LAND USE Initial Application Date: /14 - I Application # / 5 2 S`6 2 i
cu #
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. Front Street, Lillington, NC 27546 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.hamett.org /permits
LANDOWNER: SW Properties Ventures Mailing Address:
City: Sanford State: NC zip 27330 Contact* 919'770-6972 Email: robbiebrafford @gmail.com
APPLICANT': Brafford Constructio0 Mailing Address: 1738 S. Homer Blvd
City: Sanford State: NC Zip: 27330 contact # 919-770-6972 Email: robbiebrafford @gmail.com
`please fill out applicant information I different than landowner
CONTACT NAME APPLYING IN OFFICE: Robbie Brafford Phone # /n7 !
PROPERTY LOCATION: Subdivision: Summerlin rf / /� Lot #: t Lot Size; 7/ J
State Road ## I5 Z��'� 7 re yf r
State Road Name [If l � j - / sue 11.4 . �^ / ` / � Map / B 0 00k &Page:
Parcel: U I q / (2 O f PIN: / l b 7 3 — Z Z7 P00
Zoning: , f A Z Mood Zone:. / ✓ Watershed: �> q
Deed Book &Page: 7 7/0 I Y 2/ 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: Hwy 27 to Hwy 87 North towards Sanford. Drive about one mile and tum
left onto Milton Welch Rd. Summerlin will be about 1 mile on the right. Apache Trail is the first road to the right. The lot is on the left.
PROPOSED USE:
n �'� Monolithic
iI SFD: (Size _ L x . ,.3,5 Bedrooms: 3 # Baths: 2 Basement(w/wo bath): Garage: ✓ Deck: ✓ Crawl Space: ✓ Slab: Slab:
(Is the bonus room finished? (_) yes Lino w/ a closet? (i yes ( )no (if yes add in with # bedrooms)
❑ Mod: (Size x ) # 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? ( ) yes ( )no
❑ Manufactured Home: _ SW _ DW _ TW (Size x ) # Bedrooms: _ Garage: (site built? ) Deck: (site built? )
❑ Duplex: (Size _ x ) No. Buildings: No. Bedrooms Per Unit:
❑ Home Occupation: # Rooms: Use: Hours of Operation: *Employees:
❑ AdditionlAccessory/Other: (Size _ x ) Use: Closets in addition? ( ) yes (ono
Water Supply: 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 manufadured home within five hundred feet (500') of tract listed above? U yes (Jno
Structures (existing or proposed): Single family dwellings: Yes Manufactured Homes: Other (specify):
Required Residential Property Line Setbacks: Comments:
/ s
Front Minimum S Actual 37
Rear 7 9 l 9
Closest Side /
Sidestreet/comer lot
Nearest Building
on same lot
If permits are granted 1 agree to conform to all o s a ws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing statements are a an rrect the best of my knowledge. Permit subject to revocation it false information is provided.
S attire of or Owner's Agent Date
"This appll on expires S 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 LANG USE APPLICATION
Residential Land Use Application Page 1 of 1 07/10
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NAME: APPLICATION #: l a 5V, - 2_4" -- o Zi
*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)
910 - 893 - 7525 option 1 CONFIRMATION #
❑ 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. $25.00 return trip fee may be incurred
for failure to uncover outlet lid. 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 Exlstina 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 put lid back in' place. (Unless inspection is for a septic tank in a mobile home park)
▪ DO NOT LEAVE LIDS OFF OF,SEPTIC TANK
• 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
Oven 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.
{_ 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:
{ 1 — } 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 drains? Please explain.
I 1 — NO Are there any existing wells, springs, waterlines or Wastewater Systems on this property?
{_}YES ( _) NO Is any wastewater going to be generated on the site other than domestic sewage?
{_)YES (_) 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?
1_ }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.
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 Understand That I Ain Solely Responsible For The per Identification And Labeling Of All Property Lines And Corners And Making
i
The Site Accessibtc.SothaJ A'�Complete Site nation Can Be Performed.
PROPER'L'Y OWNERS O NERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE
10 /10