NCC243432_FRO Submitted_20241105

Orange County Planning & Inspections Department
ORANGE COUNTY 131 W. Margaret Lane, Suite 200, Hillsborough, NC 27278
NORTH CAROLINA 919-245-2575 or [e-mail]
Land Disturbance Permit (LDP) Application
Please refer to instructions and checklist in completing the following application.
If completing by hand, please use black or blue ink.
* Please fill out all required fields
Date*: 09/12/2024 Case Number:
Check all that apply*: ,/ Erosion Control Plan
✓ Stormwater Permit
✓ Stormwater Management Plan
General Submittal Information*
Name of Project: Stonewall Subdivision
Parcel ID Number (PIN): 9875645097 Planning Jurisdiction: Orange County
Size of Tract: 36.36 acres Area Disturbed 5.37 acres
Review Fee Payment* - To be completed by applicant
✓ Check n Credit Card (additional 3% fee to be applied after technology fee, if applicable)
Note: A 2% technology fee will be applied to the total of all fees as illustrated below.
Review Fee — To be completed by staff
Fee Amount Fee Amount Fee Amount
Erosion Control Plan Review
Required with Application $6,911 (Express) $ $
Land Disturbing Permit
Optional with Initial Application $3,822 $ $
Stormwater Management Plan Review
Orange County Planning Jurisdiction Only
Required with Application $ 1,000 $ $
Total $ 11,733 $ $
Technology fee (2%) $ 11,967.66 (234.66) $
Credit Card fee (3%)
If applicable $N/A $ $
Total $ 11,967.66 $ $
Approximate date land disturbance will begin: ASAP
Contact Information*
Landowner(s) of Record* Use additional pages if necessary and attach to application
Name: Grayrose Properties Name:
Street Address: Street Address:
1050 Rhodes Gap Trail
Current Mailing Address: Current Mailing Address:
1050 Rhodes Gap Trail
City: Durham City:
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State: NC Zip: 27705 State: Zip:
Phone: [phone] Phone:
Email: [e-mail] Email:
Contract Purchaser* (if applicable) (Use additional pages if necessary and attach to application):
Company/Organization: N/A Company/Organization:
Contact Person: Contact Person:
Street Address: Street Address:
Current Mailing Address: Current Mailing Address:
City: City:
State: Zip: State: Zip:
Phone: Phone:
Email: Email:
Person(s) or Firm(s) Financially Responsible for this Land Disturbing Activity*
Company/Organization: Grayrose Properties, LLC Company/Organization:
Contact Person: Kevin Currin Contact Person:
Street Address: Street Address:
1050 Rhodes Gap Trail
Current Mailing Address: Current Mailing Address:
1050 Rhodes Gap Trail
City: Durham City:
State: NC Zip: 27705 State: Zip:
Phone: [phone] Phone:
Email: [e-mail] Email:
Registered Agent (if any) for the Person(s) or Financially Responsible Party*
- A North Carolina agent is required if the applicant is not a resident of North Carolina.
— All firms and companies shall complete and identify agent.
Name: KEvin Currin Name:
Street Address: Street Address:
1050 Rhodes Gap Trail
Current Mailing Address: Current Mailing Address:
1050 Rhodes Gap Trail
City: Durham City:
State: NC Zip: 27705 State: Zip:
Phone: [phone] Phone:
Email: [e-mail] Email:
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Consent to Receive Electronic Communication
As the Financially Responsible Party, I consent to receiving notifications regarding this project through
electronic communication.
Email: [e-mail] Initials:
I agree to provide any updated email addresses as necessary to ensure consistent communication is
maintained between myself and Orange County Sedimentation and Erosion Control. Electronic
notifications may include Plans Review Comments, Approvals and Disapprovals.
The Financial Responsible Party is responsible for the distribution of correspondence from Orange
County to other pertinent parties.
Additional Project Information*
Project Description* Detail the scope of the project and nature of land disturbance. Use additional pages if
necessary and attach to application.
18 lot single family home subdivision on a single new public road ending in a cul-de-sac.
Plans Prepared by*
Name of Person/Firm: EarthCentric Engineering Inc.
Contact Person: Charles P. Koch, PE
License Number: NCPE#22634
Mailing Address: 204 West Clay Street
City: Mebane State: NC Zip: 27302
Phone: [phone] Email: [e-mail]
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Revised 5/14/2024

Certification and Signatures*
Signature and Witness: The above information is true and correct to the best of my knowledge and
belief and was provided by me while under oath.
A.-
_�' Kevin Currin
Signature of Financially Responsible Party Type or Print Name Legibly
07/24/2024
Title or Authority Date
I, Shawn C. Sidener a Notary Public of the County of Alamance
hereby certify that Kevin Currin personally before me this day and
under oath acknowledged that this Application for Erosion Control Plan Approval, Stormwater
Management Plan Approval, and Land Disturbing Permit/ Statement of Ownership and Financial
Responsibility was executed by him or her.
Witness my hand and notarial seal, this 24 Day of July 2024
\�.P June 27, 2026
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Signature of Notary fc/)e NOTARY
My Commission Expires
r PUBLIC V`
SEAL �'2y .
Property Owner Acknowledg'd . ,3 \
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I hereby acknowledge the above in�orilrta�ion and parties referenced herein have been granted
permission to conduct development activity on referenced property of which I own.
Z- Kevin Currin
Signature of Property Owners Type or Print Name Legibly
07/24/2024
Date
Shawn C. Sidener a Notary Public of the County of Alamance
hereby certify that Kevin Currin personally before me this day and
under oath acknowledged that this Application for Erosion Control Plan Approval, Stormwater
Management Plan Approval, and Land Disturbing Permit / Statement of Ownership and Financial
Responsibility was executed by him or her.
Witness my hand and notarial seal, this 24 Day of July 2024
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��� ��,�� June 27, 2026
Signature of Notary z `��; My Commission Expires
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Revised 5/14/2024