NCG550227_Permit (Issuance)_20170217

ROY COOPER
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MICHAEL S. REGAN
" secretary
Water Resources
ENVIRONMENTAL OUALITY S. JAY ZIMMERMAN
eclor
February 17, 2017
Mr. Mark C. Kilpatrick
13 Foxhorn Court
Hendersonville, NC 28791
Subject: General Permit NCG550000
13 Foxhorn Court
Certificate of Coverage NCG550227
Henderson County
Dear Permittee:
The Division has received and approved your request to transfer ownership of the subject Certificate
of Coverage (CoC) under General Permit NCG550000. As a result, the Division hereby reissues NCG550227.
This CoC is issued pursuant to the requirements of North Carolina General Statue 143-215.1 and the
Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated
October 15, 2007 [or as subsequently amended].
If any parts, measurement frequencies or sampling requirements contained in this General Permit
are unacceptable to you, you have the right to request an individual permit by submitting an individual
permit application. Unless such demand is made, the certificate of coverage shall be final and binding.
Please take notice that this Certificate of Coverage is not transferable except after notice to the
Division. The Division may require modification or revocation and reissuance of the certificate of coverage.
Contact the Asheville Regional Office prior to any sale or transfer of the permitted facility.
Regional Office staff will assist you in documenting the transfer of this CoC.
This permit does not affect the legal requirements to obtain any other State, Federal, or Local
governmental permit that may be required. If you have any questions concerning the requirements of the
General Permit, please contact Brianna Young of the NPDES staff[919-807-6388 or
[e-mail]].
Sin rely,
•
for S. Jay Zimmerman, P. .
Director, Division of Water Resources
cc: Asheville Regional Office
NPDES File
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh,NC 27699-1617
919 807 6300 919-807-6389 FAX
hops://deq.nc.gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/npdes-wastewater-permits

STATE OF NORTH CAROLINA •
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550227
DISCHARGE OF DOMESTIC WASTEWATER FROM SINGLE FAMILY RESIDENCES AND
OTHER 100% DOMESTIC DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and
the Federal Water Pollution Control Act, as amended,
Mark C. Kilpatrick
is hereby authorized to discharge <1000 gallons per day of domestic wastewater from a
facility located at
13 Foxhorn Court
Hendersonville
Henderson County
to receiving waters designated as an unnamed tributary to Shaw Creek, a class WS-IV stream in
subbasin 04-03-02 of the French Broad River Basin in accordance with the effluent limitations,
monitoring requirements, and other conditions set forth in Parts I, II, and III hereof.
This certificate of coverage takes effect February 17, 2017.
This Certificate of Coverage shall remain valid for the duration of the General Permit.
Signed this day February 17, 2017.
for S Zimmerman, P.G.
erector, Division of Water Resources
By Authority of the Environmental Management Commission

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550227
DISCHARGE OF DOMESTIC WASTEWATER FROM SINGLE FAMILY RESIDENCES AND
OTHER 100%DOMESTIC DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and
the Federal Water Pollution Control Act, as amended,
Mark C. Kilpatrick
is hereby authorized to discharge <1000 gallons per day of domestic wastewater from a
facility located at
13 Foxhorn Court
Hendersonville
Henderson County
to receiving waters designated as an unnamed tributary to Shaw Creek, a class WS-IV stream in
subbasin 04-03-02 of the French Broad River Basin in accordance with the effluent limitations,
monitoring requirements, and other conditions set forth in Parts I, II, and III hereof.
This certificate of coverage takes effect February 17, 2017.
This Certificate of Coverage shall remain valid for the duration of the General Permit.
Signed this day February 17, 2017.
42c //74
for S1Zimmerman, P.G. %� ...
erector, Division of Water Resources
By Authority of the Environmental Management Commission

North Carolina Department of Environment and Natural Resources
Division of Water Resources
Pat McCrory John E.Skvarla, III
Governor WATER QUALITY PERMITTING SECTION Secretary
PERMIT NAME/OWNERSHIP CHANGE REQUEST
This form is for ownership changes or name changes of NPDES wastewater permits.
• "Permittee"references the existing permit holder
• "Applicant"references the entity applying for the ownershipiname change.
I. NPDES Permit No.(for which the change is requested): N C 0 0
or
Certificate of Coverage#: N C G 56 oaan
II. Existing Permittee Information:
a. Permit issued to(company name): /9/Z too /� rc✓/ l�fl u3-e—
b. Person legally responsible for permit: ! /l
//// First Last
Title
RECEIVED/NCDEQIDWR Permit Holder Mailing Address
JAN 1 0 2017 / so, N,fir r A/c_ Z$? 7 /
City State Zip
Water Quality ( ) ( )
Permitting Section Phone Fax
c. Facility name:
d Facility's physical address:
Address
City State Zip
e. Facility contact person: ( )
First / MI / Last Phone
III Applicant Information:
a. Request for change is a result of: Change in ownership of the facility
❑ N change the facility or owner
If other please explain: ,_-r / s
b. Permit issued to(company name):
c• Person legally responsible for permit: / 1 "11/( C /k-, L44 X
First MI Last
Title
ff////f��fy)c �/Permitt Jrlr`older Mailing Address
City State Zip
Phone E-mail Address
/ 71 ii K C ,/L/0,,9-7- c ��r�'-rA-�L,C�.•ti
Page 1 of 2 Revised 7/01/2014

