LAND USE Initial Application Date: /— Application # / C )
/ /7/ ! ! 7 / 7
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. Front Street, Lillington, NC 27548 Phone: (910) 893 -7525 Fax: ( 910) 893 -2793 www.hamett.org/permits
LANDOWNER: /� yr1 1-; et /.0,/ Mailing Address: H O t') ( A 1-s. 7) / h .A i . ✓ \C.
City 5Ar∎4.0 State: (1 Zip:2 )7ACtontact # \ \ 7741LICg Email: 2'j3
APPLICANT*: (Y1 e r. , 6ci cY if f:3 Mailing Address: 4 0 7 ISS d 1
City: 'An -(01 4.9 State: !`\(. Zip: 273 Contact# ` lS`)ThY ))L Email:
'Please fill out applicant information 9 different Than landowner (� t - 1
t CONTACT NAME APPLYING IN OFFICE: 6' e-n'\ r. „,D es, P hone # � ( 170 0) ) f-,
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PROPERTY LOCATION: Subdivision: L. oat, Y pp -3
/ ti' Lot #: Lot Size: A 4 - 1 C.
State Road # ) ) 0m State Road Name: '7 i ' `c Al 4 \1 Ur �J /I ,�1 ✓4/�{J Map &Page: 2 / , 3
Parcel: !7 15 ,r ( 09/ PIN: 4 / — - //✓ 7 P.90
� '/( L ? < n
Zoning �� lood Zone Watershed: / 77 // Deed Book&Page:2 ).ti9 / L I 3\ 3 (�'Power Company ). -3.AA mils !
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 1 %I ) \ C O.A s\+ .L.e CL o n ev1. , A r Ih v r
2) 1 4,7 M \kes 1 0A. or 6'Q. (4DCACt') r;PCD)
FD: (Size USE:
Cr _
SFD: (Size h 1 1 x.S �) #Bedrooms: ? # Baths: 7 Basement (w /wo bath): (` Garage: + Deck: ':_ Crawl Space:1 °�` Slab:
(Is the bonus room finished? (UA) yes ( )no w/ a closet? (_) yes (_)no (if yes add in with # bedrooms)
❑ Mod: (Size _x_) # 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 /Accessory/Other. (Size _x ) Use: Closets in addition? (_) yes (_)no
Water Supply: ounty Existing Well New Well (# of dwellings using well ) *MUST have operable water before final
Sewage Supply New Septic 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 (V )no
Structures (existing or proposed): Single family dwellings: Manufactured Homes: Other (specify):
Required Residential Pr operty Line Setbacks: Comments:
Front Minimum 34 C. Actual 120
Rear
Closest Side i a ..
Sidestreet/comer lot
Nearest Building
on same lot
If permits are granted I agree to conform to all ordinances laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing slat n re accurate ar c d C fp the best of my knowledge. Permft subject to revocation if false information is provided.
Signature of Owner or wner' 's e DatelAC l
Owner's
"This application expires 6 months from the initial dale 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
06/02/2810 08:56 9197744684 MCSURVEVING PAGE 01
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NAME: APPLICATION #: l 5—v0 24 737
*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
de nding 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 properly.
• Call No Cuts to locate utility lines 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 recordlna 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 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.
{_) Accepted { Innovative { 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 {y[ NO Does the site contain any Jurisdictional Wetlands?
( }YES { O Do you plan to have an is[iP.alion system now or in the future?
{ }YES {{ NO Does or will the building contain any dia' ? Please explain.
I_)YES NO Are there any existing wells, springs, waterlines or Wastewater Systems on this property?
( }YES { ) NO Is any wastewater going to be generated on the site other than domestic sewage?
( }YES {ZO Is the site subject to approval by any other Public Agency?
(_ } YES { O Are there any easements or Right of Ways on this property?
( }YES { } 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.
I Understand That I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site Accessi I o T,, A Complete Site , ' < Can Be Performed.
PROPERTY OWNERS OR OWNE'.. LEGA : ' PRESENTATIVE SIGNATURE (REQUIRED) DATE
5/08
minumme
HARNETT C LINTY TAX ID# FOR F ma w DEED`
owl. slot 2010 AIM
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BK:7159 PG:431433 FEE:$f.00
Mil 131'6' i.1
r1-1- Iu 5 .
This Deed Prepared by Reginald B. Kelly, Attorney at Law
OUT OF PID #: 130509 0019
NO TITLE CERTIFICATION
STATE OF NORTH CAROLINA WARRANTY
COUNTY OF HARNETT DEED
+1 ,�1.
This WARRANTY DEED is made the .day of , 2010,
_
by and between WALDO BUCHANAN and hi�fe, LIDA G BUCHANAN, of
4269 McArthur Road, Broadway, North Carolina 27505 (hereinafter
referred to in the neuter singular as "the Grantor ") and EDWARD
YOUNG FREEMAN and his wife, MINNIE BUCHANAN FREEMAN, of 4017
Carson Drive, Sanford, North Carolina 27330 (hereinafter referred
to in the neuter singular as "the Grantee "):
W I T N E S S E T H:
THAT said Grantor, for valuable consideration, receipt of
which is hereby acknowledged, has given, granted, bargained, sold
and conveyed, and by these presents does hereby give, grant,
bargain, sell and convey unto said Grantee, its heirs, successors,
administrators and assigns, all of that certain piece, parcel or
tract of land situate, lying and being in Upper Little River
Township of said County and State, and more particularly described
as follows:
BEING all of that 1.159 acres as shown on that certain
survey entitled "Recombination Survey for Waldo Buchanan" by
Mike Cain Surveying dated June 8, 2010 and as recorded in Map
Number 2010 -433, Harnett County Registry.
See Book 1303, Page 684 for chain of title.
TO HAVE AND TO HOLD the above- described lands and premises,
together with all appurtenances thereunto belonging or in anywise
appertaining, unto the Grantee, its heirs, successors, adminis-
trators and assigns forever, but subject always, however, to the
limitations set out above.
AND the said Grantor covenants to and with said Grantee, its
heirs, successors, administrators and assigns that it is lawfully
How to Properly Mark Property. for Soil Evaluation
(MUST MATCH SITE PLAN)
•ink flag
i ' n iron
pink flag —► orange flag
+— ink flag
vs.
Legend House
iroP
flag r
range flag"
pink flag
iron �� iron
ROAD