LAND USE Initial Application Date: / " -- i° Application # / 577 Z V I
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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 / (� R 893-2793 www.hamett.org /permits
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ity: • • /ny I /_ -C ' State: /A �^ Zip:6 ?5.7,2 Contact# 717 -- 5?9 -DO7 Email: n
!Ad op n`f '/,i. . _ idailing Address:_ _
City: State! , - Lip: _ . _ - ntact # Email:
'Please fill o` applicant information if different than landowner // // S &9 " ao 7 ,
CONTACT NAME APPLYING IN OFFICE:
/� ((W!!2 Ha// Phone # 9/7 -
PROPERTY LOCATION: Subdivision: ! %n}Gror Y?.a / L S / ('� I. Lot #: / '5 Lot Size:
State Road # L 1 / C State Road Name: 6 b A. /C? Map Book &Page &92
Parcel: 5 DO c (/ S/ PIN: 9 /, - /,,[ I
( - Garik". ao(� � / /
Zoning: I 20 Flood Zone: Watershed: /L/ 4 Deed Book &Page. t / l!/ 7 Power Company`: Gule6 ( ' gl #r
e e : C ,
New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS TO � TH � E / PROPERTY FROM LILLINGTON: c4 W in I n 0' Q In la If, Qk
7a. /h Jp. N /1 LA6+
PRO USE: [�
t' SFD: (Size 2 7 x /,� # Bedrooms: # Baths: I, Basement (w /wo bath): Garage: Deck: Crawl Space: r' Slab:
(Is the bonus room finished? ( ) yes (_)no w/ a closet? (_) yes (_)no (if yes add in with # bedrooms)
❑ Mod: (Size x) it Bedrooms_ # Baths_ Basement (w /wo bath)_ Garage:_ Site Built Deck:_ On Frame_ Off Frame_
(Is the second floor finished? (_) yes (_)no Any other site built additions? (_) yes (_)no
❑ Manufactured Home: _SW _DW TW (Size _x) # Bedrooms: _ Garage: (site built ?_) Deck: (site built ?)
❑ Duplex: (Size _x_) No. Buildings: No. Bedrooms Per Unit:
❑ Home Occupation: # Rooms: Use: Hours of Operation: #Employees:
❑ Addition /Access /'r`�'r'�'er: (Size z_) Use: Closets in addition? (_) yes ( )no
Water Supply: V Cou Existing Well New Well (# of dwellings using well ) 'MUST have operable water before final
Sewage Supply: _ New Tank (Complete Checklist) 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 (_)no
Structures (existing or proposed): Single family dwellings: Manufactured Homes: Other (specify):
Required Residential Property Line Setb Comments:
Front Minimum �� Actual hi 1 1
Rear ___Z __C
Closest Side /
Sidestreet)comer lot
Nearest Building
on same lot
If permits are granted I agree to conform to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
1 hereby state that foregoing statements are u e and correct to the best of my knowledge. Permit subject o r vocation if false information is provided.
6 /a
ignature Owner or Owner's Agent
This application expires 6 months from the initial date if permits have not been issued"
A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION
Residential Land Use Application 1 of 1 03/10
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Charlie T. Carpenter, P.L.S.
PRELIMINARY SITE PLAN FORT
C / Professional Land Surveyor WYNN C ❑NSTRUCTI ❑N
1940 Juniper Church Road •
PIN 9587 -53- 6048.000
C--- Four Oaks, NC 27524 PARCEL ID 039586 0024 51
LOT 13 CAMERON PINES S/D
(919) 963
L 1 PG1002 25 ALBERT NC COURT
(919) 320 -5281 1' =aD
2009/03/19 13:19:11 Harnett County Page:2 /2
NAME:_ APPLICATION #:
*'This application to he 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 mon ths or without expiration
depending upon documentation submitted. (complete site plan = 60 months; complete plat= without expiration)
910 -R93 -7525 option I CONFIRMATION #
0 Environmental Health New Seotic System Code 800
• Place 'Oink 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 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 fines prior to scheduling inspection. 800 -632 -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 recordina for proof of request.
• Use Click2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
❑ Environmental Health Existino 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 it
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 s m type(s): can be ranked in order of preference, must choose one.
{_I Accepted {_} Innovative { onventional (_) Any
(_I 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 answey is "yes ", applicant must attach supporting documentation.
{_ }YES { Dues the site contain any Jurisdictional Wetlands?
{J
_ _// _J NO Du you plan to hove nn irrigation system now or in the future? !! // 99
{ YES (_) Does or will the building contain any ins'? Please explain._IrWG rs 1 'rte
I_1yES I_l yp Are there any existing wells, springs, waterlines or Wastewater Systems on this property?
I —IVES I _1 - Ls any wastewater going to be generated un the site other than domestic sewage?
1_1 YES I_ )Nsp
) NN Ls the site subject to approval by any other Public Agency?
( —)YES {_J NO Are there any easements or Right of Ways on this property?
{_}YES f _ }NO Does the site contain any existing water, cable, phone or underground electric lines?
