DOCUMENTS Initial Application Date:9,,Patirl
Application# I r1 Soox-)."a'T i ` '
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
\3-4-CeJntrrallLPeermitbng OB E.Fr nt Street,Lillington NC
27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.harnett.org/permits
"A RECORD SURVEY M .R E ( FF( OP RCHASE)B SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USEAPPLICATION
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APPLICANT•: �CI(QPI Ijl�l')Q�t 04 ailing Atltlress'.
City State:_Zip: Contact No: Email:
Please fell out applicant information if different than landowner
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CONTACT NAME APPLYING IN OFFICE: /v'1/ P. O 01LI / \�n di 7rd n' 1 Phone# 1'yL (��/
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PROPERTY LOCATION:Subdivision: Vf C.fort1(A I-ii Its til Lot#: l Lot Size. 0450
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tate R- Ooad# LD3 /6-State Roatl b Log.041 r�'�'�A UMTS �(fb°o51 /30 Map Book
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Zoning) T tUb Flood Zone' Jx IrWWaatershed -Deed Book&Pageg3� x1 /4 Power Company'. n u kc `lyor
'New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
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PROPOSED USE: `q l d( O 9 /r,1y ca / Meeolimi.
{/ SFO.(Size 3�(�'/Yt J)#B Id(
#BathS?'5Basement(w/wo bath):k///`Garage:V Deck C Crawl Space:V Slab: Slab:_
(Is the bonus room finished?( )yes ( )no wl a closet?(_)yes (_)no(if yes add in with#bedrooms)
❑ Mod:(Size x l#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?( )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:4 Rooms: Use: Hours of Operation. #Employees
❑ Addition/Accesssory/Other.(Size x_)Use: Closets in addition?( )yes ( )no
Water Supply: /County Existing Well _New Well(#of dwellings using well )*Must have operable water before final
Sewage Supply: 1//CNew Septic Tank(Complete Checklist) Existing Septic Tank(Complete Checklist) County Sewer 1 /.
Does owner of this tract of land,own land that contains a manufactured home within five hundred feet(500')of tract listed above?(_)yes (t'1 no
I
Does the property contain any easements whetherundergroundor overhead(Ayes (_)no- kLpt(1QQL'- FfL/iA4E/tT
Structures(existing or proposed).Single family dwellings:3 l l t(It'LSQIICfeManufactured Homes: J Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 36 ( Actual I101
Rear f l5'G(
Closest Side /0 I g7(
Sidestreevcorner lot
Nearest Building
on same fol
Residential Land Use Application Page 1 of 2 03/11
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 7 I ilmI4 /n �� - artlArg yp e kd)
+-urn ,tli+ m l;'c ona /,<<%/5 Ar •ve cCof a/ ID`s 15 a1-�'/MArods/r;
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 taiements a acc to and rrect to the best of my knowledge. Permit subject to revocation if false information is provided.
9 '7
Signature of Owne o er's Agent Date
'It is the owner/applicants responsibility to provide the county with any applicable Information about the,subjpct property,including but opt 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"
Pesioen nt 1 and Oen Application Page 2 of 2 03/11
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NAME: /• ile-hae /7fkle US-OR iirjrilleS/ �-C( APPLICATION g:
*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
Environmental Health New Septic SvstemCode 800
• All property irons must be made visible. Place "pink properly 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 aUtor Central Permitting.
• Place orange Environmental Health card in location that is easily viewed from road to assist in locating property.
• If properly 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 trio 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 verily 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 tank as diagram indicates, and lift lid straight up (if
possible) and then put Ild 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 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 to construct please indicate desired system type(s): can be ranked in order of preference,oust choose one.
I—) Accepted LI innovative {VI/Conventional I—I Any
II Alternative L) Other
The applicant shall notify the local health department upon submittal of this application if any of the tollowing apply to the property in
question. If the answeranis"yes",applicant MUST ATTACH SUPPORTING DOCUMENTATION:
I )YES I '`/INO Does the site contain any Jurisdictional Wetlands?/
I_IYES I V I NO Do you plan to have an irrigation system now or in the future!
�I (� f I
YES I—� )[NO Does or will the building contain any drains?Please ezplain.lw)0.�(fL�4"O(JFifl�e d I"[7r11 QrDLI)tCt
1I YES LY/I NO Are there any existing wells,springs. waterlines or Wastewater Systems on this property'?
I_IYES I1[I NO Is any wastewater going to he generated on the site other than domestic sewage?
{—}YES IVT NO Is the site subject to approval by any other Public Agency?
1 V1YES 1_1 NO Are there any Easements or Right of Ways on this property!— 1:30S rvct�- E PMerci-
iIYES 114 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
Stale(Uncials Are Granted Right Of Entry To Conduct Necessary Inspections To Determine Compliance With Applicable Laws And Rules.
