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LAND USE Initial Application Date: I Application it I £9 ©o ` � j© cu# COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION Central Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.harnett.orglpermits LANDOWNER:,'eCe.MU L mtC. \\e V Address: IS rn 'J ; - eA.J CA . City: \ -', qy 0..v�\ in, v' no State:J .zip:a0 Contact # �l <.W9 - SO 3 S Email: )e.CeiftiOotck jenail.CCW\ APPLICANT`: (Cl \e\ vs. A Mc \CnS Mailing Address: I� me4ll f3 view Ch. ✓✓ City: V-l) vpd. C\ a - State:NC- Zip:a1 "Contact it S°I Email: c)0....0 JL . 'Please fill out plica rmation if different than landowner CONTACT NAME APPLYING IN OFFICE: Phone # PROPERTY t LOCATION: Subdivision: 3S \ c-%S CV(\ `� Lot #: � / a Lot Size: '1, �i, State Road # 9V , laiState Road Name: .- 441 -C Map Book &Page:r � flr / Parcel ,(qQ��INyY � Q 0 0 � /4 �" PIN: re) lii C� - OP- / 977, 66 ?? Zoning: / Zone: Watershed:n A Deed Book &Page o wer Company': *New structures with Progress Energy as service provider need to supply premise number from Progress Energy. SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: L-10k Nock t tec* ov c° 01 G m\-- W T \E-F-1- nic\At Ha . if & - 1- r-s(\ nn r∎c\c a ncari i lei-4 nn 7A t- ,eic\ 1 r; j v;- 0 (Yt&xda - PROPOSED USE: Monolithic ❑ SFD: (Size x ) # Bedrooms: _ # Baths: Basement(w/wo bath): Garage: Deck: Crawl Space: Slab: Slab: (Is the bonus room finished? ( ) yes ( )no w/ a closet? (.__) yes ( )no Of 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: - •urs of Operation: *Employees: ❑ Addition/Accessory/Other: (Size x ) Use: / i / _ / :. — 7C9 • . laSeTs oe in addition? t✓yes ( )no Water Supply: County V Existing Well 'lei if • e gs I'S 42S ) 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 (ono Structures (existing or proposed): Single family dwellings:[ Manufactured Homes: Other (specify): Required Residential Property Line Setbacks: Comma Front Minimum Actual Rear Closest Side Sidestreet/corner lot Nearest Building on same lot If permits are granted I agree to conform to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted. I hereby state that foregoing statements are a urate and correct to the best of my knowledge. Permit subject to revocation if false information is provided. 1i ,.$L_ 1 l e \AA x - )O Signature f • ner or Owner's Agent Date . "This application expires 6 months from the Initial date if permits have not been issued"' A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION Residential Land Use Application Page 1 of 1 07/10 a o ° y v v$ i aaa -� ° o V o bo tc i • a O ` x 2 l o O N i G _ t O o Q 1 Meado View Court , w o SO R 1\1 2 \ -7 (Pubpc) �w • ° • S Z -y N 07° N N Les CO O \ 0 00605111 ° ° i 79'33' 120.24 � `\ a os -� .. /2 rr y 4 00 4 0g• - 2 0 a i s '-..1 /+ v'�` O ° p • v /c3 -1 / ‘ , 93 w `:? ny evl 0 p . : ° o I 1 /O 6 9 0, a � a CI m 1/ 9 /tr � w O • , •I /2 0, z8 ° Ati _' 6 34, ." 1 ! I w N c l o .s. - ;x / to l lt 4 10. 2 p N co � 4� T / ! S - v . 6 c n 5 y Q\ . „” ! a O N o8 "!y 2.0 1 :a ? / / p 3 s ?" ti IP All o i -57 r \ y / / a r N / n\ m x / + c 0� a O / / N. o9 ka � J d MAP NORTH o Map /j 2006-782 & 784 r cn rl l c b u p 13 CO Q 1 CO V uoounp O c c m 2r V c, (/)� II s a Y a°� -,.. N a o o t k- v U V1 " cn ° (n % 112 < 1� • NAME: / \e.Q.m� r `tit rS APPLICATION #: , � 0 � OO 0��7 *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 depending 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 property. • 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 recording 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 (_) Altemative ( Other The applicant shall notify the local he. department upon submittal of this application if any of the following apply to the property in question. If the answer is "yes ", app cant must attach supporting documentation. )YES ( NO Does e site contain any Jurisdictional Wetlands. )YES {_} NO D. you plan to have an 1rriEation sysi m now or in t future? {_) ' S { NO n oes or will the building contain any strains? Please ex. ain. (I YES I NO Are there any existing wells, springs, waterlines or Waste - er Systems on this property? {)YES { • ' Is any wastewater going to be generated on the site oth-. tha domestic sewage? (_)YES ( 0 s the site subject to approval by any other Public • _ency? (_ )YES ( ) NO Are , ere any easements or Right of Ways on property? )YES { NO Does the ' e contain any existing water, ca. e, phone or undergroun. - lectric lines? If yes please c. No Cuts at 800 - 632 -49 41 to locate the lines. This is a e service. 1 Have ' ead 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 So That A Complete Site Evaluation Can Be Performed. - g -13 1 PROPERTY OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE 5/08