LAND USE r In.�i itial Iicatlon Date: 1 Q1
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. �
Front Street, Lillington, NC 27546 � Phone: (910) 893 - 7525 Fax: (910) 893 -2793 www.harnetl.org/permits
` - LANDOWNER:CQIIIN l _ _► TXVe1Opr a 1 n + Mailing Address:GO EYt0.�41VC a t au* "Ro
Cit FQ1etkt.v111e. , # IC., State: NC zip:213O5 Home #: I _yy - a, E)L Contact #: Lit. DSO?,
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• APPLICANQVineSS La men Mailing Address: L # €C ssl•�, !lace �, 1 S411t 4
Cit Faleke.vi1le. state:14C Zip:2S305 Home #: Contact #: 49.t 0503
'Please 1111 out applicant information If different than 1_// - (L laa 1 ndowner
CONTACT NAME APPLYING IN OFFICE: V I neSS \le Ina L T
oJ. Phone #: 4S I ' 0%0
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., `` 1 1 ^ 1 � , Lot #: Ill � Lot Acreage: �
PROPERTY LOCATION: Subdivision w/phase o ` �L C.71.� 7 1 ^ 5
State Road #: 1II 1 -- 1 State Road Name: (\ r ems,. 1�S$(„d, p � — 4{ WA , 1 Map pB Bo L okk &Page: tool, qq p
Parcel: O )(af(D WO,D 110 'IN: O b(0 8c 1- q
Zoning: :A - � ^ Flood Zone:NI Q Watershed: 141 Q. Deed Book &Page:o2 /08 / Power Company':514EµG
'New homes with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
(262) fl tlari Qrt)
PROPOSED US � E E :: ,� ' 1� �.{ Circle:
❑ SFD (Size,L_x 5 1 ) 11 Bedrooms T # Baths � % Basement (w /wo bath) 141 Q. Garage UeS Deck n/O..p Crawl Space
(Is the bonus room finished ? w/ a closet If so add In with # bedrooms) 1
❑ Mod (Size _ x 1 # Bedrooms # Baths Basement (w/wo bath) _ Garage Site Built Deck ON Frame / OFF
(Is the second floor finished ? Any other site built additions? )
• O Manufactured Home: _ SW _ DW _ TW (Size _ x ) # Bedrooms • Garage _ (site built? ) Deck (site bulk? 1
❑ Duplex (Size _ x ) No. Buildings No. Bedrooms /Unit
❑ Home Occupation # Rooms Use Hours of Operation: #Employees
❑ Addition/Accessory/Other (Size _ x ) Use Closets in additionUyes Uno
Water Supply: (4) County U Well (No. dwellings ) MUST have operable water before final
Sewage Supply: ($) New Septic Tank (Complete Checklist) U Existing Septic Tank (Complete Checklist) (___)County Sewer
Properly owner of This tract of land own land that contains a manufactured home wan five hundred feet (500') of tract listed above? (_DYES , ( NO
Structures (existing & proposed): Stick Built/Modular Manufactured Homes Other (specify)
Required Residential Property Line Setbacks: s Comments:
/SCI
Front Minimum .3s Actual ...ss 1 1 .3 1
Rear . 44.4 •
Closest Side
_LO J1.%-
Sidestreet/comer 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 submitted.
I hereby state that foregoi swemenis area accurate and correct to the best of my knowledge. Permit subject to revocation if false Information Is provided.
I g 4 e l - 1 -0
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 5/08
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GENERAL WARRANTY DEED
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Excise Tax:$180.00
Tax Parcel ID No. Verified by County
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1 MaUlBox to: J.ewis. Deese & Nance. L. biat ee ttevIlle. NC 28301
This Instrument vies prepared by: Riche M WS. LDN File No: 09RE- 218990
i Brief description for the Index: Lots 176. 1 18 oodshlre. - - =_ Five
THIS DEED, made this the 20th day of February, 2009, • : nd • :_
GRANTOR: , • 4.f.. : • :.: r.. : - -- , •.., ..rz. FAIL ' 1> il:T _1-! i+ • i •_:
whose address is: 2919 Breezewwood Ave., Suit I • ' C 28303
(herein referred to collectively as Grantor) and
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3 GRANTEE: :. • 4 a •r .• LI 6 _ . • a • • r: is
1 whose address it 639 Executive Place, Suite 400, Fa :.i:E- r 5
«twain referred to collectively as Grantee)
j WITNESSETH
For valuable consideration from Grantee to Grantor, the receipt and : i , ay . i'' h • Is hereby acknowledged,
Grantor hereby gives, grants, bargains, sells and conveys unto Gra - si • _ . • ject to the Exceptions and
Reservations hereinafter provided, if any, the following described prope r, le : • : aunty of Harnett, State of
I North Carolina, more particularly deeolbed es follows:
1 BEING all of Lots 178,187 and 188 in a Subdivision known as WOODS ! -• - • , as shown on plat of
same duly recorded In Map Number 2007-948, Harnett County Registry,
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Said property having been previously conveyed to Grantor by instrument(e) recorded In Book c 1 , •- rc10 , and
being reflected on plat(s) recorded in Map Number 2007 -948.
Revised October 1, 2008 .
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Driving Directions from 108 E Front St Lillington, North Carolina to 165 Kimbrough Dr ... Page 1 of 1
`x
108E Front StEdit
Lillington, NC 27546 -6683
Start out going EAST on E FRONT
�' ST toward S 2ND ST /2ND ST. 0.1 mi
2 Turn RIGHT onto S 2ND ST /2ND
ST. 0.2 mi
Turn RIGHT onto E KILLIEGREY
3. ST. 0.2 mi
rn T
hf '40 4. 40 1 / NC- 2101NC -27 S2 MAIN ST /US-
. 0.2 mi
Turn RIGHT onto W OLD RD /NC -27
®
' 5. W /NC -27. Continue to follow NC -27 8.9 mi
W /NC -27.
rhj 6. Turn LEFT onto NURSERY RD. 2.8 mi
4 7. Turn LEFT onto WOOD POINT DR. 0.3 mi
8. Turn RIGHT onto KIMBROUGH DR. 0.2 mi
9. 165 KIMBROUGH DR is on the
RIGHT.
a 165 Kimbrough DrEdit
Lillington, NC 27546
http: / /www.mapquest.com/maps? 1 c= Lillington& i s =NC& 1 a= 108 +E +Front +St& 1 z= 27546 -... 6/4/2010
•
NAME:e V(f1Y �€I Ctbplrtbl APPLICATION #: I ,
*This application to be tilled 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 1 CONFIRMATION #
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 corner flags" at each corner of the proposed structure. Also flag driveways, garages, decks,
out buildings, swimming pools, etc. Place flags per site plan developed at/for 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 schedulfna inspection. 800 -632 -4949 (This is a free servlcel
• 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 CIIck2Gov 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 soil 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.
(_J Accepted (_) Innovative ($J Conventional (_) Any
(_) Alternative (_) 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.
(_)YES (p) NO Does the site contain any Jurisdictional Wetlands?
(_)YES (X) NO Do you plan to have an lineation system now or in the future?
(_)YES (x) NO Does or will the building ma
contain any y? Please explain.
I — DYES IX) NO Are there any existing wells, springs, waterlines or Wastewater Systems on this property?
(_)YES IN NO Is any wastewater going to be generated on the site other than domestic sewage?
(_J YES f v X NO is the site subject to approval. by any other Public Agency?
(_J YES (X4 NO Are there any easements or Right of Ways on this property?
(_DYES ( 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.
1 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 *nation Can Be Performed.
10 7-lb
PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE
5/08