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DOCUMENTS Initial Application Dale: 3'3 1 ) f • Application# I ' l Sb ` 161 CU# COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION Central Permitting 108 E. Front Street.Lillinglon.NC 27546 Phone. (910)893-7525 ext2 Fax (910)893-2793 www.harnettorg/permits "A RECORDEDSURVEYMAP,RECORDED DEED(OR OFFER TOP�URC1H'ASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION" LANDOWNER' AA-II Uky4L' & / 64410°'' 8r'oc Mailing Address. of 1-- C✓bwervlef✓ Ln City: I/4Vt✓N _State:WC- Zip2L33 / Contact No V? // 70°5- Email'' U-h5p4 3261COrteaL Ca'( APPLICANT': _ Mailing Address. City State Zip: Contact No Email. `Please all out applicant information if different than landowner CONTACT NAME APPLYING IN OFFICE: {__ 1� Phone# PROPERTY LOCATION: Subdivision fV \k. 110 ' Lot#: Lot Size::�II I,Ci acit5 State Road# I�iaq State Road Name': C(OWH✓le LAI l Map Book 8,Page..2Olac/ 1 7 Parcel' � N-1538 goof) J.2 PIN 15-3 - 13—67A), ooD Zoning: RA-3D Flood Zone. Watershed. NM Deed Book&Page 3033 / 'Ubower Company` Oahe 612,15.1 ENOJy 'New structures with Progress Energy as service provider need to supply premise number from Progress Energy. PROPOSED USE: Monolithic 7 SFO (Size x 1#Bedrooms #Baths: Basement(w/wo bathe. Garage: Deck: Crawl Space Slab:_Slab: (Is the bonus room finished?( )yes ()no wi a closet?( )yes ( )no(if yes add in with#bedrooms) J Mod-(Size x )#Bedrooms #Baths_Basement(w/wo bath)-_Garage: Site Built Deck On Frame OH Frame (Is the second floor finished?(_)yes ( )no Any other site built additions?( )yes ( )no J Manufactured Home: SW OW TW(Size x )#Bedrooms. Garage: (site built? )Deck (site built? ) J Duplex.(Size x )No.Buildings: No. Bedrooms Per Unit J/ Home Occupation.#Rooms: os Use: l- n Hours�rsof Operation: #Employees. ■ Addition/Accessory/Other.(Size 16 xao )Use: S !or tJC ;MAU(45 Closets in addition?(_)yes ( )no Water Supply. County Existing Well New Well (#of dwellings using well )'Must have operable water before final Sewage Supply: New Septic Tank(Complete Checklist) V--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 ( ) no Does the property contain any easements whether underground or overhead( )yes (V)no �" Structures(existing or proposed).Single family dwellings. Manufactured Homes: I Dyv Other(specify) Required Residential Property Line Setbacks: Comments: Front Minimum 3'7 Actual 931 I qQ �I Rear 2S 10' 1 Closest Side 5I1 Sidestreet/corner lot Z 1,t Nearest Building &r t on same lot SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: Mkt tt 121 E ;Li. The-i -lake Hwy 2-1 -0,Q4-4 13e-tucwt , Nowt 4 rah h diA111.7 #vaeyes C4aeef kit FDCIo.i N9teJ C4apc1 G—d CYOJSOVtr 301, C97 fret"c ov 1-64e, Glutei cf✓yfl( yttt xtulce a Ie.4 a4+o C✓ouMI4eid Lfn. P �y isc -F/sf Phot. 0-i fte__ lei! plc '/" . cal de -Sac- 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 foregoing statem is a e accurate and correct to the est of my knowledge. Permit subject to revocation if false information is provided. eit.w et< 3/31/17 S gnature Owner 6r Owner's Agent Date '""It is the owner/applicants responsibility to provide the county with any applicable information about the subject property,including but not limited 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 expires 6 months from the initial date if permits have not been issued** LB =CD b LEGEND p1 1. House 2. StoragewBuilding( (10'x) 3. Firewood Shed (10'x6') - ooa She'd-6 from Rea,Pmnad,c,e . r• Proposed New storage-e rmm Pear 0-P?it ten- 4Proposed New Storage •r Building (16'x20') • ws,ar1: ABEr e A W © —Ee, —> J* CD I J �^ � � I � \ • N tit Iry� 1 .0 1 ACRES ima,ar,�e saB a S i • ee,wee� , IIg > \1 v y o ^ 1 cc J CI CI- 0N vN orewa •'yu' a _ On e3 o w o T I a b oow_ to w� Ia i Vl I co:' C 20' public drainage women 20' public drainage roomer20' • ' 4' Ln ditch' /- Mon Wc(i Tdn 10' on each id—4.1%2-4--r- N6 67. 