LAND USE Initial Application Date: / Z — " /— /0 APPIkation # � ✓ fa z.5 $4
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. Front Street, LJBington, NC 27548 Phone: (910) 893 -7525 Fax: (911 www.hamett.orglpenn8a
LANDOWNERS /! , //J /1 lam'/ v! 5 Mailing Address: 7 Uy � / / 7,/,
City:( llvryo/12 Staiete/C ZlpE,,1' ntad # Email:
APPLICANT e__ Mailing Address:
City: State: Zip: Contact yl '1 Email:
'Please 1111 out applicant Information If different than landowner / /
CONTACT NAME APPLYING IN OFFICE: ca Phone . /�� e %'' c.' ' ' /_
PROPERTY LOCATION: Subdivision: �� pp '7� ///JJJ / Lot #: Lot Size
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State Road 00 State Road Name: Nl/, / '2/ / +'//.' /1/ Maps oo �Pegee: /
ParcParcel: 0 1 1 p r 0 as / PIN: 96-Cr/ p v , J7
Zoning: Z loodZone: X Watershed} /.40- Book &Page: , (f //1 /'a/ - - ` /y
Power Company':
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
SPECIFIC DIRECTIONS TO HE PROPERTY FROM ULLINGTON: /A .--A X 7-
A e V' l- y./ / /i/ /� ' ZS /7 /lam (G e.� , A! i/
a xdoic /20dr-7 & d s 7; c4
PROPOSED USE:
X �� JJ / m Monolithic
2
SFD: (Size x «7 ) 0 Bedrooms:1 # Bathe:1 BaseeM(w - bath): Garage:_ Deck:_ Crawl Space:_ Slab: Slab:_
(le the bonus room finished? Li yes no w/ a closet? Li yes Lino (if yes add In with # bedrooms)
O Mod: (Size x ) 0 Bedrooms 0 Baths Basement (w/wo bath) Garage: Site Built Deck: On Frame Off Frame
(Is the second floor finished? Li yes (.)no Any other site built additions? (__) yes Lino
O Manufactured Home: _ SW DW _ 7W (Size x ) # Bedrooms: Garage:_(site buitl?_J Dedc_(site built?_)
O Duplex: (Size x ) No. Buildings: No. Bedrooms Per Unit:
O Home Occupation: 0 Rooms: Use: Hours of Operation: //Employees:
O Addition/Accessory/Other. (Size x ) Use:. Closets in addition? U yes (__)no
Water Supply. minty �leting Well L __— New Well dwelllrga using wed ) 'MUST have operable water before final
Sewage Supply: slew Septic Tank (Complete Checldle° if Existing Septic Tank (Complete Checkllsf _ County Sewer
Does owner of this tract of land, own land that contains a manufa ured home within five hundred feet (500') of trail listed above? vs yes L_)no
Structures (existing or proposed): Single family dwellings: e b Manufactured omen: Other (s
Required Residential Property Line Setbacks: Co 1. ti/t4
mme : ii , ' / nil 1 / r _ 4 - 1 0 , /
Front Minimum Actual /, i D/1 . t r g y 4/1 ✓era i yr 3'F ,
Rear r✓ . , at /4 . N ( _
act
Closest Side
Sldeetreeticomer lot
Nearest Building
an came lot
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 statements are accurate correct to the best of my knowledge. Permit subject to revocation if false information is provided.
--Ii // 7/5 ' / /
Signature of Owner or Owner's Agent Date
"This application expires 8 months from the Initial date N 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
Harnett County Zoning Overlay Page 1 of 1
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W ' I Owner Information.
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6n ASti ? � ' .� * ' Si NAME DAVIS GENEVA J
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http:// gistools. harnett. org/ giswebsiteutils /ZoningOverlay.aspx ?PID= 099555 0011 12/1/2010
NAME: APPLICATION #: / 971 2 ,5 ‘. YID
*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 1 CONFIRMATION #
❑ Environmental Health New Septic SystemCode 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 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 request.