I Understand Thal I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site Access hie So hat Comp ete Site Evaluation Can BePerformed.
T L q -ac'-/17
PR PERTY 0 NERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE
10/10
Dowggn Envelope D:331483CA-CF484AOAA8CCE55A2[E35SCA
OFFER TO PURCHASE AND CONTRACT-VACANT LOT/LAND
)Consult"Guidelines"(form IIG)for guidance in completing this form]
NOTE: This winner is intended for unimproved real property that Buyer will purchase only for personal use and does not have
immediate plans to subdivide. It should not be used to sell property that is being subdivided unless the property has been planed,
properly approved and recorded with the register of deeds as of the date of the contract.If Seller is Buyer's builder and to sale involves
the construction of a new single family dwelling prior to closing,use the standard Offer to Purchase and Contract—New Construction
(Form 8001) or, if the congruence is completed, use to Offer to Purchase and Contract (Form 1-T) with the New Cwarniciion
Addendum(Form 2A3-T).
For valuable comide tion,the receipt and lepl sufficiency of which ate hereby acknoMedged,Buyer offers to purchase and Seller upon
acceptance agnea to all and convey the Property on the terms and conditions of this Offer To Purchase and Contract and any addendum
or modification mode in eccuduns with in tervs(together the"Contract").
I. TERMS AND DEFfNTITONS:The teens lined bele dull have the respective meaning given them as set forth adjacent to each
tem. "Bayer." NL I p a f� vO(1 rv)
(e) "Properly":The Property shag include ill dust real mate described below together with all appimenancea thereto including the
improvements located thereon.
NOTE: If the Property will include a manufactured(mobile)banels),Buyer and Seller could consider including to Manufactured
(Mobile)Home provision In the Additional Pmvbima Addendum(Standard Form 2A11-T)with this offer.
Street M)kpa: C . UI clav:ix HiLIS INRAW
City. —yte1•f;�f,T.e(L11
Zip: -3.2Sala
County: .� .North Caroline
NOTE: Governmentel authority over taxes,zoning,school districts,utilities and mW delivery may differ from eddreu down.
Lege]Description:(Complete� applicable) t .I
Plat Reference:Lot/Unit 7‘t ,BloekSection ,Subdivision/Condominium Vt C•TW7xa 7,''7 U S
,as sown on Plat lido enb0 atpye(s) 'nSO
The PIN/PID or other slemipcuion number sf the ... w D
Orherme or un of m: lym 44 t edin CM.,ALLL
Some or Wofthe Property may badaunbed in Deed Book neap XIc,.
(d) "Purchase Prla"....tris ib
S 41i paid in U.S.Dollars upon the following terns:
S BY DUE DILIGENCE FEE made payable and delivered to Seller by the Effective Date.
S •;)h0.03 BY INITIAL EARNEST MONEY DEPOSIT made payable and delivered to Escrow
Agent named in Paragraph 10) by 0 cash 0 persona]cheek 0 official bank check
Q wire maga, Q entree& transfer, EITHER 0 with this offer OR 0 within
five(5)days of the Effective Dau of ibis Contract.
S BY (ADDITIONAL) EARNEST MONEY DEPOSIT node payable and delivered to
Escrow Agee named in Paragraph 1(1) by cash, official bank check, wire transfer or
electronic transfer no bur than ,1ZL6
BEING OF gilt ESSENCE with regard to aid date.
S BY ASSUMPTION of the unpaid principal balance and all obligations of Seller on the
mining loan(s)secured by a deed of must on the Propeny re accordance with the attached
Loan Assumption Addendum(Standard Form 2A6-T).
S BY SELLER FINANCING in accordance with the attached Seller Financing Addendum
S 4/ *suit a1 (Standard Form 2A5-1).
BALANCE of the Purchase Price in cash at Settlement(none or an of which may be paid
with the proceeds of a new loan).
T Tbla form Jointly approved by: Pap I of 1 I STANDARD FORM I3-T
North Candles Bar Aasuiadon Revised 7/7017
North Carolina A laden of REALTORS.,lag. I/na 'T_-.. 07/7017
Buyer initials r/�//`nJ Seller initials�""
rtesT, o I0)Noli N.t.FwiwYxrtar ma Pisa nmmsan1 F.:,01111111.7•30 twiny
l.*ad m pant Mtc't9e 110Th F s.,,,aY sew.Fri..we.a..,YM rer_ana_mp
DocuSIgn Envelope ID:332433CA-CF4&AbA.BSCC-E5SA2DE350CA
communication given in connection with this Contact.Any written notice or communication may be transmitted to any marling address,
e-mail address or fax number sec forth in the"Notice Intonation"section below.Any notice or communication to be given to•party
herein,any any fee,deposit of other payment to be delivered to a party herein, may be given to the party or to such party'.agent.Seller
and Buyer agree that the "Notice info n nation" and "Acknowledgment of Receipt of Monies" sections below shall nm conaimte •
material pan of this Contact,and that the addition or modification of any infornution therein shall not constitute a rejection of an offer
or the creation of a counteroffer.
