NCG551411_Owner Name Change_20180813

ROY COOPER
Governor
f Ay MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Water Resources Interim Director
ENVIRONMENTAL QUALITY
NPDES Certificate of Coverage (CoC)
NCG550000 OWNERSHIP CHANGE FORM
I. Please enter the CoC number for which the change is requested.
Certificate of Cove age
N O G 5; 5 1-
II. Please provide the following for the requested change(revised permit).
a. Request for change is a result of: `i Change in ownership of the residence/property
❑ Name change of the facility or owner
If other please explain:
b. Permit will be issued to(company
name, if applicable): _
c. Person legally responsible for permit: H s cJ
RECEIVED/DENRJDWR First MI Last
AUG 13 2040 .,,�>v c(2—
Title
Water Resources /d i GET w L.14. NJ Z
Permitting Section Permit Holder Mailing Address
�aNA Nf_c • o
City State Zip
( gig ) 8l — ICooza
Phone E-mail Address
d. Facility name(discharge):
e. Facility address:
Address
City State Zip
f. Facility contact person:
[if different from Owner] First MI Last
( )
Phone E-mail Address
III. Permit contact information(if different from the person legally responsible for the permit)
Permit contact:
First MI Last
Title
Mailing Address
City State Zip
( )
Phone E-mail Address
IV Will this permitted facility continue to discharge the same volume and type of wastewater as
prior to this ownership or name change?
NI Yes
❑ No(please explain)
Revised 11/2017

NV_ 5c33
6.airlebtAka
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: 370.00 Parcel Identifier No:
Prepared By: Lance A. Wootton
Return to : Grantee
The property transferred herein ®includes ❑ does not include the primary residence of the grantor.
THIS DEED made this 16 day of August,2016, by and between:
GRANTOR GRANTEE
Robert Lynn Hooker and wife, JoBeth Hooker Joseph C. Robinson, Jr. and wife, Cathy G.
7985 Hunters Creek Drive, Olive Branch,MS 38654 Robinson
11124 S.Lowell Road,Bahama,NC 27503
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.
WITNES SETH, 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 or parcel of land situated in Durham County, North Carolina, and more particularly
described as follows:
CONTAINING 0.79 ACRES, MORE OR LESS,AND BEING SHOWN ON PLAT OF PROPERTY OF
CHARLIE B. CRABTREE,NOW ON FILE IN THE OFFICE OF THE REGISTER OF DEEDS OF
DURHAM COUNTY IN PLAT BOOK 75 AT PAGE 26, TO WHICH PLAT REFERENCE IS HEREBY
MADE FOR A MORE PARTICULAR DESCRIPTION OF SAME.
ALL OR A PORTION OF THE PROPERTY HEREINABOVE DESCRIBED WAS ACQUIRED BY
GRANTOR BY INSTRUMENT RECORDED IN BOOK 3918,PAGE 992,DURHAM COUNTY
REGIS FRY. PARCEL ID: 190207
1

The Property hereinabove described was acquired by Grantor by instrument recorded in Book 7584 at Page 507.
A map showing the above described property is recorded in Plat Book 75,Page 26.
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.
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 except for the exceptions
hereinafter stated. Title to the property hereinabove described is subject to the following exceptions:
Easements and restrictions of record.
IN WITNESS WHEREOF,the Grantor has hereunto set his hand and seal, or if corporate, has caused
this instrument to be signed in its corporate name by its duly authorized officers and its seal to be
hereunto affixed by authority of its Board of Directors, the day and year first above written.
IN TESTIMONY WHEREOF,the said Grantors have hereunto set their hands and seal,the day and
year first above written.
r� (SEAL)
peft. s , o r
o' / �. (SEAL)
oBe � Hoo e
(SEAL)
(SEAL)
State of / County of - h�
1 certify that the following person(s)personally appeared before me this day, each acknowledging to me that he
or she signed the foregoing document:Robert Lynn Hooker and Jo - Hooker. Witness us, hand and official
stamp or seal this f day of August,2016.
My Commission Expires: 6 - L- v ,;,L -..
(SEAL - STAMP) 4, Notary Public
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