ENVH RefundHarnett
COUNTY
COUNTY OF HARNETT
CHECK REQUEST FORM
Account Number:
110-0000-345.18-00 FX -1 Mail to payee
Project Number:
F Check to be picked up by:
Vendor Name:
1 & S Development Co.
Vendor Number:
(Requires approval of Finance Officer)
Remittance Address:
1172 Vic Keith Road
Approved: Disapproved:
Sanford, NC 27332
Description
Amount
Membership Application
Portion of Harnett Land Use fee collected in error
$ 250
00
for a soil evaulation. Site has county sewer & no
.
septic tank needed per Jennifer Brock. Remainde
of fee to Bldg account line (see email attached)
to be moved 25
00
Total Amount Due
Application # 10-5-25080
.
$ 225
00
.
Reason for check request:
Same as above - see email
This check request has been examined by me and is hereby approved for payment.
Department Head or Authorized Designee Date
This insturment has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director
Susan G. Stewart
From: Jennifer Brock
Sent: Wednesday, August 25, 2010 11:52 AM
To: Sheila Sudia
Cc: Charlene Sharp; Susan G. Stewart; Richard Del Conte; Donna Johnson
Subject: MOVE MONEY
Account Correction:
Application Number 10-50025080
Money taken in the amount of $250.00 on the health line with account number 11000003451800.
$25.00 of that above listed amount needs to be moved to account line 11000003223001 (Building). The
remaining amount of $225.00 needs to be refunded to J&S Development.
Thanks
jb
hznni f zr ,-5. 3rock
108 C. front St.
Lillington NC27546
(91108.93-7525 QXt.6433
jbrock@harn~m.oro
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Initial Application Date: 8 I Q
OATr
Application # to - 5C'0=L9J t Q
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION CU#
Central Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893-7525 Fax: (910) 893-2793 www.hamett.org/permft
LANDOWNER: J & S Development Co. 1172 Vic Keith Rd
Mailing Address:
City: Sanford State: NC Zip: 27332 Contact # 910 987 0692
Email:
APPUCANT': Same Mailing Address:
Clhr State: Zip: Contact #
`Please fill out applicant information if Mwent than landowner Email:
CONTACT NAME APPLYING IN OFFICE: Jerome Crumbley Phone # 910 987 0692
PROPERTY LOCATION: Subdivision: Carolina Lakes
Lai 56 Lot Size• less .5
State Road # I S State Road Name: 'ZuFFO -0 L-A t`E Map Book&Page: C / 17 y t3
Parcel: _ PIN: 11595 - a9 8~fo oe.,n
Zon4 . Zone. Wa
- temhed: P' Deed Book&Page _A-7 I r~ 1 J a Power Company': ~ P'1 ~
'New structures with Progress Energy as service provider need to supply premise number
from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILUNGTON: Carolina Lakes; left onto Carolina Way; rt onto Pineridge Cove, 4th lot
right
PROPOSED USE:
GY SFD: (Size _4__0.x.!! ! Bedrooms: 4 Monolithic
! Baths:_ Basement(w/wo bath):- Garage.- Deck: AL Crawl Space: ✓ Slab:_ Slab:
(Is the bonus room finished? (Zj yes (ono w/ a closet? (6 yes (__)no (if yes add in with # bedrooms)
❑ Mod: (Size x_j # Ssdrooms,_ # Baths- Basement (w/wo bath),"- Garage:- Site Built Deck:- On Frame- Off Frame_
(is the second floor finished? U yes (_jno Any other site built additions? yes (__)no
❑ Manufactured Home: _SW _DW-TW (Size x_ j # Bedrooms: - Garage:^(sits built?____) Deck:_(site built?__j
❑ Duplex: (Size No. Buildings: No. Bedrooms Per Unit:
Home Occupation: # Rooms: Use:
Hours of Operation: +lfErrtployees:
❑ Additlon/Accessorytother (Size x_) Use:
Closets in addition? yes (Jno
water Supply: ✓ County Existing Well New Well of dwafts using weN
Sewage Supply: ) `MUST have operable water before final
New Septic Tank (Complete Checkftf) Existing Septic Tank (Complete Charddist) ✓ 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? (J yes (Jno
Structures (existing or proposed): Single family dwellings: A Manufactured Homes:
Required Residential P Other (afYY
^opaKY Line Setbacks: Comment*:
Front Mini num.- Actuai-310-
Rear L-V21 V 3
Closest Side Ja a 1
Sidestreettoomer 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
I hereby state that foregoing statements are accurate and correct to the best of my knowledge. Permit sobbj sect touch work and the speWona of plans submitted.
revocation if false iMormormadon is provided.
7/19/10
Slanature of Ow r Owneea Agent Deb
"This application expires 8 months from the initial dab H 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