NCC224013_FRO Submitted_20221205

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NORT 14 CAROLINA
ORANGE COUNTY PLANNING AND INSPECTIONS
ERO N CONTROL AND STORMWATER DIVISION
APPLICATION
EROSIONCONTROL PLAN
LAND DISTRUBING PERMIT (LDP)
^-7 I ORMWATER MANAGEMENT PLAN (SMP)
+� (> E 'Y.,-1b d �i�, 131 W, ret Lane - Post Office
arga
lsborough, NC 27278
0 [phone]
htt s:l./www.oranl�ecottntvnc eovll3{}�/Erosion
1. Name of Project: 1100 Columbia Street
-Stormwater Pv, /-L�
2. Parcel Identification Number 9788204502,9788205716,9788206500 Chapel Hill
(PIN): Planning Jurisdiction; p
3. Size of Tract: 3.69 acres; Area Disturbed: 2.1 acres
4. Fees:
Erosion Control Plan Review 630 r Required with Application $ I —
Land Disturbing Permit Date Paid
Optional with Initial Application $ 630
Date Paid
Stormwater Management Plan Review
Orange County Planning Jurisdiction Only NA Date Paid
Required with Application $
tal $ JA-L/*!!
T"
5. Approximate Date L d Disturbance Will Begin: JUlY 15, 2022
5. Landowner(s) of Record: (Use additional pages if necessary and attach to application)
CH Hotel Associates Limited Partnership
Name
Name
3008`Anderson Drive
Street Address Street Address
3008 Anderson Drive
Current Mailing Address Current Mailing Address
Raleigh NC 27609
State Zip
19-623-4668
'elePhone Fax
'[e-mail]
mail Address
City
Telephone
Email Address
OR OFFICE USE LY
l?f Rece t�
Receipt #
Receipt #
State Zip
Fax
Page 1

Future Landowners (if applicable): (Ilse additional pages if necessary and attach to application)
Company / Organization
Company / Organization
NA
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:
White Oak Properties, Inc.
Contact
Contact
Roland Gammon
Street Address
Street Address
3008 Anderson Drive
Current Mailing Address
Current Mailing Address
Raleigh NC 24609
City State Zip
City State Zip
919-623-4668
Telephone
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)
NA
Name
Street Address
Current Mailing Address
City State Zip
Telephone
Email
Page 2

MA
Use development of11UO8Columbia Street inChapel Hill, NC.

10. Plans Prepared By:
CJT P.A. Chuck Hill P.E.
Name of Person or Firm Contact Person
111 W Main Street [e-mail]
Mailing Address Email
Durham NC 27701 919-682-0368
City State Zip Telephone
11. Signature and Witness: the above information is true and correct to the best of my knowledge and belief and was
provided by with under �aifi"
J
V
Roland Gammon
Signa Qf Financially Responsible Type or Print Name Legibly
Title or Authority Date
a Notary Public of the County of
hereby certify that 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 ", -, ,, , Day of
Signature of Notary
SEAL
M B
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P U B Lca
0'V
&
My Commission Expires
Page 4