If yes please call No Cuts at 500 -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 Applitvhle 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 ccessih • So T' •. A Complete Site Evaluation Can Be Performed. I /
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PROPERTY 0 ( NERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) ATE
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WARRANTY DEED
Excise Tax: 5240.00 Recording Time, Book and Par
Tax Map No. 03- 9586-0024-51 72 Parcel Idem;tier No: 03-9506-002454; 03-
x3- 9596 e 631586�ipa2y -3t
Marl alter recording to: Grantee e va
This instrument was prepared by: S. Sa ill -,,/lo at
/ . /Of l �a
THIS DEED m y ot_ b and between
GRANT e •
James Matthews Custom House LLC a North Carolina L Co any
Mailing Address: 782 Peony Road Benson NC 27504
GRANTEE
Wynn Construction, lac. a North Carolina Corporation
2550 Capitol Drive 1
Suite 105
Creedmaor, North Carolina 27522
Property Address: 25 Albert Court, 26 Albert Court, 12 Albert Court and 0 C - • P i es Drive! Lob 13,16,17, & 19
Cameron Pines Subdivision„ NC
Mailing Addrea: 2550 Capitol Drive Suite 105 Creedmoor NC 27522
The designation Grantor and Grantee as used herein shall include said parties, their heir, • . ai:• • s, and shall include
singular, phut, masculine, feminine or neuter as required by context
WITNESSE N, that the Grantor, for a valuable consideration paid by the Grantee, the receipt o . . creby ■ owledged,
has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all • . pa • I of land
and more particularly described as follows:
BEING all of Lot 13, containing 0.347 gems, more or less, Let 16, contaiing 0.378 acres, more or • • • • • 7,
containing 0.347 acre, more or leas, Cameros Pines Sttbdivtston, according to a survey entitled, " . • Pin�r
Subdivision, Surveyed for and Owned by: James Matthews Custom Roma, LLC," by Stanch & Assoc eY don 1
Land Surveyor, P.A., dated November 1, 2006, and recorded November 29, 2007, Is Book or Maps 200 at 7 s I 1 : a
1003, reference to which Is hereby made for • more complete and accurate description.
BRING all of Lot 19 canleining 0.744 acres, more or lent, Cameron Pines Subdivision, according to a survey a ird
Ille .
a. Lots 18 and 19, Cameron Pines Subdivision, Surveyed and Mapped for James Matthews Custom Homes,
• • . & Anodises, Professional Land Surveyor, PS, dated January 18, 2010, and recorded January 15, 2010,
1. : • . o • < 2010, at Page 48, Harnett County Register of Deeds, reference to which is hereby made for a more
le . d se.. rate description.
on . the property hereinabove described was acquired by Grantor by instrument recorded in Book 21 W , Page
1 .. Or County Registry.
A W. 'ngJhe-apov described property is recorded in Plat Book 2007 , Page 1002 -1003 , and referenced within this
inn. �f J J
Does the • • • • • • -• • • • - i Inc' • e the primary residence (yeshio) ? No
TO HAVE I r ' OL a , . of or parcel of land and all privileges and appurtenances theme, belonging to the Grantee
in fee simple.
And the Grantor • - • 4 , t Grantor is seized of the premises in fee simple, has the right to convey the same in
I fee simple, that title i • ` 4 . n • • clear of all encumbrances, and that Grantor will warrant and defend the title against
the Iawttl claims of . i except for the exceptions hereinafter attend.
•
• Title to the properly h �'�y. . - 'bed is • •'ect to the following exceptions:
1. Ad valorem taxes for the . - .10 • . be
2. Easements, restrictions, d is . of io the Harnett County Register of Deeds.
3. Restrictive Covenants of ..- 1 ..t
' at Page 880; and as Amended In Deed Book 2499, et Page 656,
Harnett County Register of • hick Is hereby made ea if fully set forth herein.
IN W117410$S WHEREOF, the Gr . . . a ..1a, Ms hand and seal, or If corporate, bus caused this instruments be
signed b its corporate name by Its .. -. , e), the day and year lint above written.
James Matthaas Custom Homes, L a
Carolina Limited. Liabili • , • • any (SEAL)
r
B (SEAL)
e: Member/Manager CiP
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NORTH CAROLINA �0 v r • '
I, to undersigned Notary Phbli , i J p4 o • s ^ t : •r : e aforesaid.
• certify that :fames Nopines per • • :1 : • • ;r • before me this
day teed at-knowledge/71 that he /She is Mewtbex I • Mfc{li+ew
CALs barns, LLC . a North Carolina L-LC_. au: • : • : • i • .. duly given
and as the act of such entity, he/she signed the foregoing in- • T •t its • ;.. and on its
behalf as its act and deed. Witness my hand and official stamp .. se • n.. the day
of Ap t l , 20 J.Q. .
Natan ublic;Name: 4. nn Seii �.... ,,,'L 1 N", 9�i
My Commission Expires: � �t/3 � N 0
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