LAND USE Initial Application Date: / 20(0 Application # / P 5 779 2 - 415 --
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting {{^� E. Front Street, L;Ilington, NC 27546 Phone: (910) 893-7525 Fax: (911 -2793 y n www.harnett.org/ /permits
LANDOWNER: ct...4l f'1 t 53 D u f 7 3
A Mailing Address: 3 .0:11,9,t_
city: Sert 1 #qkC S l zip: Z&3Yc 9 /o -�/3E &'V_7? Email:ea ehryi,c. a& y f tirtArmy..
APPLICANT': -5 k LtA/olowve Mailing Address:
City: State: Zip: Contact # Email:
* Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE: S&ne AS Phone #
PROPERTY LOCATIO7: ubdivision: N/A o // /� �� Lot -oott Size: , r.! l
State Parcel: / # , z 4 State R Q' The L /7. i �/c 4 _ �� - Map B /4 k7g ' / /
O ` / PIN: 7/47
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Zoning:14 �L w7 Flood Zone: Watershed: N !Z Deed Book &Page: 7b L7 /J ) 7 Power Company *:
New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
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SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: - ''�'# L 87 ,r7 .
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PROPOSED USE:
Monolithic
❑ SFD: (Size _ x , ) # Bedrooms: # Baths: Basement(w /wo bath): Garage: Deck: Crawl Space: Slab: Slab:
(Is the bonus room finished? ( yes ( )no w/ a closet? ( yes ( (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 ( Any other site built additions? (_J yes (
❑ 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:
Addition /Accessory/Other: (Size 1.2 x 4201 ) Use: 6 f9 (PI Closets in addition? ( ) yes (K)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) /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 (501Y) of tract listed above? (_) yes (✓ )no
Structures (existing or proposed): Single family dwellings: 1 - r Manufactured Homes: Other (specify): Ic r Srta4
Required Residential Property Line Setbacks: Comments: 1 / AOorno,4 to sr err 134E_
Front Minimum 3 Actual /V/
Rear � 3�/ 1�/
Closest Side / O p
.2
Sidestreeticorner lot 2° /y7
Nearest Building V` 3
on same lot
If permits are granted I agr' o confo . to all ordinances and laws of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that fore. • g siateme• s are cc P- orrect to the best of my knowledge. Permit subject to revocation if false Information is provided.
Signature ofirier 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
Residential Land Use Application Page 1 of 1 10110
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NAME: APPLICATION #: / 6 5 — ' 919 25" 6 y
*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 1.8 FALSIFIED, CHANGED. OR T1113 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) /1 //
910 893 - 7525 option 1 CONFIRMATION# 5 y
❑ Environmental Health New Septic System Code 8 00
• All property irons must be made v isible. Place "pink p roperty flags" o n each corner i ron 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 oracle property.
• All lots to be addressed within 10 business days after confirmation. $25.00 retum 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 En vironmental 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.
$d Environmental Health Existing Tank Inspections Cod e 800
!!! 111 • Follow above instructions for placing flags and card on property.
• Prepare for inspection by removing soil over over outlet end as diagram indicates, and lift lid straight up Of
possible) and then close back down. (Unless inspection is for a septic tank in a mobile home park)
• After uncovering outlet end call the voice permitting system at 910 - 893 -7525 option 1 & select notification permit if
multiple pe rmits, then u se co de 800 for Environmental Health ins pection. Please n ote c onfirmation 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
I f applying for • • orization to construct please indicate desired system type(s): can be ranked in order of preference, must choose one.
{_} Accepted } Innovative {_} Conventional {_} Any
{_} Alternative {_} • • -r
The applicant shall notify the local health •e,: s ment upon submittal of th • pplication if any of the following apply to the property in
question. If the answer is "yes ", applicant must a • • • upporting do . entation.
{_ }YES {_} NO Does the site contain any Jurisdi •ona : etlands?
{_ }YES {_} NO Do you plan to have an 's_ , •• I - n now or • - he future?
{_ }YES {_} NO Does or will the bd • ing contain any drains? Please expla
,}YES {} NO Are there an isting wells, springs, waterlines or Wastewater Sys on this property?
{_ }YES {_} NO Is any •stewater going to be generated on the site other than domestic sews..
(_ }YES {_} NO . e site subject to approval by any other Public Agency?
{_ }YES {_} . S 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.
1 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.
1 Understand That , II Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site • hat • • • - - t• Evaluation Can Be Performed.
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PROPERTY OWNE',•?" OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) DA
E- Health Checklist 1 of 3 10/10
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IIYr Mire NC REV STAMP: 48.80
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This "--d • e•= '- y Reginald B. Kelly, Attorney at Law
PID#': 01•: _ : 010523 0019 02
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STATE OF NO'•4 : Q WARRANTY
COUNTY OF HA-,k: DEED
This WAR • D m -•e the 30 day of April, 2009, by
and between DUR'..r ` 4 .•• and wife, PEGGY P. BAREFOOT;
SHIRLEY BAREFOOT ::, _ ,• ATSY BAREFOOT WEST and husband,
DALLAS M. WEST; CAR' •OT WARREN and husband, CHARLES
WARREN; and BENNY G : - . wife, PEGGY C. BAREFOOT, of
365 Overhills Road, , No .arolina 28356 (hereinafter
referred to in the neuter si s.1a- a- "the Grantor ") and DENNIS
LEE DAY and wife, YOLANDA • -,.. 0.•Y o 1483 Bethel Baptist Road,
Spring Lake, North Caroli = 2: -•0 e• inafter referred to in the
neuter singular as the Grate =" ,
W I T N E S S} H
THAT said Grantor, for valu =.• °- = ..ration, receipt of
which is hereby acknowledged, has gi - g ed, bargained, sold
and conveyed, and by these present: ••-s = •y give, grant,
bargain, sell and convey unto said Gr -•. s „ -irs, successors,
administrators and assigns, all of tha - t- - ece, parcel or
tract of land situate, lying and being in Up -.e i le Township of
said County and State, and more particula• •es• :•_. as follows:
FIRST TRACT: BEGINNING at a conc - - c•- - r, it being a
corner between the lands of the Viola w:. ei•= and the
lands of J.M. Mitchell, and runs thence - • . h . de -:reel 15
minutes West 536 feet to a new corner in .- : t; of the
road which runs from Bunnlevel to Highway 2 i; _ = along
the center of said highway, South 72 degree- - 1 n s West
10 feet to a corner; thence North 17 degrees 47 m. t s West
223.9 feet to a new cement corner; thence North 71C - -r: - : 57
minutes East 496 feet to the BEGINNING, containi a '.l
more or less, and being a part of the four -
described in deed from Martin B. Barefoot and wife, • e