7"E Sl __ _— _IIBAY.' 'OZ:E 16 on each _1 5� 67.00 -- -7_7:27SS �n' a.1 epch glee igpH.-- / I 10 side s .R: i ^ Y U / r / Permanent EBB c -.l. / Cul-de-sac `ti ^,.t;D Al C w Q) .+ VI 15. --.C.,)D.60 ACRES --.C.,) __ v _ _ 2j?3S y ERP+1 25 R QJ� 03i' Re 21 ERB o q 1 c , d O i • `a ytircy/ p� r0 • 0.76 AC 0 CJ SITE PLAN FOR 40 0 40 80 ANTHONY WAYNE BROCK and wife, 11 I I I I a ..., SONYA BARBOUR BROCK GRAPHIC SCALE 1 .5" = 80' NAME: APPLICATION It: *This application to he filled nut 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 SVsfemCode 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 aVfor Central Permitting. • Place orange Environmental Health card in location that is easily viewed from road to assist in locating properly. • 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 aiven at end of recording for proof of request. • Use Click2Gov or IVR to verity results. Once approved, proceed to Central Permitting for permits. 1 f 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 lid back In plane. (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 I & 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. S DTIC I applying for authorization to construct please indicate desired system lype(st: can be ranked in order of preference,must choose one. I I Accepted I-1 In rive {_) Conventional II Any i I Alternative I— ther Th- applicant shall notify the ocal health d. 'artment upon submittal of this app teat en if any of the following apply to the pr perty in qui stion. If the answer is"y-s",applicant UST ATTACH SUPPORTING aOC MENTATION: i YES I1 NO aoes the site conta any Jurisdictional Wetlands? I— YES I—I NO Do you plan to hay: an 'tat now or i the futu -? i1 S I_I NO Does or will the buil I ing contain any drains?Ple se explain II ES II NO Are there any existin; wells,springs,waterlines r Wastewa.-r Systems on this property? i—IY S I—I NO Is any wastewater goi g to he generated on the ite other tha domestic sewage? I—II(I { I NS Is the site subject to ap'royal by any other Pts is Agency? I—I YE II N Arc there any Easement•or Right of Ways of this property'! I—I YES { ) N I Does the site contain any -xisting water,Cale,phone or under_ ound electric lines? If yes please call No Cuts . 800-632-49 ' to locate the lines. ',is is a free service. I Have Rea 4.This A plication And Certify That The Infor • 'on ' i vided Herein Is True,Comp 9e And Correct. Aulh' 'zed County And Stale Officio Are .ranted Right Of Entry To Conduct Necessary Inspections To Determine Comp'.nee With Applin Ile Laws And Rules. I Understand a Am Solely Responsible For The Proper Identification And Labeling Of All Prnpe ines A , orners And Making The Site Accessib o That A Comp Site Evalutotion Can Re Performed. ,07 ROPERT WNE OR OWNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) 7 DAT 10110 I — . ev Kimberly S. Hargrove REGISTER OF DEEDS Harnett County NC 2012 SEP 14 11:36:02 nM 8K:3033 PG:320-321 FEE:3y25.s00 INSTRUMENT 20120114731 daMCNEILL tf41P ,...;11,i;r4;c-211 # 1111110 20120141 ade 110. fQ{rrrY f NORTH CAROLINA gE9L WARRANTY DEED Excise Tax: 520.00 wRecording Time,Book and Page: Tax Ma,No. Parcel Identifier No: Ptn of 021538 9000 2 Mail after recording to: Lynn A.Mr, p m ce Drive,Dunn,NC 28334 This instmment was prepared by: Lynn • . ws, • Lig, THIS DEED made this r ,: 4 September , 2012 by and between T GRA a ' Kurt Andrew Stabler and wife,Janet Helen Stabler Mailing Address: 152 Crownview Lane,Dunn,NC 283 : — GRANTEr Anthony Wayne Brock and wife,Sonya Barbour Brock Property Address: 1.01 acres on Crownview Lane,Dunn,NC 28%34 Mailing Address:40 Brush Arbor Lane,Dunn,NC 28334 The designation Grantor and Grantee as used herein shall include said parties, .