NCC242318_FRO Submitted_20240730

Orange County Planning & Inspections Department
ORANGE COUNTY 131 W. Margaret Lane, Suite 200, Hillsborough, NC 27278
NORTH CAROLINA 919-245-2575 or planninqappsoranqecountync.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.
* Please fill out all required fields
Date: 7// 2Y Case Number:
Check all th t apply: N/ Erosion Control Plan
Stormwater Permit
n Stormwater Management Plan
General Submittal Information*
Name of Project: Hunt Residence
Parcel ID Number (PIN): 9767892017, 9767880334 Planning Jurisdiction: Orange County
Size of Tract: 21.74 + 0.66 R/W acres Area Disturbed 3.5 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:
Contact Information*
Landowner(s) of Record (Use additional pages if necessary and attach to application):
Name: Christian L. Hunt and Joan E. Hunt Name:
Street Address: 1607 Claymore Rd. Street Address:
Chapel Hill, NC 27516
Current Mailing Address: Current Mailing Address:
1607 Claymore Rd.
City: Chapel Hill City:
State: NC Zip: 27516 State: Zip:
Phone: [phone] Phone:
Email: [e-mail] Email:
Page 1 of 4

Contract Purchaser (if applicable) (Use additional pages if necessary and attach to application):
Company/Organization: N/A Company/Organization:
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 Finn(s) Financially Responsible for this Land Disturbing
Company/Organization: N/A Corn pany/Organization:
Contact Person: Christian L. Hunt and Joan E. Hunt Contact Person:
Street Address: 1607 Claymore Rd. Street Address:
Chapel Hill, NC 27516
Current Mailing Address: Current Mailing Address:
1607 Claymore Rd.
City: Chapel Hill City:
State: NC Zip: 27516 State: Zip:
Phone: [phone] Phone:
Email: [e-mail] Email:
Registered Agent(if any)for the Person(s) or Financially Responsible Party:;;;.: .43::`Y;
(NOTE:a North Carolina agent is required lithe applicant is not a resident of North>Carolina)
Name: NIA Name:
Street Address: Street Address:
Current Mailing Address: Current Mailing Address:
City: City:
State: Zip: State: Zip:
Phone: Phone:
Email: Email:
Page 2 of 4

Additional Project Information*
Project Description (detail the scope of the project and nature of land disturbance):
Project will include the construction of a single family residence and a private access driveway. Scope of
work will also include a swimming pool, private well and onsite wastewater system.
Plans Prepared by:
Name of Person/Firm: Civil Consultants, Inc
Contact Person: Tony Whitaker
License Number: NCPE #014999
Mailing Address: 3708 Lyckan Parkway, Suite 201
City: Durham State: NC Zip: 27707
Phone: [phone] Email: [e-mail]
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.
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Signature of Financially Resp able Party Type or Print Na tme Legibly
Pr __e._,k..‘ E\,v,N..,.rs T 1+ 1 t a Li
Title or Authority Date ,�
I, vim. h 6. a Notary Public of the County of J ,/
hereby certify that i4 --5+i a vj L- � �+" 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 harp �J end notarial seal, this I Day of � 20 7-4(7-4(
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Signature of Notary My Commission Expires
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PropertyI9, ►bwledgement*
filI hereby acknowledge the above information and parties referenced herein have been granted
permission to conduct development activity on referenced property of which I own.
AMR
Signature of Property Ow Type or.Pri t Name Legibly
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Date
ao lV �'> Notary Public of the County of L •
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hereby certify that G\r���rai' I �� Au✓�r 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.
1
j Dayof 1 I
Witness my hand and notarial seal, this '� � � / ��-`'�'.
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Si na '% My Commission Expires
Notary Public ,
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20 04-12-2027
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