DOCUMENTS Initial Application Date: 13 Jf/t 1.., ZO(T" Application a I 1 SOO y II Q
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street,Lillington,NC 27546 Phone:(910)893-7525 ext.2 Fax:(910)893-2793 www.harnett.orglpermits
^A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN AREARREQUIREDQWHEN SUBMITTINGMITIA LAND USE APPLICATION^
LANDOWNER:\\ or J(L2S if 1AXIS-472"4S�siINCidailing AOddress':cl, &COs /G ru3 .
City:Y.-
APPLICANT':
K S u`iIJ,L.-A-- Statea(,C Zip: t T'/IContact No laa1O -3Lr•�1pzre Email:
APPLICANT': ¶L)Fs.(- -OA. (.LC. . II'' Mailing Address: ez) Ys D> ( r ?-?--t 11
City: .�MhLL... SA— State61,,Zip Contact No:7(0 - Z3�'34c(Email:} .(•o �.I t')1250'1.net
*Reese fill oga rant information if different than landownnr/� ' ,, `- � I11', q
CONTACT NAME APPLYING INOFFICEC I li I I)M` Y • Phone# Ties — z;77' 3{C I
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PROPERTY LOCATION:Subdivision: 'Ci.O4-i rtal- 1IL- Lot#: SA Lo't'1Size'.'.
State Road# SSttate Road Name: 1351 Fe c,ta, C - . Luu o,' - Atc-259a Map Book&PageOGO)1l `D
Parcel'.��61/N0��7��4/-J 6004/'2f IL PIN: 65T—T_ *7' O 574
Zoning':p..Aa sed Zone: t Watershed':�rl Deed Book&Page: —FP Power Company:
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PRO OSED USE:
nolithiC
SFO:(Sizetx 351()#Bedrooms:'A#Baths: t-13asement(wlwo bath): ',Garage: Deck:_Cravd Space:_Slab'. 4._
(Is the bonus room finished?(_)yes ( )no wl a closet?( )yes U no(if yes add in with#bedrooms)
❑ Mod:(Size x )#Bedrooms_#Baths_Basement(w/wo bath) Garage: Site Built Deck: On Frame Off F ame_
(Is the second floor finished?( )yes U no Any other site built additions?U yes ( 1 no
❑ Manufactured Home:_SW_DW TW(Size x )#Bedrooms:_Garage:_(site built? )Deck: (site built? )
❑ Duplex:(Size x )No.Buildings: No.Bedrooms Per Unit:
U Home Occupation:#Rooms: Use: Hours of Operation: #Employees:
U Addition/Accessory/Other:(Size x 1 Use: Closets in addition?(U 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?( )yes el)no
Does the property contain any easements whether underground oroverhead( 1 yes (✓)no
Structures(existing • •ropose. Single family dwellings: ✓/ Manufactured Homes: Other(specify):
Required Residential
PProperly line Setbacks: Comments:
Front Minimum S0 Actual ,
Rear 25 (06
Closest Side (6 l ,‘
Sidestreeucorner lot IW/r4
Nearest Building N/.Y'
on same lot
Residential I and Use Application Page t o12 03111
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
If permits are granted I agree to co ances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing st _ . - and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
�� •,,;drr• • nor or• nor'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 responsibw 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"
Residential Land Use Application Page 2 oft 03/11
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IVERCON, INC. Sweetwater - LOT # 56 SCALES I" 30'
FO Sox 64778 910-337.3561-ph
Fayetteville,NC 28306 910-31)-5-76-Mr
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NAME: Z/62Loti( I lei-LG, APPLICATION#:
*This application to be tilled 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 fl
Environmental Health New Septic SystemCode 800
• All properly 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 properly is thickly wooded, Environmental Health requires that you clean out the underarowth 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 reauest.
• 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 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
it multiple permits, then use code 800 for Environmental Health inspection. Please note confirmation number
given at end of recordina 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 cons t please indicate desired system type(s): can he ranked in order of preference,must choose rte.
i—} Accepted ( Innovative {_} Conventional {_} Any
(_} Alternative l_} 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. lithe answernsis"yes",applicant MUST ATTACH SUPPORTING DOCUMENTATION:
{_}YES (_�/NO Does the site contain any Iuisdictional Wetlands?
(_!YES (y'NO Do you plan to have an irrigation svlu now or in the future'!
(_}YES I y�NO Does or will the building contain any drains?Please explain.
DYES 1I NO Are there any existing wells,springs,waterlines or Wastewater Systems on this property?
(_}YES IV Is any wastewater going to be generated on the site other than domestic sewage?
(_}YES 1✓)/NO Is the site subject to approval by any other Public Agency?
{_}YES (✓I NO Are there any Easements or Right of Ways on this property?
(ZYES i—! NO Dues 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 • ,. a'd- • •.ponsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The dipp/1O C' plete Site Evaluation Can Be Performed.
- - -_ /3 frit. ZA/_-.
J.'r - RS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE
10/10
0 TO PURCHASE AND CONTRACT-VACANT LOT/LAND
[fats 'Guidelines"(form 12G)for guidance in completing this form] {I
NOTE: This contact is ' Ica • vet real properly that Buyer will purchase only for personal use and does not have
immediate plans to subdivide. not be used to sell property that is being subdivided unless the property has been platted,
properly approved and rec register of deeds as of the date of the contract If Seller is Buyer's builder and the sale involves •
the construction of a new single firmly dwelling prior to closing, use the standard Offer to Purchase and Contact—New Construction
(Form 800-T) or, if the construction is completed, use the Offer to Purchase and Contract (Form"2-T) with the New Conslrucdon
Addendum(Form 2A3-T).
