DOCUMENTS Application# 1 , -4 gteiu
HARNETT COUNTY CENTRAL PERMITTING
PO BOX 65 LILLINGTON NC 27546
(910) 893-7525 FAX: (910) 893-2793 www.harnett.org/permits
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APPLICATION FOR EXISTING SEPTIC SYSTEMt NSPECTION
FOR MORTGAGE COMPANIES, COMMERCIAL CHANGE OF
OWNERSHIP, FIRE DAMAGE, ETC.
NOTE: A DEED OR OFFER TO PURCHASE IS REQUIRED AT TIMF OF APPLICATION.
laerve. LAs) o ►ifs
Date: t h ' "?-)1 - t Li Er, ll ►�•i-Et,I�,� ¢�, 4
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Proposed Buyer or Business Name: ei�a urn lilnrw¢_ •
Applicant/Mortgage Co: (a0Ds. e;
Mailing Address: k Oak Lhe-) •
City: State: _ Zip:
Telephone: ( ) Other#: ( )
Current Land Owner: C_SL-Ci - kipysLMLY1 Phone: 1/9 f".0 302.55—
Property Address:
PIN: IkoM-\ • "U 3t4e, o C 0 Parcel: CS-1 1 10 00 01'6
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State Road#: ¶ State Road Name: cc Lr ez a..r' 1 194
Name of Subdivision: Lot# (If Applicable)
aycare: #of employees #of children Hours:
staurant: #of employees t of seats
Directions: (please give concise, complet directions from Lillington, NC to the property)
tito 2 7 - Ceetis , g o Ykr•k. re, io 02 2 7
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There is a$1 00.00 charge for this service. This approval is subject to revocation if the
intended use of the septic system changes or if false information is provided on this
application.
Your signature below certifies that all above information is correc
Signature of Owner, Authorized Agent or Applicant: ( Z 2
FOR OFFICE USE ONLY
AUTHORIZATION FOR USE OF EXISTING SEPTIC SYSTEM
Signature of Environmental Health Specialist Date
SEPTIC 4/()8
C i TOWN OF COATS ZONING PERMIT APPLICATION
NOTE: Attach a site plan that includes property lines(front,side,and rear),location of proposed structures(including driveways,
decks,etc.),and existing structures. This plan should be drawn to scale. Also,in order to receive a Privilege License from the Town
of Coats to open a business,you must have a valid Zoning Permit,along with all applicable inspections from Harnett County.
Permit No.: j 0 i i )' - ) Date: ) .)/ 3/ ►4 Fee : 3 J_c`.
Parcel ID*: O1 I i Oo n / ) 2- Area Zoned As:
APPLICANT: PROPERTY OWNER:
Name(Print) C e,/4. . 55%F, le.f.Isa 4) Name 4°e:7 1k' 57:64if167
Address go 6-beAiezer CA. /r Address fD CA--.....e.zee- a:/. ,/.
City,State Co -5' // City,State c'rt. ,G
Zip Code .2- 7, -/ Zip Code 2 7_57.7-/
Phone# 9/ f 9 -O -3 J-5 ' Phone# 9/, 8-O -3.A3"5.---
Location of Property: IN-TOWN ETJ ETJ(contiguous)
Present Use of Property:
PROPOSED USE OF PROPERTY:
[ ] Single Family Dwelling: #Rooms: #Bedrooms: Square Feet:
[ ]Multi Family Dwelling: #of Units: #Bedrooms (per unit): Square Feet(per unit)
[ ] Mobile Home(single lot): Single wide: Double Wide:
[ ]Mobile Home Park: Section 16, Zoning Ordinance must apply
[ ]Business: Total#of employees per day Type of business
[ ] Others(specify):
[ ] Existing structure: Renovate: L/ Addition: Demolish:
WATER AND SEWER SUPPLY:
Water: [ ]Private [ ]Public [ ] Proposed [ ]Existing
Sewer: [ ]Private [ ]Public [ ] Proposed [ ]Existing
Applicant: I certify that all of the information presented in this application is true,complete, and accurate to the
best of my knowledge. False information is grounds for rejection of the application.
Signature: (iffrif/7...-'4Zz....,ex- Date: /D - ,/- /`4
ZONING ADMINISTRATOR USE ONLY
Notes: 17)C-72. r-i ,r.-. 7t=corz 772 :"J,,,, [[-1\1-2%44 —`
Approved: p---12 Denied: [ ] i
Zoning Administrator: Date: ) 0/3/ 1 1-
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� ,�gst Of ce Box 675 • Coats, North Carolina 27521
(910) 897-5183 voice • (910) 897-2662 fax
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Harnett County Zoning Overlay Page 1 of 1
-N Harnett Zonin Overlay Results„..- ...,,..,s
O Zoom in O Zoom out *Pan
---` �,, s 4 Map Scale=One Inch=52 feet
■
* 4,;'1 Owner Information:
om`' PID 071600 0182
l : NAME STEPHENSON CECIL W
ADDRESS No Data*IL
.- .,. # CITYST COATS,NC 27521-0000
r ACRES 0 8149126
-” Zoning Overlay Results%
/ ID Zoning Acres
N. -410 400 46, ...4.4 ,.- 24 COATS 0.81
* ' *..Je i, ,, , sr ,:- t ti. ..