19. EXECUTION: This Contract may be signed in multiple originals or counterparts, all of wbeb together constitute one and the
same Ytlnuntent.
20. COMPUTATION OF DAYS/TIME OF DAY: Unless otherwise provided, for purpose. of this Contract, the teen"days" shall
mean consecutive calendar dank including Saturdays,Sundays,aha holidays,whether fetal,slate,local or religious.For the papaws
of calculating days, the count of"days" .hall begin on the day following the day upon which any act or notice as provided in this
Contract was required to be performed or made.Any reference to a date or time of day shall refer to the date ad/or time of day in
the State of North Carolina.
THE NORTH CAROLINA ASSOCIATION OF REALTORS.,INC.AND THE NORTH CAROLINA BAR ASSOCIATION MAKE
NO REPRESENTATION AS TO THE LEGAL VALIDITY OR ADEQUACY OF ANY PROVISION OF THIS FORM 94 ANY
SPECIFIC TRANSACTION.IF YOU DO NOT UNDERSTAND THIS FORM OR FEEL THAT IT DOES NOT PROVIDE FOR YOUR
LEGAL NEEDS,YOU SHOULD CONSULT A NORTH CAROLINA REAL ESTATE ATTORNEY BEFORE YOU SIGN IT.
This offer shall become a binding contract on the Effective Date.Unless specifically provided otherwise,Buyers failure to timely deliver
any fee,deposit or other payment provided for heroin shell not prevent this offer from becoming a binding coaack provided that any
such Wilure shall give Seller certain rights to terminate the tonna as described herein or as otherwise permitted by law.
Date 9-an-1 Date: 9/26/2017
Buyer 7f2ir a4-44;y:-\ Scla�4D, Wail
muuw»mes
Date: Date:
Buyer Seller
Entity [^1 - JI Buyer. � /TYY]E'rc Tito Seller
Name? /Cmpgr•oyparoe+aJ ani/etc) (Name of LLC/CmpontioNPaneMdp?maUac.)
By: rZ rani/etc)
Br.
Num re QltiI II !'gOn None:
Title: [r�PSi'rIPa'h"/--'/'7 Tide:
Dau: J I-r2()—/1/ Dae:
Page ofll
STANDARD FORM 12-T
Revised 7/3017
0 7/3017
r,oww opine'auaey+IAw IWO PM*war.i,rue.WNW Wari011 tAMee
Dominion Envelope ID:332483CACF08AA6A-8$CC-ESSA2DE358CA
NOTICE INFORMATION
NOTE: INSERT AT LEAST ONE ADDRESS AND/OR ELECTRONIC DELIVERY ADDRESS EACH PARTY AND AGENT:
APPROVES FOR THE RECEIPT OF ANY NOTICE CONTEMPLATED BY THIS CONTRACT.INSERT'MA"FOR ANY WHICH I
ARE NOT APPROVED.
BUYER NOTICE ADDRESS: SELLER NOTICE ADDRESS:
Mailing Address, Mailing Address:
Buyer Fax*: Seller Fun:
Buyer Email: Seller E-mail:
SELLING AGENT NOTICE ADDRESS: LISTING AGENT NOTICE ADDRESS:
n
Finn Name: C2u 1.31 � ) fOat g/�D�ualAcn Firm Nanne: KQ..nhlu al Aca-k- ikutt4c(
Acting a uyda Agar Seller's MAR t DDual Agct Acting ce roller's i 0 Dual Agent l
Finn Licensees L Finn Licensees r 3 G7
Mang Address:�-,(/( 1 u PK ai, Mailing Address:
f x1F RL,V&as M1 F(�L .i?�r�>rl('Sb I� M
Individual Selling Agent: ngP-Y a- KS-14M Individual Listing Agent: Ain l,ll /41^,-
CI Acting n a Designated Dual Agent(checkconlyoif applicable) 13 Acting as a Dcsigneted Dual Agent(check only i(applicable)
SNlury Agnl License is L 39q49 / Listing Agent License n://� aa5353
Selling Agent Pinner: 95- Xt4$sc Listing Agent Phoned: 9/0• 9-31 -J (1.75
Selling Agan Fait: -119 - S5a - 7SO1 Luting Agent Fax#:
Selling Agent E-mail: &._t t. illeel1 .TMMG tmatieting Agent E-mail.
(THIS SPACE INTENTIONALLY LEFT BLANK]
Page 10 of 11
STANDARD FORM 12-T
Revised 7/2017
0 7/2017
ntluant Lyyuq sr nplqu ism F1Nn W.mai,Fran,.N[hyn 48026 yy-- —, Uminld