•
d. Facility name:
e. Facility's physical address:
Address
City State Zip
f. Facility contact person:
First MI Last
Title
)
Phone E-mail Address
IV Will the permitted facility continue to conduct the same commercial/industrial activities conducted prior to
• this ownership or name change?
s El No(please explain) �s// /es/'2
If applicable,the applicant shall submit a major it modification request to DWR.A major modification shall be
defined as one that increases the volume,increases the pollutant load,results in a significant relocation of the
discharge point,or results in a change in the characteristics of the waste generated.
V. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE
INCOMPLETE OR MISSING:
I. This completed application is required for both name change and/or ownership change requests.
2. Legal documentation of the transfer of ownership(such as relevant pages of a contract deed,or a bill of sale)is
required for an ownership change request. Articles of incorporation are not sufficient for an ownership change.
Applicable regulations:40 CFR 122.41,40 CFR 122.61 and 15A NCAC 02H .0114
The certifications below must be completed and signed by both the permit holder prior to the change(Permittee),and the
new applicant in the case of an ownership change request. For a name change request,the signed Applicant's Certification
is sufficient.
PERMITTEE CERTIFICATION(Permit holder prior to ownership change):
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.
Signature Date
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 inc de ,this application package will be returned as incomplete.
71 / (
Signature Date
**************************
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
NPDES PERMIT NAME/OWNERSHIP CHANGE REQUEST
Page 2 of 2 Revised 7/01/2014

I
. Inspection Date: Start Time: End Time:
SINGLE FAMILY WASTEWATER SYSTEM CHECKLIST
1/9/2o15
Permittee: ll/ .4✓)( C /)I I—I,, Tr-} I( Permit: /
Address: / a/✓ �T l •-fA.y'-i�0/1 mail- �--' 3'2 1
G1
Phone:(X2 ') 6 ..�--_,2-_5 5 CCell Phone:(?$) Cv 04'- ///e County:/7 .-i -5 c'-7
The Permittee is responsible for the operation and maintenance of the entire wastewater treatment and disposal system.
Doesn't Did Not
Yes No Apply Investigate
1. Is the current resident in the home the Permittee? P'- n 0 0
2. If not does the resident rent from the permittee? I I ! I Li I
3. Change of Ownership form needed?(mail the form with the inspection letter) Q-- El n n
4. Is there a inspection and maintenance agreement with a contractor? ❑ I ❑
5. If yes to#4 who is the contractor?
SEPTIC TANK The septic tank and filters should be checked annually and pumped/cleaned as needed.
• 6. Is all wastewater from the home connected to the septic tank? ❑ I I ❑
7. Does the permittee/resident know where the septic tank is located? fEt I I I I I I
8. Has the septic tank been pumped in the last 5 years? 5 2 n ❑ I I
9. If yes to#8 date, if known v Vtrs! -i j /4 proof,describe
10. Does the septic tank have an EFFLUENT FILTER or SANITARY T? (circle one)
11. If Yes to filter when was the filter cleaned? By whom?
SAND FILTER!TREATMENT PODS YES f NO By 7 If no proceed to the next section.
Accessible sand filter surfaces shall be raked and leveled every six months and any vegetative growth shall be removed manually.
12. Is system something other than a sandfilter? I I I I I I n
13. If yes,what kind?(examples-Peat,Textile,Other or brand name-Advantex,etc.)
14. Does the permittee know where the sandfllter is located? ❑ El ❑ ❑
15. Does the sandfilter require maintenance? El n n El
It maintenance is required explain in the comment section. /
DISINFECTION!UV YES n NO (✓.� If no proceed to the next section.
The ultraviolet unit shall be checked weekly.The lamps and sleeves should be cleaned or replaced as needed to ensure proper disinfection.
n n I I n
16.Is UV working?
17.Has the UV Unit been serviced and bulbs cleaned? I I LI LI Li
18. Who completes the weekly check for the UV?(Non-Discharge)
DISINFECTION!TABLETS YES n NO I I If no proceed to the next section.
The tablet chlorinator unit shall be checked weekly to ensure continuous and proper operation.
19. Does the permittee have the correct chlorine tablets?(lf none, mark No) ❑ I I I ❑
20. Does the Permittee know the location of the chlorinator? I I I I ❑
21.Were chlorine tablets observed in the chlorinator? U Li L21 . ❑
22.Are tablets contacting water?If possible poke them to determine. I I El Div U
DECHLOR(Discharge only) YES I I NO f " If no proceed to the next section.
The dechlorinator unit shall be checked weekly to ensure continuous and proper operation.
23. Does the permittee know where the dechlor is? n LI L. I
24. Does the permittee have the correct dechlor tablets? El n I I ❑
25. Were dechlor tablets observed in the dechlorination chamber? n LiU �
26. Are tablets contacting water? If possible poke them to determine. El n El n

