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Initial Application Date: Application# I I SOCH- 1403 CU# COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION Central Permitting 108 E. Front Street.Lillington,NC 27546 Phone.(910)89&]525 ext.2 Fax:(910)B93-2793 www.hamett.org/permits RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION•' LANDOWNER:Dakota Land Partners, LLC Mailing Address:5511 Ramsey Street, Suite 100 City: Fayetteville State:NC Zip:28311 Contact No: 910401-5504 Email: Leri.Elkins@mdssycreekmgmtCDEO APPLICANT` Dakota Land Partners, LLC Mailing Address. City: State: Zip: Contact No: Email: '°lease fill out applicant information if differentNthan �landowner " — J' Jeri Ewnlkins 910-001.5504 CONTACT AME APPLYING IN OFFICE: /n�-- Phone# PROPERTY LOCATION:Subdivision: Mamie Bell Ridge 4 M Iss+�y Lot#: Lot Sae: I •I SQL State Road]#1291 StateRoadRoad Name: Old US 421 a I MapMBook 8 Page:000 / I O Sb Parcel: i3olc30 bon �I PIN: U,IC^J,J b5,^ 3590 Zoning:RA-30 Flood Zone: X Watershed: NA Deed Book 8 Page'.?'1y / 17 W Power Company: 'New structures with Progress Energy as service provider need to supply premise number from Progress Energy. PROPOSED USE: Monolithic SFD:(Size 30 x SO )#Bedrooms d#Baths: Basement(w/wo bath): Garage: Deck: Crawl Space: Slab: ✓ Slab:_ (Is the bonus mom finished?( )yes ( )no w/a closet?( )yes ( )no(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?( J yes (_)no Any other site built additions?U yes (J no ❑ Manufactured Home:_SW_DW TW(Size s )#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_x )Use Closets in addition?I )yes ( 1 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(500')of tract listed above?U yes (✓)no Does the property contain any easements whether underground or overhead( )yes (✓)no Structures(existing o proposed): - gle family dwellings: Manufactured Homes: Other(specify). Required Residential Property Line Setbacks: Comments: Siont Minimum 3 Actual _.�/1 �l Rear as 19�{yI � Closest Side ‘CC 0, W SidestreeVcorner lot Nearest Building on same lot u_.-.Ilm Ar -alOn '�Jc m] APPLICATION CONTINUES ON BACK SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: ^1 2 it kJ" on b 10,1 he Caffer/m ,Qin/, f2iq,IJ Gain odd US t-IZI • *s bit is'Ia- a b .. re f`(lfmte Teo Curie 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 submied. I hereby state that foregoing statements are accurate and cor the best of my knowledge. Permit subject to revocation if false information is provided. i g7/a//� Signature of Owner w Agent bate "9t is the owner/applicants responsibility to provide the county with any applicable information about he 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" I� i.ial Lard �Fl:anon F. __ _ t. r VIOA717y MAP 1 IMPERVIOUS SURFACE AREA NOTE: Not To Scale p j DESCRIPTION AREA ALL DIMENSIONS, LOCATIONS AND FEAIDRES SHOWN ON ;War?.. THIS PLOT PLAN E ACT OXIMATE AND LLOCAPONNOF ALL FEEALY AN TURES In Z HOUSE w/ PORCH 1'267 S.F. ARE SUBJECT is CXANGE ANO NAY NOT BE INSTALLED p O� ye DECK/PATIO/HVACXACTLY AS SHOWN ON PLANS AND/OR IN MODELS. 18 S.F.SFPLACEMENT W HOME, DRIVEWAY. SIDEWALKS AND x DRIVEWAY & WALKS 868 S,_ EXTERIOR FEATURES ARE SUBJECT TO MODIFICATION AS tr b DEEMED NECESSARY By FIELD PERSONNEL. i j i TOTAL (PROPOSED)= 2,153 S.F. oi LOT AREA = 49,989 S.F. CUSTOMER DATE 2 % IMPERVIOUS AREA =4.3% OLD US Hwy 421 SR 1291 CUSTOMER DATE Px. ?pUa;O� (r \ ` / WADE JURNEY REPRESENTATIVE ()ATE A° / /Imm �� O �VAI. POR STAKING: SFRipf.KQ '� P115 PLOT PLAN AS PREPARED BY RESIDENTIAL LAND SERVCES. > IS CORRECT AND IS XEREBY APPROVES FOR STALING ON THE DATE SHOWN BELOW. FRONT - 50' q SIDE - 10' C' REAR - 25' WADE JJFNEY HpAES REPRESENTATIVE PATE CORNER SIDE - 20' HI I: PLAN APPROVAL. °� :l- ,I - p 0 ISE •DEL)ROOMs__` — .. ® A 54 S4 i-l_µ-)— - .n19Af Wn IB1w 6169'58'01"W ® 216.55' 1 I I I 1 49,989 S.F. I m 145.7 I 1.15 AC I 51 O I m m, Ni(N 59 En 3 I in tt N I N I to :ci cN Di 58 i ",,, `9'_4`u. ®o Two-LAR e NEV.E7/25/101BX 21 Z �... _J Z N 4. 