NCC223904_FRO Submitted_20221122

wArrr ,rApprpi p-�
Land-DisW rbi ng
permsli Applicatio 0
Pkasc compksc-Wh pupes of this form and retrn toy Fla Offis�;,Uw,
ph i ,Am= Mail Adds
so East SL PO Box 548
HmsbMtk NC 27312 Piu ors, :NC 27312
Pu rr= (4$) 5454269
N-74m see PERM 17'1- NG FLOW CF LART to CICICaninc Wh i-Ch 1eun i L and plan rc-galrCmLFM apply tip
fur peoym and rhw a- ow cpf EbrL, Wxcs t>--Jow_
IA:ad-13Arurhing 1Pecmit. The follcm•Frr- koms = r-UgUimd w 6brmin this permit; compJerad
Te=-wrr_ pTans, gad fc=, L=d_GmwrhiAg Pit applicmiom rests[ ire Tuck A papw s ats on
OM 2WkW On VOLh the Z-OW ama nt of daurb=cc F9r A PMWXk'[S. AJI Ckxaring and di51iffbanoe
mu!z be -CwILmkd veium cake 415=bcd area.
Plan Review Jm: SMdismwbCdwm
IFum mr, mu>aod t* to the =1 w hAe afrr-
Ic= T =e 6t is S50& UI-2 acres isSI.#W. and 2.01-+ is SEA 00.
Plan R?qui.-ecrr ws-
Ja_ u.>?Ign, s*>fflit (1) CVY qfm aeon ommrW plan Cmplewd & wAlcd t+y a profs ssiorsal Jand
sum-zx or_ pLmfcffKmA +-nes-, w rrpswr,d l ae ar&wL n vs plan mint McCt the criteria of the
mham CDRFFW Erosim Cor&:bi P#am ROvIww CbWUL t wed irtlud& zU applicabk oms=etjon detai Es-
T rrxe cm k fvumd Cm the Chalham Camt W'at and melon INIblita, can Ow Fxu4m Comd
!_ -e. Thy m rst SSE#& aLl low sue, and fO&Tal minimum pIM 5 i y c %.
Gemerad Plum! wbm?r (1) 007y Of Silt Pbn along with tbc Chad= C oura+y R&WmL6a Ckmaml FJsn- Sirs
pia.r Fc rKil mWLerd to bc' oornpkmd by a ClGSign pgofc Anal. The I riklential Gencml PIm can b--- fed
cn thu C-r4= Coanry 11 zlerAhed Prolmdk; wicbs= on the ReskfemW Const ioa webp e- lndicam-
IL,; dmiwts) aa� shy i th dal F:k�n,
El R lontial Lot Permit_ -R& 1 bPawing Amm am n-qu4vd m obiairs ihis perm GE: cmpk-tcd
ami i=gion. site p1m and fee- J?AGE 3 mFTNA-KI. F OR- -
rm rrvuimI-
Ng Rupircr ems= I PJEan_J �IuNr - - -- �-- -- .
S 1 UU Dal lee ',roc 912D 4WAIn PVPefty bmmdn-imL '€Tie 5XrpIM J"U rCd I } I
itl�rrrr�c+al�rF I- it , or Ctr=3 Permrtupm Dcpmrtm=Em 5056aw—
A L CHECKS h IAI FE 1'&AYAIM.V 10 CI CATFLAM {O[ MrY
PaW IaF3

Land -Disturbing
C 11-1ATT iAl4'� C�ntJN-rY Permit Application
hl Lr R 1 14 { n 9; rI # J X% J
-Th v m ai Eing and sir�ei address of tl« priaripal place ul bu2 inelcs for the person?en €i h f nanciRil} rx�punsilAe sLnd
the Is rstl uw r]cr s) must bb prmid,t-d. A 'PLO, box is NOT acceptable ws an add rcM&
�-If #hc iilaancially responsible per&onr'part_+• is different from the current land owner. eta agreemcut signed by both
partirc m ust he provided alkwinZ the FinancbIly recponsi hie part}- pe"rrn to condo et the Lunn -disturhinZ activity an
tli a property,
PJFLOJECT NAMC: 1 F)ATF- 1
AW)RE SS' ()F pRoj EC T, 111 Stevens Creek Dr, Pittslmro N C 27312
T,A7[T UDF,"NGITiTDE OF PROPERTY AT ';ZTF. ENTRANCE, CE, 1- .123
T'ARC..RL hrf5]= 0091988
TOTAL W1,3TURRYD AC R F 5 oe [JA RE ITEFT' 0-93 s
PURPOSE OF AC']']V rfY. % c;R()
FEri' A -MOUNT S[JRNUTlCEIT;
**1 _AEI DO W N E?R(S) OF REC.OIk1] (attach Pa to list additional owners)
Pl.e&%e provide a oamplew list of parmcrs, managing mcmb m and rcgis[ucd agctal-s if dhf: r46ppn�3h1t� entity iir
Eand o%-ner is a group -of individuals, corporate organ Lz tion or entity.
Name: Dan Mor�m, Fr dent- TripleA Moms _ Phone'-812-0$91
Addb!m, FIG Box 1117. 1 Mlyr p"S. N :7;40 T� F�M,�11= 1$ura *1eAhomes.org I i
DIY L,
* * F INANCI A I LY R C:S KW Si BL I : PARTY parr, I icable oniv if different from -Droaerty owner
Karat: Phone'
Address: k -MaiJ=
1-.irnaburc:
NOR E I C AK L I KA A licablc unly if x a �IQirfQi l I . ji E • pgrty dogs rwt sirl in
Nortli Carolina)
N=eL Phone:
Address: f fvEail=
sigrMUT;
EN ULLR6jLRVKY0K
Company ?pant&= 'dw6;R1 Land $enrirm, PLLC
Address: 1917 Evans Rd, Cary NC 77:513
Cowact per&01i, man Rhaadm-
nanc= !�19L-�78-9#18
E-Mail: € MR&s'- & cjWn
EROSION CONTROL
Persr�o to c+UatAd,-t sh(IWEd eFL(kSi1)J(k & WdiMfEt
cootrn� bmwz arise d wing I at14istu rbikEg AC91Aty:
Contact Person_ Garry F31tm
C'r�y Name Triple A Homes-__ --- r
Phone; 919L45&4X41
L'Mai1. 9e t �roreree.orq
Page 2 of A

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