DOCUMENTS Initial Application Date: '~l 47 I'1 Application# 1'4 SV v 1 5 I Ai
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPUCATION
Central Permitting 108 E.Front Street,Lillington,NC 27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.hamett.orglpermits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER: L (1-"1Qi-- Mailing Address:) I '
City: AV Cf CreGk. State:41'C Zip: Contact No: Old/ ef0 Email:
APPUCANr: s0 Mailing Address:
City: State: Zip: Contact No: Email:
'Please fill out applicant information if different than landowner Lie,"
11,^,
CONTACT NAME APPLYING IN OFFICE: J e 114"1 L' LAJ kG( Phone# (J/.0) Clef `/41Z 6r
PROPERTY LOCATION:Subdivision: ACIL `i J Lot#: 3 Lot Size; OsF7
State Road# 5.37 State Road Name: Qbr Map Book&Page: aka J J vo
1 V►�► Y
Parcel: x1 c)L..0 Is 1 bbLPD D`1 PIN: aD O I - a S --�lSl idI oo 0 n
Zoning:N�M Flood Zone: )0 Watershed Deed Book&Page:J �7.3 / 707`7"i ower Company*: Duke- `IVIre f5
New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE: ,( r�, OLA
, � Monolithic
SFD:(Size "5 x�O)#Bedrooms:,-#Baths: .Basement(w/wo bath):,Garage:!Deck:_Crawl Space: Slab:
(Is the bonus 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:_Site Built Deck: Frame_Off Frame_,
(Is the second floor finished?( )yes ( )no Any other site built additions?(_)yes (_)no
U Manufactured Home:_SW_DW TW(Size x )#Bedrooms:_Garage: (site built?_)Deck: (site built? )
U Duplex:(Size x )No.Buildings: No.Bedrooms Per Unit:
❑ Home Occupation:#Rooms: of
`+ Use: , Hours o�Operation: #Employees:
U Addition/Accessory/Other:(Size x'aq)Use:,^ A .L gyp ati(' -� Closets in addition?(_)yes ( }no
Water Supply: V Couounty 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?C__)yes (._._ no
Does the property contain any easements whether underground or overhead(_)yes ( a
Structures(existing a proposed Single family dwellings: I/ Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
t
Front Minimum c�l35 Actual /00
Rear Ot /
Closest Side 10 30
Sidestraeticorner lot `+�
Nearest Building ID ,V`kJul'�r
on same lot
Residential Land Use Application Page 1 of 2 03/11
APPLICATION CONTINUES ON BACK
•
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 1`v" (, • aq /0 AC 7' ,-, -
b Id` Co S Rd. 4-0 ack. G-rv ' Ch. Rd. -r...0„ ° •�v
ling. C�t 0.� d� ����. 1"uv ►. L� 4— J
If permits are granted I agree to conform o all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing stateme re a urate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
56—"/y
n. 1ff • ner or Owner's Agent T Date
"'It Is the owner/applicants responsibility to provide the county with any applicable information about the subject property,including but not limited
to: boundary information,house location,underground or overhead easements,etc.The county or its employees are not responsible for any
incorrect or missing information that is contained within these applications."`
"This application expires 6 months from the initial date if permits have not been issued**
Residential Land Use Application Page 2 of 2 03111
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NAME: APPLICATION#:
*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 1S FALSIFIED,CIIANOED,OR'1'I1E SiTE IS ALTERED.1I!IN THE IMPROVEMENT
PERMIT OR Al ITHORIZATION TO CONSTRtICI'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 I CONFIRMATION#
0 Environmental Health New Septic System Code 8 00
• All property irons must be made v isibie,Place"pink p roperty flags"o n each corner i ron 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 oracle oronerty.
• All lots to be addressed within 10 business days after confirmation. $25.00 return trip fee may be incurred
for failure to uncover outlet lid, mark house corners and oronerty lines. etc. once lot confirmed ready.
• 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 En vironmental Health inspection. Please note
confirmation numberpiven at end of recording for proof of request.
• Use Click2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
0 Environmental Health Existing Tank Inspections Cod e 800
• Follow above instructions for placing flags and card on property.
