TOWN SEPTIC RApplication # C9 J56 V
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
Telephone Number 910 - 893 -7525 Fax 910 - 893 -2793
Application for Environmental Health Improvement Permit in Areas Zoned by Municipalities
Land Own r I form ti Applicant Information:
Name: l i nt e- aw/ Name ✓►1 d � ���
AdckT. 11 g KI h4, A s: r` s.
wvV e ° G �3 V u
Phone: S - Phone: /d0-
Property Location: t
E911 Address: L4
PIN or Parcel Number: --0 �
Subdivision: Lot Number: t
Lot Size:-J,, �ZZoonn� Lam.
�q�cifi Directions to Job from Lillington: -
'I c -,7 P C. f! -4, /BOA -1 /A vi'Al-h-0 - a.:7 105 _-
Proposed
(t< Single Family (Size: `Z9 x �) # of Be rooms: Basement�voling Basement w/ Plumbing: Deck: Slab ravel Space
() Multi Family Dwelling # of Units: # of Bedrooms /Units:
() Manufactured Home (Size: x ) # of Bedrooms:
Garage: Deck:
() Business Square Footage Retail Space: Type:_
() Industry Square Footage:
() Home Occupation # of Rooms: Use:
( ) Addition to Existing Building Size:
Other:
Type:
Use: Dckl yf V-)anf 10
�r to 01-
Water Supply: ( ounty ( ) Well () Other /Aw `'�
Sewage: )New Septic Tank (complete new tank checklist) �xisting Septic Tank ( ) Sewer
There is a $250.00 charge for new tanks, $100 for existing tanks. This approval is subject to
revocation if the intended We of the septic syst changes or if false information is
provided on this appli o . Y ur signatu be certifies I information above is correct.
Applicant Signature: � %) Date:
PIT
4/07
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BRJBF DESC N F R
THIS DEED MADE THIS _
FOR REIA& IO REGISTER OR OEE06
21 26 01731.46 PM
RK:2344 PG:5ii -514 FEE420,00
K REV 57W :V20.88
lNS1RRK I M190 Q
WARRANTY DEED
Parcel Id Nos. 02- 1516-09 -21 -0004
McRae, Attorney, 65 Bain Street, Lillington, NC 27546
McRae, Attorney, 65 Bain Street, Lillington, NC 27546
6 00 acres Avesboro Township
101 Fecan Lane, Durm, NC
p C #A � BY AND BETWEEN
GRANTOR
GRANTEE
Eliza Lou P Crews, widow,
rlham D Powell
Dolores P Allison
wife, Patsy L Powell
and husband, Arnold Allison,
11 ngaway Drive
Olga P Fmnie,
Du , North Carohna 28334
and husband, Alden Ftnrue
Post Office Box 6
Manteo NC 27954
The designation Grantor and Grantee as used er 1st ll include said parties, their heirs,
successors, and assigns, and shall include singular, I asc line, fer canine or neuter as required
by context.
WTI'NESSETH, that the Grantor, for valuable considers, on in y Grantee, the receipt of
which is hereby acknowledged, has and by these presents oe ant, ar n, sell and convey unto
the Grantee in fee simple their undivided interest in that n p ce f 1 situated in Anderson
Creek Township, Harnett County, North Carolina and more p is ly r ed as follows
BEGINNING at the southwestern corner of that prope coiWeeye Pope and
others by deed dated January 13, 1%6, recorded in 4 ge 89, of the
Barnett County Registry and runs South 00°53' West a d of .02 eet to a
stake, corner, thence South 89 °16' West a distance of 99.13 t t a ak corner;
thence South 00 033' East a distance of 100.00 feet to a stake, ; th cc outh
89 °48' West a distance of 833A7 feet to a stake in the line dividi C e Ta and
L. B. Pope, corner; thence North 02 °35' East a distance of 280. fe to stake,
corner; thence North 88°17' East a distance of 899.83 feet to a stak co en
South 51 °10' East a distance of 47.93 feet to a stake, corner; then o h 0"R§3'
West a distance of 90.24 feet to the BEGINNING, containing 6.00 acres. IMIS4rhoof
land being a portion of the L. B. Pope Estate land as shown in Book 243, a 6, o
the Harnett County Registry.
For further reference see Deed Book 1471, Page 930 and Deed Book 668, Pa 52 ,
Harnett County Registry.
