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LAND USE Initial Application Date: I' _ lb - /✓ Application # / 9 5-29 2 ‘ Z2_ 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.harnett.org /permits LANDOWNER: SW Properties Mailing Address: 1738 S. Horner Blvd City: Sanford State: NC Zi 27330 Contact # 919 - 770 -6972 Email: robbiebrafford©gmail.com APPLICANT': Brafford Construction Mailing Address: 1738 S. Horner Blvd City: Sanford State: NC Zi 27330 Confect it 919'770-6972 Email: 'Please fdl out applicant infomtation it different than landowner CONTACT NAME APPLYING IN OFFICE: Robbie Brafford Phone # 919'770 - 6972 PROPERTY LOCATION: Subdivision: Summerlin ., Lot #: 17 Lot Size: .58 State Road # 1 ' State Road Name: M' / 7 Oi / ' / t w 1_./ /4I Map Book &Page: 2 Pit, 4 3 Z Parcel: 99567 0054 45 PIN: 9567 931058 , DCf Zoning: RA Flood Zone ` Watershed: l / fill Deed Book&Page: 2710 / 891 Power Company': Central Electric 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 from Lillington to Hwy 87 N. Approximately one mile on the left is Milton Welch Rd. Go down Milton Welch Road and Summerlin is about one mile on the right. PROPOSED USE: 1, Monolithic fd SFD: (Size *SD x Cab) # Bedrooms: 3 *Baths: 3 Basement(w/wo bath):_ Garage:_ Deck:_ Crawl Space:_ Slab:_ Slab:_ (Is the bonus room finished? ( ) yes (ono w/ a closet? (_J yes ( )no (if yes add in with # bedrooms) ❑ Mod: (Size _x ) # Bedrooms_ *Baths Basement (w/wo bath)_ Garage:_ Site Built Oeck:_ On Frame Off Frame_ (Is the second floor finished? (__) yes (_)no Any other site built additions? (J yes (ono ❑ 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: U Hours of Operation: #Employees: ❑ Addition/Accessory/Other: (Size x ) Use: Closets in addition? (J yes L. 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 manufactured home within five hundred feet (500') of tract listed above? ( ) yes (jJno Structures (existing or proposed): Single family dwellings: Manufactured Homes: Other (specify): Required Residential Property Line Setbacks: T Comments: Front Minimum 3 4 Actual . 3 � Rear L 4^ Closest Side ____L_ L Sidestreeticorner lot Nearest Building on same lot If permits are granted I agree to conform to all o ' s and t te of North Carolina regulating such work and the specifications of plans submitted. I hereby state that foregoing statements a te an e best of my knowledge. Permit subject to revocation if false information is provided. S attire of or or Owner's Agent Date • "This application expires 6 months from the Inhfal 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 Residential Land Use Application Page 1 of 1 07/10 1 r i 3 i i 1 . ,_ li--- — 1 - w APialAdr-v i c i .....' 1 r h 1 _ __, . , _±..._ lin L, 1 NAME: APPLICATION #: i 4 ' 2 4 (O 2Z *This application to he 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) 9W- 893 -7525 option I 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 sail 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 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 put Ild 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 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. J_) Accepted (_I Innovative {_) Conventional {_) Any {_) Alternative (_J 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? 1 — I YES ( NO Do you plan to have an irrigation system now or in the future? {_AYES {_) NO Does or will the building contain any drains? Please explain. 1_IYES 1 — NO Are there any existing wells, springs, waterlines or Wastewater Systems on this property? 1_IYES 1_) 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 1_) 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. 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 1 Am Solely Responsi or The Proper Identification And Labeling Of All Property Lines And Corners And Making The Site Accessible at A Co a Site Evaluation Can Be Performed. PROP 0 NE OR OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DATE 10 /10