DOCUMENTS Initial Application Date: 1 I aI ! V/ Application I 1`X L ) ri 5LP
CUM
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street, Lillington,NC 27546 Phone:(910)893-7525 exl.2 Fax:(910)893-2793 www.harned.orglpermits
^A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND/USEE APPLICATION"
LANDOWNER: Demon : s qtr pLe_I(
Mailing Address: 210 1-. .0d26-6.(00j1ThCh . I . � l }�
City. R L m�o, 1i'I / State':GA Zip: 3/32LIContact No: -r/2 iN593ps Email: CliiAn.S-CLmey6_1I�` m�Tr1F
APPLIC,A,��NIIT*:ff e"Otnet5 dneun..QrI \4 ..yy//ppnpgg Address: up2gSO WGmL' ^1G- _ Rd I'
City: W�N<r State':NG Zip:CD3l Contact No. C?/egCCO k Email: -I-
-I-4Q'TQ4:42.7c)e- w/ &,i, .
*Please fill applicant
if different
CONTACT NAME APPLYINGeIN OFFICE than Ian /e r/C� Phone# _// rqq `
PROPERTY LOCATION:Subdivision: if/
41,4*
p ! Lot#: Lot Size: 3,31 61-C--
State
CL
State Road11a 1131 State Road Name:
I{1,4 k g(. �/ 1 n (OW Book 8 Page'. Q0q. / 0/5-3
Parcel/� VS3 �a/ bnoS{gV I PIN: 0531- 10-5432 . (OW
Zoning flood Zone: /� Watershed:Ail Deed Book 8 Page: 2Ic IS Power Company':
'New structures with Progress Energy as service provider need to supply premise numbe�rr from Progress Energy.
PROPOSED USE:
Monolithic
❑ SFD:(Size )#Bedrooms: #Baths:_Basement(w/wo bath): Garage: Deck:_Crawl Space: Slab:_Slab:
(Is the bonus room finished?( )yes (_)no wl 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?( )yes ( )no Any other site built additions?i ( )yes (_)no
l/
Er Manufactured Home:_SW DW TW(Size ?T x 510 )#Bedrooms: 3 Garage:=(/site built? V)Deck: V(site built? ✓)
❑ Duplex.(Size x )No.Buildings: No.Bedrooms Per Unit:
❑ Home Occupation:M Rooms: Use: Hours of Operation: #Employees.
❑ Addition/Accessory/Other:(Size x )Use: Closets in addition?( )yes ( )no
Water Supply: VCC my Existing Well New Well(#of dwellings using well )'Must have operable water before final
Sewage Supply. V 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?(_)yes (V)no
Does the property contain any easements whether underground or overhead(_ s (_)no
Structures(existing or proposed):Single family dwellings: Manufactured Homes her(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 3s Actual 275 r u�t_
Rear 2� 290` ur-c_V &SIC
Closest Side 10 Set
Sidestreet/comer lot
Nearest Building to {(A(!r
on same lot
Residential Land Use Application Page 1 of 2 03111
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGjON: /i 27 It) & 5 7 ttt
L44 ,9p --1-0 7111,1r7k — 60 app 2 ,r,Y12s 2 kit;,C cru.
av .
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 submitted.
I hereby state that foregoing s . emare ac, rate and correct to the best of my knowledge. Permit sublet to revocation if false information is provided.
i
1 �2320/i
Signature of•.' miner'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"'
•
Residential Land Use Application Page 2 of 2 03111
I E PLAN APPROVAL yy
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.'t BEDROOMS____ ___
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NAME: SCL elt(Ie'�}rA,r�/ APPLICATION R:
*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 I CONFIRMATION#
1 TEnvironmental 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.
• It 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 it 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.
:I 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 typets): can be ranked in order of preference,must choose one.
i
fI Accepted fI Innovative f/I Conventional f—} Any
IJ Alternative II 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-r-±"NO Does the site contain any Jurisdictional Wetlands?
