DOCUMENTS Initial Application Date:f/
Appllcatlon p Sea�{ �� s(-ThCMSCOUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permihing 108 E.Front Street,Lillingtoo NC 27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.harnett orglpermits
"A RECORDED SURVEY MAP,RECORDED DEED PROFFER TO PURCHASE)8 SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER.Dakota Land Partners, LLC Mailing Address 5511 Ramsey Street, Suite 100
CO: Fayetteville Slate:NC Zip 28311 Contact No: 910-401-5504 Email: Jeri.Elkins@mossycreekmgmt(0 yi
APPLICANT':Dakota Land Partners, LLC Mailing Address:
City: State: Zip Contact No: Email:
n ease fin out appricenl information if different than landowner
er: --..-H— LL�
CONTACT NAME APPLYING IN OFFICE:Jeri Elkins Pone#910-001.5/504 / o
PROPERTY LOCATION:Subdivision: Mamie Bell Ridge Lot#. 9✓a Lot Size: 0.63 a&
State Road u 1291 State Road Name. Old US 421 Map Book&Page: 2C0 7l 250
Parcel: I30/r,3(N)I &O29 -2i/,nL ,/ PIN. O6330y 56 blIP
Zoning:RA-30 Flood Zone: � Watershedl•J F f Deed Book 8 Page' t 1 4_ 7 7 W Power Company:
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
4 SFr):(Size LIO x 50 #Bedrooms: q Slabnllmi`
) 4 #Baths:k Basement(w/wo bath)._Garage: peck:_Crawl Space:_Slab: ✓ Slab:
(Is the bonus room finished?( )yes (J no w/a closet?J yes ( )no(if yes add in with#bedrooms)
❑ Mod:(Size_x )#Bedrooms_ft Baths_Basement(wNvo bath) Garage: Site Built Deck: On Frame OH Frame_
(Is the second floor finished?L. yes ( )no Any other site built additions?(J yes (__)no
❑ Manufactured Home: SW DW TW(Size_x )St Bedrooms. Garage: (site built? )Deck: (site built? )
O Duplex:(Size x )No.Buildings: No.Bedrooms Per Unit:
❑ Home Occupation:it Rooms: Use: Hours of Operation: //Employees:
❑ Addition/Accessory/Other:(Size x_.)Use: Closets in addition?f )yes ( )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?J yes U no
Does the property contain any easements whether underground or overhead( )yes IL)no
Structures(existing or mposed)'. Ingle family dwellings: k. Manufactured Homes: Other(speciy):
Required Residential Property Line Setbacks:'// Comments:
Front Minimum Sc Actual NO
Rear OS 115594
Closest Side 10 39.5
Sidestreet/corner lot
Nearest Building
on same lot
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 12I N le if (Xdo (_a/1e,'Gr 4?
rtc��1 (un},) Oki US ILLy LI . len ton fY\Qmie ler41tcon Or
le P4 a' t IYlbm'le `})e,1 I Orct
1 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.
hereby state that foregoing statements are accurate ect • -best of my knowledge. Permit subject to reevocation i[false information is provided.
dir
Signature of Owner• Ow er's Agent 'Date ��
"'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
SETBACKS ALL DIMENSIONS. LOCATORS AND FEADJRES SHOWN ON
THIS PLOT PLAN ARE APPROXIMATE AND ARE ONLY AN
FRONT - JS' ARTISTS RENDITION, EXACT LOCATOR OF ALL FEATJRES
ARE SUBJECT TO CHANCE AND MAY NOT BE INSTALLED
K -J SIDE - 10' EXACTLY AS SHOWN ON PLANS AND/OR IN MODELS.
PLACEMENT OF HOME. DRIVEWAY. SIDEWALKS AND
Ac m D REAR - 2S EXTERIOR FEATURES ARE SUBJECT TO MODIFICATION AS
o p y CORNER 510E - 20' DEEMED NECESSARY BY FIELD PERSONNEL.
FS O
T
2
j e CUSTOMER DATE
a I
421
CUSTOMER DAZE
OLD US HWYTT
S.R. 1291 WADE JURNEY REPRESENTATIVE DATE
SITE s r
wiz-N
4'
&• IMPERVIOUS SURFACE AREA
co
DESCRIPTION AREA
VICINITY MAP HOUSE w/ PORCH 2,078 S.F.