-ir het s cesso .,and assigns,and shall include singular,plural,masculine,feminine or neuter as required by context. WITNESSETH,that the Grantor,for a valuable consideration paid by the Grantee,th- rec- • of w:- H ereby acknowledged, has and by these presents does grant,bargain,sell and convey unto the Grantee in fee Si os le,a : a ertai• lot or parcel of land and more particularly described as follows: BEING all of that Parcel I,containing 1.01 acres,as shown on survey map dated Augu. 10 Il -ntitl . "Map for Kurt Andrew Stabler and wife,Janet Helen Stabler" and recorded in Map Book 2012,Page • nett my 'egistry. TOGETHER WITH a 30 foot Private Road easement from the above described Parcel 1 to :w ew e 2 :hown on survey map entitled"Map for Kurt Andrew Stabler and wife,Janet Helen Stabler" and recor: •din . • . : k 21 2,Page 447,Harnett County Registry. O If the Grantees herein desire to give or sell the property to anyone other than their heirs,they agree g, i e G n . herein or their heirs the first option to buy back the property herein described for the original price ' s tb : 9 co. - to the Grantees of any permanent improvements such as a septic system,well etc.Foundations Bible Col • Id h ye the second option to puchase under the same terms. // /\ (17 or • :rttion of the property hereinabove described was acquired by Grantor by instmment recorded in Book 2816 ,Page 8_ , �. . ;e County Registry. A • • - owi g the above described property is recorded in Plat Book 2012 ,Page 447 ,and referenced within this nt. les • . • •. ribed property include the primary residence(yes/no)7 No - E.��aaayhhaa TO OLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in f.sim And .e Grantor • .• ants wi h th- Grantee,that Grantor is seized of the premises in fee simple,has the right to convey the same in fee sim. - it , s mark-a; e ,. free and clear of all encumbrances,and that Grantor will warrant and defend the title against the lawful clai of a , . horn 'ever except for the exceptions hereinafter stated. Title to the p ..--fly -'nab bye • is subject to the following exceptions: 1.2013 ad va em t' es w, h afiot yet due or payable 2.Restrictions, •mei : and ghts of way as they appear of record IN WITNESS WHE' OF ee_anto :as hereunto set his hand and seal,or it corporate,has caused this Instrument to be signed In its corporate : • e :y Its . a harked oRieer(s),the day and�nd��yeaar�r first above written.�/f// Al. ���Ew(j ' 9 ' ..)c (SEAL) (Entity Name) urt ldrerew Stab ( ) By: //lam/e�[[//n l SEAL Janet Helen Stabler Title: By: (SEAL) Title: (SEAL) NORTH CAROLINA HARNETT COUNTY I certify that the following person(s)personally appeared before me is s oh ,., 0. -,,ing met at he or she signed the foregoing doeent: Kurt Andrew Stabler an• e Janet He •n S able es y ham and official stamp or seal, this the Tkday of ..1.14T! i r_ , -inner My Commission Expires: ��3 I Lj -fff ,,p,wupryr, Not: , , ,,�� P- MATT Print Notary . �/I R L 4dss 3 �a.,...... .,h'F :: -:' NOTARY ‘.cnt --"-:> 2•'. PUBLIC io 2. 