ORIGINAL LAND USE - ENVH WORK COPY6irsfvg Wo rli Ir
Initial Application Date,L Application # Lj v a 2L
6�
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E Front Street Ldlington NC 27546 Phone (910) 893 7525 ext 2 Fax (910) 893 2793 www harnett org/permits
"A RECORDED SURVEY MAP RECORDED
� DEED (OR OFFER TO PURCHASE) & SITE PLAN ARE
ERREQUIRED WHEN SUBMITTING A LAND U E APPLICATION'
CNDOWWWNER 5'fA,aGIL fuditpeors, VG Madmg Address 4(o(v 61�uL
ry A Orf cvt mc- Zip Zji�7L Contact
�NNo, , Email
APPLICANT 601#415-1 11 13w IAX;2 Mailing Address
City 4"ep— State Zip Ziq!:2 Contact No Email
Please fill out applicant mfoanation it drferant than landowner
CONTACT NAME APPLYING IN OFFICE Phone
.,tn�1JG�ICLI�V Phone# gra-29r-(ag40
PROPERTY LOCATION Subdivision /Pm/ro �r% 1 �� Lot# W3 Loot Size - 766
State Road #_ State Road Name I r �1c��y G 2 Map Book & Page gait I b4
Parcel "21)
J - Z -J' PIN "1 :r1 — ✓ 1e�— 22-37- COO
Zoning LU Flood Zone Watershed Deed Book & Page ZZ / 1 t ato0 Power Company
New structures with Progress Energy as service provider need to supply premise number
from Progress Energy
PROPOSED USE
�1
Monolithic
❑ SFD (Size �� x # Betlroorti 2 Baths 2 Basement(w/wo bath) ✓Garage ✓ Deck Crawl Space _ Slab _ Slab—
(is
lab_
(Is the bonus room finished? L_j yes U no wl a closet? (__j yes U no (if yes add in with # bedrooms)
❑ Mod (Size _x----) # Bedrooms_ # Baths_ Basement (wtwo bath)_ Garage _ Site Built Deck _ On Frame_ Off Frame_
(Is the second floor finished? L_) yes L—) no Any other site built additions? (_) yes L_) no
❑ Manufactured Home _SW _DW TW (Size�x_) # Bedrooms _ Garage _(site e built?Deck _(site built?__)
❑ Duplex (Size _x_) No Buildings No Bedrooms Per Unit
❑ Home Occupation # Rooms Use
❑ Addition/Accessory/Other (Size _x_� Use
Hours of Operation #Employees
Closets in addition? (__) yes (__) no
Water Supply V County _ Existing Well _New Well (# of dwellings 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 manufactured home within five hundred feet (500 ) of tract listed above? U yes (� no
Does the property contain any easements whether underground or overhead (J yes L—) no
Structures (existing or proposed) Single family dwellings
Required Residential Property Line Setbacks
Front Minimum 35 Actual 36
Rear 25
Closest Side 10 100
Sidestreeticorner lot
Nearest Building _
on same lot
Residential Land Use Application
Manufactured Homes Other (specify)
Pagel of 2
APPLICATION CONTINUES ON BACK
03111Z� �Z
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINOTON
It parmss are granted I a ree conform to all ordltnd
laws of the Slate of North Carolina regulating such work and the specifications of plans submdletl
I hereby state that foreg mg ements are accurre o the best of m kedge Permit sub act to revocation if false Information is provided
Signature of Owner or Owner's Agent Data
**It Is the ownerlapplicants responsibility to provide the county with any applicable Information about the subject property Including but not limped
to boundary Information house location underground or overhead easements etc The county or its employees are not responsible for any
Incorrect or missing Information that Is contained within these applications
This application aspires s months from the Initlai date If permits have not been Issued
Residentol I and U.,n Application Plge 2 of 2 03'11
Department of Environment, Health and Natural Resources
Division of Environmental Health
On -Site Wastewater Section
SOIL/SITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated:
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: Public❑ Individual ❑ Well
Evaluation Method:[] Auger Bo ' g ❑ pit ❑ Cut
Type of Wastewater: Sewage ❑ Industrial Process
Sheet:
Property ID:
Lot #:
File #:
Code:
Property Size:
❑ Spring
❑ Mixed
❑ Other
P
R
O
F
I
.1940
SOIL MORPHOLOGY
.1941
OTHER
PROFILE FACTORS
L
E
#
Landscape
PosSlope %
Slope%
Horizon
Depth
(N.)
