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DOCUMENTS
Initial Application Date:_ I n t r7 Application# lJl.l 1 (') E M �1 3(4S / ��- COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION CUk Central Permitting 108 E. Front Street,Lillington,NC 27546 Phone:(910)893-7525 ext.2 Fax:(910)893-2793 www.harnettorg/permits "A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)S SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION' LANDOWNER: IP/I 11, c rTm^^a y M o,fI '> 7 Mailing Address: S /p/ - .) ‹.2 City' - .rch State'.0 6 Contact No: 5i6 4/d Email'. APPLICANT': WO ill e ;Comm sr r, M sem-7_4 M7 Mailing Address'. City: State: Zip. Contact No. Email. 'Please It ow applicant information if different than landowner CONTACT NAME APPLYING IN OFFICE: Phone# PROPERTY LOCATION:Subdivision: Lot#: C9% _ /0' 3 Ac.State Road ifName: FVe Lot Size State Road i(� 1'Y(_t= O C Map Book 8 Page- ZOO(y (7 to z9 Parcel: Oq 575 0198 51 AlPIN. .Q5171�5v _ Llc< -l�(0R5 0� Zoning-Q.47�H Flood Zone. X Watershed: A Deed Book 8 Page:3+20;10 ,sower Company': 'New structures with Progress Energy as service provider need to supply premise number from Progress Energy. PROPOSED USE: Moj SFE). (Size x )#Bedrooms #Baths: Basement(w/wo bath): Garage. Deck:_Crawl Space: Slab: Slab IIIM1ic (Is the bonus room finished?( )yes ( )no w/a closet?(_)yes ()no(if yes add in with#bedrooms) U Mod:(Size x )if Bedrooms #Baths Basement(w/wo bath) Garage. Site Built Deck' On Frame Off Frame (Is The second floor finished?( )yes ( )no Any other site built additions?( )yes ( )no Manufactured Home._SW TW(Size R 8' x 91'e )#Bedrooms. 3 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 x )Use. Closets in addition? NAZ� U yes (_)no Water Supply: V�,VCounty Existing Well _New Well(#of dwellings using well )'Must have operable water before final Sewage Supply: K New Septic Tank(Complete Checklist) Existing Septic Tank(Complete Check fist) 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 properly contain any easements whether underground or overhead(_)yes ( )no Structures(existing or proposed)-Single family dwellings: Manufactured Homes: Cher(specify): Required ResidentialPropertyLine Setbacks: Comments: Front Minimum "J'J Actual O S Rear _25_ 9 Closest Side 10 ,,25/ 3 S SidestreeVcorner lot Nearest Building on same lot Residential Land Use Application Page 1 of 2 03/r 1 APPLICATION CONTINUES ON BACK • • SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 1m•-11 e Nr$y" a 2 S tr 44' /tr A:.T R-= c F v Lcff c .� A�- Tiny L < (—' F an IJroc Et _AI an 9uM Tarn AlSh / v ✓t Fc en c-r d F91loa dcr)1- 'JO "-x41, 11 I- (1):0 /- If permits are granted I agree to conform to all ordinances and laws of the State of rh Carolina regulating such work and the specifications of plans submitted. I hereby state that foregoing st- -- -teme tsprto and correct to Di- .est �owledge. Permit subject to revocation if false information is provided. „ca../I S - /Ca - /7 moi'` igh to : •f Owner or Owne sAgent Date '"It is the ownerlapplicants 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" 9p' Pae 2 of 2 03111 Residential Land Use Application 9 VI v :\ t-9 , / / 9 i " �.\ ``� N/ \ / �''i) / 3 ` / / apt �. le it 1 Y /s /�• . H : �/ f / '1� ). /-.1 ., 14 ,...