LAND USE Ini;Al Applicaion Date: Lo • — I 0 Application # / ,512 o 2 J 171
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting �108�E..'""v Front Street,
t, Street, 1 ", "-y- -tnnn, NC27 Phone: ( � 910) 893 -7525 Fay: (910) 893 -2793 www.harnen.org /permits
LANDOWNER: ( `" j �' E •• Land C 2 �"" e � ., ' G - wlallln9 EXeC.U,'kive -Place Slit City: Fa tltville State: MC Zip:2%3b6 Home #: Contact #: L itt"' 050:
• APPLICANT':CoviresS Land Development Mailing Address:toJI Efkalt •1Iic. 'Place Sake 403
City: FaleMevilte State:14C 71p:23305 Home #: Contact #: p (>503
'Please fill out applicant Inlormation if different than landowner 0401 o
CONTACT NAME APPLYING IN OFFICE: �-'^IdLX,.Y,.7l� �b�K�V . Phone #: 4 D 1 p - 050'5
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PROPERTY LOCATION: Subdivision w /phase or section: NICCI p uGVI t CC) Lot #: 11 Q Lot Acreage: ,Q
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State Road #: 11 t l State Road Name: Map Book &Page: 2001/ 9 T
Parcel:: O�1 ? S cC7(o ooa% alt P : n5n(O- S5 `' -k'5 t)
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Zoning:RA' Tog Flood Zone: MI a, Watershed: N Q. Deed Book &Page: Q 2 t 89/0539 Power Company': 612
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New homes with Progress Energy as service provider need to supply premise number tram Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
See t s-_ iS
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PROPOSED 0 9 : � ( F p - 9 n Circle:
O SFD (Size A ft +S x . Jf1) # Bedrooms 1 4' # Baths 5 Basement (w /wo bath) 14,A. Garage le s Deck n10._ ._ Crawl Space 3
(Is the bonus room finished? w/ a closet if so add in with # bedrooms)
O Mod (Size _x_) # Bedrooms_ # Baths Basement (w /wo bath) Garage Site Built Deck ON Frame / OFF
(Is the second floor finished? Any other site built additions?
• ❑ Manufactured Home: SW DW TW (Size x ) # Bedrooms • Garage (site built? ) Deck (site built? )
O Duplex (Size x ) No. Buildings No. Bedrooms/Unit
O Home Occupation # Rooms Use Hours of Operation: #Employees
O Addition/Accessory/Other (Size x ) Use Closets in addition( )yes (_)no
Water Supply: (A County Li Well (No. dwellings ) MUST have operable water belore final
Sewage Supply: W New Septic Tank (Complete Checklist) Li Existing Septic Tank (Complete Checklist) ( )County Sewer
Property owner of this tract of land own land that contains a manufactured home w /in five hundred feet (5001 of tract listed above? ( (%NO
Structures (existing & proposed): Stick Built/Modular Manufactured Homes Other (specify)
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual 310
Rear S1 LI 1
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Closest Side 1 O 4" r
Sidestreet /corner lot
Nearest Building
on same lot
If permits are granted I agree to conform to all ordinances and laws of the Stale of North Carolina regulating such work and the specifications of plans submined.
I hereby slate that foregoi sslements are accurate and correct to the best of my knowledge. Permit subject subje to revocation if false information is provided.
Signature of Owner or Owner's Agent Date
"This application expires 6 months from the initial date If no permits have been Issued*'
A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION
Please use Blue or Black Ink ONLY
LAND USE 5/09
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Southeastern Soil & Environmental Associates, Inc.
P.O. Box 9321
Fayetteville, NC 28311
Phone/Fax (910) 822.4540
Email mikeOsoutheastemeoil.com y° .1 f (,
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SOIL/SITE EVALUATION • SOIL PHYSICAL ANALYSIS • LAND USE/SUBDIVI.SIONPLANNING
GROUNDWATER DRAINAGE/MOUNDING • SURFACE/SUBSURFACE WASTE TREATMENT SYSTEMS. EVALUATION & DESIGN
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Driving Directions from 108 E Front St Lillington, North Carolina to 252 Kimbrough Dr ... Page 1 of 1
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401 108 E Front St Edit
Lillington, NC 27546-6683
1. Start out going EAST on E FRONT
ST toward S 2ND ST/2ND ST. 0.1 mi
Turn RIGHT onto S 2ND ST/2ND
2. 02 mi
ST.
3, Turn RIGHT onto E KILLIEGREY
ST 0.2 mi
, i403 4. 4 T o u i rn mi L c E . F 2 T th o iN nt e o - S 27 MAIN ST/US-
0.2 mi
Turn RIGHT onto W OLD RD/NC-27
el 5. W/NC-27. Continue to follow NC-27 8.9 mi
W/NC-27.
6. Turn LEFT onto NURSERY RD. 2.8 mi
7. Turn LEFT onto WOOD POINT DR. 0.3 mi
\S/ 8. Turn RIGHT onto KIMBROUGH DR. 0.1 mi
C3 9 252 KIMBROUGH DR is on the
LEFT.