51.0 t',n(;I ED C+ In U m 6 28' I^ Sr8 106'437 to C. e L — — - J 206.96' S6-10'43'E NCSR # 1291 OLD US 421 60' PUBLIC RAW THIS DRAWING DOES NOT THIS PROPERTY MAY BE SUBJECT TO ANY AND ALL APPLICABLE DEED REFLECT AS—BUILT INFORMATION RESTRICTIONS, EASEMENTS, RIGHT-OF-WAY, UTILITIES AND RESTRICTIVE COVENANTS WHICH MAY BE OF RECORD OR IMPLIED PRELIMINARY PLAT NOT FOR RECORDATION, CONVEYANCES OR SAME 50mil 0 50 HOUSE LOCATION PLOT PIAN _ imi . SCALE: 1" - 50' FOR NCSR #1291 TRACT TWO, DB 3074, PG 776 RESIDENTIAL PIM./'1 Upper Little River Township, HarnettttCounty, North Carolina PLLCLAND SERVICES, . PROPERTY OF: WADE JURNEY HOMES 1500 Piney Plains Road, Suite 102 MAP BOOK 2003 PAGE 1139 DEED REFERENCE Cary, North Carolina 27518 Phone (919) 977-1554 Firm License k P-0873 DRAWN BY: JWW DATE: MAY 2, 2017 NAME:1V JUG. I_at\d Pod InCI'3 APPLICATION#: *This application to be filled out when applying for a septic system inspections County Health Department Application for Improvement Permit and/or Authorization to Construct IF THE INFORMATION IN THIS APPLICATION IS FALSIFIED.CHANGI?D,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=fill months;Complete plat=without expiration) / 910-893-7525 option I CONFIRMATION# t7 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 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. U 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 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 Iptc(sl: can he ranked in order of preference, must choose one I1 Accepted 1I Innovative II) 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_ YES I ANO Does the site contain any Jurisdictional Wetlands? I—I YES IX I NO Do you plan to have an irrigaEJLystem now or in the future? I_IYES I /1 NO Does or will the building contain any drains?Please explain. I )YES I.2I NO Are there any existing wells. springs, waterlines or Wastewater Systems on this property? II YES ILI NO Is any wastewater going to he generated on the site other than domestic sewage? I_IYES {7 I NO Is the sire subject to approval by any ether Public Agency? I—I YES (1) NO Are there any Easements or Right of Ways on this property? rI YES (L) NO Does the site contain ally existing water, cable,phone or underground electric lines? If yes please call No Cuts at R00-632-4949 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 Slate 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 Properly Lines And Corners And Making The Site Accessible So That A Complete Site Evaluation Can Re Perforate PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATS NATURE(REQUIRED) DATE (0/I tl Or' r P N 8888888188888888188888888 aYP!YYYPPY E„.„ 8 i i I6 3 II. , 1 + k iii iiliiiBiilliiEERiRiiimmilli I 1 »u} ,`: i$3Et -g c EEiiSEiiEIEEEEiiiEEEtiidiiilliia I a g ' _ s g b g" }ngiiiiisE�Eiilia EE�EEiiiiUglailSlEE i I "%. 1 '7 ia. 5-'i i leisA Ni 111111111111;111111 111111i1 o 1!t6 I ilii ii fifffi6ilfifiiiffffii- .le:• ` ilaminalawaaaa.' _-_..fra`,i ij t4 �.� 1s I�IffWa " ....M.1 4 i " 0 i , Clitliect, -->., 1;11400* k n r1 ' y •4111 113:.1/® •` -tg4�•. Ii c it k i �r�� a ' — I !II ;•nae1.. + , i - .i•, I .__3,___ t tor �' I I Arria- 11111111 ' a>° ®: ; 4`.J 2 . ,;,._ I ill Ik fill• - ;® '. 't.' 1 Y alv: .. 