{_)YES f!} NC) Do you plan to have an irrigation ystem now or in the future?
! }YES 1-4—NO Does or will the building contain any drains?Please explain.
lIYES 1 O Are there any existing wells,springs, waterlines or Wastewater Systems on this property?
fIYES 1— NCO. Is any wastewater going to be generated on the site other than domestic sewage?
l__}I YES 1LI NO Is the site subject to approval by any other Public Agency?
IyrES�I
fI NO Are there any Easements or Right of Ways on this property?
IJYES II NO Does the site contain any existing water, cable,phone or underground electric lines?
If yes please call No Cuts at 800-632-4949 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
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 cels e Th A Complete Site Evaluation Can Be Performed.
.� Ce/23/2017
PROPERTY OWNERS 0 WNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE
•
10/10
Sti.np 539-153
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PROCEDURES AND GUIDELINES FOR MANUFACTURED HOMES
RA-30 Criteria Certification
I, r 7botaJ S-Ie.,new�asn t�A/v�� $CheuMrllandowner/agent of Parcel Identification Number
/ 3 b538 aa oC o f , located in an RA-30 Zoning District, do hereby certify the
following:
The multi-section manufactured home shall meet the following appearance standards,
verified by zoning inspection approval, prior to the issuance of a Certificate of Occupancy:
1. The structure must be a multi-section unit built to the HUD code for manufactured
homes.
2. When located on the site, the longest axis of the unit must be parallel to the lot
frontage.
3. The structure must have a pitched roof that is covered with material commonly used in
standard residential roofing construction. Said material must be installed properly and
be consistent in appearance.
4. The structure must have masonry underpinning that is continuous, permanent and
unpierced except for ventilation and access.
5. The exterior siding must consist predominantly of vinyl, aluminum, wood, or
hardboard; and must be comparable in composition, appearance, and durability to the
exterior siding commonly used in standard residential construction. Said exterior
siding shall be in good condition, complete, and not damaged or loose.
6. The minimum lot size must be one (1) acre excluding any street right-of-way and the
minimum lot frontage must be 150 feet as measured at the right-of-way line or along
an easement whichever applies.
7. The tongue or towing device must be removed.
By signing this form, I acknowledge that I understand and agree to comply with each of the
seven (7) appearance criteria listed above for the multi-section manufactured home I propose
to place on the above referenced property. I further acknowledge that a Certificate of
Occupancy (CO) entitling me to apply for electric service will not be issued until each
appearance criteria has been met and approved.
7-3-r7
nature of Lan+f•wner/Agent Date
*By signing this form the owner/agent is stating that they have read and understand the
information on this form
7/10
Harnett County Parcel Report Page 1 of I
Print this page
_ Harnett
<9 u b T Y EWMw
Legal
shoes reats•new rwth TR#A 3.65AC MArnE EUNICEAUTRY 093.153 Harnett County GIS
PID:130538 000501
Tax Data Last Modified:
MN:
0537.10-5432 000
CakulMetl Land Unita/Type:AC m
REID:0050745
Neighborhood;
9uCWloon:
Actual Year Bulb:
Deeded Acreage;331 ac
Tot W cula4neYear:I2 J 2 Fl
Total Ammar 347099929M
Bale Mang b0 Year:13/alp
Account Number:1400^ 40418
Bele Price:EPoCJ
Owners:CAMPBELL DENNIS L B CAMPBELL TERRILYNN
Deed Book&Page:3695C018
Deed Date:
