NC0071323_Owner (Affiliation Change)_20240830

a ` NC DEPARTMENT OF ENVIRONMENTAL QUALITY
�i , DIVISION OF WATER RESOURCES
ill ",
„
* #! WATER QUALITY PERMITTING SECTION
NORTH CAROLINA NPDES PERMITTING
Environmental Quality
PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
Permit Number: NCO0_7J_1J_3J_2J_3_ or NCG5_/_/_/ /_
1. Facility Name: Etowah Sewer Company WWTP
II. NEW OWNER/NAME INFORMATION: RECEIVED
1. This request for a name change is a result of:
AUG 3 0 2024
_X a. Change in ownership of property/company
b. Name change only NCDEQ/DWR/NPDES
c. Other(please explain):
2. New owner's name (name to be put on permit):
Henderson County NC
3. New owner's or signing official's name and title: Marcus Jones
(Person legally responsible for permit)
County Engineer
(Title)
4. Mailing address: 1 Historic Courthouse Square, Suite 6 City: Hendersonville
State: NC_ Zip Code: 28792 Phone: [phone]
E-mail address: [e-mail]
III. FACILITY AND DISCHARGE INFORMATION
1. Will the waste stream for the facility remain the same as under the previous owner? Yes X No 0
2. Will the treatment system and discharge location remain the same? Yes X No 0
"No Responses" i
If either or both of these questions are answered"No"then more information will be needed to review the
request. Please attach documentation to describe and explain the changes to the facility activities, waste
stream, treatment process or outfall location. The Division may not be able to process the Permit
Name/Ownership Change request and may require that the new owner file a new permit application.
DQ��)"' North Carolina Department of Environmental QualityI Raleigh I Division of Water Quality
S12 North Salisbury Street 11617 Mail Service Center ,North Carolina 27699-1617
Opylrlmen1 A EmlranmonWi O.1
919.707.9000

NPDES Name and Ownership Change
Page 2 of 2
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION UNLESS ALL OF THE
APPLICABLE ITEMS LISTED BELOW ARE INCLUDED WITH THE SUBMITTAL.
REQUIRED ITEMS:
1. This completed application form
2. Legal documentation of the transfer of ownership (such as a property deed, articles of
incorporation,or sales agreement)
3. Information to document facility,waste stream, treatment system or outfall changes as noted in
item III above (if appropriate)
Applicant's Certification:
I, Marcus Jones , 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 and attachments are not included, this application package will be returned as
incomplete. I understand that Permit Name/Ownership Change can only take place through action
taken by the Division of Water Resources and that no actions on my part or the part of my company
result in the automatic transfer of permit coverage.
Signature: Date:_8/23/24_
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING INFORMATION & MATERIALS,
SHOULD BE SENT TO THE FOLLOWING ADDDRESS:
NC DEQ/ DWR/ NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Version 07/2021

BK 4199 PG 277 - 279 (3) DOC# 1001018950
This Document eRecorded: 08/19/2024 02:34:57 PM
Fee: $26.00
Henderson County, North Carolina Tax: $800.00
William Lee King, Register of Deeds
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $0O.00
Parcel Identifier No. Verified by County on the day of .20_
By:
Mail/Box to:Office of the County Attorney for Henderson Counts,
'this instrument was prepared by: Charles Russell Burrell Lvithout title search)
Brief description for the Index: Tracts. Mills River Township
THiS DEED made this 1(Q day of August. 2024,by and between
GRANTOR GRANTEE.
ETOWAH SEWER COMPANY. INC.,a North Carolina COUNTY OF HENDERSON
Corporation,also know as Etowah Sewer Company a body corporate and politic of North Carolina
1 Historic Courthouse Square, Suite 5
Hendersonville, North Carolina 28792
Enter in appropriate block for each Grantor and Grantee: name.mailing address,and. if appropriate,character of entity,e.g.
corporation or partnership.
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, all that certain lot, parcel of land or
condominium unit situated in Mills River Township,Henderson County,North Carolina and more particularly described as follows:
Page I of 3
NC Bar Association Fort No. 3< Revised 72013
Printed by Agreement with the NC Bar Association North Carolina Bar Association-NC Bar Form No.3
submitted electronically by "van winkle Law Firm"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Henderson county Register of Deeds.

BK 4199 PG 277 - 279 (3) DOC# 1001018950
BEING ALL rights in real estate, including but not limited to fee simple ownership and easements,used in the
operation of Etowah Sewer Company in the Etowah area of Henderson County,North Carolina.expressly including
but not necessarily limited to the parcels described in Exhibit A hereto,which is incorporated herein by reference.
All or a portion of the property herein conveyed does not include the primary residence of a Grantor.
TO HAVE AND TO HOLD the aforesaid parcels 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,other than the following exceptions:
IN WITNESS WHEREOF,the Grantor has duly executed the foregoing as of the day and year first above written.
(SEAL)
,�!'ETOWAH SEWER COMPANY,INC. Print/Type Name:
By: t'. `"'C.J� /ti- (SEAL)
Name&Title: Kevin G ' m.President Print/Type Name:
By: (SEAL)
Print/Type Name&Title: Print/Type Name:
By: (SEAL)
Print/Type Name&Title: Print/Type Name:
State of -County or City of
I,the undersigned Notary Public of the County or City of and State aforesaid,certify that
personally appeared before me this day and
acknowledged the due execution of the foregoing instrument for the purposes therein expressed. Witness my hand and Notarial stamp
or seal this day of ,20 .
My Commission Expires: Notary Public
(Affix Seal) Notary's Printed or Typed Name
State of North Carolina-County of Henderson
I,the undersigned Notary Public of the County of I-lenderson and State aforesaid,certify that Kevin Griffin personally
came before me this day and acknowledged that he is the President of Etowah Sewer Company,Inc.,a North Carolina
corporation,and that by authority duly given and as the act of such entity,he signed the foregoing instrument in its name on its
behalf as its act and deed. Witness my hand and Notarial stamp or seal, this l 1, day of August,2024.
4
My Commission Expires: ►O— 19_2A74 %`` cYQ _t9� � e. (lQ.Cm_Notary Public
(Affix Seal) • 7 NOTARY ' Notary Printed or Typed Name
ES r.,,,'.1.I
`3, PUBLIC' ,1

BK 4199 PG 277 - 279 (3) DOC# 1001018950
EXHIBIT A
BEING all that rights,title and interest in the property described in the following listed instruments,all of which
are recorded in the Henderson County,North Carolina,Registry,which instruments are incorporated herein by
reference:
Book 3157, Page 547
Book 3157, Page 543
Book 3157, Page 539
Plat 2017, Page 10737
Plat 2017, Page 10736
Plat 2017, Page 10735
Plat 2017, Page 10734
Plat 2017, Page 10733
Book 1652, Page 468
Plat 2016, Page 10041
Book 1620, Page 313
Book 1475, Page 581
Book 1401, Page 6
Book 1401, Page 9
Book 1364, Page 365
Book 858, Page 747
Book 833, Page 513
Book 803, Page 711
Book 783, Page 821
Book 782, Page 470
Book 782, Page 465
Book 782, Page 460
Book 782, Page 455
Book 728, Page 289
Book 728, Page 285