>:,, JET zy �`Pi N ♦ � " , 1 V'» NN o7 A ' is D d 0 • 4. d' ••• tV o �. # p 4 p + C D © �^/ 1 C. n .y �a�ti ti c ? Y x mJ m u� I 9 s m �, F oh � O r Pi ��r Y L Z q T > p en N L min N 1 1 N p Np pp pN O � e N aN by ♦ d0 bgIA �\ v ! G P N f $ N N o . " � _ ^ ' D d u vi r r z NAME: Wl i!. e Tan eJ fiers-ti A-/r 7 APPLICATION#: *This application to he 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# C 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 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 given at end of recording for proof of request. • 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 properly. • 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 & select notification permit it 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 sy m type(s): can be ranked in order of preference,must choose one. 1—I Accepted I—) Innovative I ) nventional IJ Any i_I Alternative II 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—IVES ) 4NO Does the site contain any Jurisdictional Wetlands? l_IVES 14Z) NO Do you plan to have an irrigation system now or in the future? 1-1 YES 1�NO Does or will the building contain any&Mos?Please explain. I—IVES IJII NO Are there any existing wells,springs, waterlines or Wastewater Systems on this property? LI YES (fO Is any wastewater going to be generated on the site other than domestic sewage? 1—IYES I ) NO Is the site subject to approval by any other Public Agency? 14/YES f_) NO Are there any Easements or Right of Ways on this property? I—IYES l f---'l 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 Stale Officials Are Grinned 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 The6$/'f//3JJ'fe eyes le ..tut etc S7-t-uadon Can Performed. / PROPT�I 0 R N RE S LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) ATE 10/10 ??Edeid55555p _ 1 1iti1I! $!,4p r a O ? 3�I ddfg 4;" 6 z� / $ ) ° Po pol 01 Pal °� .1y' p Q ° ^�9 '' Y °I P *4.r. ' ii ' ' i til i 1 lat.ar .. .:..3.‘1, •'--11,41,,i 1 i . ,:rri * ....,. d r d Sit ,-g i1 i* s. "Ly AA E tc 01 tscul Eli '' A ,.1 s� --"I`�. /,% f R O �.A a °i y ..44 c ov p ° w Q '� fie A `% A i ` p � ni �, a °�, a� dF9@ _ a i Ff r ap e C 3 a •0 c �a�6�j' i E .1E gag $ a 1 0 ap 0ig © IR-4111. �[z -gyp m liPiB qI { � IIS ?ld' S cl�N+ 1i 3a cc aP 1114 5 ° SI ° �a , Date; 5 -10- 17 APPlicationR PROCEDURES AND.GUIDEUNES FOR MANUFACTURED HOME INSPECTIONS RA-20R&RA-20M Certification Criteria I, v ifi t ,T Ni n-c Aev7 7 o?understand that because I'm located in a RA-20R or RA-20M Zoning District and wish to place a manufactured home in this district I must meet the following criteria, verified by toning inspection approval,before I will be issued a certificate of occupancy for this home, I. The home must have a pitched roof, for a manufactured home, whether A-shaped or rounded, which has a minimum rise(measured at the center of the home)of twelve (12) inches for every seven (7) feet of total width of the home. (Example: A home measuring fourteen (14 ft.) in width must have a twenty four(24) Inch rise as measured from the center of the roofline to the baseline of the roof.) (See Illustrations Below.) r PC Rod rMshRka. e. Rounded f • Note: Most Rounded Roofs Will Not Meet The Roof Pitch ` Requirement As Illustrated. The Measurement From The Peak Of The Roof To The Base Line Of The Roof Must Be 12" For Every 7'Of Total Width Of The Home. (Ex:14'Wide Home=24" Roof Rise) Continued Mobile Home RA-20 RIM Criteria Page 1 of 2 12/10 2. The home must be underpinned,consisting of a brick curtain wall or have galvanized metal sheeting,ABS or PBC plastic color skirting with interlocking edges,installed around the perimeter of the home. Skirting shall be consistent in appearance,in good condition, continuous,permanent,and unpierced except for ventilation and access. 3. The homes moving apparatus must be removed,underpinned,or landscaped. (See examples below.) •. ., N;' r 4. The home must have been constructed after July 1"1976. r [/ /inn/f 5- l0 - I `2 Signature of Property Owner/Agent Date • By signing this form the owner/agent is stating that they have read and understand the Information on Ms form. Moble Home RA-20 RN Gnarls Page oft 12110