Loading...
LAND USE RR • Initial Application Dater ^� 1�\ I1� Application I55 aci3 C Lt 1 CU# OUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION Central Permitting 1 E.Front Street,Lillington,NC 27546 Phone:(910)893-]525 ext:2 Fax:(910)B93-2793 w�ww..vharnettorg/permits "A RECORDED SURVEY MA/P,RECORDEDDEED(OR OFFER TO PURCHASE)8 SITE PLAN ARE REQUIRED WHEN SUBMITTING A LANDUSL/ © ,/) ,f LANDOWNER: IL]t."..) s L-JYA1T` Oi CNV Mailing Address: . r _ �M s _ 9-1j 1~CZ City'_.s.a4 -rr ^nI lstata'.f.i Zip:31calf ontactNo':GGF I -&(. 311kmall: Sr. vY1- ir lLx- e \IC.I.OQ rC- lx1 APPLICANT': t '�L) S U .1.+Gic: t cr Mailing Address: &u /'9 C City: State:_Zip: Contact No. Email: 'Please fill out applicant Information)(different than landowner CONTACT NAME APPLYING IN OFFICE: • Phone# PROPERTY LOCATION:Subdivision: 1 .1 ny'y�y"�(�, ` \C A,I I •\o n ( Lot#': Lot Size:c)(\.!,I t✓ State Road# /� State oo \me'. )J &' t I t+t-`^^) M.I l l l G, 1C). p 1R-6-Map Book 8 Page: / Parcel I I C Wi l DOCC PIN.��-7 )--�k (D5OCi LO o d ZoningM1A-2 (1) Flood Zone: Watershed:`'NtS1Y Deed Book 8 PagePt°° I 7a5 Power Company: ' V`4 l - 'New structures with Progress Energy as service provider need to supply premise number from Progress Energy. PROPOSED USE: / 3 u lhlc U SFO:(Size.+ x S 1 )#Bedrooms t #Bas:a.Basement(w/wo bath)'. ✓Garage: {Deck: t'Crawl Space: Slab:_Slab: Slab'. (Is the bonus room finished?( )yes (I)no wl a closet?( )yes (j)no(if yes add in with#bedrooms) ❑ Mod:(Size x_)#Bedrooms_#Baths Basement(wlwo bath)_Garage._Site Built Deck:_ On Frame Off Frame_ (Is the second floor finished?(_)yes (_)no Any other site built additions?( )yes ( )no ❑ Manufactured Home: SW DW TW(Size x )#Bedrooms Garage. (site 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: • Co/ Lnry 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?(_)yes (✓)no Does the property contain any easements whether underground or overhead(_)yes (_LIcno Structures(existing or proposed):Single family dwellings: Air t I Manufactured Homes Lin Other(ssppeecify):� Required Residential re erty Line Setbacks: Comments:,, -r 41"J3w L1Y' 1 `((h��y-,A...'S,,J LAYV�K Front Minimum Actual I 5- #_, �kJO�,�-NJSd. \t CL N5t \vvND s Rear /R���/�) WOO Y P C -Y Closest Side t `� 4.CD `' SidestreeVce �rner lot 1 "�1 v h r‘-) /y7 O I a �\�/ Nearest Building O (SOC S on same lot _- Residential Land Use Application Page 1 of 2 1-A 03111 APPLICATION CONTINUES ON BACK SPECIFIC DIRECTIONS` �" TO THE PROPERTY FROM LILLINGTON: atO NOr4-L\ �-O' VlarVtt- 4 CI cs.)\rotL• (LJTrnyc Qc24 (Aa W S.kp S( C Ma ghct.zs MIL Pout/ Pd) Sora c Ith!— Q. crass '(1c1 (S 1..h tiLy Q$ ) 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 foregoy'+ statements are a ate and correct to the best of my knowledge. Permit subject to revocation if false information is provided. u -kucarc9rx, la-i3 11s— Signature of Owner or Owner's Agent Date "`It is the ownerlapplIcants 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 03/11 NAME: (LAOS Vl• y11-01,C-0 APPLICATION#: J I U/ Li LI *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 345 PERMIT OR AUTHORIZATION TO CONSTRUCT SHALL BECOME INVALID. The permit is valid for either 60 months or without expiration kr- depending upon documentation submitted. (Complete site plan=60 months;Complete plat=without expiration) e.7T n —r — LA.� 910-893-7525 option I CONFIRMATION# D i J 1 -1 I Environmental Health New Septic SystemCode 800 { jr t3 1-o b( co_U e d -q 19 -S(Q K- 311 - • 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 properly. I • If 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 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. 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 lank as diagram indicates, and lift lid straight up (if possible) and then put lid beck 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 8 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 m construct please indicate desired stem type(s): can be ranked in order of preference.must choose one. II Accepted I—I Innovative I_ Conventional 1-1 Any II Alternative I_I 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 IIYES 10/„I ppp'''O Does the site contain any Jurisdictional Wetlands? {_}YES I frtJO Do you plan to have an irrigation system now or in the future? IIYES I Does or will the building contain any drains'!Please explain. 1—IYES I I Are there any existing wells,springs,waterlines or Wastewater Systems on this property? IIYES . I Is any wastewater going to be generated on the site other than domestic sewage'! I—IYES { Il pi 0 Is the site subject to approval by any other Public Agency? f—I YE,S Illi) NO Are there any Easements or Right of Ways on this property? DYES 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 Thyp/g `ite Afcessible S T�ha A Complete Site Evaluation Can Be Performed. 1 IfNQ � U r5 \JhUe-. C' YlrerZ. 4-10— I )-- 3 \ PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE 10/10 HARNETT COUNTY,NORTH CAROLINA GLS/LAND RECORDS 0. lippio CD AddressPoilts i!a Road Centerines MajorRoads Rivers 4006 Parcels Co n—BAY City its �y�,. +� Hamett_2013.sid s., Green:Band 2 ��!e!�� ir✓ : • - .. ■Blue. Baro 3 0 © ® + 4` - 4237120 -41, = r. 4 'o,_ -• - Hamett County GIS Myua or ee.map NY be al M sale nak dM uw of. nuke Agp�,al Misr lwpyr.take„ 305 W ComehusHarnett Blvd,Suite 100 b^ +aoawcwary Me.up..n.o Man.nc«y..k..n,,, a taken. b rise awu go..nbnn...nrp anrd boron Mr marl b.pU Nr Mhamka �� Harnett` Llllington NC 27546 /Urn.*Carr.a Coded olfa.le Phone: 910-893-7523 www.hamettorg .aeon.caws or Aum or..c•ry warp from n:° "'e.S proand duct claim.damage.10eL b.�-- --•-=--- aq 1 _ 11,„, r wu s, ` GIS" Sho ws C0 �� 5 1 cy\.e_ ,J . ,...,,,-... 4. (2-4.'3' SITE PL APP2ROVAL. DIS1RICT 0 USE *BEDROOMS ` 13115 r on Adrnini n�+a \ L1%.1--