For valuable consideration,the receipt and legal sufficiency of which are hereby acknowledged,Buyer offers to purchase and Seller upon
acceptance agrees to sell and convey the Property on the terms and conditions of this Offer To Purchase and Contract and any addendum
or modification made in accordance with its terms(together the"Contract").
1. TERMS AND DEFINITIONS:The terms listed below shall have the respective meaning given them as set forth adjacent to each
term.
(a) "Seller": Diversified Investors, Inc.
f(b) "Buyer": Ivercon, Inc.
(c) "Property":The Property shall include all that real estate described below together with all appurtenances thereto including the
improvements located thereon. NOTE: If the Property will include a manufactured (mobile) home(s), Buyer and Seller should
consider including the Manufactured (Mobile)Home provision in the Additional Provisions Addendum (Standard Form 2A11-T)
with this offer.
Street Address: 115 & 138 Polly Court, Linden, NC 28356
City: Zip:
County: Harnett ,North Carolina ,
(NOTE:Governmental authority over taxes,zoning,school districts,utilities and mail delivery may differ from address shown.)
Legal Description: (Complete ALL applicable)
Plat Reference:LotAnit 53 & 56 ,Block/Section ,SubdivLsion/Condominium Sweetwater
,as shown on Plat Hook/Slide atPage(s)
The PIN/PID or other identification number of the Property is:
Other description:
Some or all of the Property maybe described in Deed Book at Page
(d) "Purchase Price": I.
$ 56,000.00 paid in U.S.Dollars upon the following terms:
$ BY DUE DILIGENCE FEE made payable and delivered to Seller by the Effective Date.
$ BY INITIAL EARNEST MONEY DEPOSIT made payable and delivered to Farrow
Agent named in Paragraph 1(0 by 0 cash Q personal check 0 official bank check
Q wire transfer,HITHER 0 with this offer OR 0 within five(5)days of the Effective
Date of this Contact.
$ BY (ADDITIONAL) EARNEST MONEY DEPOSIT made payable and delivered to
-_. Escrow Agent named in Paragraph 1(f)_by cash or immediately available funds such as
official bank check or wire transfer no later than TIME
BEING OF THE ESSENCE with regard to said date.
$ BY ASSUMPTION of the unpaid principal balance and all obligations of Seller on the .:
existing loan(s)secured by a deed of trust on the Property in accordance with the attached
Loan Assumption Addendum(Standard Form 2A6-T).
$ BY SELLER FINANCING in accordance with the attached Seller Financing Addendum
(Standard Form 2A5-T).
$ 56,000.00 BALANCE of the Purchase Price in cash at Settlement(some or all of which may be paid
with the proceeds of a new loan),
This form Jointly approved by: Page 1 of 11 ^ STANDARD FORM 12-T
North Carolina Bar Association u Revised 712015
North Carolina Association of REALTORS®,Inc. wetC 712015
Buyer initia1t F— Seller initials
r&MAXPT Je.9gam In ameba=auAPotlry,M3•NC21103 Marc 4910044711 Pia:(910)&544C45 4113a.nry
9m Xo,6" P,Wuctl Mn tl{Forme M a pip& I 1070 Floe MY Roar{Rax,NM4en cane ateasosaans
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20. COMPUTATION OF DAYS/TIME OF DAY: Units otherwise provided,far Flypasts of this Contract,the term days" shall
meat consecuuveceltadac days,including Saturdays,Sundays,and hnu*tys,whether fedesl,awe,local or religious,For the purposes 'I
of calculating days,the muni of"days" shall begin on the day ioRowins the day upon which any=or natio as provided in Jus
Caottact was metered to bepcikornmd at made.Royre(reoce to a date or time of day shall refer to the date mmdlortime of day in E.
the State of North Ceram i i.
:
THE NORTE CAROLLNAASSOCIATION OF REALTORS®,NC.AND THE NORIA CAROLINA BAR ASSOCIATION MACE I_.
NO REPRESENTATION.LSI TO TEE LEGAL VALIDITY OR ADEQUACY OF ANY PROVISION OF THIS FORM IN ANY t-
DI
SPECC TRANSACTION.IFYOUDO NOT UNDERSTAND THIS FORM OR MEL THAT IT DOES NOT PROVIDE FOR YOUR
LEGAL M1EDS,YOU SHOULD CONSULT A NORTH CAROLLNA REAL ESTATE ATTORNEYBEFORE YOU SIGN it P
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This offer shall become a binding contract on theEdeciivo Data Unless specifically provided otAerwisc,Buyers Marc to timely deliver fi.
any fee,deposit or mha payment pm'laded for herein shall not prevent this offer fain becoming a binding contract,provided that any F:
such fafum shag gtvcaller3ustmiurisks to terminate the contract as described herein or as otherwise pentdned by taw. is
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Date: De - 1-
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Buyer Seller ('
Date: i Date:
Buyer Seller I_.
Entity Buyer: Entity Scaar. -� 9 i
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Page 9 of 11
STANDARD FORM 11-T
Revised 72015
6.72015
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