NCC241934_FRO Submitted_20240625

Orange County Planning & Inspections Department
ORANGE COUNTY 131 W. Margaret Lane, Suite 200, Hillsborough, NC 27278
NORTH CAROLINA 919-245-2575 or planningappsAorangecountync qov
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.
Date: 29-May-2024 Case Number:
Check all that apply: Erosion Control Plan
n Stormwater Permit
I I Stormwater Management Plan
General Submittal Information
Name of Project: RILEY & PRICE RESIDENCE
Parcel ID Number (PIN): 9865457847 Planning Jurisdiction: ORANGE
Size of Tract: 61 +/- acres Area Disturbed 3 • 93 acres
Fees — Section Completed by Staff
Fee Amount
Erosion Control Plan Review
Required with Application $
Land Disturbing Permit
Optional with Initial Application $
Stormwater Management Plan Review
Orange County Planning Jurisdiction Only
Required with Application $
Total $
Approximate date land disturbance will begin: JULY 2024
Contact Information
Landowner(s) of Record (Use additional pages if necessary and attach to application)
Name: HEATHER RILEY Name: JARED PRICE
Street Address: 1416 Newpoint Drive Street Address: 1416 Newpoint Drive
Durham, NC 27713 Durham, NC 27713
Current Mailing Address: 4711 Hope Valley Road Current Mailing Address: 1416 Newpoint Drive
#4F-609
City: Durham City: Durham
State: NC Zip: 27707 State: NC Zip: 27713
Phone: [phone] Phone: [phone]
Email: [e-mail] Email: [e-mail]
Page 1 of 4

Contract Purchaser (if applicable) (Use additional pages if necessary and attach to application)*
Company/Organization: N/A Company/Organization: N/A
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: Company/Organization:
Contact Person: HEATHER RILEY Contact Person: JARED PRICE
Street Address: 1416 Newpoint Drive Street Address: 1416 Newpoint Drive
Durham, NC 27713 Durham, NC 27713
Current Mailing Address: 4711 Hope Valley Road Current Mailing Address: 1416 Newpoint Drive
#4F-609
City: Durham City: Durham
State: NC Zip: 27707 State: NC Zip: 27713
Phone: [phone] Phone: [phone]
Email: [e-mail] Email: [e-mail]
Registered Agent (if any) for the Person(s) or Financially Responsible Party:
(NOTE a North Carolina agent is required if the applicant is not a resident of North Carolina)
Name: N/A Name: N/A
Street Address: Street Address:
Current Mailing Address: Current Mailing Address:
City: City:
State: Zip: State: Zip:
Phone: Phone:
Email: Email:
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Additional Project Information
Project Description (detail the scope of the project and nature of land disturbance):
CONSTRUCTION OF A SINGLE FAMILY RESIDENTIAL DWELLING UNIT ON APPROXIMATELY
61+/- ACRES OF LAND
Plans Prepared by:
Name of Person/Firm: VETERAN ENGINEERING ASSOCIATES, INC.
Contact Person: THOMAS R. KAGARISE, P.E., PRESIDENT
License Number: 011622
Mailing Address: POST OFFICE BOX 1625
City: DURHAM State: NORTH CAROLINA Zip: 27702
Phone: [phone] Email: TOM@VETERANENGINEERINGASSOCIATES COM
Page 3 of 4

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.
`' PinLita L1 1 t' HEATHER RILEY & JARED PRICE
ignature of intanciall s onsible PartyType or Print Name Legibly
p Yp 9
LAND OWNER 5 - ,g9, 9 L4
Title or Authority Date
a Notary Public of the County of
hereby certify that HEATHER RILEY & JARED PRICE 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, this27d /Day of 4'1-1 , 2aZ4(9
gderk feeu."4, a 3- oz-i
Signature of Notar p5RNERA My Commission Expires
ppUG1AS�OtAR ale
SEAL DURNiA COUNTf'N•C.
Propert a er Acknowledgement
I hereby acknowledge the above information and parties referenced herein have been granted
permission to conduct development activity on referenced property of which I own.
HEATHER RILEY & JARED PRICE
ignature of Property n rs Type or Print Name Legibly
Date
a Notary Public of the County of
hereby certify that HEATHER RILEY & JARED PRICE 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, this21"Day of /uGL , 20 Zi{
Signature of Notary My Commission Expires
SEAL NP035:R`V��
DCOG\)' NOSN p001A C•
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