Doesn't Did Not I
' Yes No Apply Investigate
PUMP TANK YES [ NO r-t- If no proceed to the next section.
All pump and alarm sytems shall be inspected monthly.(non-discharge)
27. Is the pump working? I I n I I I I
28.Are the audible and visual high water alarms operational? El n n I I
29. Does the permittee know how to check the pump&high water alarm? # I I I I I n
30. Last functional test PUMP AUDIBLE &VISUAL
DISCHARGE ONLY YES El NO E If no proceed to the next section.
A visual review of the outfall location shall be executed twice each year(one at the time of sampling to ensure rn-o-visible solids or evidence of a malfunction.
31. Does the permittee know where the outfall is located? [1� n n El
(,Q
32.Were you able to locate the outfall? I I I
33. Is the end of the discharge pipe visible and accessible? 1 n I ! El
34. Is outlet discharging? n U n
35. Is right of way maintained around the discharge point? E n El El
36.Any Lab Results available? n l n
37. Is there evidence of solids around the discharge point? n U
Ci
DRIP or SPRAY YES n NO IX-----If no proceed to the next section.
The irrigation system shall be inspected monthly to ensure the system is free of teaks and equipment is operating as designed.
38. Is the system DRIP or IRRIGATION(circle one)? If irrigation number of sprinkler heads.
39.Are the buffers adequate? n I ❑ n
40. Is the site free of ponding and runoff? I El U n
41. Does the application equipment appear to be working properly? I I El n El
42. Is there a minimum two wire fence surrounding entire irrigation area? I 1 El U n
GENERAL
43.Are the treatment units locked and or secured? E El El
44. Has resident had any sewage problems? If yes explain in the comment section. n El Li
45. Does the system match the permit description? if no explain in the comment section. `r , I n
�/
El
46. Is the system compliant? L' I,� Li47. Is the system failing? If yes,take pictures if possible. 1 I ' n, ❑
48. If system is failing,any sign of children or animals contacting sewage? nI
I I Li. n
NOD Sent#: - - - NOV NOV Sent#: - - -
Comments: A Photos Taken? / //YES [�l NO (1
!/ .. (, Gie'vt L�7'' �/i i_5' �S r Pic /___, ?/(PJ 414 ,- 4r—e r 4
/ / --r<
C i16 /.t 3�1C 4ti/ G l/ /J �'�cj
t/ W'n! G 4 c/
C / ', , / _ �' A VI. ,C-e1 � /-fI
A.)71- 1- t Dil i .J v-r' 477.e /
INSPECTOR: SIGNATURi ?7--/ ('

BOOK 1679 PAGE 193 (3)
848907 1111 11111 III It
This do9u1m2e/2n0t
16 0 08 557PMd filed:
WILLIAM LEE KING, Henderson COUNTY, NC
Transfer Tax:$469.00
00
Doc Stamps $ 4 b 9. — Prepared By: Kenneth Youngblood
P YM
STATE OF NORTH CAROLINA
GENERAL WARRANTY DEED
COUNTY OF HENDERSON
THIS DEED,made and entered into this' /,2, day of September, 2016,by and between
Elbert Hugh Dampier,single(herein collectively referred to as the"party of the first part"and having
a mailing address of 205 Emerald Bond Lane Apt 302,Durham,N.C.27705)and Mark C.Kilpatrick
and wife, Laura Kilpatrick (the "party of the second part" and having a mailing address of 13
Foxhorn Court, Hendersonville,N.C. 28791);
WITNESSETH:
The said party of the first part, for and in consideration of the sum of Ten Dollars($10.00)
and Other Valuable Consideration to him in hand paid by the said party of the second part, the
receipt of which is hereby acknowledged,has bargained and sold,and by these presents does bargain,
sell, and convey in fee simple unto said party of the second part, their heirs and assigns, a certain
tract or parcel of land lying and being in, Henderson County, North Carolina, more particularly
described as follows:
See Attached Legal, Description
TO HAVE AND TO HOLD the aforesaid tract or parcel of land,together with all privileges
and appurtenances thereunto belonging to them,the said party of the second part and their heirs and
assigns in fee simple forever.
And said party of the first part does covenant that he is seized of said lands in fee and has the
right to convey the same in fee simple, that title to same is marketable and free and clear of all
defend the title herein conveyedagainst the lawful
encumbrances, and that he will warrant and
claims of all persons whomsoever. This conveyance and these warranties are made subject to the
right-of-way of Hunters Lane and Foxhorn Court,to the utility easements and restrictive covenants