X • 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)
• r ` 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
(liven 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.
{_) Accepted 1_} Innovative . 1 -1 Conventional {_} Any
1 Alternative 1 —) 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:
( { NO Does the site contain any Jurisdictional Wetlands?
{_)YES (_) NO Do you plan to have an irrieation system now or in the future?
(_ }YES {_} NO Does or will the building contain any drains? Please explain.
1 —}YES I NO Are there any existing wells, springs, waterlines or Wastewater Systems on this property?
(_ }YES {_) 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?
1_1 YES (_) 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 I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site Accessible So That A Complete Site Evaluation Can Be Performed. //n a e X2 /�
PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATIV SIG ATURE (REQUIRED) DATE
10 /10
•
DIAO OF A TYPICA SEPTIC T K
1
1111 • UTLB"P LID
0
POSSIBLE POSSIBLE
HOUSE HOUSE
CONNECTION _ CONNECTION
POSSIBLE
HOUSE
CONNECTION
POSSIBLE LID SHAPES
I SQUARE (SHOWN ON DIAGRAM)
ROUND
RECTANGLE (OLDER TANKS) _
I
. 1cook .
(Continued Perm Rows Side)
41) •
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The above land am cony.... .G!. At • • . See Ma No.— Pep—. TO HAVE AND TO .• • -'...p • .. , wbb ad the appurtwna.tbsiwmto E.to bi ,or " in aej.m'a apy • info the Gnntcc, bb
kehA mde Gu'''ar' rte - '
A thhe • Cmocer mmt . m ... o! ski premise' m w will and ha theasltt t due tree t urns ow against fen a all fa d i ma Ina front of
amtha sram (with the esc'pde pden' .. dun a h will ID e war r as a anddefe vd the sold Me m the nst u the lawful demo °frp prawn whomaawe.
When a[iesena baud' m e. .. .. • . *ban Include the plead end the m tlm mu
uelne shall Weds the fenee or the ter.
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STATE OF NORTH A ; LINA - w � . a .PO/SYAe§$_ j4 ei8ntttwetr, � ' - •
1 V + • tEX ! °tale County, de hereby certify the
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STATE OF NOR "TW ' . . . • L he of said County do hereby redfyth.& _ .. -
Garmw.patomlly appatedbrfove ae eldsdq and reimovlcd {ad n
Mann toyhand and notfhflseal, th'stha . day of .19_.
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STATE OP NORTH CAROLINA. f ) l t.. .1 // ,`M Y. i. : ' ••••• ,•••• ••• ,• '
The agoBQ arriftnte(s) of I , � ]' _ a •r• • • . l / • pp
s lam) vedtbd to be coma- This Ittunmana guar enemata for don this �i v ' • . , 1
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recorded In the eee of the Para of Duds of �: `•
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tary Acknowledgment attached to deed from Christine Davie Polite, et ale, to
illiam Ben Davie and wife, Genever Davis, and James A. Davis, dated December
• 1987.
O. 1 : CAROLINA.
A' NTT COUNTY.
, ='TTY L. JOHNSON, a Notary Public, in and for the aforesaid State and
•. .• ty, fy that Glee, E. Sanders peraa,ally appeared before me this day and
sworn, stated that in his presence Christine Davis Polite and husband,
• N om .. '. • ta ..ties W. Davis and wife, Nellie Davis; Glendora D. Saimders, single;
Dd , and wife, Debra Saunders; and Sarell A. Saunders, single, and
• ; - . - - fe, Carolyn E. Davis, signed the foregoing instrument.
