LAND USE •
tnlllal Application Date: l � I � Application # /C ��
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION CUB`_
Genital Permitting 108 E. Front Street, LIIIIngton, NC 27548 Phone: 910 893 -7525
Phone: ( 910) Fax: (91 O) 893-2793 www.harnett.orglper
LANDOWNER: p p/� Malting Address: (nFC(0 (Dena t LYm
• Cit r1 \ State: 1�{l Zfp:�1/CZ. l(�-�-{?- Jl` -�,',,�, t � a '' o `( t `` #; A
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APPLICA : M A. .1. S. Mailing Address: �C�,R�J t` c1 } J/1
City: 1 . - 11\ �P /-� „+ —t
la1n _ I act #:
* Please an a •pilcenf Information U different then n landowner
ZIP �1411ome #:Adowner
CONTACT NAME APPLYING IN OFFICE: C(\ (c t L. V PR se.
Map BDOk &Pge: 121 4.. Phone #: C I V� " ��t+�^ (")1.4, (")1.4, �s
PROPERTY LOCATION:
� Subdivision: Ter Ter 5\fYY'LOV\ 1' �1G�S
State Road it rl t h State Road Name: ' nny 9 r ed- Lot # Lot age:&t e: �7
Parcel. b3 Q 7_- 7 �' r fij/1 PIN: cn� R- r I CO ��� --
Zoning:t - /
O '+C � t
012 Flood Zone: N0 Watershed: M Deed Book&Page: 2 )_" / , '/2/ _Power Company"tc. ,pSS G)(155L
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: J J
J314`1 g'7 Not-Eh .- On) Spot r lake- cahr'xA , i rnil-t -to Hw`f M .
' r K*_. r • 4:4 e lb vYi ILe
- 1 . 3 I r M )2"“ 011 V\ rmvpr Road , Ana in at? aux1 rynar& \ '12.mftts r
r eem1Mrnnh \VA Nt5 nr cknt,or 1.0 oh Coven f\ ° ocO/11
OSED USE: to (include Bonus room es a bedroom if It has a closet)
SFD (Siz9'i l--, x, .) # Bedrooms j_ Basement (w/wo bath)
# i// _ pole:
Garage Deck Crawl Sp Slab
❑ Mod (Size x____) # Bedrooms # Baths Basement (w /wo bath) Garage Site Built Deck _ ON Frame /Of
❑ Manufactured Home: _SW OW TW (Sizex ) # Bedrooms Garage
❑ Duplex (Size _x No (alts built? ) Deck (site built? )
No. Buildings No. Bedrooms/Unit
❑ Home Occupation # Rooms Use
Hours of Operation: #Employees
❑ Addition/Accessory/Other (Size x__) Use
remise number from Progress Energy Closets
-- in Lino
'Homes with Progress Energy as service provider need to supply PPIyP Energy/71 (SIR
Water Supply: (j) County (_i Well (No. dwellings MUST have operable water before final o — 1 7 U B
Sewage Supply: g New Septic Tank (Complete New Tank Checklist) Li Existing Septic Tank ( ) County Sewer
Property owner of this tract of land own Land that contain a ma9ufactured home Win five hundred feet (500') of tract Haled above? (__)YES ( N O...,._
Structures (existing or proposed): Single family dwellings 1 ` Manufactured Homes
Other (specify)
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual bb
Rear 25' , y 9 � o ' o
Closest Side lb r. ci0
Sldestreetcorner lot 86 15 l.,
Nearest Building _[p_ S___.
f
on same lot
If permits are granted I agree to conform to all ordinances and laws of the State of North Carolina regulating such work and the specllioatlons of plans submit
I hereby state that oregoin! statements are accurate and correct to the best of my knowledge. Permit subject to revocation If false Information Is provided.
Signature of Owner or Owner's a ent
Dete
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"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
LAND USE Please use Blue or Black Ink ONLY
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NAME: L q0 �{,Y 5) flIMM) 1-1) 1 ) APPLICATION #: ` � 767 Z � /6C1
*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 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 aVfor 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 nrinr to schedulina inspection. 800- 6324949 (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 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 property.
• Prepare for inspection by removing soil over door as diagram indicates. Loosen trap door cover. (Unless
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 recordina 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 system type(s): can be ranked in order of preference, must choose one.
{_} Accepted Li Innovative ( } Conventional {_1 Any
{} Alternative (_1 Other
The applicant shall notify the local health department upon submittal of this application if any of the fallowing apply to the property in
question. If the answer is "yes ", applicant must attach supporting doctunentation.
(_,}YES N) NO Does the site contain any Jurisdictional Wetlands?
{N) NO Do you plan to have an jrrieatiomsystem now or in the future?
(_ }YES {s) NO Does or will the building contain any dra' ? Please explain.
i — iYES {\.]) NO Are there any existing wells, springs, waterlines or Wastewater Systems on this property?
{y,} 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 NO NO Are there any easements or Right of Ways on this property?
{_)YES Na} 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 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 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 SIGNATURE (REQUIRED) DATE
5/08
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RNETT COUNTY TAX ID#
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R ; ' OLINA GENERAL WARRANTY DEED
Emile Tea: S ; .00
Parcel Menem N• O39 - Ly;4, Valledby Camay ante day of ,20
By.
MEWS*: b: Than C e ille, P.A. 150 N. McPhateon Church Read. Ste B. Fayetteville, NC 28303
This thsU m lint swag prephaad • . • a I . • & , P.A., 130 N. McPherson Church Road, Ste B. Fayetteville, NC
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grief description f w th. bidet LT 9- 7, 25 - ! RS HILL 0-06,9-01.
THIS DEED maderids AA day of +tr 2Qg. by sod Women
Ilr GRANTEE
STAFFORD - TURNER DEVELOP f T CT REGENCY HOMES, INC.
Vat n.i Field f 16 LOTS, PERSIMMON HILL
tATS / W( t HARNETT COUNTY, NC
Tbe deslpatbnGr mmandGrntee es uedberdnshall . .. Mirk atccea aa,andenlpla,
Spier, plural, mascuI e, or neuter u ,. s . ....
WITNESSETB,tha9aG=mt *et valuable .•....... ,. . theaoelptofrddokes h mabyedmowiedged,bm
eedbytosepres =hdoea1hargalo,eeamdconvey .a,.. -. ` le, all that nmhmbtapacdofloidsitaad
i Poe C9tyof HARNETT COUNTY Barbeque T. 77211. Barnet County, NaMCarolma and
more punlctlydeacrmed es fbaoaa:
Being all of Lots 9 - 17, 25, 36 - 41 in a subdivision known as Pere ; • ivision and duly recorded in Plat Cabins
2006, Page 894 and 895, Harnett County, North Carolina Registry.
page
A map thawing the above described property is recorded In Plat Book 00 ...
The pmparry heaahmbwedasaErod an4nnnd by Gtmturlhi• . -•
• 6 r 894
NC Bar Amchitka PomtNo. L-3 O 1976, Revised O 1977, 2002
Printed by Agreement with the NC Bar Association -1981 Sof@to - .,., Rd., Raleigh, NC 27609
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