Not To Saqls ; R AN APPROVAL
T yy� PATIO/HVAC 18 S.F.
_ 1SE r/ � DRIVEWAY & WALKS 701 S.F.
'dl
-- - TOTAL (PROPOSED)= 2,797 S.F.
1_AS. _ —_ LOT AREA = 27,592 S.F.
SILi --2_N1838:3":K � % IMPERVIOUS AREA =10.1%
- - - - - 9.o. V
25' SETBACK Z
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10' SETBACK \,n 9 I A .M —
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\V O i673 \l'a N
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159.0' 96 \\
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PB 2013 PG g 27.592 S.F. at
o, 0 0.63 AC \ o
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p DD 39 5'
1/400
40.4' o 1
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THIS PROPERTY MAY BE \ '- U)
SUBJECT TO ANY AND ALL \ HI
APPLICABLE DEED
RESTRICTIONS, EASEMENTS, L. ��'— J
RIGHT-OF-WAY, UTILITIES 35' SETBACK N
.
AND RESTRICTIVE COVENANTS v 360'
WHICH MAY BE OF RECORD J
OR IMPLIED. E
EO'
au W
TILDEN HOWINGTON DRIVE
50' PUBLIC R/W
CURVE RADIUS ARC LENGTH CH LENGTH CH BEARING
Cl 25.00' 38.87' 35.07' N37105'53'W
APPROVAL FOR STAKING THIS DRAWING DOES NOT
IS
THIS
PLAN AS HEREBY APPROVED°FOR°STAKNG ON THE REFLECT AS—BUILT INFORMATION
DATE SHOWN BELOW.
WADE DANE! HO4AES REPRESENTATIVE DALE PRELIMINARY PLAT
NOT IDA RECORDATION. CONVEYANCES, OR SALM
50 0 50 HOUSE LOCATION PLOT PLAN
mill
FOR
SCALA t" = 50' #16 TILDEN HOWINGTON DRIVE
IDE_ 1 T LOT 96, MAMIE BELL RIDGE, PHASE ONE
� Upper Little River Township, Harnett County, North Carolina
LAND SERVICES,S, DT i (7r PROPERTY OF: WADE JURNEY HOMES
L1,50001Pineyy Plains` Rood. Suite 102 MAP BOOK 2007 PAGE 256 DEED REFERENCE
Cary. North Corolina 27518
(919)Phone 977-1554
FirmDRAWN BY: E.G. DATE: APRIL 19, 2017
License 919 A 7- 554
Dakota Land Partners, LLC
NAME: -. _ APPLICATION#:
*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 INFORMA'T'ION IN THIS APPLICATION IS FALSIFIED,etIANGED,OR THIP SITE IS ALTERED.THEN THE IMPROVEMP:N'I
PERMIT OR AtITIORI%ATIONTO('ON STR UCT SI I AI.I.BECOME INVALID. The permit is valid either 60 months or without expiration
depending upon documentation submitted. (Complete site plan=60 months;Complete plat=without expiration)
910-893-7525 option I CONFIRMATION#_
D Environmental Health New Septic SvstemCode 800
• All property irons must be made visible. Place "pink property flags" on each corner iron of lot. All properly
lines must be clearty 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.
• It property is thickly wooded, Environmental Health requires that you clean out the underarowth 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 trio fee may be incurred
for failure to uncover outlet lid,mark house corners and Drooerty 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.
1-1 Accepted { I Innovative l-1 Conventional 1—I Any
f__I Alternative I7 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 I5 NO Does the site contain any Jurisdictional Wetlands'!
I YES ( x } NO Do you plan to have an irrlpftion system now or in the future?
I_IYES 1 x I NO Does or will the building contain any drains? Please explain._ _
I_ _IVES I l No Are there any existing wells,springs,waterlines or Wastewater Systems on this property'!
I YES 1°1 NO Is any wastewater going to he generated on the site other than domestic sewage?
f—}YES f x 1 NO Is the site subject to approval by any other Public Agency'?
I_)YES I'1 NO Are there any Easements or Right of Ways on this property'?
lI YES l'}NO Does the site contain any existing water,cable,phone or underground electric lines?