Book 1679
of record, and to 2016 Henderson County ad valorem property taxes. Page 194
The real property conveyed herein includes the primary residence of the grantor.
IN TESTIMONY WHEREOF, said party of the first part has hereunto set his hand and seal
the day and year first above written.
• �2' /g. ,,(_,C J «✓ (SEAL)
Elbert Hugh P ampier
STATE OF NORTH CAROLINA
COUNTY OF Jur-IA/k
I, a Notary Public of the County and State aforesaid, certify that Elbert Hugh Dampier
personally appeared before me this day and acknowledged the voluntary execution of the foregoing
instrument for the purpose stated therein. Witness my hand and official stamp or seal,this day
of September, 2016.
M Commission Expires: "..4.7)DAA
,
Notary Public
P'/,,
1p O%�cc NOTARY :
-o PUBLIC
G,9 ?
n►nnitiu"

•
• Book 1679
Paae 195
Being all of Lot 13 of Hunter's Crossing Subdivision as shown on the plat thereof recorded in
Plat Cabinet A, Slide 117-A, of the Henderson County,North Carolina, Registry, reference to
which is hereby made for greater certainty of description.
There is also conveyed herewith a non-exclusive right of way over all of those roadways shown
on the plats of Hunters Crossing Subdivision as recorded in Plat Cabinet A, Slide 99, 105, 117-
A, 119-A, 149-A, 150 and 150-A, of the Henderson County,North Carolina Registry.
This conveyance is subject to those restrictive covenants affecting Hunters Crossing Subdivision
as recorded in Deed Book 610, Page 542, of the Henderson County,North Carlina Registry, and
as supplemented in Deed Book 622, Page 179 and Deed Book 626, Page 133, of the Henderson
County,North Carolina Registry
Being the same property conveyed to Elbert Hugh Dampier, by deed recorded in Deed Book 845,
Page 697, Henderson County,North Carolina, Registry.

• Attorneys Title
104 North Main Street
R3 Hendersonville, NC 28792
Phone: [phone]
Fax: [phone]
j\ttorriers TITitle Email: [e-mail]
State License ID: NC-1000145144
Kenneth R Youngblood Mark C. Kilpatrick and Laura Kilpatrick
Attorney at Law 13 Foxhorn Court
240 3rd Ave W Hendersonville, NC 28791
Hendersonville, NC 28739
October 26, 2016
File No. 16H023298 Amount Due: $0.00
Loan Coverage: $134,000.00
Owner Coverage: $234,500.00
Owner: Mark C. Kilpatrick and Laura Kilpatrick
Property: 13 Foxhorn Court, Hendersonville, NC 28791
Feel free to contact Jennifer Gardner ([e-mail]) should you have any questions or
concerns. We appreciate your business. We value your loyalty. Connect to the Source.
AttorneysTitle.com
Attorneys Title
16H023298

•
Form No. 1402.06 Owner Policy No.5011400-998740
ALTA Owner's Policy(6-17-06) Issued with Policy No. 5018100-902645
ALTA OWNER'S POLICY
First American Title Insurance Company
SCHEDULE A
Name and address of Title Insurance Company: Attorneys Title, 104 North Main Street, Hendersonville, NC
28792
Policy No. 5011400-998740
Address Reference: 13 Foxhorn Court, Hendersonville, NC 28791
Amount of Insurance: $234,500.00 Premium: $679.00
Date of Policy: September 12, 2016 at 02:08 PM
1. Name of Insured:
Mark C. Kilpatrick and wife, Laura Kilpatrick
2. The estate or interest-in the Land that is insured by this policy is:
Fee Simple
3. Title is vested in:
Mark C. Kilpatrick and wife, Laura Kilpatrick
4. The Insured Mortgage you executed in favor of the lender and any assignments thereof, if any, are described
as follows:
Deed of Trust executed by Mark C. Kilpatrick and Laura Kilpatrick, husband and wife, as joint tenants, to
Trustee(s)for the benefit of United Community Mortgage Services, Inc. dated September 12, 2016 and
recorded on September 12, 2016 at 02:08 PM in Book 2877, Page 161, Henderson County Registry, securing
the sum of$134,000.00.
5. The Land referred to in this policy is situated in Henderson County, North Carolina and more particularly
described as follows:
Being all of Lot 13 of Hunter's Crossisng Subdivision as shown on the plat thereof recorded in Plat Cabinet A,
Slide 117-A, of the Henderson County, North Carolina, Registry, reference to which is hereby made for greater
certainty of description.
Attorneys Title
16H023298