LAND USE Initial Application Date: / Z ` / 7 '— /O Application # , / 'f 5: 2 5 1.- 7-‘ 2 #
COUNTY -OF HARNETT RESIDENTIAL LAND USE APPLICATION CU
Central Permitting 108 E. Front Street, Llllington, NC 27548 Phone: (910) 893 -7525 Fax: (910) 893 -2793 www.harnett.org /permit:
LANDOWNER: �.i� it - . mantas 1111 . Malting Address: (p (0 1t Lm
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Ciry:.1 • %l State: iP lome 1 - 4 4&
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APPLICAN : �j,, St A 1 la 1 _ * MailingAdd ,1, �I. r R 1 l l._
city if ilnlas - State: N�LP iome #:c \ gaLCAE wact #:
`Please All o • • leant Information if different than landowner '
CONTACT NAME APPLYING IN OFFICE: • VT\ (.\-1 E t E Pre-Ai sQ_ Phone Q : 1 Its t » o - 5'5
PROPERTY LOCATION: Subdivision: I1Q�'� OY /)
Lot #:_ _Lot Acreage: 0 3
State Road #: 91- 11 \.1 State Road Name: m �Y AS 1tiO &c.L .. Map Bock &Page: Q00% /
Parcel: _ D. 9 4 5 7 51\ O I s 5 25 PIN: q cs1 s- 4. o - 7 y a Li, on o
Zoning: 1.4%. - c7,QR Flood Zone: X% Watershed: N (7. Deed Book &Page ___ _I Power Company:
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
W g W7 t.) cn411 -0 H LON a H : Go . \ c QS-4- on H IA) \-1 2t) for a rri i i es
Vice LIZA*. on MA Roc(ri , As\nQcovrA 1.s c■ e l€4-1--
PRO SED USE: 6 D) (Include Bonus . roam ss a bedroom II k has a dos t) `/ - C`cle:
SFD (Size % Gx O # Bedrooms . # Baas/. Basement (w/wo bath) Ntie Garage y Deck / Crawl Space / Slab •
❑ Mod (Size x ) # Bedrooms 4 Baths_ Basement (w /wo bath) Garage Site Built Deck ON Frame / OFF
❑ Manufactured Home: SW DW TIN (Size x . ) 4 Bedrooms Garage (site bulk? 1 Deck (site built? )
❑ Duplex (Size _x ) No. Buildings No. Bedrocros/Unit
❑ Home Occupation # Rooms Use Hours of Operation: #Employees
❑ Addition/Accessory/Other (Size x • -.) Use - Closets In additlon(Jyes ( )no
*Homes with Progress Energy as service provider need to supply premise number from Progreso Energy
Water Supply: `� County (J Well . (No. dwellings ) MUST have operable water before final
Sewage Supply: IA) New Septic Tank (Complete New Tank Checklist) U Existing Septic Tank 1 ) County Sewer
Property owner of this tract of and own land that contains a manufactured home win five hundred feet (500') of tract listed above? (DYES UNO
Structures (existing or proposed): Single family dwellings ' e S Manufactured Homes Other (specify)
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual 31
Rear Z S qi LIR
sest Side to
�
destreet/comer lot 2- O
Nearest Building 1 L
on same tot
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 submittec
I hereby state that (oregoing statements are accurate and correct to the best of my knowledge. Permit subject to revocation if false Information is provided.
�— Jam$ to
(\_ Signat of Owner or Owner's nt Date •
"This application expires 6 months from the Initial date If no permits have been Issued"
A RECORDED SURVEY MAP, RECORDED DEED (OR OFFER TO PURCHASE) AND PLAT ARE REQUIRED WHEN APPLYING FOR LAND USE APPLICATION
Please use Blue or Black Ink ONLY
LAND USE ` 4/08
SITE PLAN APPROVAL �®
DISTRICT USE ---
#BEDROOMS 11 25 )
7oning Administrate
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'x C D= 511 °16'01 "W 26.42' G p
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Wynngate Drive 50' Public 12/W 0
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NAME: j^b ' 1 a ! 2 I RSi 0 Ck 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 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 System Code 800
• Place "pink property flags° on each corner iron of lot. All property tines 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.