Dome Adbeu:210 RIDGEWOOD PARK CT APT C RICHMOND HILL,GA 31324 Plat Book f Page:0099-0153
Inebument Type:VU
PropMyAtNafa:AUTRY RD NC 1 > V
4 I//r,
( / Vacant
er Improved:
CIO,,State.Zip:,NC
Quallfles ode;Y
Building Count 0
Transfer or Split:T
Township Code:13
Fire Code:
Parcel Building Value:$0 Prior Bulking Value:EO
Parcel Oubmilding Value $0
Prior Outbuilding Value:$0
Parch Land Value:$21520 Prior Land Value:$13240
Parcel Special Land Value:$0
Prior Special Land Value:$0
Total Viso $21520
Parcel Detested Value:SO Prior Deterred Value:$0
Total Minted Value:$21520
Ma Assessed Value:$13240
Legal Land Units,Unit Type:3 AC
Prior Land Units:3 31 ac
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http://gis.hamett.org/E91 IApp/Parcels/ParcelReport.aspx?pin=0537-18-5432.000 6/23/2017
Application#
Harnett County Central Permitting
PO Box 65 Lillington, NC 27546
Telephone Number: 910-893-7525 Fax 910-893-2793 www.harnett.org/permits
Application for Manufactured Home Set-Up Permit
(Please fill out each part completely)
Pan I-Owner Information:
Home Owner--/ Information (To be completed by owner of the manufactured home)
�' j
Name: ���� 1 -e 5 S�e/JAemunn- Address: /0250 i/IO/E site'„4..„, kW
City: GvAh State: de- ZI34S
p: 2g Daytime Phone:( )9/O 10 850 nig
Landowner'}�'betas
(To /bIe completed by landowner, if different thanthabove))
Name: betas L�jrnvbru1 /1 A Address: 2/a y. 4A(o&A ParK a.L e9 ±&'
City: 1x:e1,.nOnd �;II State: GA Zip: 3132Li Daytime Phone: ( )912 th ; Sti 5
Part II-Contractor Information (To be completed by Contractors or Homeowner, if applicable.
Name,address, &phone must match jufbrmation on license)
A. Set-Up Contractor Company Name: Chh.tr its --/-,0-n12.---
Phone:
n¢iPhone: 91(731;ale l g Address: I 27 /✓Orm eie¢Rjk
City: LylmA#4,41- state: 'Vt- Zip: 2831,0
State Licit 35-51# Email: c-I-eve Srtror. c Ot 0/401 i co-,,,,_ I
B. Electrical Contractor Company Name: �e fVi rO, g 0 Ik-kc0 n c )0103593103
Phone: 910-423"(plot/ Address: >7`11/M&Cana a 77r.
City: f a r K-I-Pr1 /. State: e Zip: 2837/
State Licit Zoo 3'4 L Email: 5O-e-yr on SCl -(-Cera/ /iv�(a! R.hoa. c.0)„,,—,C. Mechanical Contractor Company Name: l(5 nTeiCk9r P(c "kCC',-VP/y,tn C.
Phone: (1 le 5-25 S97Ca Address: P4 &x -i-3
City: Air yv%fit- State: Aki/ Zip: 253/1
State Lic# /0571 H-31 Email: el.�u4. O� Cyr. .
D. Plumbing
Contractorac /Company Name: JUT0SS i-7S/C7- d / /_
Phone: 9/t'7j r 72OI Address: 67170 eau/icii r are ,tl/
City: bioi Ler-ham, State: ALI- Zip: 28358
State Lic# porno- PI Email:
Part Ill-Manufactured Home Information
Model Year: 2r
01 / Size: 2g X Sty Complete& follow zoning criteria sheet
Park Name: Lot Number:
I hereby certify that I have the authority to apply for this permit, that the application is correct including the contractor
information and have obtained their permission to purchase these permits on their behalf, and that the construction or
installation will conform to the applicable manufactured home set-up requirements, and the Harnett County Zoning
Ordinance. I understand that if any item is incorrect or false information has been provided that this permit could be
revoke
1, k� !x/23/20/7
Signature of wner-. Date
'Effective July 1,2004,a County Tax Department Moving Permit must be provided before a Set Up Permit will be issued. It is
purchased from the tax office of the county that the home is moved from. If the home is from a dealer, we need proof of year on the
4 Form 500 and it available, the serial number
List of inspections and Egress requirements available upon request. Progress Energy customers must provide Premise Number.
