ENVH REFUND1
NORTH CARETNA
Account Number:
Project Number:
Vendor Name:
Vendor Number:
Remittance Address:
Date 03 -04 -14
110 - 0000 - 345.18 -00
John Benson
46 Sherman Pines Drive
Fuquay Varina, NC 27526
❑X Mail to payee
Check to be picked up by:
(Requires approval of Finance Officer)
Approved: Disapproved:
Reason for check request: Duplicate fee for ENVH Existing Tank Permit included and charged in error when
customer applied for building permits at Central Permitting under app. # 14 -5- 32958.
Was previously assigned app # 13- 5- 326108 in which the permit for an Exisiting Tank
was issued and paid for.
This check request has been examined by me and is hereby approved for payment.
Department Head or Authorized Designee Date
l
Graham H. Byrd, R.E.H.S.
ThJs'Wf�,.n4e,t has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director
Description
Amount
Existing Tank Fee
$ 100.00
Location: 46 Sherman Pines Drive
Lt. 20 Sherman Pines
Total Amount Due
$ 100.00
Reason for check request: Duplicate fee for ENVH Existing Tank Permit included and charged in error when
customer applied for building permits at Central Permitting under app. # 14 -5- 32958.
Was previously assigned app # 13- 5- 326108 in which the permit for an Exisiting Tank
was issued and paid for.
This check request has been examined by me and is hereby approved for payment.
Department Head or Authorized Designee Date
l
Graham H. Byrd, R.E.H.S.
ThJs'Wf�,.n4e,t has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director
Initial Appffcatlon pater �.. Application # R500 i 5 00 3 O'er
IL
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893 -7525 ext:2 Fax: 8t F,oh metttor
"A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) & SITE PLAN ARE REQUIRED WHEN 6B T APP LICATI
LANDOWNER: ��tt Mailing Address: L, (2 bC
�r e+,c p ,• as _
City: Cur W4 �c.... a Statwtj r- zip:�7 JXContact No: Email: _ Aalia- t..,s.o +: ia~ eP
APPLICANT': Mailing Address:
City: State: Zip: Contact No:
`Please fill out applicant information if different then landowner
Email:
CONTACT NAME APPLYING IN OFFICE:_ 1e \111. g c r, A pb- Phone # j 1 .R - 6 L 0 - $r 00
PROPERTY LOCATION: Subdivision: i,es n. .. i r.B i Lot #:Q Lot Size: I
State Road # y {fr Stcate Road Name: _ �•e r N,.L ; .. 1 ill r Map Book & Papg�e.C�-�l"
Parcel: �J PIN: r)AL -1 - S �•i ��0 ' C OLS
Zonin Flood Zone:„` Watershed: deed Book & Pagd• -� +� Power Company':
'New structures with Progress Energy as service provider need to supply premise number from Progress Enen,
PROPOSED USE:
❑ SFD: (Size x �) # Bedrooms:,,•_ # Baths: Basement(w /wo bath):_ Garage:_ Deck:_ Crawl Space:____ Slab
(Is the bonus room finished? (_j yes L_) no wl a closet? (__,_) yes (_) no (if yes add in with # bedrooms)
❑ Mod: (Size x ) # Bedrooms # Baths,•,_,_., Basement (wlwo bath)_____ Garage:,.,_,_ Site Built Deck:_ On Frame_ Off
(Is the second floor finished? (,) yes (•••_) no Any other site built additions? (,__) yes no
❑ Manufactured Home; „,,,_ SW ,rDW _TW (Size x,,•• ___) # Bedrooms:....,_ Garage :(site built ?•`•,•_„) Deck:_(site built?
❑ Duplex: (Size x ) No. Buildings: No. Bedrooms Per Unit:
❑ Home Occupation; # Rooms: jw: - Hours of Operation:
`CA AddftianfAcrassory/Other. (S e,3kx•�} Use: ® ,o Closets in addition? Oyes
O Y4 th 1 N "'t"4.t
Water Supply: Y / County Existing Well ^_New Well (# of dwellings using1 welt ) "Must have operable water before fir
Sewage Supply: New Septic Tank (Complete Checklist) -V�f Existing Septic Tank (Complete Checklist) County Sewer
Does owner of this tract of land, own land that contains a manufactured home within five hundred feet (500') of tract listed above? (_••,:) yes (eIn
Does the property contain any easements whether underground or overhead (__•_) yes (,) no
Structures (existing or proposed): Single family dwellings: Manufactured Homes: Other (specify):
c . C- -A (.'1 �, \ :.
Required Residential Property Line Setbacks: Comments:..
Front Minimum Actual ,.;�,S
Rear 15y
Closest Side,,,,_
Sidestreettcomer lot ` '-7\ ..
Nearest' Building �,Q _ O r�
on same lot' Residential Land Use Application Page 1 of 2 � F r J�— t
'0311
APPLICATION CONTINUES ON BACK
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BP200I08 Harnett County
Application Receipts Inquiry
Application number. . . . . 14 500:32958
Property . . . . . . . . . : 46 SI-IERMAN PINES DR
Cashier . . . . . . . . . . VBROWN
Receipt number, date, time. 0242531 2/28/14
Payment amount, type . . . $565.00 CP IU1LDING PERMIT PYWI'S
Check number . . . . . . . 000000000
Fee
000
Cls
Type
Amt paid
A
RR
0
A
SE
100.00
P
PF
000
P
PF
60.00
P
PF
55.00
P
PF
25.00
P
PF
75.00
P
PF
50.00
Credited amt
.00
.00
.00
.00
.00
_00
.00
.00
Press Enter to continue.
F3 =Exit F12 =Cancel
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i�l't' 4
Structure Permit Inspection
000
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CPER
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CPIR
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CPMR
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CPPR
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401"" I
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3/03/14
09:43:08
08
Bottom
e� IaVik
Signature of Environmental Health Specialist
Date