NCC223650_FRO Submitted_20221025

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Soil Erosion and Sedimentation Control
Permit Application
Please complete both pages of this form and return to:
Physical Address Mailing Address
80 East St. PO Box 548
Pittsboro, NC 27312
Phone: [phone]
Pittsboro, NC 27312
For Office Use:
Please check one of the boxes below for the perm -it that you wish to apply for:
*For Land Disturbin
and Multi -Lod Residential Permits
amount of disturbance in acres for all
arceUlotsd
lease include all
arcels/lots on one a
lication with the total
Land -Disturbing Permit: This permit is required for the following activities: (1) all new commercial, land
clearing/development, and non-residential projects greater than 20,000_ft2 and construction of all new residential dwellings
greater than 25,000-ft' of uncovered or disturbed land
a. The following items are required to obtain this permit
i. 3 copies of an erosion control plan which was completed and sealed by a professional land surveyor, professional
engineer, or registered landscape architect. This plan must meet the criteria provided on the Chatham County S&EC
Plan Review Checklist and must include all disturbance and clearing for the project including driveways, yards, and
septic systems for residential projects.
ii. A permit fee of $250/acre of disturbance and a plan review fee for $250/acre of disturbance. These are rounded up
to the next whole acre. Example 1 acre or less is $500, 1.1-2 acres is $1,000, 2.1-3 is $1,500.
❑ Multi -Lot Residential-. This permit is required for all multiple lot construction in the same subdivision by the same buil er thai
cumulatively disturbs greater than 25,000-ft2. All submittal requirements are the same as the Land -Disturbing Permit listed
above.
El Residential Lot Permit: This permit is required for all disturbance related to home building activities that do not exceed 25,000-
ft' of disturbance. This disturbance must include driveways, yards, and septic system clearing. The following required submittals
must be submitted to Central Permitting when you apply for your Building Permit.
a. The following items are required to obtain this permit
i. A plot plan
showing clearing
boundaries
and
approximate Iocation of the areas listed above must be included, This
plot
plan is
not required to be
completed
by a
surveyor or engineer.
it. A permit fee of $100 must be paid to Central Permitting when you apply for your building permit.
Should you have any questions regarding the above permits or required submittals please contact:
Land Development/Commercial Prgiects
Morgan DeWit, PE
Senior Watershed Specialist
919-542-8268
ni roan. wits am e.
Residential/Multi-Lot Residential Projects
Drew Blake
Watershed Specialist
919-545-8394
drew.blake
Page 1 of 3
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CoLIN-rY
Soil Erosion and Sedimentation Control
Permit Application
PROJECT NAME: Morgan Ridge Subdivision - Phase 2 DATE: April 29, 2021
EEEEEEN�LOCATION OF PROJECT: South side of No J0 ones Ferry Road MW at Chatham/Orange County boundary
PARCEL #: AKPAR 1435 and 69883
TOTAL ACRES OF ALL PROPERTIES TO HAVE DISTURBANCE: 80.25 Aces
(In the case of residential permit, total acres of subdivision phase)
TOTAL DISTURBED ACRES or SQUARE FEET: 9.61 Acres
PURPOSE OF ACTIVITY,• Construction of 2600 LF of public roadway and stormwater basins
FEE AMOUNT SUBMITTED:
$5000.00
($250/acre plan review fee, $250/acre land disturbing permit fee)
LANDOWNERS) OF RECORD (attach
Name0: Morgan Ridge Partners, LLC
Address: 104 Amber Wood Run
Chapel Hill, NC 27516
aize to list additional owners
FINANCIALLY RESPONSIBLE PARTY (a
Name:
Address:
NORTH CAROLINA AGENT (a
North Carolinal
Name:
Address:
ENGINEER/SURVEYOR
Company Name,* Warren D. Mitchell PE
Address: 104 Amber Wood Run
Chapel Hill, NC 27516
Contact Person: Warren Mitchell
Phone: [phone]
E-Mail. [e-mail]
ficable onl
Phone: [phone]
E-Mail: Warrendmit�14ellpe@gji}ail.com
S lig attire
licable only if different from
Phone:
E-Mail:
Signature:
roverty owner
if owner or financially responsible
Phone:
-0
E-Mail,
Signature:
ROL
does not reside in
Person to contact should erosion & sediment
control issues arise during hand -disturbing activity:
Contact Person: Warren Mitchell
Company Name : same
Phone: [phone]
E-Mail: Warrendmitchel[[e-mail]
Page 2 of 3

Soil Erosion and Sedimentation Control
CHXFHA.M COUNTY IN, " " "' " C ^ TA � � N ^ Financial Responsibility/Ownership Form
PLEASE READ THE FALLOWING INFORMATION,
1}This section must be signed in the presence of a Notary
2) All Land -Disturbing permits are valid for up to (2) years from the date of issuance. If circumstances warrant, the permit may be
extended For (1) year per the conditions of the Chatham County Soil Erosion and Sedimentation Control Ordinance. Uponwritten
notice, the Land -Disturbing permit may be revoked for failure to comply with the Ordinance. If the permit is revoked, all other
permits and approvals are withheld until the property is once again in compliance with Chatham County regulations. Also, upon
written notice, a civil penalty (fine) can be instigated against the property owner and/or additional financially responsible party (if any)
for violations of the Chatham County Soil Erosion and Sedimentation Control Ordinance. This penalty is up to $5000.00 per violation
per day and is assessed daily for every day the property is in violation. Interfering with or hampering an inspection can result in a civil
penalty without written notice.
3} The information provided on this form is true and correct to the best of my knowledge and belief and was provided by me while
under oath.
4) This form must be signed by the property owner if an individual. If owned by a company or corporation, this form must be signed
by an officer, director, partner, attorney-in-fact, or other person with authority to execute instruments for the corporation and
accompanied by a complete list of all partners, managing members and registered agents of the company or corporation.
OWNER OF PROPERTY:
Name and Title: Warren D. Mitchell, member
Company (if applicable): Morgan Ridge Partners, LLC
Signature:
ADDITIONAL FINANCIALLY RESPONSIBLE PARTY (if any):
Name and Title:
Company:
Signature:
NORTH CAROLINA AGENT (if any):
Name and Title:
Company:
Signature.6
:
,, a Notary Public of
.,f
County in the stale
uu iiereoy ceniry tnai A 1 � ' i .,t' . 1 personally
appeared before me this day and under oath acknowledged reading the information above and acknowledged that the
above form was executed by him or her.
Witn y hand and official seal, this the C1 day of
Notary Public
My commission expires
Page 3 of 3
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