DOCUMENTS Initial Application Oat- Application /si.)()Li /4 a
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E. Front Street,Lillington,NC 27546 Phone:(910)893-7525 exC2 Fax:(910)893-2793 www.harnett.orglpermits
'A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)a 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: 910-401-5504 Email: Jeri.Elkins@dmossycreekmgmt LO(1)
APPLICANT':Dakota Land Partners, LLC Mailing Address:
City: State' Zip: Contact No: Email:
'Please fill out applicant information n amerem than landowner
64-1-4 u-: w 3u3
CONTACT NAME APPLYING IN OFFICE:Jeri Elkins Phone#910-401.// (�5504 /\/1,a+✓
PROPERTY LOCATION:Subdivision: Mamie Bell Ridge Lot#' 10 r{ Lot Size. 0.Yea-.
State Road#1291 State Road Name'. Old US 421 Map Book 8,Page- 260J / Z5
Parcel: I3O(03oa 0029 Oct PIN: C430 55" 3297
Zoning'.RA-30 Flood Zone: Watershetlx-11/ -1
Deed Book 8 Page' /Y/ / ower Company:
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
Monolithic
g( Sal,(Size 40 x 50 )#Bedrooms'±/ #Baths:2-Basement(w/wo bath). Garage: Deck' Crawl Space'._Slab'. ✓ Slab:_
(Is the bonus room finished?( )yes (_)no w/a closet?(__)yes ( 1 no(if yes add in with#bedrooms)
❑ Mod(Size x )#Bedrooms_#Baths_Basement(wAwo bath) Garage:_Site Built Deck:_ On Frame_OR Frame_
(Is the second floor finished?( )yes (__)no Any other site built additions?(_)yes U no
❑ Manufactured Home:_SW_DW TW(Size x )#Bedrooms: Garage:_(srte 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?( )yes ( )no
Water Supply: 1 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?1 1 yes (1)no
Does the property contain any easements whether underground or overhead( )yes (/)no
Structures(existing oi prop .Single family dwellings: \ Manufactured Homes. Other(specify).
Required Residential Property Line Setbacks: Comments:
Front Minimum Actual 36
Rear 7 IS�th(,
Closest Side d V 34- d
Sidestreebcorner lot
Nearest Building
on same lot
•
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 12/ N / le (-+ orrlo Will Ile Cameron led
ric�l# OnAo ( U US Nw t-i21 . len on ft\o n1e 1cncon Or
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tit mete 'bei Grc,ler
d permits are granted I agree to conform to all ordinances and laws of State of North Carolina regulating such work and the specifications of plans submitted.
J hereby state that foregoing statements are accurate •• correct to r •-sl of my knowledge. Permit subject to revocation if false information is provided.
Signature of 0 er • •wner's Agent •ate
**It is the owner/applicants 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"
NOTE:
/ ALL DIMENSIONS. LOCATORS AND FEATURES SHOWN ON
THIS PLOT PLAN ARE APPROXIMATE AND ARE ONLY AN
ARTISTS RENDITION, EXACT LOCATOR OF ALL FEATURES
\ ARE SUBJECT TO CHANGE AND MAY NOT BE INSTALLED
h J N EXACTLY AS SHOWN ON PLANS AND/OR IN MODELS,
PLACEMENT OF HOME, DRIVEWAY, SIDEWALHS AND
a ...-
Z EXTERIOR FEATURES ARE SUBJECT TO MODIFICAI1 N AS
LD DEEMED NECESSARY BY FIELD PERSONNEL.
Z N N
Q. o a CUSTOMER DATE
n
i -l- o
ry CUSTOMER DATE
OLD US HWY 421 G)
Q. WADE JURNEY REPRESENTATIVE DATE
S.R. 1291
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VICINITY MAP
Not To Scale 46 SETBACKS
\ " PCK�I FRONT - 35'
a. ..-.
:,- � E�O� SIDE - 10'
2.Si Si REAR - 25'
47 CM CORNER SIDE - 20'
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IMPERVIOUS SURFACE AREA HOWINGTON DRIVE
DESCRIPTION AREA 50' PUBLIC R/W
HOUSE w/ PORCH 1,978 S.F.
DECK/PATIO/HVAC 18 S.F.
DRIVEWAY & WALKS 653 S.F.
a-
TOTAL (PROPOSED)= 2,649 S.F. CURVE RADIUS ARC LENGTH CH LENGTH CH BEARING
LOT AREA = 41,256 S.F. Cl 255.00 100.65' 100.00 N602053-E
% IMPERVIOUS AREA =6.4% 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 PRELIMINARY PLAT
RESTRICTIVE COVENANTS WHICH MAY BE OF RECORD OR IMPLIED NOT TOR RECORDATION CONVEYANCES OR RNFR
50 0 50 HOUSE LOCATION PLOT PLAN
mi. ..= FOR
SCALE: 1" = 50 #46 BELLA HOWINGTON DRIVE
IDE' - T LOT 68, M owIEns BELL RIDGE, NONE
RESIDENTIALUpper Little River Township, Harnett County, North Carolina
LAND SERVICES, P I r PROPERTY OF: WADE JURNEY HOMES
1500 Piney Plains Road. Suite 102 MAP BOOK 2007 PAGE 256 DEED REFERENCE
Cary, North Caroline 27518
Phone (919) 977-1554
Firm919p P-0873 DRAWN BY: E.G. DATE: APRIL 19, 2017
License
Dakota Land Partners,LLC
NAME: APPLICATION#:
*This application to be filed 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 ll?SITE IS ACFERP.D.THEN TIIf.IMPROVEMEN'I
PERMIT OR AUTHORIZATION TO CONSTRUCT SIIALL BECOME INVALID. The permit is vand 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# _
U 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 type(s): can he ranked in order of preference,must choose one.