• Prepare for inspection by removing soil over over outlet end as diagram indicates, and lift lid straight up(if
possible)and then close back down. (Unless inspection is for a septic tank in a mobile home park)
• After uncovering outlet end call the voice permitting system at 910-893-7525 option 1 & select notification permit if
multiple permits, then u se code 800 f or Environmental Health ins pection. Please n ote 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 stem type(s): can be ranked in order of preference,must choose one.
{ I Accepted {_} Innovative {^ Conventional { } Any
{_} Alternative 1_} 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 {l/ Does the site contain any Jurisdictional Wetlands'?
{_}YES { ry Do you plan to have an irrigation system now or in the future?
{_}YES {_l/;N Does or will the building contain any drains? Please explain.
I^IYES ;_(/}N Are there any existing wells, springs,waterlines or Wastewater Systems on this property?
{_}YES { Is any wastewater going to be generated on the site other than domestic sewage?
{_}YES {(/; Is the site subject to approval by any other Public Agency?
{�}YES {_, N 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 Accessible '' hat A Complete Site Evaluation Can Be Performed. /
•
PROPER 'S " E' OR OWNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) ` DATE
E-Health Checklist 1 of 3 10110
FOR REGISTRATION
Kimberly Hargrove
REGISTER Orr"
Harnett Ccunty
?013 NOV 20 12 0i 46
BK:3173 EPG•707-708
EXCISEE:$26 00
INSTRUMENT q 228.Oe 75
HARN!ETTCOUNTTY -FAX ID# TWESTER
- - ,-- 2013018775
Parcel#
Excise Tax: Recording Time,Book &Page:
Prepared by: Mail after recording to
HAYES, WILLIAMS, TURNER&DAUGHTRY,P.A. Grantee
804 West Broad Street
Dunn,North Carolina 28334
File#: 2013 Misc
NORTH CAROLINA GENERAL WARRANTY DEED
NO TITLE CERTIFICATION
This deed made this 11th day of November,2013,by and between:
GRANTORS: GRANTEE:
KATHY M.POPE a/k/a CATHY JEFFREY L.WALKER
MARIE POPE and husband,
Post Office Box 1
STEPHEN D. POPE
405 Old Post Road Buies Creek,North Carolina 27506
Erwin,North Carolina 28339
The designation Grantor and Grantee as used herein shall include said parties,their heirs,successors,and assigns,and shall
include singular,plural,masculine,feminine or neuter as required by context.
WITNESSETH: That the Grantor, for a valuable consideration paid by Grantee, the receipt of
which is hereby acknowledged,has bargained and sold, and by these presents doth grant,
bargain,sell and convey unto the Grantee,in fee simple,all those certain tracts or parcels of land
lying and being in Neill's Creek Township,Harnett County,North Carolina,and more
particularly described as follows:
Being all of Lots 3 and A totaling 1.56 acres, more or less,as shown on Map entitled
"Kathy M.Pope and husband, Stephen D.Pope,NeilI's Creek Township,Harnett County,
North Carolina,made by Joyner Piedmont Surveying,Dunn,N. C.,dated September 24,
2013, and recorded at Map Book#2013 Page 340 recorded on October 22,2013,Harnett
County Registry. This being a part of the property conveyed to the Grantors in Deed Book
3061,Pages 377-379 Harnett County Registry.
TO HAVE AND TO HOLD the aforesaid tracts or parcels of land and all privileges and
appurtenances thereto belonging to the Grantee in fee simple.
And the Grantor, covenants with the Grantee,that Grantor is seized of said premises in fee
simple,has right to convey the same in fee simple, that title is marketable and free and clear of
all encumbrances, and that Grantor will warrant and will forever defend the said title against the
lawful claims of all persons whomsoever, except the following.
IN TESTIMONY WHEREOF, the Grantors have hereunto set their hands and seals, the day and
year first above written.
(SEAL)
KATHY M. POPE a
CATHY ' E POPE
4 /j
1',//44,, (SEAL)
ST PHE ". POPE
NORTH CAROLINA,
HARNETT COUNTY
I, l� oat bs ,Notary Public, hereby certify that KATHY M. POPE a/k/a
CATHY E OPE and STEPHEN D. POPE each personally appeared before me this
day and acknowledged the due execution of the foregoing Deed of Conveyance.
Witness my hand and notarial seal,this f( day of November, 2013.
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