ENVH REFUNDe
NORTH CAROLINA
Account Number:
Project Number:
Vendor Name:
Vendor Number:
Remittance Address:
Date : June 4, 2014
Multi
110 - 0000 - 345.18 -00
Larry Cameron
104 Hodges Avenue
Dunn, NC 28334
Mail to payee
Check to be picked up by:
(Requires approval of Finance Officer)
Approved: Disapproved:
Reason for check request: Area is being serviced by public sewer.
This check request has been examined by me and is hereby approved for payment.
Department Head or Authorized Desi nee }� %
Graham H. Byrd, R.E.H.S. /' G n //- '�;
i . strument has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director
Date
Description
Amount
Soil Evaluation Fee
$ 750.00
Application: #14 -5 -33589
Location: Titan Roberts Road, Lot 8
Total Amount Due
$ 750.00
Reason for check request: Area is being serviced by public sewer.
This check request has been examined by me and is hereby approved for payment.
Department Head or Authorized Desi nee }� %
Graham H. Byrd, R.E.H.S. /' G n //- '�;
i . strument has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director
Date
Initial Application Date: Application # ✓ .+F 5 CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 10$ E. Front Street, Lillington, NC 27546 Phone: (910) 893 -7525 ext2 Fax: (910) 893 -2793 www.harnett.orglpermits
"A RECORDED SURVEY MAP, RECORDED DEED (OR 6FFER TO PURCHASE) & SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION`
LANDOWNER4,24rni Mailing Address:�p_g
City: J, State:lyc Zip: Contact No: Email:
APPLICANT *: t2 o,., 6r1d%- Mailing Address: Ir Y GAS -
City- -- I[aY t State _ Zip: Contact No: Email:
*Please fill out app[icant information ff different than landowner
CONTACT NAME APPLYING IN OFFICE: Phone #
PROPERTY LOCATION: Subdivision: Lot #: Lot Site:
State Road #_
Parcel:
Zoning
W-6
'New structures with Progress Energy as service provider need to supply premise number
from Progress Energy,
PROPOSED USE:
Monolithic
❑ SFD: (Size x } # Bedrooms:_ # Baths: ' Basement(w/wo bath):_ Garage:___,_ Deck:, Crawl Space:____ Slab:_ Slab:_
(Is the Cronus room finished? (,) yes (_) no w/ a closet? (_) yes (_) no (if yes add in with # bedrooms)
❑ Mod: (Size x ) # Bedrooms_ # Baths_ Basement (w /wo bath)____„ Garage: Built Deck:_ On Frame_ Off Frame„_
(Is the second floor finished? (_) yes (___) no Any other site built additions? (_) yes (_) no
CI Manufactured Home: _SW ,_,_,DW ,rTW (Size x ) # Bedrooms: Garage:_(site built?_) Deck :_(sfte built? )
D Duplex: (Size x ) No. Buildings: No. Bedrooms Per Unit:
❑ Home Occupation: # Rooms: Use: _'Hours of Operation: #Employees:
❑ Add ition /Accessory /Other: (Size Lox l Use +�7`J``!!�I f Closets in addition? (_) yes ( —) no
Water Supply: ounty ._ Existing Well New Well (# of dwellings using welt ) `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 it undred feet (500') of tract listed above? (_) yes _) no
Does the property contain any easements whether underground or overhead ( yes (__) no
Structures (existing or proposed): Single family dwellings: Manufactured Homes: Other (specify):
Required Residential Property Line Setbacks:
Front Minimum Actual
Rear
Closest Side
Sidestreet/corner lot
Nearest Building
on same lot
Residential Land Use Application
e
Comments: ',;��blS 3Gltir; .- �A'!`? .t /;w6..S 7i �G
Page 1 of 2
APPLICATION CONTINUES ON BACK
03/11
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BP821U01 Harnett County 6/04/14
Application Fees Maintenance 09:40:57
Application number . :
Address . . . . . . :
Position to . . . . .
Type options, p
1= Select
Amount
Opt To Apply
_ 3.00
_ 100.00
_ 40.00
_ 25.00
_ .00
.00
14 50033589
60167 *UNASSIGNED
ress Enter.
Description
_ MAIL -IN PROCESSING FEE
_ PZ FLOOD PERMIT
_ PZ* SITE PLAN REVISION
_ REVIEW RESIDENTIAL PLANS
_ SOIL EVAL/NEW SEPTIC TANK
911 REFLECTIVE SIGNS
F3 =Exit F9= Display all F12 =Cancel
12
Starting characters
Previously
Applied
.00
.00
.00
.00
750.00
.00
Paid Inactive
.00
.00
.00
.00
750.00
.00
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