If yes please call No Cuts at 800-632-4749 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 Rolm.
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 C to • rand.
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09/09/11 Application#
Harnett County Central Permitting 4 14 '1-Th
Each section below tabs filled outPO Box 65 LIlington NC 27546
by whomever performing work 910 893 7525 Fax 910 693 2793 www helmet orypemnta
Must be owner or licensed
contractor Address company Application for Residential Building and Trades Permit
name 8 phone must match ,, 1
Owners Name C.A.)0 44 Ju rht� Ir1awiGS LLL Date (0113117
t7
Site Address tit T14fL \ k} LAa4DV1 aOt Phone QII.I-Ql!____L/
Directions to lob site from Lllington "Tate t+W y Z 10 5.1-4441-igt Gtc4 an-la
'S./Nut/It5l-. 'tyl 4-urri 0 nn-10
,vim
Subdivision _ 1V1jt of(�I-2-aiat Lot qt1
Description of Proposed Work 5� #of Bedrooms 3
Heated SF L Unheated SF 40Z- Finished Bonus Room', Crawl Space _Slab 1(
General Contractor Information
llLl e 53(raC2.- 3[,n(Q
Buil ing Coo tractor s Company Name Telephone
3 .♦ :. ... : a, . ' S. , 0 " as illzetlkv1Akv,n afhorne.6.
Address L%410 Email Address
yGZ42 C4/11License#
•
Electrical Contractor Information /
Description of Work t(rl r yak 'f N4ktJ I Service Size 7M Amps T-Pole (/ Yes_No
Crtarbcri tteu-ascot 'gar.-5 -1.40an
Electrical Contractor s Company Name Telephone
l lL'(ro jL1712 „7.12.15-
Address
7.1L13Address .JJ Email Address
1O5L(,
License#
Mechapical/HVAC Contractor Information,
Description of Work LIZ/1/ncc L Air
eonacar+Alr 33(.4-1G1-1 430
Mechanical Contractors Company Name Telephone
9 D. box 577 C(tfnman5,L7 o17
Address Email Address
�I7 L5C
License#
Plumbing Contractor Information
Description of Work PI(rnbtn 4}04l #Baths
13ai1t� PlurryjingqTAG 33Li • L-416.t
Plumbing Contractor s Company-Name Telephone
1d6 3K (.eats L4,Lt.c- PA .
Address Email Address
L
Licensense ft#
Insulation Contractor Information
21_,..:\(Ski Zna4S.tv-.tw-
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 Harnett County Zoning Ordinance I state the information on the above
contractors is correct as known to me and that pv aranrna below I have obtained all subcontractors
permission to obtain these osrmits 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 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 schedule
Qal.lot.4 (.4113111
Signature of Owner/Contractoscer(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 pnor
to issuance of the permit and at any time dunng the permitted work from any person firm or corporation
carrying out the work
Company or Name l.4.ljt4-•
t�. I',, '
Sign w(Title"(a�. VjarniiN:bnrc1n
1 a,I.nt� Date (111217
DO NOT REMOVE!
Details: Appointment of Lien Agent Piled on: 06/12/2017
Entry #: 668447 Initially filed by: wjh2013
Designated Lien Agent Project Property
Print & Post
Invawnl iOC Insurance Company M BR 96
16 Tilden How mitten Lin C': O
nnllnve 995 Iwmne tom Lillingion NC 29546 1y _
Aan .:re. ie W Imre:SI Sona 509 Raleigh, flamcn Counry
,l 17601 O .j'G
Phone:555.0%.53X4
Property Type Conrnecon:
Fax:011-nvs 0 Please post This nonce on the Job Site.
¢noil:nmrvu(u hvmm..am - 1-2 Family Bu dung Suppliers
and Subaonr in&t
Scan this Image with yoursmart phone to
e
w this filing You can thennart file a Notice
Owner Information
to Lien Agent for this project.
RIH,LI C
33011 Battleground Nve Suite 230
Greensboro. NC 27410
United States
trretl':nabiau:s uietumeyhomes com
PhomW 19-995-5654
View Comments 10)
Technical Support Bodine:( )690-73x4