SETUP
1
DATE:8/29/2017 SALES AGREEMENT
BUYER(S): Thomas Scheunemann
J�a nett Scheunemann
ADDRESS: 62 Wade Stedman Rd Wade,NC 28395
DELIVERY ADDRESS: TBD Autrey Road Lillinton,NC
TELEPHONE: (910)850-1178 SALES PERSON FULL NAME:Al Parker
BASE PRICE: $ _ 98.753 70
Make: Clayton Model: Rocketeer 4608
Year Length Width
2.398 64 Stock#
Slate Tax Serial No. RSO CVew ❑Used
Local Tax 0.00
TRADE: Make: N/A Model:
Year Length Width Title#
Serial No.
1. CASH PRICE $ 101.152 34 Amount owed will be paid by: I:Buyer Dello:
Owed to:
Land Purchase 35.000 00 OPTIONS:
Land Payoff 35.000.00 14 SEER Heat Pump,Septic Tank, Water Tap and Water Supply Line, Pier and
Title Fees 52.00 Perimeter Footers, Brick Curtain Wall,2 Sets of Wood Steps
Filing Fees 0.00
HPP/HBPP 854.94 SELLER RESPONSIBILITIES:
HPP tax 0.00 Deliver and Set Home to Manufacturer Soecifications Electrical and Plumbina
Connections.
BUYER RESPONSIBILITIES:
Access to Site
2. TOTAL PACKAGE PRICE $ 137.059.28
May not meet local codes and standards.New homes meet Federal
Trade Allowance Manufactured Home Standards.
0.00
I UNDERSTAND THAT I HAVE THE RIGHT TO CANCEL THIS PURCHASE BEFORE
Less Amount Owed 0.00
\IIDNIGII'1' OF THE THIRD BUSINESS DAY AFTER THE DATE THAT I HAVE
Trade Equity 0.00 SIGNED TIIIS AGREEMENT.I UNDERSTAND THAT THIS CANCELLATION MUST
BF IN WRI'ONG.IF I CANCEL THE PURCHASE AFTER THE THREE-DAV PERIOD,
Cash Down Payment 500.00
1 UNDERSTAND THAT THE DEALER MAY NOT HAVE ANY OBLIGATION TO GIVE
ME BACK ALL THE MONEY THAT I PAID THE DEALER. I UNDERSTAND ANY
3. LESS ALL CREDITS CHANGE 10 THE TERMS OF THE PURCHASE AGREEMENT BY THE DEALER
$ 500.00 WILL CANCEL IHIS AGREEMENT.
ESTIMATED RATE OF FINANCING_ % NUMBER OF YEARS
4. REMAINING BALANCE $ ESTIMATED monT IILY PAYMENTS $
136.559.28
i ! tti14.-. §'x}- I r '( C T r t '
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IAN,
Location Type of Insulation Thickness R-Value tt a EPd} y '. i . s,l t 1 } ncc §A
d act t r+1dYC',r-4 t^ s tii9if`st i4 1652C I w Floors Fiberglass 722 4` -Ci
'T %" ifP. t17gkr'I ter
Exterior Fiberglass 3.5 11 {" 1/Loci, ,L wit.cti sco 'f.t d `sr+. r I ¢Fir . t
Ceilings Fiberglass 8.5 30 � �tlR: K c 71:74Az
wi
SELLER:
This insulation irfomation war ftmished by the CMH Homes, Inc.d/b/a-Mamfcturer and is disclosed in compliance with the Federal ' ^'
Trade Commission Rule 16CRF SECTION 460,1a.
IAt
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Signature of
signature of
Sales Agreement NC-(2312)-Slsegr11014 Re' sod 04/2013
Page I oft