DOCUMENTS Initial Application Date: /—// Application# 1 el SOCY4 a del Coo
DRB# CU#
COMMERCIAL
COUNTY OF HARNETT LAND USE APPLICATION
central Permitting (Elly 08 EFront Btms.blfinglJon NC 27546 {Mailing)POPO Box 65 Ellington NO 27546 Phone/). )893725 apt Y 2 Far(910)6932798 ww.hamet.org/permits
LANDOWNER: J X4J�''OJ// i *tile Mailing Address:Te / z�/ I /. a7
City: r/n/ /�State�v,A/ Zip 77 Contact# �.4' •) 4;Y'CF/hl Email:
APPLICANT': MAch //QI Tito 14— O Mailing Address: A 6L� 4dt'7
City: Bunn State Zipu(tnrContact# Email:
'Please fill out applicant information if different han land er
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CONTACT NAME APPLYING IN OFFICE: ern i/�`Z( �IYC'LcZJ� A Phone# //(7 9t9 6333
PROPERTY LOCATION:Subdivision: /c� A YJ/iL FiehrLfICC ^ Lot#. Lot Size:15. 3.3 f)C.
State Road# ) !2f�T/I State` Road Name: c2 k O{$G •14 .UPy NC —z CP �T(M`ap�BBook&Pzagg 00S/ _IS
parcel//: D-_a I ;:;!; Dos a aaOaa F&F)(� PIN:1 ^1,.. p/ 1 -7 /'L ! S .00�
Zonir�-e-w"in Flood Zone: X Watershed/�..P1 Deed Book&Pagat/IS / % Power Company':DOC,Perf IS
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
/51 /NS. An 11 —
PROPOSED USE: G -11-4......4-4-. hold
❑ yAUlti-Family Dwelling No.Units: No. drooms/Unit: r L '$. v'�'COA,94 .�L4V%
IV.' Business Sq.Ft. Retail Space: Type: QC'ta fJ I Employees: Hours of Operation:
LI Daycare #Preschoolers: #Afterschoolers: ` #Employees: Hours of Operation:
❑ Industry Sq.Ft: Type: #Employees: Hours of Operation:
❑ Church Seating Capacity: #Bathrooms: Kitchen:
❑ Accessory/Addition/Other(Size x_)Use:
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
Comments:
If permits are granted I agree rm to all ordinances a•laws 'f the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that foregoing are. urate and w act to 1.e best of my knowledge. Permit subject to revocation if false information is provided.
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Signature of Owner or Owner's Agent Date
"This application expires 6 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 LAND USE APPLICATION
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NAME: (��/ CS 11)-1 ' £ar/YS APPLICATION#: q-L2 7 Le
*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 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 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 given at end of recording for proof of reauest.
• Use Click2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
-)o 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 8 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(sl: can be ranked in order of preference,must choose one.
l_j Accepted II Innovative {_l Conventional I } Any
I—I 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:
i_I YES I- Does the site contain any Jurisdictional Wetlands?
i }YES I_ on syNO Do you plan to have an irrigation now or in the future?
i_IYES I!/7 NTl Does or will the building contain any drains?Please explain.
AYES Il N Are there any existing wells,springs.waterlines or Wastewater Systems on this property?
{_}YES t.//N9/ Is any wastewater going to be generated on the site other than domestic sewage?
LUTES I—�/1 N'9 Is the site subject to approval by any other Public Agency?
(_IVES jJ N Are there any Easements or Right of Ways on this property'!
i_I YES ( NO Does the site contain any existing water,cable,phone or underground electric lines?
If yes please call No Cuts at SO0-632-4949 to locate the lines. This is a free,service.
I Have Read Thi' plication And Certify That The Information Provided Herein Is True,Complete And Correct. Authorized County And
State Officials . .nted Right Of Entry To Conduct Necessary Inspections To Determine Compliance With Applicable Laws And Rules.
I Understain Solely Respon ible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site A. Th C e Site valuationeCan Be Performed.
/fin. G ) p 54—/7
PROPE'TY OWNERS OR 0 NERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE
10/10
,-� Harnett
( � COUNTY * (FMf any Sortswpr,..m
NOPTM CAROL/NA 1''YI
vialwranaryp
Application for Plan Review
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Application# I r-1 l 5O 4 I a^J�
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Date Received: .5---/-77 Received By: (/[AI 3,� S
Name of Project: /7 SZvYi�� 42,„_/�1 /3/F p,/ �q/
Physical Address of Project: 7) 60 q€0,7_, / zv/i(0,C(R ,14y
uN , NC ✓
Plans Submitted By: /; QYYI ZZ/Lc, r /Zr/�-rv`
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Project Phone: ( )- 79,A- 573y ///J
Contact Person/Address: /540 YNlc goy /t 1
Contact Email: /` Quh;,e-4 L f1c Ziic o i1.
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Contact Phone: ( %/`7 )- xv- 57,7 ( )- -
Contractor's Namellnto:
Contractor's Phone: ( ji27 )-f'I - _5Q j7y
• Plans that are submitted will be reviewed as quickly as possible with an average time of review
between 7-10 working days.
• Status checks may be conducted on plan reviews by visiting the website
htto:llhteweb.hamett.org/Click2GovBP/Index.isD or by calling the Harnett County Central Permitting
Office (910-893-7525,Option#2),or the Harnett County Fire Marshal's Office(910-893-7580).
• Approved plans must be picked up from the Central Permitting Office and all fees paid before any
required inspections can be conducted.