OWNER NAME: nwM
--�
APPLICATION #: COXIS () 3(0
*This application to be filled out only when applying for a new septic system.*
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 depending upon documentation submitted. (complete site plan = 60 months; complete plat = without
expiration)
DEVELOPMENT INFORMATION
New single family residence
❑ Expansion of existing system
❑ Repair to malfunctioning sewage disposal system
❑ Non - residential type of structure
WATER SUPPLY
❑ New well
• Existing well
• Community well
Public water
❑ Spring
Are there any existing wells, springs, or existing waterlines on this property?
{v/ 'yes {_} no {_I unknown
SEPTIC
If applying for authorization to construct please indicate desired system type(s): can be ranked in order of preference, must choose one.
{_} Accepted
{_} Alternative
{Conventional
{_} Innovative
{_} Other
{_} Any
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 is
"yes ", applicant must attach supporting documentation.
answer
{_ }YES
{ �, }/ NO
Does the site contain any Jurisdictional Wetlands?
{YES
{_} NO
Does the site contain any existing Wastewater Systems?
{_ }YES
{%Zf NO
Is any wastewater going to be generated on the site other than domestic sewage?
{_ }YES
{ . } O
Is the site subject to approval by any other Public Agency?
{d }AYES
{_} NO
Are there any easements or Right of Ways on this property?
{_ }YES
{ VJ 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.
1 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 Ycessibl e o That A Complete Site aluation Can Be Performed.
RO R Y OWNERS OR WN S LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE
3/07
Application Number: Co �0(0 ( RR5—Y
Harnett County Central Permitting Department
PO Box 65, Lillington, NC 27546
910 - 893 -7525 _ w Environmental Health New Se c S stems est
Environmental Health Code 800
• Place "property flags" on corn of lot. All property lines Just be clearly flagged approximately every 50 feet
between corners.
• Place "house corner flags" at each corner of where the house /manufactured home will sit. Use additional flagging to
outline driveways, garages, decks, out buildings, swimming pools, etc.
• Place flags at locations as developed on site plan by Customer Service Technician and you.
• Place Environmental Health "orange" card in location that is easily viewed from road.
• 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. No grading of property should be
done.
• 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 and give code 800 for Environmental
Health confirmation. 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 permits.
Environmental Health Existing Tank Inspections
Environmental Health Code 800
• Place Environmental Health "orange" card in location that is easily viewed from road. Follow above instructions for
placing flags 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 and give code 800 for Environmental Health
confirmation. 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.
0 Health and Sanitation Inspections
• After submitting plans for food and lodging to Central Permitting, please allow approximately 7 -10 working days for plan
status. Use Click2Gov or IVR to hear results.
• Once all plans are approved, proceed to Central Permitting for remaining permits.
71 Fire Marshal Inspections
• After submitting plans for Fire Marshal review to Central Permitting, please allow approximately 7 -10 working days for
approval. Use Click2Gov or IVR to hear results. Once all plans are approved, proceed to Central Permitting for permits.
• Fire Marshal's letter must be placed on job site until work is completed.
0 Public Utilities
• Place stake with "orange" tape /name thirty feet (30) from the center of the road at the location you wish to have water
tap installed.
• Allow four to six weeks after application for water /sewer taps. Call Utilities at 893 -7575 for technical assistance.
Building Inspections
• After submitting plans for Building Inspections, please allow approximately 3 working days for review. Use Click2Gov or
IVR to hear results. Once all plans are approved, proceed to Central Permitting for permits.
• For new housing /set up permits must meet E 911 / Addressing guidelines prior to scheduling final inspection.
• Use Click2Gov or IVR to hear results.
E911 Addressing
Addressing Confirmation Code 814
• Address numbers shall be mounted on the house, 3 inches high (5" for commercial).
• Numbers must be a contrasting color from house, must be clearly visible night and day at entrance of driveway if home
is 100 ft or more from road, or if mailbox is on opposite side of road.
• Once you purchase permits and footing inspection has been approved call the voice permitting system at 910 - 893 -7525
and give code 814 for address confirmation. This must be called in even if you have contacted E911 for verbal
confirmation. Check Click2Gov for results and address.
• Inspection results ns a A wed online at ://www.hamett.org/services-213. as then select Click2Gov
Applicant/Owner Signatu f Date
11/06
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