I Accepted 1I Innovative iII Conventional 1_1 Any
I Alternative 1I Other
The applicant shall notify the local health department upon submittal or this application if any of the following apply to the property in
question. lithe answer is"yes",applicant MUST ATTACH SUPPORTING DOCUMENTATION:
1_I YES 1`I NO Does the site contain any Jurisdictional Wetlands?
JAMS LINO Do you plan to have an li•s ' _ 'lI now or in the future?
(_]YES I-1 NO Does or will the building contain :my<Irainc?Please explain.
I—IVES I1 NO Are there any existing wells. springs,waterlines or Wastewater Systems on this property?
IVES tx1 NO Is any wastewater going to be generated on the site other than domestic sewage?
I_IYES f x I NO Is the site subject to approval by any other Public Agency?
IYES I±I NO Are there any Easements or Right of Ways on this property?
I—IVES 1'I NO Does the site contain any existing water,cable,phone or underground electric lines?
If yes please call No Cuts at 8IX)-632-494)to locate the lines. This is a free service
I flaw Read This Application And Certify That The Information Provided Ilerein 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,.....
PROPERTY OWNERS OR OWNERS LEGAL REPRES T VE SIGNATURE(REQUIRED) DAT .
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09109111 Applicartionn#
Harnett County Central Permitting 4' qa5
EBCh section below to be hued out PO Box 65 Lilimgton NC 27548
by
Earl,
sec oer performing tog work 910 803 7525 Fax 910 893 2793 www hamett orglpermits
Must be owner or bcensed
contractor Address company Application for Residential Building and Trades Permit
name 8 phone must match
Owners Name uJadGJUrtitis( L4 niGS LL.L Date (AINI1
Site Address t-Ile &Me- 14030tnialean pc_ Phone QIG�4r5•S___
Directions to job site from Lillingtonr
' 1 /L1e,Q. NC, 1-1-Loki Z IQ3 "//.JC.- L a--E on-la
5.lxcul,,y+- rn 4cn -ke0 an-ho g.
Subdivision .MC-v1 f3tilt t Lot UPS
Description of Proposed Work SGZ #of Bedrooms 5
Heated SF ItOO Unheated SF 402- Finished Bonus Room9 Crawl Space _Slab V
General Contractor Information
(LI O J1 ( . 33(,Z�rZ Sedger
Building Co tractor s Company Name Telephone
331,6 61444C3raurtdAUtt6l,ries) Cite,/attire) Tack:0Za,4(J..Wrtryu.fhomC6.
Address Lit-ISO Email Address Com:
4ZUZ
License#
• Contractor /
Description of Work Elearic.a.A y\64nJ I Service Size 7M Am /Yes T-Pole Yes_No
OLP:flax% LiteI rp.I 'z31.-5hq.40On
Electrical Contractors Company Name Telephone
III-n 11 1712.6411.7.00 8ijriilevy 1-721'5-
Address J Email Address
1 e5l It
License#
MechapicallHVAC Contractor Information
Description of Work 6l L/}1n rs 4. Ai r'
r+
PprvSaAir 33/.4.14 4730
Mechanical Contractors Company Name Telephone
Q D. box 571 ClL rnrnartS 2.1 otZ
Address Email Address
y� 1R
License#
Plumbing Contractor Information
Description of Work PIUMb,�ncql 1-n444aj I #Baths
30.114 Pill r1\10 nqq "LYsG. 33G • LO5.n4Zf
Plumbing Contractors CompanyName Telephone
1-153g1an 91.4•v.` 00 .
Address Email Address
LUSOG
License#
Insulation Contractor Information
j„1do.r-C Tr s.,Kt un
Insulation Contractors Company Name &Address 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 Electrical Plumbing and
Mechanical codes and the Hamett County Zoning Ordinance I state the information on the above
contractors is correct as known to me and that J,v sianmo below I have obtained all subcontractors
permission to obtain these permits and if Apy changes occur including listed contractors site plan
number of bedrooms building and trade plans Environmental Health permit changes or proposed use
changes I certify it is my responsibility to notify the Harnett County Central Permitting Department of
any and all changes
EXPIRED PERMIT FEES-6 Months to 2 years permit re-issue fee is$150 00 After 2 years re-issue fee
is as per current fee schedple
Signature of Owner/Contracto cer(s)of Corporation Date
Affidavit for Workers 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 pequry 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
Val-las 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 NameU-
�Sign wmde411L&, ma-rang-It rvt,Jnte— Date LII ('1
DO NOT REMOVE!
Details: Appointment of Lien Agent
Entry #: 666426 Filed on: 2017
Initially fileledd by by:: wjh2013
Duigneted Lien Agent Project Property
Print & Post
Inves ion Title Insurance Company MBR 604
Online:uvvalenmetont 46 Bella Howington Dr.
Lillingwq NC 27546
n� '
Andres':w W.Hargett-s:_Sane Sm aalagh, Harnv County
NC 27601 KnA
Phone::0.8.6[m-7384
Fat v;arm:ni Property Type
Contractors:
awllounnmrr:liemnccum . _. Please post this notice on the Job Site.
1-2 Family Dwelling Suppliers end Submntraeton:
Scan this tillage with your dmat phone to
ecan
w this thing.Youthen CID a Nonce
En Owner Information
Lien Agent this project.
WJH,LI C
33011 Battleground Ave Suite 230
Greensboro, NC 27410
United States
Loam!.nahimtgw:ele/umeyhumtei.com
Phone'.414-995-5654
View Connnents(11)
Technical Support Hotline:t 8Na 690-73X4.