HomeMy WebLinkAboutNCC216851_FRO Submitted_20211210MA,
DIUNCE COUNTY PLANNINC; AND INSP£C710NF.
• P.Rll14117N CDNTW01. AND STORM WATFR DI'ASION
A A GE
COU APPLiCA3'ION
fV'jJ V t EROWPICONTKOL PLAN
... i oUND D16TJWaLNc: FERMYT 4LDPI
Ell W.M Hllsbrormigh. 14C 2272278 Box 8181
1 f919) 245.2575 f tea`
h •I •.oran c. 0 1 i[} rnsion-Canunl Srormwarcr —E -7. Zp-L
1. igamenrpr jet, 4613 Friends School Road
2. F-vW rdmtl4c*Wu Number jN : -' "6 s Orange
� ) Planning Jurildirlioa:
1 She of Tract: 25•26 acres: Aria Disturbed: 6-06 acres �?- J�-J97 3 60 5 [=
4. Pere:
v
Eresiop ContVI Plan Review ✓C 1j. f.�«
RequnTdwhh Appiiraden _ S 7e"
FOR OFFICE. u5E ONLY
Land ❑Wurbing Permit {{ Drre PaidDPLiausg wall leihd Applu6-Date Paid R— r Mtarmwatcr.Hanagcmmt Plan Rview Pp�v F C--'y 1'loaniryl 7nriWie6-pair Dale Paid Re�pl q
Requircd,;[h Appl -m m S
5. Approximate Date [.and Dhturbaam WRI Begin: 3eptBmber 30
(x Landowner(s) of Record; (U..ddiri—I pages if Karasary and W=b m app1W.Ur )
Gardner -Lee Properties ]tl. LLG
Vw[ie 1•'omc
623 Fast Franklin Street
A�
823 Fast Franklin Street
Cvrrnl[ M duta AeA
Chapel Hill NC 27514
City S[iee yip
404-610-0499
Tr:rFhooe Fu[
Alston ga rdner@gmall, com
�ti 9-2-7-Zl
Cwrtrt Mailing Addtas
E
maAddress
T'Fr—
Fr • , Landowners (if appicable): t°I
:aainefgrIrQqyW rt4�h lu appli[ wny
- -. � � Campgrty � prgaoizatiorl
Same Company I Org-i-,m on
cow
Con4c� .
Sheet Addrcse
C�renr �eeiling Address
CSrtreat Mating pddrcsg
City S a e
�A city
Telephone
releplinne
�neail a -mail
7. Person(s) or Firm(s) Financially Responsible for this Land Disturbing Activity:
Company 1 DrgavisOn: Company! Organize M!
Gardner -Lea Properties III. LLC
Contact Can[=
Lucy Stokes
Sur el Address
101 West Chapel Hill St
C Wreot Mailing Address
PO Box 216
City Slale zip
Durham NC 27702
Telephone
919-730-8520
lucy.stokes 19[�7a gmail.com
Clrncat Mailing Addscse
Stab
City SWO
Tdnpbane
e-mail
$ Registered Agent (if any) for the Pergon(s) or Firms) Financially Responsible:
(NOTE: a North Carotins agent is mgaurd if the rpplicant iA not a resident of Nnm Carolina)
nla
Strcd
City s a
Tckplwnc
Address Lmad
lil, Plans Prepared By:
'"ETERM ENGINEERING ASSOCIATES, INC,
Nwrm of Pcrson or Firm
PO BOX 1625
6Msiting Addy a
Durham NC 27702
City —Fmc zip
A
Thomas R. Kagarise, President
tom @vete ran engi n ee rin gassoci ates. co n
&nail
919-201-2175
11, Signature and Witness: the above information is true and correct to the best or my knowledge and belierand was
provided by me while under oath,
of finl.udnef�� folzQ s i
re ancially Responsrbk Type or [N,,.,. Legibly
ignalu
Ti� Auth ty
1, � nr,;4e r k Ui kluri, ,, a Notary Public of the County of t -aa4e.
hereby certify thalcatso
t fir 5f p personally before me this day and under Oath
acknowledged that this App n for Erosion Control Plan Approval, Stormwater Management Plan
Approval and Laud Disturbing Permit 1 Statement ofOwnership and FinaacW Responsibility
was executed by him or her.
Witness my hand and notarial seal, this Day of ALd,,sq
5 goal My Conuumim Expirca '
SEALFER"�,"��
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