LAND USE Initial Application Date: 1 b - 7- ! P Application # 0 ,5- 'c 25` 5i .b
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108
611 08 E. Front Street, Lillington, NC 27548 Phone: (910) 893 -7525 Fax: (910) 893 -2793 ! www.harnett.org/permlta
LANDOWNER: r 1, r ,'5 4 Mailing Address: 1199 Hen, ,c,- / r/
City: . w/ =Ore/ State:/VC Zip: 2 733 2Contact # 7/9 7c1.1 Orr? S Email: v=Ach ' - G. _ r. - es . /,6cy-
APPLICANT*: C(r. S Lc) rd/,cc r' e Mailing Address:
City: State: Zip: Contact # Email:
'Please All out applicant information if different than landowner -
CONTACT NAME APPLYING IN OFFICE: 5-c M.t Phone # ,
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PROPERTY LOCATION: Subdivision: fQ ft S, 4 al ,114 i I Lot*: S i
1 Lot Size: / e /
State Road 1 #
/1/ P State Road Name: (ra(/(r /f Map Book&Page• tot / Si v
Parcel: 75 �3 /.7 / / e 2 2 67 / q PIN: 7 7 / 0 (� — 2,5, ✓✓i
Zoning:_t�tf G �Ffood Zone: Watershed: A /�- Deed Book&Page: 2A/& 4 I Power Company':
`New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 2 7 &.J ¢o Alec vcr fin/ ,Vc r A/i
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PROPOSED USE:
Monolithic
❑ SFD: (Size x ) # Bedrooms: # Baths: Basement(wlwo bath): Garage: Dedc Crawl Space: Slab: Slab:
(Is the bonus room finished? ( J yes (__)no w/ a closet? (J yes (___)no of yes add in with # bedrooms)
❑ Mod: (Size _ x 1# 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? U yes (___)no
❑ Manufactured Home: SW _ OW 1W (Size x ) # Bedrooms: _ Garage: (site built? ) Deck: (site built? )
❑ Duplex: (Site x ) No. Buildings: No. Bedrooms Per Unit:
X Home Occupation: # Rooms: Use: Hours of Operation: #Employees: Addltion/AccessoryOt r. (Size /< x2Q) Use: ,S roe Closets in addition? (J yes (2cno r Supply: County _ Existing Well New Well (# Iings 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 manufactur home within five hundred feet (500') of tract listed above? (.__) yes (
Structures (existing or proposed): Single family dwellings: -, I Manufactured Homes: Other (specify)
Required Residential Property Line Setbacks: Comments:
Front Minimum_ ? Actual b
Rear 7/
Closest Side S 3
Sidestreet/comer 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.
1 hereby state that foregoing stat�re accura�rrect to the best of my knowledge. Permit subject to revocation if false information is provided.
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Signature of Owner Or Owners 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
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NAME: APPLICATION #: /// C 0 2_4 ✓ 4
*This application to be tilled out when applying for a septic system inspection.*
County Health Department Application fort iprovement Permif andlo 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 # l i7 U ,{'
❑ Environmental Health New Septic SvstemCode 800
• All property Irons must be made visible. 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.
• All lots to be addressed within 10 business days after confirmation. S25.00 return trip fee may be Incurred
for failure to uncover outlet IId. mark house comers and property 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 Environmental Health inspection. Please note
confirmation number given at end of recordlna 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 outlet end of tank 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 use code 800 for Environmental Health inspection. Please note confirmation number (liven
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
0 applying for authorization to construct please indicate desired system type(s): can be ranked in order of preference, must choose one.
(_) Accepted {_I Innovative {_) Conventional (_) Any
{_) Alternative {_) 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 {_) NO Does the site contain any Jurisdictional Wetlands?
{_} YES (_) NO Do you plan to have an irrieation system now or in the future?
(_) YES {_) NO Does or will the building contain any guild? Please explain.
IYES ( _ I NO Are there any existing wells, springs, waterlines or Wastewater Systems on this property?
{_)YES 1_) NO Is any wastewater going to be generated on the site other than domestic sewage?
(_) (_) NO Is the site subject to approval by any other Public Agency?
{_)YES {_) NO 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.
1 Have Read This Applkation And Certify That The Information Provided Herein Is True, Complete And Correct. Authorized County And
State Oflidals Are Granted Right Of Entry To Conduct Necessary Inspections To Determine Compliance With Applicable Laws And Rules.
1 Understand That 1 Am Solely Responsible For The Proper Identincadon And Labeling Of All Property Lines And Corners And Mailing
The Site Accessible • hat A Complete to Evaluation Can Be Performed.
5 ac/ 20 /es
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PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE
11/09
DIAGRAM OF A TYPICAL SEPTIC TANK
~- OUTLEt LID
POSSIBLE POSSIBLE
HOUSE HOUSE
CONNECTION _ CONNECTION
l
POSSIBLE
HOUSE
CONNECTION
POSSIBLE LID SHAPES
SQUARE (SHOWN ON DIAGRAM)
R ECTANGLE ( OLDER TANKS) - ROUND
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FOR REGISTRATION REGISTER OF DEEDS ,` i
E7 -% t,.._. ., '^ ,,...,/,, KUIBETTY COUNTY NO "
7.._1�dSi51_ 2009 MRY 04 044113 PM
BK:2622 PG:51 -53 FEE;S11
NC REV STRMP:SE1
__.._._..� tTRUT 2119106661
NORTH CAROLINA GENERAL. WARRANTY DEED
Excise Tax: $ 413 day of , 20_
Parcel Identifier No• 9577 -88- 17.0
2800 Verified by _
By:
MaiUBoxto:
T he Barfield Law Firm 2929 Breezewood Avenue Ste 200 Fa etteville NC 28303
twas y, The Barfield Law Firm, 2929 Breezewood Avenue, Ste 200, Fa etteville, NC 28303
This instrument prod b
Brief description for the Index: LT 59, PERSIMMON HILL
THIS DEED made this 30th day of 20S by and between
GRANTOR GRANTEE
Homes, LLC Christopher A. Lord and wife, .
New Century Alysha H. Lord
Dunnn, , N NC 28833 34 2 Drive 1149 Hoover Road
Dunn, Sanford, NC 27332
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The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include t
singular, plural, masculine, feminine or neuter as required by context. a
WITNES SETpresents dH, tbattbe Sa oes grant G cantor, fora valuable coaegue Tiderationpaid by ow the ns hip, H Grantee, the receipt of whiccertainlotorph is hereby erc e m l o
acknowl edged, has
s
and by these bargain, sell and conveyumlto the Grantee m fee simple, all that nford Barb arnett County,
in the City of rte.
more p articularly described as follows:
BEING all of Lot No. 59of Persimmon Hill Subdivision as shown on plat map recorded in Map Number 2006, Pa 894,
Harnett County Registry. Reference to said map is hereby made for greater certainty of description. t,
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The property hereinabove described was acquired by Grantor by instrument recorded in Book 2305 page 5 — ' ;
894 xi u
A map showing the above described property is recorded in Plat Book 2 06 page �
do 333 E. Six Forks ltd., Raleigh NC 27609 k
NC Bar y Agreement Form the NC BOD ar Association Revised 1981 2002 SoftPro Corpora
Printed by s #:: ,;f
y Agrell>mt � NC Br Ass -1981 4
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