NCC215735_FRO Submitted_20211020

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ORANGE. COUNTY PLANNING AND INSPECTIONS
EROSION CONTROL AND STORMWATER DIVISION
APPLICATION
EROSION CONTROL PLAN
LAND DISTRUBING PERMIT (LDP)
STORMWATER MANAGEMENT PLAN (SMP)
131 W. Margaret Lane - Post Office Box 8181
Hillsborough, NC 27278
[phone]
httns://www.oranaecountvne.,iov/1302/Erosion-Control-Stormwater
1. Name of Project: Richmond Residence
2. Parcel Identification Number (PIN): 9845166279 Planning Jurisdiction: Orange County
3. Size of Tract: 50 acres., Area Disturbed: 1.6 acres
4. Fees:
Erosion Control Plan Review 240
Required with Application 5
Land Disturbing Permit 480
Optional with Initial Application
Stormwater Management Plan Review
Orange County Planning Jurisdiction Only 300
Required with Application
FOR OFFICE USE ONLY
Date Paid Receipt
Date Paid Receipt #
Date Paid Receipt #
Total $ 1,020
5. Approximate Date Land Disturbance Will Begin: Upon Permitting
6. Landowner(s) of Record: (Use additional pages if necessary and attach to application)
William Bradford Richmond
Name
2215 Broad Branch Circle
Street Address
2215 Broad Branch Circle
Current Mailing Address
Richmond VA 23238
cit` State Zip
n/a
Telephone Fax
Email Address
Name
Street Address
Current Mailing Address
City State Zip
felephone Fax
Email Address
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Future Landowners (if applicable): (Use additional pages if necessary and attach to application)
Company / Organization Company / Organization
nla
Contact Contact
Street Address Street Address
Current Mailing Address Current Mailing Address
City State Zip City State Zip
Telephone Telephone
e-mail e-mail
7. Person(s) or Firm(s) Financially Responsible for this Land Disturbing Activity:
Company / Organization: Company / Organization:
McDowell and Jordan. LLC
Contact Contact
Josh MCDowell
Street Address Street Address
208 Green Street
Current Mailing Address Current Mailing Address
Elon NC 27244
City State Zip
Telephone
336-684-1591
City State Zip
Telephone
e-mail e-mail
[e-mail]
8. Registered Agent (if any) for the Person(s) or Firm(s) Financially Responsible:
(NOTE: a North Carolina agent is required if the applicant is not a resident of North Carolina)
It \ n �► �- > !s
Name City State Zip
Street Address Telephone
hone
Current Mailing Address Email
- Ov,_ ty�-QOctJ����pCdg1� C%O_r�Y
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9.
his project is located in Orange County, North Carolina. The subject property is currently undeveloped, wooded land, with
opes from 5 to 15%. Construction of a new house, driveway, and septic area is proposed. The site is being cleared and
raded to provide buildable area for the proposed home and the associated drive. Please see attached plans.
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10. Plans Prepared By:
The L.E.A.D.S. Group; PA
Name of Person or Firm
505 East Davis Street
Mailing Address
Burlington
City
NC 27215
State Zip
Chad Huffine
Contact Person
[e-mail]
Email
336-227-8724
Telephone
11. Signature and Witness: the above information is true and correcf to the best of my knowledge and belief and was
provided by me while under oath.
qA y � & Q ��
Sign re of Financially Res isible Tvpe or Print Name l_.e`ib
��
Title or Aut ority Date
1, a Notary Public of the County of l o � a h C-�P—
hereby certify that bCtE WQ q h e V-- 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 U"ay of &q L.
�(-303�
Signature of Notary MN Commission Expires
SE
Carole C Johnson
r NOTARY PUBLIC
90MY , NQ
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