.1941
Strucnne/
Texture
.1941
Consistence
Mineralo
1942
Soil
Wetness/
Color
.1943
Soil
D th Ql.
.1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
y�
�z-
Description Initial Repair System
System
Other Factors (.1946):
Site Classification (.1948):
Evaluated By:
Others Present:
Available Space .1945)
S stem T s)
Site LTAR
ND41¢ a
CURVE RADIUS
LENGTH
\
C-1 335 01:
6921
111
C-2 2500'
4443
C-3 33500
8693
srt
SETBACKS
FRONT - 35
=
SIDE - 10
REAR - 25
/
VICINITY MAP NTS
NOTES/LEGEND
NOT AN ACTUAL SURVEY
AREA BY COORDINATES
R/W - RIGHT OF WAY
0 8 - DEED BOOK
THIS LOT IS NOT LOCATED IN
A FLOOD HAZARD AREA PER
FEMA MAP 8371095860D7
EFF DATE 10/3/2006 ZONE
10 X
SIGHT TR
DELTA CHORD CH BEARING
11 50'14 6909 N 49 14 45 9V
101 49 40' 3881 N 04 15 01 W
14 52 06' 8669 N 39 13 25 E
10 UTILITY
/
EASEMENT
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DECK 0356 ACRES />
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/
<\ PROPOSED
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1105
PROPOSED PLOT PLAN FOR
STANCIL BUILDERS INC.
20 HUMVEE CT - ULLINGTON 27546
LOT 143 PATTON S POINT - PHASE II
MAP 82008-151 - DB 2271 PG 860
BARBECUE TOWNSHIP
HARNETT COUNTY - NORTH CAROLINA
SCALE i = 40' FEB 14 2011
PIN 89597-51-2232000
0 10 20 q M !0
BENTON DEWAR h ASSOCIATES
PROFESSIONAL LAND SURVEYOR
5920 HONEYCUTT ROAD
HOLLY SPRINGS NO 27640 11-13S
(919)-562-9613
NAME �i(A�1GL rJU IGTX.f�J�7I —CklG APPLICATION
"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 BECOM&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 I CONFIRMATION #
Environmental Health New Septic System Code 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 attfor 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 $25 00 return trio fee may be incurred
for failure to uncover outlet hd. mark house corners and oropertv 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 ekist) 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 outlet end of tank as diagram indicates and lift lid straight up (if
possible) and then u d'b�aOpAplace (Unless inspection is for a septic tank In a mobile home park)
• ,DD`NOTTIC TA`K1K
• 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
given at end of recording for proof of request
• Use Chck2Gov 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
(_) 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 { ufNO Does the site contain any Jurisdictional Wetlands?
{_) YES
{ vfNO
Do you plan to have an imeauon system now or in the future?
(_) YES
{ vf•NO
Does or will the building contain any drams? Please explain
(_)YES
I of NO
Are there any existing wells springs waterlines or Wastewater Systems on this property's
{_} YES
{ ✓f NO
Is any wastewater going to be generated on the site other than domestic sewage9
{_}YES
{ ✓fNO
Is the site subject to approval by any other Public Agency9
{_}YES
{Vf NO
Are there any Easements or Right of Ways on this property?
{_} YES
{ -1"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 Imes This is a free service
I 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 Unders an That I Am Solely R onsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site c le So That AC a Site Ev@lustron Can Be PgrfQrmed
PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE
10110