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Download Results:
Zo n i ng Po l y go n_071600___0182.zip
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http://gistoolbox.harnett.org/giswebsiteutils/ZoningOverlay.aspx?PID=071600 0182 10/31/2014
Page 1 of 1
Selected Parcels Feature
Parcel Identification
PIN 1 600-16-4349.000
JParcelNumberl 071600 0182
JREIDI 0031546
Owner Information
[AccountNumberl 701825000
JNamel] STEPHENSON CECIL W
jName2l
JAddress II 80 EBENEZER RD
jAddress2l
[Address3l
JCityl COATS
[State' NC
JZipCodel 27521-0000
Assessment Data
[ParcelBuildingValuel 118790
JParcelObxfValue]
JParcelLandValuel 20000
JTotalAssessedValue] 138790
Property Information
IStreetDirectionl
ICnitNumber I
JHouseNumberl 000080 •
JStreetNamel EBENEZER CHURCH
JStreetTypel RD
IStreetSuffixl
Legal Desciption
JLegalDescrlptionl .8 AC J R STEWART PC D/64-D
JLegalLandUnitsl 0.8
JLegalLandTypel AC
GIS Cale Acres 0.81491253
IPIatBook]
JPIatPagel
Structure Data
JActualYearBuiltJ 1940
JTotalAcutal.AreaHeatedl 1770
Sales Information
JDeedBookl 00586
JDeedPagel 0184
JDeedDatel 1973-02-04 19:00:00
JSaleYearl 1973
[SalePricel
Parcel Links
Zoning Overlay 071600 0182
Soils Overlay 071600 0182
MC • 071600 0182
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http://gistoolbox.harnett.org/Freeance/Client/PublicAccess 1/printFrame.html 10/31/2014
09/09/11 Application , I#
Harnett County Central Permitting t LA 3`� L'I-
PO Box 65 Lilhngton NC 27546
Each section below to be filled out 910 893 7525 Fax 910 893 2793 www harnett orglpermits
by whomever performing work
Must be owner or licensed
contractor Address company Application for Residential Building and Trades Permit
name&phone must match
Owners Name Al L_>--). tel s 0 j\1YTh _ Date �v•31 'iLl
Site Address '�C7 ' g.t / U'` �t Phone
Directions to job site from Llllington
fbdiv -- --� Let - -
Description of Proposed Work CLia. --tip ,.¢„i *C�1 S #of Bedrooms
Heated SF Unheated SF Finished Bonus Room9 Crawl Space Slab
General Contractor Information
Building Contractor s Company Name Telephone
Address Email Address
License #
Electrical Contractor Information
Description of Work Service Size Amps T-Pole Yes No
Electrical Contractor s Company Name Telephone
Address Email Address
l - VN.DC
License #
Mechanical/HVAC Contractor Information
Description of Work V t 1 C—k" t.i `5S-c-1)-- ` \-j
Mechanical Contractor s Company Name Telephone
Address Email Address
License #
Plumbing Contractor Information
Description of Work --------- at s
)plumbing Contractors Company Name Telephone ,,N
Mdress _- Email Address
Jf.
Licensa�_��
Insulation Contractor Information
U i a ion ontractor s Company Name &Address Telephone
*NOTE General Contractor must fill out and sign the second page of this application
I hereby certify that I have the authority to make necessary application that the application is correct
and that-the construction will conform to the regulations in the Building Electrical Plumbing and
Mechanical codes and the Harnett County Zoning Ordinance I state the information on the above
contractors is correct as known to me and that by signing below I have obtained all subcontractors
permission to obtain these permits and if any changes occur including listed contractors site plan
number of bedrooms building and trade plans Environmental Health permit changes or proposed use
changes I certify it is my responsibility to notify the Harriett County Central Permitting Department of
any and all changes
EXPIRED PERMIT FEES- 6 Months to 2 years permit re-issue fee is $150 00 After 2 years re-issue fee
is as per rrent ee sc edule
/D— 3/—/fL
ignature o Owner/Con actor/Officer(s)of Corporation ) )ate
Affidavit for Worker's Compensation N C G S 87-14
The undersigned applicant being the
General Contractor Owner Officer/Agent of the Contractor or Owner
Do hereby confirm under penalties of perjury that the person(s) firm(s) or corporation(s) performing the work
set forth in the permit
Has three (3) or more employees and has obtained workers compensation insurance to cover them
Has one (1)or more subcontractors(s) and has obtained workers compensation insurance to cover
them
Has one (1) or more subcontractors(s)who has their own policy of workers compensation insurance
covering themselves
Has no more than two(2) employees and no subcontractors
While working on the project for which this permit is sought it is understood that the Central Permitting
Department issuing the permit may require certificates of coverage of worker s compensation insurance prior
to issuance of the permit and at any time during the permitted work from any person firm or corporation
carrying out the work
Company or Name
I��ign wfTitle �/ — Date