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COUNTY OP HMNerr RESDOmML LAND USN APPLICATION cut /
Cans Psnn9dnp 109 E. From Sire* UttrngM, IC 27541 Phan (910) 9907525 Fax: (910) 990 ss.w
2799 www.hwnywnnr
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LA NOOwPwR: 4 e,/ �SoYle3 !'ravJ T x f4 Co 4PAMIng Amass: 24 e l. Coa rt4 - /'.f LA
cny: e ? rdo,o1 wo.lr st.b:!`!C Z - lSofHorne t. "t-1 C I Comm it: 6 146 - k-t q t- 3 5 i ;
APPLICANT: SA WI -t_ Maine Address: N n q_ 7 7 D - 54 9 e
City: Stab: Zhc Home t Contact t
'NEON a1 out Applicant inlanraan d dewed than landsman
CONTACT NAME APPLYING IN OPPICE: 5 A 01 -� Phone t
PROPERTY LOCATION: Subdivision orphan or secden: /ALAsow! 6 emthz s '0.1 Lot t 1- Lot Acmes: 5. 0 0
Stab Road It Il t 5 stab Road Niro: 91 o S5 £,1„ P\ TS Tel ti-.{ g n
�n Map BaohaPeps: zoos / 5q
Mom* O3c S P9 Oto`( 02 PIN: 95 f en - S a t - %- B. UUG
Zoning: 1 R0 - 10 2 Flood Zane )( Marsh* 114 Deed BoorBPapw 2 °44 / 9 Ia ( Pose Candpry:
lbw hams wOh Preplan Enna es eavkr provide. mod b awl" limbo nurnbor ham Prowess Emory.
OPepf C o1ReUTIONS TO TM PROPERTY PROM ULNNGTCI S v 0 all a cv v1 't Z 1 +o r d u
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PROPOSED USE:
Char
O SFD (SW A ) Si Sadism*_ 0 Baths_ Basonae Woo SOS _ Grope Ddb Crab Span / Sib
(Is Its banes mom IhiNed9 W • ebeet d so add In nth // bedroom)
O Mad (Su _ s ) s Bedrooms_ It Mho_ Bssanaa hMwo bdq _ Oanspe Mb Bull Dedr ON F,SItS / OFF
lb dts mood Ilea Nihdl My other Ste bldt drone )
o Maadearnd Hams: _ SW _OW ,_TW (Stse x ) 0 Bedpan _ Obey (sets bra) Ds* (ate b a,_)
o Dan (Bbe _y_j W. Dulles Na Beboarol k*
O Home Oooug4m a Ibom9_,Uw Hale a Comer SEmpbYwb
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Mar Supple W1 'm b L4 Ws0 oar. d it. 9e1e9rraarrww amble war below Ind
Sows Supply: LJ Now Sao Twd Cl.._ (41.dang Sept Tank (Canna astral) L_1Caww
pmpabauroral this not al Ord ONG Sid IhnlsontsIns a mandistind homy Ma Ike hunted fat MOM ei Not Isisi above LJYd l itilir
Sures (Saha A pews* Wok Bdkwhbdlr IWr MaaaaSHann o0rppmdy) 1EX T5104 - 44. 4
Rrg9MadRUldanaul Property UnsSet Coaeml* fry` 4 S k /ILO 4 Co,.tfT .'crass wjo PAa Ott I'S „T./ - db7l
Front 9Eldanms 3 5 Aabal 2' S , Cv tr° •-k c..z u.;.... CA Plc r . ;'t c 7 'tic 4- Par-, -r 5 `�
Rnr ZS 100 i.1 - -i -,, . ,. ',:: 0 0 2 g6
MANI Skis 10 ILA
9kisstrosteco r lot Z_
Noway Building Co Coo
on some ha
II moms we wanted 1 awes to =dorm to ail adnsnces and lase a dm Stan of North Combo rewi9np adin war and de spscIIeadae el phew abnIISAt
I booby age that lapp steals am soma se to II* amid te bee d my hnobd h rs
pe. Pen sunned lo wc d tabs Mammon moo bs mon Is provided.
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Slpnawe ol Owner or Own ev s Aiwa Dab
*MS s_,,t can expires 9 monde how be WITS deb B no pasrhs haw bean (nus •
A sE00rW sues YAP. RECOIIOW MED (OR OPP61 TO PURCHASE) NO PLAT A/W tlnataNED WW1 APPLIAO FOR LAID UM AFPUCATION
Please use Oka a Black Ink ONLY
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NORTH CAROLINA GENERAL WARRANTY DEED
Parcel Identifier No. part of 03 -9564 -0107
Mail after recording to L. Holt Pelmet, P. 0. Box 1609
Lillington, NC 27546
This inatrwnent web prepared by L.. Holt rslmet with HD TSAR Can1'rnICATIOH
Brief Description for the 5 B .O a :eaa R Sans *Weill Hein,
THIS DEED made this January 26, 2005, by and between
8
nrrrr sus Ife1BZLL GRAY end husband, LES MY GRAYI
ICY LIB Nib, unmarried: MARY ALICE Net 68082, widow,
MILDRan HALL B726msr and husband, JOB Hiewl'1
m av HO M LL azaacc= and husband, ALL111 f1 RasOBCR
JILL 6. MVO and husband, MW C. STORM CASON !
