad Valorem taxes for 2021 and subsequent years;
This conveyance made subject to all valid covenants,declarations,easements and rights of way of
record.
Witness the signatures and seals of the Grantors:
id,(a L fbAlz-- (SEAL)
Alice Parker,Personal Representative
for the Estate of Lillie H.Philpot
•
(Notary Seal) State of NC,County of Durham
I certify that the following person(s)appeared before me this day,
acknowledging that he or she voluntarily signed the foregoing document for
the purpose stated therein and in the capacity indicated: Alice Parker,
Personal Representative In The Matter of The Estate of Lillie H.
,.� tk LE 'ec Philpot p
Z+ ., Ee4,6t6.y
�`� �ssIONF p This the day of-January;2022.
=-� J15 Tozr. l .�Y�Notary Public;my commission expires: I j1SI�7o2�-
g 3w 20.
•,,,��T,gfR'Y'pV.90

•
Book9607 - Page 803 Page 3 of 3
EXHIBIT A
LEGAL DESCRIPTION
Said lot or parcel of land is situated in Durham County,North Carolina,being more particularly
described as follows:
BEGINNING at a stake in the northwest side of the Ferrell Road at the
northeast corner of the Property of Charles Franklin Jones and wife,
Barbara Ann Jones, as shown in Plat Book 58 at page 81, Durham County
Registry, and running thence north 46' 44' 10" west 240.72 feet to a
stake; thence north 71° 38' east 146.2 feet to a stake; thence south 85°
25' eae.t 57 feet to a stake; thence south 50° 02' east 111.8 feet to a
stake in the northwest side( of Ferrell Road; thence along and with the
northwest side of said road south 38° 11' 38" west 171.37 feet .to a stake,
the place of beginning, and being the Property of GERALD ROGER PHILPOT
and wife, LILLIE H. PIIILPOT, as per plat and survey thereof on file in
the office of the Register of•Deeds of Durham County in Plat Book 69
at page 75 , to which reference is hereby made for a more particular
description.
•
Property Address (for convenient reference only):
2639 Ferrell Road
Durham, NC 27704