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Date 411311 Site Address ftQI IA 64,115 ZI PhoneQtG•4r5•Sr._4 Directions to lob site from Lllbngton "Cute.JUC, L-kz J ZI/)5 t!t Q44. Oj.ydj 5.fNaain�- cin 4 n 0 nnaf 1p E. >n+51- Subdivision t4I-M I L ti! 0-146e,e Lot Q Description of Proposed Work SCp. #of Bedrooms Heated SF I g2.lt Unheated SF 341 Finished Bonus Room? a) Crawl Space Slab Ni( General Contractor Information (41.111 Building Cohtractor s Company Name Telephone Telephone n� 3 sa :, , _ a&6 ,., o 17&h/zpGkrkkirrt4,,ivp 6• Address Z,-/41O Email Address OS! '-i4Z4Z License# • E%tncal Contractor Infonnabon Description of Work LL LE f ic.aA -rh4l_(I Service Size 1 D Amps T-Pole I/Yes No CrttnAuv+ Litt-WV-0 1 331A-561--1•QOQn Electrical Contractors Company Name Telephone I1t-nil T-A9.5}Lzoo Purl'visirnin A-1415 Address Email Address Joel(' License # fAechapical/HVAC Contractor Information Description of Work Lilt llnr� L Air enSoAir r wr+ 33G-141-1 Q130 Mechanical Contractors Company Name Telephone F D• box 571 Cli.lrman5, 2.1017 Address Email Address 1-17 1k License # Plumbing Contractor Information Description of Work plQMbt 11,64-011 #Baths obi ly 17Iurrltpinct L. ?7311 • '-t76.t 74Zf Plumbing Contractors Company+fvame Telephone '153u Lcwzs L&Lc. en . Address Email Address Z Licensense ## py' ,,..,,t�,, � � Insulation Contractor Information Insulation C`tracL7tors Company ame&�Addr1 ss Telephone 'NOTE General Contractor must fill out and sign the second page of this application I hereby certify that I have the authority to make necessary application that the application is correct and that-the construction will conform to the regulations in the Building Electncal Plumbing and Mechanical codes and the Harnett County Zoning Ordinance I state the information on the above contractors is correct as known to me and that by sinning below I have obtained all subcontractors permunon to obtain these permits and if any changes occur including listed contractors site plan number of bedrooms building and trade plans Environmental Health permit changes or proposed use changes I caddy it is my responsibility to notify the Hamett County Central Permitting Department of any and all changes EXPIRED PERMIT FEES-6 Months to 2 years permit re-issue fee is 6150 00 After 2 years re-issue fee is as per current fee schedple 7 `rcQA. ei - 11I13I1'1 Signature of Owner/Contractor�cer(s)of Corporation Date Affidavit for Worker's Compensation N C G S 87-14 The undersigned applicant being the / General Contractor _Owner V Officer/Agent of the Contractor or Owner Do hereby confirm under penalties of perjury that the person(s) firm(s)or corporation(s)performing the work set forth in the permit Has three(3)or more employees and has obtained workers compensation Insurance to cover them Has one(1)or more subcontractors(s)and has obtained workers compensation insurance to cover them /Has one(1)or more subcontractors(s)who has their own policy of workers compensation insurance covering themselves _Has no more than two(2)employees and no subcontractors While working on the project for which this permit is sought it is understood that the Central Permitting Department issuing the permit may require certificates of coverage of workers compensation Insurance prior to issuance of the permit and at any time during the permitted work from any person firm or corporation carrying out the work Company or Name (it I U-IL✓. • Sign wide/ id.aalestS gar ia-(r./aor-cltvvt,ln,C Date 1.113111 DO NOT REMOVE! Details: Appointment of Llen Agent Entry #: 668453 tilFiied on: 06led by:2017 Initially ed wjh2013 Derigneted Lien Agent Project Property Print & Post Investors lite Insurance Company MBR9 1291 Old US 421 Online;urns lon.ne.mm Lillingtnn.NC 27546 mares.:19 W Hagen Si.Suiur i0> Itulr:yle IIWnW County NC 27M)i O'hYO Phone:tlXNnWu)XJ Property Type cameannn: Ps.:,113aMQ-si I Please post notice on the lab Site Email: uownru'Nang cod 1-2 Family Duelling Suppliers and Su bcontncton: Scan this image with your mut phone Co ew this filing_You can then the a Notice Owner Information to Lien Agent for this project. W1H,LLC 3300 Battleground Ave Suite 230 Greensboro, NC 27410 United Slates Email: hitahu wasejumeyhomv7.com Phony.919-995s654 View Conal enP m) Technical Support Hotline:001K1 690-7314