• Call No Cuts to locate utility lines odor to scheduling Insoectlon. 800 632 - 4949 (This Is a free service)
• 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 CIIck2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
0 Environmental Health Existing Tank Inspections Code 800
• Follow above instructions for placing flags and card on property.
• Prepare for Inspection by removing soil over door as diagram indicates. Loosen trap door cover. (Un[ess
inspection is for a septic tank in a mobile home park)
• After preparing trapdoor 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 de ired system type(s): can be ranked in order of preference, must choose one.
{_) Accepted [_) Innovative {) Conventional {_) Any
{_} 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.
YES Imo.) NO Does the site contain any Jurisdictional Wetlands?
[._)YES [N) NO Do you plan to have an jrrieatipa now or in the future?
[_]YES eS) NO Does or will the building contain any drain ? Please explain.
i,}YES ("f) NO Are there any existing wells, springs, waterlines or Wastewater Systems on this property?
[_ }YES {N,} NO Is any wastewater going to be generated on the site other than domestic sewage?
(_ }YES Nt } NO Is the site subject to approval by any other Public Agency?
(. }YES j} NO Are there any easements or Right of Ways on this property?
(,_ }YES 1y,} NO Does the site contain any existing water, cable, phone or underground electric lines?
If yes please call No Cuts at 800 - 6324949 to locate the lines. This is a free service.
I Rave 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.
‘ 171 7 1 r `/. 3 -!
PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE (REQUIRED) IIATE
5/08
ler' EINUIIIII
• vamp ru of Dams
RNETT COUNTY TAX 10 # PA
von 20
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OR y: • OLINA GENERAL WARRANTY DEED
Excise Tax: $ 714.00 Parcel Identifier • 1 39.. 1 *tar ° Verified by County oaths day of ,20
By.
MslVBox to: Thorp, C • - ills, P.A. 150 N. McPherson Churcb Road. Ste B, Fayetteville. NC 28303
The hnmonem wu Prepped • . ' „rp 1 • e dt
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e, P.A., 150 N. McPherson Church Road, Ste B, Fayetteville, NC
Bdafdssaipdcn fig teindex, LT9- 7,25 -0 BRS1MMONHILL e- OfB7o -O-
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THIS DEED made tdt ISW day of� a 2Q%,by sad between
0• •r GRANTEE
STAFFORD - TURNER DE • ra T LJ REGENCY HOMES, INC. .
4ti YLIt%SS Fled OP 16 LOTS, PERSIMMON HILL
Y1CI VI 1‘6,t4C • HARNETT COUNTY, NC
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Thedsitution Omarmad Grantee at usedhereinsha8 �. •••• bah; mecmtan, and assigns, and Pull Include tingphr, P�+4 owuadme. ibmmme a aweer as .: .
WTTNESSE2'B,mattlmOrama, faavtlaable opridpa•:• .. pnteceiptafwhicbis hmebyaduowledged ,bas
ISbytha.Passffi Van R ref and canvey '• ^^ ..'.... le, a8 thatcatam tm
btapaloflaodnlated
int& Chy of HARNETf COUN Barbs T Hews Cwmy,NsthCaml'mamad
mac pardaalady deprmcd a &Boas:
Being all of Lots 9 - 17, 25, 36.41 in a aubdiviaian known as ' - : W .. ivision and duly recorded in Plat Cabinet
2006, Page 894 and 895, Harnett County, North Carolina Regieoy.
Thorpmpasty hsehssbove datadbed wet aogo'ved by b7'.. . PIP — .
A map showing the above described property L recorded in Pitt B '006 , 894
NC Bar Association Perm No. L-3 0 1976, Revised 0 1977, 2002
Prletedby Agreement with the NC Bar Association -1981 Boftm ,,.,, -. Rd., Raleigh, NC 27609
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