ENVH Refundiff
Harnett
COUNTY
NORTH CAROLINA
Account Number:
Project Number:
Vendor Name:
Vendor Number:
Remittance Address:
Date: August 30, 2016
COUNTY OF HARNETT
CHECK REQUEST FORM
110-0000-345.18-00
Wayne H. & Sue Gardner
180 Walter Allen Lane
Fuquay Varina, NC 27526
5 Mail to payee
Check to be picked up by:
(Requires approval of Finance Officer)
Approved:_ Disapproved:
Reason for check request: Applicant planning on building a deck next year and requests refund for tank
inspection.
This check request has been examined by me and is hereby approved for payment.
Department Head or AuthorizeV Designee Date
Graham H. Byrd, R.E.H.S. �
This i stru nt has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director
Description
Amount
Environmental Health Existing Tank Fee
$ 100.00
HTE# 16-5-39493
Location: 180 Walter Allen Lane
Total Amount Due
I $ 100.00
Reason for check request: Applicant planning on building a deck next year and requests refund for tank
inspection.
This check request has been examined by me and is hereby approved for payment.
Department Head or AuthorizeV Designee Date
Graham H. Byrd, R.E.H.S. �
This i stru nt has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director
Initial Application Unto -'b - ` �Application # _1 6X �q"
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION CU# �—
Central Permitting 108 E Front Street, Lillington, NC 27546 Phone: (910) 893-7525 ext 2 Fax (910) 893-2793
-A RECORDED
SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE)8. SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION -
LANDOWNER: Ll/r�,%/) a' �y� fav Ne -y= S�tP
/ ailing Atlpdress:_
City: �U /t7 ��}'I-j State A%C Zip:Z7?kontacl No:QZ� M-Sa Sd' Email:
APPLICANT': ���`�%[� Mailing Address: Poo
oo
Stale:_ Zip: Contact No:
'Please fill out applicant Information if different than landovrtrer Email:
CONTACT NAME APPLYING IN OFFICE: -(A" l,fAr f V,,- ?i 7 /� V rh SO ($+
v Phone #_ N ' t� dt, _ (j
PROPERTY LOCATION: Subdivision:
1 p'` ' ' ` I Lot #:,_ Lol Size
Slate Road # Slate Road Name: J p U �/Q �T-fj� � I � / ✓1 �1
�+N-�M u N 1�n1,�$ (� �p�Ma�p^/Bo/o�k�8 Page: � 3 d
Parcel PIN: �i�' /�Q" JL4 ci a `��]
2-6
Zoning: Flood Zone: ���%�� �,,) /O
Watershed: Deed Book 8 Page:'��'�-"z-flick-`LPower Com an
p y:
•New structures with Progress Energy as service Provider need to supply premise number
PROPOSED USE:
from Progress Energy.
❑ SFD: (Size _x_)
# Bedrooms._ # Baths:_
(Is the bonus room finished? (_)
bath : Basemen[ w/wo
( ) _Garage:_
yes (_) no w/ a closet? (_)yes (_)
Monolithic
Deck:_ Crawl Space:_ Slab:_ Slab:_
no (if yes add in with # bedrooms)
❑ Mod. (Size _x_)
# Bedrooms_ If Baths_
(Is the second floor finished? (_)
Basement (w/wo bath)_ Garage:_ Site Built Deck:_ On Frame_ Off Frame_
yes (_) no Any other site built additions? (_) yes (_) no
❑ Manufactured Home:
_SW _DW _TW (Size_x
_) If Bedrooms. _ Garage:_(site
built?—) Deck:_(site built?_)
❑ Duplex: (Size _x_) No Buildings: No. Bedrooms Per UI
] Home Occupation: # Rooms: Use:
Hours
#Employees:_
] Addition/Accessory/Other: (Size Use:
Closets in addition? (_) yes (_) no
Vater Supply: my _ Existing Well _ New Well (# of dwellings using well
'Must have operable water before final
lewage Supply: _ New Septic Tank (Complete Checklist
)xisling Septic Tank (Complete Checklist) _County Sewer
Ices owner of this tract of land, own land that contains a manufactured home within five hundred feet (500') of tract listed above? (_) yes (_) no
ices the property contain any easements whether underground or overhead (_) yes (_) no
tructures (existing or Proposed): Single family dwellings:
Manufactured Home
Required Residential Propert) Line Setbacks:
Minimum Actual ' i
7 ���QL
Side l s %.
et/corner lot
arest Building
same lot
Residential Land Use Application Page 1 of 3
APPLICATION CONTINUES ON BACK
Other (specify):
03/11
Susan G. Stewart
From: Donna Johnson
Sent: Wednesday, August 17, 2016 10:02 AM
To: Susan G. Stewart
Subject: 16-5-39493
Good morning, Susan. I hope you are doing better. O The gentleman on this application would like his money
refunded. He is not going to build a deck. He is going to wait until next year. Mail refund to address on land use
application.
Thanks,
Donna F. Johnson
Harnett County Development Services/Central Permitting Dept.
Project Coordinator/Customer Service Rep.
PO Box 65 Lillington, NC 27546
910-814-6431(0)
910-893-2793 (f)
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