PA TER80N and husband, meow BRIAN PATTBBBONI and
TRAVIS LTWI MURRILL, single
3154 Rosser Pith= Road
Hroadaay, IIC 27505
Chang RILL PAYTERBON and husband,
MRCP BRIAN PATTBRa@i
106 COtmtry Lane
Broedwey, NC 27505
The designation Grantor and Grantee as used herein shall include said
parties, their heirs, succeeeore, and assigns, and shall'includa singular,
plural, masculine, feminine or neuter ae required by rfontext.
RITNFSSHLH, that the Grantor, for a valuable consideration paid by the
Grantee, the receipt of which 1s hereby acknowledged, has and by these
presents
all that certain lot to, or parcel of land situated in the City of N /A,
Barbecue Toimahip, Harnett County, North Carolina andj more particularly
described as follows:
All of that certain part and parcel of len 5.00
acres, more or less, located in Barbecue P, Harnett lying ba the sou t of Reeser
Finns% tenctle oad g (NCBR 1215) as as shown Apostles! carp of survey dated
December 22, 2004, by Thomas J. Matthews, Professional Lead
Surveyor, and recorded as lap No. 2005 -59 in the Harnett Comity
Registry and being described by metes and bound% as follows,
0zonar a at an existing iron ;dye located at the point where
the western line of that parcel conveyed to J113 S. stone by
Deed recorded at Hook 2006, Pages 645 -650, *matt Monty
NAME: 1J E-50 , - 1 (1) ATkBa-Sc 1 APPLICATION #: ID-S 21/44 (00c1
•Thb application to be tiled out when applying for ■ senile system Inspection.•
County Health Department AnDUcation for Improvement Permit and/or Authorization to Constru“
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 # 10c) Co 9 5
❑ gnvlronmenbl Health New Septic Syste/jCode 800
• All orooerty Irons must be made visibly. Place 'pink properly flags' on each comer iron of lot. All property
lines must be clearly flagged approximately every 50 feet between corners.
• Place 'orange house comer flags' at each comer of the proposed structure. Also flag driveways, garages, dada,
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 San out the onstgmezah to allow the sod
evaluation to be performed. Inspectors should be able to walk freely around site. Do not grade property.
• 41? lob to be addressed within 10 business days after confnnatfon. 525.00 Tatum bin fee may be incunsq
for failure to uncover outlet 114 mark house corners and property lines. etc. once lot confirmed ready,
• After preparing proposed site call the voce permitting system at 910-893-7525 option 1 to schedule and use code
800 (after selecting notg(oetlen permit (l maniple permits exist) for Environmental Health Inspection. Please note
conflrnlation number given at end of recordinv far proof of reauet ' • 1.
• Use CIIck2Gov a IVR to vertfy. results. Once approved, proceed to Central Permitting for permits.
Environmental Health E dstInA Tank lnsncBonlj Code; 800
• • Fdlow above instructions far pladng,flegs and cad on proper*
• Prepare fd . Inepedpin; by'retnoving• soli Over outlet end of tank as diagram Indicates, and lift lid straight up (1
possible) and then dose back down.(Unleea Inspection is for a septic tank In a mobile home park)
• After uncovering outlet end cab the voice permitting system at 910 - 893 -7525 option 1 8 select notification permit if
multiple permits, then use code 800 for Environmental Health Inspection. Please note confirmation number Given
at end of recordinO for Groot o► reauGM.
• Use Ciick2Gov or IVR to hear results. Once approved, proceed to Central Permitting for remaining permits.
SEPTIC
applying for authorization to mistrust please indicate desired system type(s): can be ranked in order of preference, must choose one.
LI • epted (_} Innovative L} Conventional Any
- r • ( ) Other
The applicant shall no' - local health deparbnent upon - • —• of this application if any of the folio apply to the
question. If the amass, is , applicant MUST ATTAC ' ' PORTING DOCUMENTATION:
8 Y property in
(_} YES LI NO Does the site .. • • ad dicttioansl Wetlands
(_) YES (_) NO Do you plan , :..ve:.. .. . . now or in thefnum?
(_I YES L} NO Dom . 1 the building con ..• • • • *g}pg? Please mcpbb.
( YES ( NO • - there any existing welt, springs, • • ince or Wastewater Systems on thla property?
L) YES (_.) .: Is any watewatet going to be generated on the . p - than domestic sewage?
(_) YES _} NO Is the site subject to approval by any other Public A:i..
{ ' S {_) NO Are them any easements or Right of Ways on this property?
L I YES L} NO Does the site contain any existing water, cable, phone or underground electric lines?
If yea please call No Cuts at 800 - 6324949 to locate the lines. 'lids 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 Crated Right Of Entry To Conduct Necenary Inspections To Determine Complaace With Applicable Laws And Ruler.
1 Understand That 1 Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corner And Making
The Site Accessible So That Complete te Evaluation Can Be Performed.
P OPERTY OWNERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE
5/08