NCC242051_FRO Submitted_20240708

,, a'►,\ Applications may he %uhmitted online:
https;/-c h:itliimcountync.vicwpointcloud.com/cntegotieVIU
I ,aml-I)isliirhiog
I erritil Application
!'Icase include all required sieattires.
For Office Use:
Physical Address Mailing Address
• O East St. PO Box 548
Pittsboro, NC 27312 Pittsboro, NC 27312
Phone: [phone]
Pleas• see PERMITTING FLOW CHART to determine which pelnl,t, plan, and tee requirements
apply to your project and then check one of the boxes below:
m Land-Disturbing Permit. The following items arc required to obtain this permit: completed
application, plans, deed, and tees. All clearing and disturbance must be included when calculating
disturbed area.
Fee R uirements:
Sec attached PERMITTING FLOW CHART
For fees that are rounded up to the next whole acre.
Ex'ample: 1 acre or less is S500, 1 .01-2 acres is $1,000, and 2.01-3 is $1,500.
Plan Requirements:
Design Plan: submit (1) copy of an erosion control plan completed & sealed by a professional land
surveyor, professional engineer, or registered landscape architect. This plan must meet the criteria of the
Chatham County Erosion Control Plan Review Checklist and include all applicable construction details.
These can be found on the Chathini County Watershed Protection website, on the Erosion Control
webpage. This plan must satist\ all local, state, and federal minimum plan requirements.
General Plan: submit (1) copy of site plan showing proposed disturbance limits along with the Chatham
County Residential General Plan. Site plan is not required to be completed by a design professional. The
Residential General Plan can be found on the Chatham County Watershed Protection website,
Residential Land-Disturbing Permit webpage. Complete table on sheet 1 of Residential General Plan.
Residential Lot Permit. The following items are required to obtain this Nrinit: completed
application, site plan, and fee. Page 3 "Financial Responsibility/Ownership Form- not required.
Fee Requirements: Plan Requirements:
S 100 flat fee Site Plan showing property boundaries and proposed disturbance limits. The site
plan required by the Environmental Health Department can be used as a base.
Al I ( 1 I I:CKS MADE PAYABLE TO Cl IATHAM COUNTY
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•
• Land-Disturbing
.� ;t .� ,�} r •� �« � Permit t»it Application
"The mailing an11 Street the principal 1►I:tr e oi ',miners for the person/entity financially responsible ,inri
the hind os%ner(s) n1u%1 he In 00% hied. I',O. I►o% is Nit ) I acceplatrle :is an :address.
*"If the financially respon%ilde party is different I, inn the current land ►II\ in r , an agreement signed h', both parties
must he prosiiled allr►ssing the lin:ineialls re5pfi,\ihk party to condliu I thy Lind-disturbing actisity on the property.
This agreement is pi °sirlr(l on page 3 id thi• :ippIiratian and must hr rrrnmpletcrl in its entirely.
1`ROJ EC 1 \ \\1 t;: JLE Residential Inc 437 Lakestono Estates DATE:E: 04/26/23
At)DRLss t)1 PROJECT: 437 Lakestone Estates
LATITUDE/I ONGITUi)1., 01 I'M HI It 1'Y AT SITE ENTRANCE: 35.663463,-79.087346
PARCEL, #(S): 66049
TOTAL DISTURBED ACRES or SQUARE FEET: Less than 1 acre
PURPOSE OF ACTIVITY: Primary Residence
FEE AMOUNT SUBMITTED: 350 RIVER BASIN: CAPE FEAR
* * LANDOWNERS) OF RECORD (attach page to list additional owners)
Please provide a complete list of partners, managing members and registered agents if the responsible entity or
land owner is a group of individuals, corporate organization or entity.
Name: David Stafford Phone: [phone]
Address: 5707 Highcroft Drive E-mail: dstaffo.gmail.com
Cary, NC 27519 Signature: /�4'v" 1�.r/1./ / AP
i
**FINANCIALLY RESPONSI131,1: PARTY (applicable only if different from property owner)
Name: Phone:
Address: _ — E-Mail:
Signature:
NORTH I CAROLINA AGENT (applicable only if either owner or financially responsible party does not
reside in North Carolina)
Name: Phone:
Address: E-Mail:
Signature:
ENGINEER/SURVEYOR EROSION CONTROL
Company Name: Ritchell- Puckett Land Surveying Person to contact should erosion & sediment
Address: 105 Swallow Hill Ct. control issues arise (luring land-disturbing activity:
Cary, NC 27513 Contact Person: Joel Bond
Contact Person: Randy Company Name: JLE Residential Inc
Phone:[phone] Phone: [phone]
E-Mail: [e-mail] E-Mail: [e-mail]
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05-01-24 ANTICPATED END DATE: 1 1 -01-24
ANTICIPATED START DATE: