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Home My WebLink AboutNCG130001_Change of Ownership_20180521I. Please enter the permit number for which the change is requested. NPDES Permit (or) Certificate of Coverage N C S O 1 1 1 1 1 1N C G1 13 I C I 6 I n I 1 II. Permit status prior to requested change. a. Permit issued to (company name): 7;;;_, '; 1405 S G� IS 1hL b. Person legally responsible for permit: & n=( First MI Last n LA-) A ✓' Title 2 0 S "tnl Permit Holder Mailing Address �AQ AA WG 7 10 1 City State Zip Phone Fax c. Facility name (discharge): S:�;p rre SS --T n L d. Facility address: ryv.2 h S4— Address D,2 r V\q rV\, K C City State Zip e. Facility contact person: [. 2 ,'j (!-.r2r First / MI /Last Phone III. Please provide the following for the requested change (revised permit). a. Request for change is a result of: Change in ownership of the facility ❑ Name change of the facility or owner If other please explain: b. Permit issued to (company name): c. Person legally responsible for permit: First MI Last 004 "jo.e'f! / ✓gin 5P r Title Pry (SC)." -_)_j9--? Permit HolderMailingAddress �oL N C City State Zip I� )' k o�-3353 'i; 110-e�i�ew�Cs-n:-vi Phone -mail Address C.1 f 5 c d. Facility name (discharge): ' I .�e_ W C. S-�_. S.2 v J t cc S L LC__ e. Facility address: 20 S 401 innay\ Sd- Address o iri�c i j C 2A770 f City State Zipf. Facility contact person: )a wk wQ 11 , ) First MI Last (9tq ) ( -5353 VX �e(�11� LLA5+C, V IC.. - Phone E-mail Address IV. Permit contact information (if different from the person legally responsible for the permit) Revised Jan. 27, 2014 Division of Energy, Mineral & Land Resources FOR AGENCY USE ONLY Date Received Land Quality Section/Stormwater Permitting Year Month Day NCDENR National Pollutant Discharge Elimination System NORTn GROUNRDevnmrnEu*ov EN-- 4Np NA tMNL RESOURCES PERMIT NAME/OWNERSHIP CHANGE FORM I. Please enter the permit number for which the change is requested. NPDES Permit (or) Certificate of Coverage N C S O 1 1 1 1 1 1N C G1 13 I C I 6 I n I 1 II. Permit status prior to requested change. a. Permit issued to (company name): 7;;;_, '; 1405 S G� IS 1hL b. Person legally responsible for permit: & n=( First MI Last n LA-) A ✓' Title 2 0 S "tnl Permit Holder Mailing Address �AQ AA WG 7 10 1 City State Zip Phone Fax c. Facility name (discharge): S:�;p rre SS --T n L d. Facility address: ryv.2 h S4— Address D,2 r V\q rV\, K C City State Zip e. Facility contact person: [. 2 ,'j (!-.r2r First / MI /Last Phone III. Please provide the following for the requested change (revised permit). a. Request for change is a result of: Change in ownership of the facility ❑ Name change of the facility or owner If other please explain: b. Permit issued to (company name): c. Person legally responsible for permit: First MI Last 004 "jo.e'f! / ✓gin 5P r Title Pry (SC)." -_)_j9--? Permit HolderMailingAddress �oL N C City State Zip I� )' k o�-3353 'i; 110-e�i�ew�Cs-n:-vi Phone -mail Address C.1 f 5 c d. Facility name (discharge): ' I .�e_ W C. S-�_. S.2 v J t cc S L LC__ e. Facility address: 20 S 401 innay\ Sd- Address o iri�c i j C 2A770 f City State Zipf. Facility contact person: )a wk wQ 11 , ) First MI Last (9tq ) ( -5353 VX �e(�11� LLA5+C, V IC.. - Phone E-mail Address IV. Permit contact information (if different from the person legally responsible for the permit) Revised Jan. 27, 2014 NPDES PERMIT'NAM &OWNERSHIP CHANGE FORM Page 2 of 2 penrl" voniaq� WMV Will the permitted JAcilit) clMinue lo conduct 11he same industrial activities conduced prior to this oWner, hip or name change? i 19i Uwwaw evok) v1 Required Items: 1111s If 1. HE REII k%1 It I 's, A RV INCONJIIJ.I,.I 1,. ()1? i% wqmwd hw N"j, iiAnju cj,q, ail iamovil Twul-nomit "into the ininwo, to"I wjyjo, I d,, da ii NU 01 001 NE99WId IAN ann"m"hW,+iwT. W,,, 1 1 iild;iai`Ittii<iiit)i€ Fait." not '(111,16clit f(Nall mvncf�shlp k1lan"?c, ........ ........... ......... ................ .................... ......... --- ....... —, — — I ...... The cuuHmitmix below niml Ix oniqvicted mw <'c by lie !N�rinn holder pl-il)f ids I ON: <'inpc., and the iwvv alThicallt in the case uAni ownevy CNw, Applicant's collit'ication�tily a dic sqw(f I attest t ti ppilumum h" a nwm- =110 AW .affil n iN2 k -n rat c a it(! completc it I I tit my knmI, lcdie. I untk" .1 oil Wal I at 1 w! Applicalml ate IM COMPWWd and 1% it all mqwwd sWy, lE'tSittti3 s` `6 [);lie FRI" It AUK GAt a , V!QnLK3 e� I ORO n qql1mm"M k" a "a"w "WM W% Woud Ami; LO"qWClc M The jWS1 of llq kM,a jay, I ME conqi1ded and Am it all n, Wvd i ply, PINASE SEND IJIF: i (),Ipl FII,: .it1, A( 0 1 RIP1. \ I H 10, d w 1612 Nt" I Sol U, I a w f�alcql+, Nol Ih Cat,oho;i �-,`699- I nt 1 Book8279 - Page86 Page 1 of 5 FOR REGISTRATION Shun A. Davis REGISTER OF DEEDS Durham County, NC 2017 Sep 29 08:38 AM 841:8279 PG:86.90 DEED FEE: $25.00 INSTRUMENT # 2017034978 EXCISE TAX: 52.500.00 0 RUE TE 111,111111 T 11111111 111 2017034378 NORTH CAROLINA GENERAL W 4RRANTY DEED Excise Ta -2,'5oo- Oo Parcel Identifier No. Verified by W County on the day of 20 By: MailBox to: Dan Wall, P.O. Box 2197, Apex, NC 27542 This instrument was prepared by: Boma J. Freeman, Jr. (without benefit of title examination) Brief description for the Index: THIS DEED made this 3 day of September 2017, by and between GRANTOR Fortress International (Durham), LLC P.O. Box 21289 Durham, NC 27703 GRANTEE Elite Waste Services, LLC P.O. Box 2197 Apex, NC 27502 Enter in appropriate block for each Grantor and Grantee: name, mai)ing 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 the City of City Cit} Township, Durham County, North Carolina and more particularly described as follows: SEE ATTACKED EXHIBIT "A" The property hereinabove described was acquired by Grantor by instrument recorded in Book page All or a portion of the propem= herein conveyed _ includes or X does not include the primary residence of a Grantor. A map showing the above described property is recorded in Plat Book page 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. NC Bar Association Form No, 3 G 1976, Revised O UV20M 2013 This standard form has been approved by; Printed by Agreenrent with the NC Bar Association North Carolina Bar Association — NC Bar Form No. 3