LAND USE initial Application Date: / D — I — //O Application # D 4 ao 7 7J7
Cliff
COUNTY OF HARNETY RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. Front Street, Lillington, NC 27548 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.hameti.orglpernits
LANDOWNER: SGo S Mailing Address: 51.2 5 1 y be
City: Rut v all • \) lx c ( n a . State: N3 L Zip: 71521, Contact # 4 291 . 4 1 1 z- Email: 5E4G4-1A 66 R t..(L) lA ako D• tom
APPLICANT': S 14A i ktS.S Moo u L Mailing Address:
City: State: Zip: Contact # Email:
`Please NI out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE: Sect\ Phone #
i L J //
PROPERTY LOCATION: Subdivision: r L ill D H t /4 Lot #: /2 Z Lot Size: iii / Cr `,c
State Road 2 2 3 e%) 7 State Road Name: 7 1 jays p 0/ Map / Book &Page: 29414 O 7
Parcel: 00 Z 9 53 O Z d/ , y , 92 PIN: t /' 6Y 15 /5 agO
Zoning:7A /Flood Zone: Watershed:. Deed Book &Page: 2 2 / `/ 9//n� r Company *: /1/42,7 'New structures with Progress Energy as service provider need to supply premise number /U from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: Nor 19n I-1 D 1
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CV V I L.'tt r , c-- 4k -\ 7E-
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PROPOSED USE:
Monolithic
❑ SFD: (Size x ) # Bedrooms: # Baths: BasemeM(w/wo bath): Garage: Deck: Crawl Space: Slab: Slab:
(Is the bonus room finished? (J yes Lino w/ a closet? L_) yes (__)no (if yes add in with # bedrooms)
❑ Mod: (Size _ x ) 0 Bedrooms # Baths Basement (w/wo bath) Garage: Site Built Deck: On Frame Off Frame
(Is the second floor finished? (__) yes Lino Any other site built additions? (D yeti (= )no -
❑ Manufactured Home: _ SW _ DW _ TW (Size x ) # Bedrooms: _ Garage: (site built? ) Deck: (site built?___)
❑ Duplex: (Size _ x ) No. Buildings: No. Bedrooms Per Unit:
• ome Occupation: # Rooms: Use: Hours of Operation: #Employees:
Addition/Accessory/Other: (Size N i x 2I 1 y ) Use: 60A t., S. Q Do " Closets in addition? ( Kl yes (__)no
❑ er Supply: X 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 v�/
Does owner of this tract of land, own land that contains a manufactured home within live hundred feet (500') of tract listed above? (__) yes (pino
Structures (existing or proposed): Single family dwellings: 6 KT Manufactured Homes: Other (specify): p tt t loo AuS fonts
Required Residential Property Line Setbacks: Comments:
Front Minimum Actual
Rear
Closest Side
SldestreeUcomer 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 fo 'n state rrkAnte,are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
1D - (5 .2t>to
Slgnatur of Owner or Owner's Agent Date
"This application expires 6 months from the Initial date H permits have not been Issued"
A RECORDED SURVEY MAP, RECORDED DEED IOR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION
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NAME: WA t�.v.,\,trA APPLICATION #: /0 ✓ 77 2 CJf/
*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) // Z `z�rl O
910- 893 -7525 option 1 CONFIRMATION #
❑ Environmental Health New Septic SystemCode 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. $25.00 return trip fee may be incurred
for failure to uncover outlet ltd. mark house corners 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 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 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 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.
1 -1 Accepted (_) Innovative 1 -1 Conventional 1 -1 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 1_1 NO Do you plan to have an irri¢ation system now or in the future?
1_1YES 1_1 NO Does or will the building contain any ? Please explain.
(_}YES I — NO Are there any existing wells, springs, waterlines or Wastewater Systems on this property?
(_)YES j_) NO Is any wastewater going to be generated on the site other than domestic sewage?
1_}YES 1_1 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?
(_IVES 1_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 lines. 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 Omcials Are Granted Right Of Entry To Conduct Necessary Inspections To Determine Compliance With Applicable Laws And Rules.
1 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 P rf@ ormed.
\1pY. 1D 0
PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE
I 1/09
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DIAGRAM OF TYPIC • C TANK
1
,. , BEM F
r : LID
II
POSSIBLE POSSIBLE
HOUSE HOUSE
CONNECTION — CONNECTION
POSSIBLE
HOUSE
CONNECTION
POSSIBLE LID SHAPES
I I SQUARE (SHOWN ON DIAGRAM)
RECTANGLE (OLDER TANKS) — ROUND
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HARNETT COUNTY TAX ID#
iL . 1 r 7 . t. . Rat .: 1- rr
IB a DEEDS
, t, .'luY
O X96 11:r. 1 : d:! P!1
. hard r wit fr PEW II 216686828
STATE OF 0 • OLINA GENERAL
COUNTY OF WARRANTY DEED
Excise Tax: $400.00 0
Parcel ID Number: 08065302011 0' 1. 6 .71
Prepared by & Mail to: The Law :. ' • • . nt Mercogliano, P.A., P.O. Box 1281, Fuquay- Varina, NC 27526 '
Title Insurance Provided by: Statewide itlort A O
THIS DEED made this 18 day of A / .106 .y and bet--n
GRANTOR r GRANTEE
Michael Anderson Honies, Inc. cha ierg and Amy Schaberg
180 Woodland Ridge Drive yl:. tone Drive
Fuquay - Varina. NC 275264• NC 27526
e
The designation Grantor and Grantee as used herein shat I inc ude , :: ies, their heirs, successors, and
assigns, and shall include singular, plural, masculine, feint ' • required by context.
WITNESSET.
TI IAT the Grantor. for a valuable consideration paid by the G • - i - ei. of which is hereby
acknowledged. has and by these presents does grant, bargain, sell an. - on , • o he Grantee in fee
simple. all that certain lot or parcel of land situated in Hectors Cree To •.: ip . • ld County and State,
and more particularly described as follows:
BEING all of Lot No. 122 of Victoria Hills Subdivision. Phase 6, as sin w• .n . f s ey
dated February 15, 2005 by Mauldin-Watkins Surveying, P.A., Fuquay- : j -r. • . rth t arolina
and recorded in Hook of Maps 2005. Page 655, Harnett County Registry, ref.. -ne • :p t
hereby made for greater accuracy of description. The metes and bounds desc ' . u sho6')
thereon is incorporated herein by reference. �
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