NCC243305_FRO Submitted_20241028

Orange County Planning & Inspections Department
ORANGE COUNTY 131 W. Margaret Lane, Suite 200, Hillsborough, NC 27278
NORTH CAROLINA 919-245-2575 or planningapps(a�orangecountync.gov
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*: 07-08-2024 Case Number:
Check all that apply*: 0 Erosion Control Plan
❑ Stormwater Permit
❑ Stormwater Management Plan
General Submittal Information*
Name of Project: Project Sunny - MAF-Il
Parcel ID Number (PIN): 9824564353 Planning Jurisdiction: City of Mebane
Size of Tract: 21.0 acres Area Disturbed 10.6 acres
Review Fee Payment* - To be completed by applicant
n Credit Card (additional 3% fee) n Check
Note: A 2% technology fee will be applied to the permit fee as illustrated below.
Review Fee — To be completed by staff
Fee Amount
Erosion Control Plan Review
Required with Application $3,480
Land Disturbing Permit
Optional with Initial Application $0
Stormwater Management Plan Review
Orange County Planning Jurisdiction Only
Required with Application $0
Total $3,480
Technology fee (2%) $69.60
Credit Card fee (3%)
If applicable $0
Total $3,549.60
Approximate date land disturbance will begin: October 1st, 2024
Contact Information*
Landowner(s) of Record* Use additional pages if necessary and attach to application
Name: Morinaga America Foods Inc Name:
Street Address: 4391 Wilson Rd Street Address:
Current Mailing Address: SAME AS STREET Current Mailing Address:
City: Mebane City:
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Revised 5/14/2024

State: NC Zip: 27302 State: Zip:
Phone: Phone:
Email: Email:
Contract Purchaser* (if applicable) (Use additional pages if necessary and attach to application):
Company/Organization: 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 Firm(s) Financially Responsible for this Land Disturbing Activity*
Company/Organization: Company/Organization:
Contact Person: Stuart Caldwell Contact Person:
Street Address: 500 W 5th Street Street Address:
Current Mailing Address: SAME AS STREET Current Mailing Address:
City: Charlotte City:
State: NC Zip: 28202 State: Zip:
Phone: [phone] Phone:
Email: [e-mail] Email:
Registered Agent (if any) for the Person(s) or Financially Responsible Party*
- A North Carolina agent is required if the applicant is not a resident of North Carolina.
- All firms and companies shall complete and identify agent_
Name: Name:
Street Address: Street Address:
Current Mailing Address: Current Mailing Address:
City: City:
State: Zip: State: Zip:
Phone: Phone:
Email: Email:
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Revised 5/14/2024

Consent to Receive Electronic Communication
As the Financially Responsible Party, I consent to receiving notifications regarding this project through
electronic communication.
Email: [e-mail] Initials: SGC
I agree to provide any updated email addresses as necessary to ensure consistent communication is
maintained between myself and Orange County Sedimentation and Erosion Control. Electronic
notifications may include Plans Review Comments, Approvals and Disapprovals.
The Financial Responsible Party is responsible for the distribution of correspondence from Orange
County to other pertinent parties.
Additional Project Information*
Project Description* Detail the scope of the project and nature of land disturbance. Use additional pages if
necessary and attach to application.
Proposed 117,500 SF expansion of an existing 100,435 SF manufacturing facility on 21.0 acres along Wilson Road in
Mebane, NC. Expansion includes additional parking area and storm pond. Work will consist of fine grading, utility installation,
building construction, and paving/landscaping along with all required appurtenances.
Plans Prepared by*
Name of Person/Firm: Kimley-Horn &Associates
Contact Person: Ashton Smith, PE
License Number: 036849
Mailing Address: 421 Fayetteville St, Suite 600
City: Raleigh State: NC Zip: 27601
Phone: [phone] Email: [e-mail]
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Revised 5/14/2024

Certification and Signatures*
Signatu e and Witness: The above information is true and correct to the best of my knowledge and
belief was prov' ed by me while under oath.
Stuart Caldwell
Signature o Financially Responsible Party Type or Print Name Legibly
Project Manager 7/12/2024
Title or Authority Date
I, Ateic44.1 AO/ a Notary Public of the County of e ms
hereby certify that , ,a, e..-4dve..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 hand and notarial seal, this 12 Day of July 2024 \\\`,.0'DREWN1/4�.
� .Ci/ � Gcc> �� 2 Co = Notary Public
Signature of Notary My Commission Expires = Cabarrus County g.
SEAL '//� o?/0/ C ACt���`��\`
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Property Owner 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.
Signature of Property Owners Type or Print Name Legibly
Date
I, 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 My Commission Expires
SEAL
Page 4 of 4
Revised 5/14/2024

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.
Signature of Financially Responsible Party 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 My Commission Expires
SEAL
Property Owner 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.
9-it;i/C/
ek,wo, )\/ yuk Julfsh; kawa
Signat of Property Owners Type oY Print Name Legibly
JUL /0 2z2,4-
. Date
I, H i Sky° Tw jo a Notary Public of the County of vV
hereby certify that Mori\ot k i wSh i KA wA 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 12 Day of Sul y , 20 Zy-
TAl y u z , z0 z ,
Signature'6f My Commission Expires
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Y O r
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a •NDaa° Page 4 of 4
�n/nu1a1/1N�`�� Revised 5/14/2024