4CI 252 Kimbrough Dr Edit
Lillington, NC 27546
http://www.mapquest.com/maps?1 c=Lillington&1 s=NC&1 a=108+E+Front+St&1 z=27546-... 6/4/2010
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FOR R r 7N 8M I ER CC D[FD6
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; dip _ �„ - RHO PG:539-611 FEE:,S22.00
II II _ NC REV STRIF:$150.80
ifrr 11�1 1¢Hj ,;�s11449
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5, GENERAL. WARRANTY DEED
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Excise Tax:3150.00
Tax Parcel ID No. ebe Verified by County
on the _ _ day of l By:
Mat/Box to: Lewis. Deese & Nance. , P. ( 330 lteville, NC 28301
This Instrument was prepared by: Riche • M ;a, r. LDN File No: 09RE- 21899C
Brief description for the Index Lots 176. 1; ; 18: oodshlre. - ,.,.= Five
THIS DEED, made this the 20th day of February, 2009, ' : nd_ t • GRANTOR: ,14.4 I' ,„ . - . I.. _ _ :.: r,1L .. :. a :1, a nr n
whose address is: 2819 Breezewood Ave., Su' _ ' O,' V'' Ills C 28303
t (herein referred to collectively as Grantor) and
. 1 GRANTEE: _: 131_ ,s _. • • • q 1 ., Rd ... > a • it _ t ,�!J!i2 i• •r
whose address is: 838 Executive Place, Suke 400, Fay: : : , 5
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(herein referred to collectively as Grantee)
WITNESSETH•
For valuable consideration from Grantee to Grantor, the receipt and �e' hi • Is hereby acknowledged,
Grantor hereby gives, grants, bargains, sells and conveys unto Grant - �- si - . .•'ect to the Exceptions and
Reservations hereinafter provided, if any, the following described prop : • - e • unty of Harnett, State of
i North Carolina, more particularly described es follows:
BEING all of Lots 176,187 and 188 In a Subdivision known as WOODS • • , as shown on plat of
i V same duly recorded In Map Number 2007-948, Harnett County Registry, „
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1 Said property having been previously conveyed to Grantor by instrument(s) recorded in Book .c 1 - - 210 and
being reflected on plats) recorded in Map Number 2007 -948.
4111
Revised October 1, 2008
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NAME:CAVIf1t55 Loll[ pflrien APPLICATION #:
*This application to be filled out when applying for a septic system inspection."
County Health Department Application for Improvement Permit and/or Authorization to Construct
IF THE INFORMATION IN THIS APPLICATION IS FALSIFIED, CHANGED, OR THE SITE IS ALTERED, THEN THE IMPROVEMENT
PERMIT OR AUTHORIZATION TO CONSTRUCT SHALL BECOME INVALID. The permit is valid for either 60 months or without expiration
depending upon documentation submitted. (complete site plan = 60 months; complete plat = without expiration)
. 910 - 893 - 7525 option I CONFIRMATION #
A Environmental Health New Septic System Code 800
• Place "pink property flags" on each corner iron of lot. All property lines must be clearly flagged approximately
every 50 feet between corners.
• Place "orange house comer flags" at each corner of the proposed structure. Also flag driveways, garages, decks,
out buildings, swimming pools, etc. Place flags per site plan developed aVfor Central Permitting.
• Place orange Environmental Health card in location that is easily viewed from road to assist in locating property.
• If property Is thickly wooded, Environmental Health requires that you clean out the undergrowth to allow the soil
evaluation to be performed. Inspectors should be able to walk freely around site. Do not grade property.
• Call No Cuts to locate utility lines prior to scheduling inspection. 800 -692 -4949 (This is a free service)
• After preparing proposed site call the voice permitting system at 910 -893 -7525 option 1 to schedule and use code
800 (after selecting notification permit if multiple permits exist) for Environmental Health inspection. Please note
confirmation number given at end of recording for proof of request,
• Use Click2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
❑ Environmental Health Existing Tank Inspections Code 800
• Follow above instructions for placing flags and card on property.
• Prepare for inspection by removing soli over door as diagram indicates. Loosen trap door cover. (Unless
inspection is for a septic tank in a mobile home park)
• After preparing trapdoor call the voice permitting system at 910-893-7525 option 1 & select notification permit if
multiple permits, then use code 800 for Environmental Health inspection. Please note confirmation number
given at end of recording for proof of request.
• Use Click2Gov or IVR to hear results. Once approved, proceed to Central Permitting for remaining permits.
SEPTIC
If applying for authorization to construct please indicate desired system type(s): can be ranked in order of preference, must choose one.
f Accepted {_) Innovative lYI Conventional ( Any
1_) Alternative f_J Other
The applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in
question. If the answer is "yes ", applicant must attach supporting documentation.
{_IYES {X) NO Does the site contain any Jurisdictional Wetlands?
{_IYES (X) NO Do you plan to have an irrieation system now or in the future?
{_)YES (.) NO Does or will the building contain any inning? Please explain.
I — IYES NO NO Arc there any existing wells, springs, waterlines or Wastewater Systems on this property?
{_IVES f X) NO Is any wastewater going to be generated on the site other than domestic sewage?
f_) YES l v NO Is the site subject to approval by any other Public Agency? •
{_I YES ILy NO Are there any easements or Right of Ways on this property?
I_I YES (r1 NO Does the site contain any existing water, cable, phone or underground electric lines?
If yes please call No Cuts at 800-632-4949 to locate the lines. This is a free service.
I Have Read This Application And Certify That The Information Provided Herein Is True, Complete And Correct. Authorized County And
State Officials Are Granted Right Of Entry To Conduct Necessary Inspections To Determine Compliance With Applicable Laws And Rules.
1 Understand That I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site Accessible So That A Complete Si valuation Can Be Performed.
PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE
5/08