9 • 4, ... , 0 _40 , f / " 09109111 Application# Harnett County Central Permitting Each section below to oe filled out PO Box 65 Liii ngton NC 27546 910 893 7525 Fax 010 893 2793 www harnett erg/permits by whomever performing work Must be owner or licensed contractor Address company Application for Residential Bwldtna and Trades Permit name Si phone must match Owners Name Alk'ItavL 'U - c 64)Jc— Date Site Address Itd? Cvdun✓cew L_ Phone rllc1y1-15-7aff Directions to Job site from Lillltngton ,7kc Mkt Y21 E. "f+' /kit 27. FeGar - / 2-7 11+ ?44e/ a l Ref. Lox,tiialC J� A10v�i are/ kjr it 0BW2✓<ei ' I-. Athr 1y / -. rrt pte,e o_ kit_ le 1- psi At/—ale Subdivision Lot Description of Proposed Work /6 V 2° 'GI,,TM 99 L7' �'-L #of Bedrooms _ Heated SF Unheated SF Finished Bonus Room? Crawl Space Slab _ General Contractor Information 9.uv e✓— ei I`1-c1'5-7005" Building Contractors Company Name Telephone Address Email Address License# Electrical Contractor Information Description of Work Service Size Amps T-Pole Yes _No Dwil ev-- qkg—`i?5---7oas Electrical Contractors Company Name Telephone Address Email Address License# Mechanical/HVAC Contractor Information Description of Work l'cl/ fr Mechanical Contractors Company Name Telephone Address Email Address License # Plumbma Contractor Information Description of WorkL/ # Baths Plumbing Contractors CompanyP/NNaame Telephone Address Email Address License # /Insu atton Contractor Information Insulation Contractor s Company dme&Address Telephone *NOTE General Contractor must fill out and sign the second page of this application I hereby certify that I have the authority to make necessary application that the application is correct and that-the construction will conform to the regulations in the Building Electrical Plumbing and Mechanical codes and the Harnett County Zoning Ordinance I state the information on the above contractors is correct as known to me and that by Nanlna below I have obtained all subcontractors permission to obtain these permits and if my changes occur including listed contractors site plan number of bedrooms building and trade plans Environmental Health permit changes or proposed use changes I certify it is my responsibility to notify the Harnett County Central Permitting Department of any and all changes EXPIRED PERMIT FEES-6 Months to 2 years permit re-issue fee is$150 00 After 2 years re-issue fee is as per current fee schedule edrIA 3/37//7 Signature of ner/Contractor/Ofhcer(s)of Corporation Date Affidavit for Worker's Compensation N C G S 87-14 The undersigned applicant being the General Contractor Owner Officer/Agent of the Contractor or Owner Do hereby confirm under penalties of perjury that the person(s) firm(s)or corporation(s) performing the work set forth in the permit Has three(3)or more employees and has obtained workers compensation insurance to cover them Has one(1)or more subcontractors(s)and has obtained workers compensation insurance to cover them Has one(1)or more subcontractors(s)who has their own policy of workers compensation insurance covering themselves Has no more than two(2)employees and no subcontractors While working on the project for which this permit is sought it is understood that the Central Permitting Department issuing the permit may require certificates of coverage of workers compensation insurance prior to issuance of the permit and at any time during the permitted work from any person firm or corporation carrying out the work Company or Name Sign wattle J nit CI Date 3/3/./7./7 HARNETT COUNTY CASH RECEIPTS *** CUSTOIER RECEIPT *** Oper: 3BROCK Type: CP Drawer: 1 Date: 4/86/17 52 Receipt no: 305242 Year Number Amount 2817 58041071 147 CROONVIEN LH DUNN, NC 28334 84 BP - ENV HEALTH FEES EXT TANK 4188.80 SONYA BROCK Tender detail CP CREDIT CARD $180.08 Total tendered {1ea.e0 Total payment $108.88 Trans date: 4/06/17 Time: 9:11:19 ** THANK YOU FOR YOUR PAYMENT **