• . notarial seal this 28th day of February, 1
;*
Notary
My Comm • •
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S NORTH CAROLINA: Haman Count
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W elb „_Cp+ 3 'are b ;c !No'anes Pub c3 ia,'are ' ' ' :d ;01,e 43j
' .. This Instrument was
press hied for refits tre lion
recordedIn mis office at Book gpaga j! JIB
This dayof (nt, It_G� 3
a R V st 0..1
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COUNTY, K 6 itgieter of peels+ -fit pap�iy •
FILED Mg
nvvc PAR t i—
REEGISTEn OF DEEDe
GAY LE P. HOLDER
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-1 of .. ,, :m Ben Davis and wife. Geneve' Davis and ,Tamps A. Davis
� .... a�, y ... -. N• Edgar R Bain ry. _ /. _ _ IPSO . 30 ' . Go
w ..7��feso ermwn601 �1in nwWhvu r be, Yadldnv9r. M. C. 17055
frOF , ORTH CAROLINA,,Jlarnett County.
THIS D- •. • •,ba day of December , 19 L. by and breean Christine Davis Polttaa nd_
d • e : • • lite. Prentiss W. Davin and wife. Nellie Davis. William Ben Davin red wife. flenwver Davig,
G1e • . D .a •.. - :, single, Marvin A. Samdera and wife, Debra Saunders. and Sorrell A. Saunders, single,
GI • E.: • •- • ere and Charles Davis and wife, Carolyn Davie___ County
and sea a . mro - • - railed GRANTOR, rd William Ben Davis and wife. Genever Davis, and James A.
Davis • .65 Cameron. NC 28326 .
IS of Camay and Sea aeon's Carolina, 6„ie.Rar wad GRANTEE.
=ESE consideration of the ow of TRW Dollar
and «ha deed and • - ,. •.. - a had paid by neee, the Ge she mein whereon* wl
hereby aehnoeddd. has glen, ward, ha/pined, sold
and conveyed, s..4 c..... s bargain. set convey rod anther unto she Ganaa his helm adlee =m em and amine. premises in
- o wnship Harnett , County, North Caroline. do 'Md u fobs.,:
• BEGINNING at an 10 easternmost line of the Herbert Davis estate lands,
dividing earner bet • and 4 as shown upon a plat of the Herbert Davis estate
lands as prepared by SS ambeau, Registered Surveyor, in September, 1987 and runs
thence with the West. •• a Herbert Davie lands North 04° 46' 53' East 157.61
feet to an iron pipe di • •, eon tracts 2 and 3, rams thence with the dividing line •
between tracts 2 and 3 Sou - 3' " me
1378.16 feet to an iron stake, dividing to
between !recta 2 and 3 it e - - • � an and A.C. Cameron, lima thence with the
line of Swan and Cameron - • 3' est 148.86 feet to an iron pipe dividing corner
between tracts 3 and 4 and • the dividing line between tracts 3 and 4 North
85 0' 40' West 1380.42 feet to -• • • • place of BEGINNING and containing 4.844
awes, more or less, and being • • • • as shown upon the he einabove referred to
plat. This is a portion of the tea • f •v - : -• to Herbert Davis by Deed which appears
of record in Book 444, at Page 64, •(9t�t . •• .. Re . • .
Herbert Davis died intestate on N• - 4, 98 :.. • =f :waiving as his sole heirs at law five
children, Christine Davis Polite. Pren •• e ■ via, • Miami Ben Davis, Mary Davis Saunders,
and Charles Davis. Since the death o •ert eavis, Mary Davis Saunders died intestate
and left surviving as her sole heirs at law G1e • ; . Sa • • -• . • •, husband, and three children, •
-
endora D. Saunders, Marvin A. Same• . •r• Sorrella
s Deed is being given far the purpose of di •• • : t oning the lands of Herbert
Davie among his heirs at law.
Wiliam Ben Davis and Genever Davis join in th ex • this deed for the purpose of
creating an estate by the entireties in a one -bal interest •• - ch tract of land and for the
purpose of conveying a one -half interest in such • - ••es Davie, who la the San of .
•
William Ben Davis.
•
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(Confirmed an Rene. Se.)