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DOCUMENTS Initial Application Date:`0/13/i / Application# 1 l (AO(J J O. Cil# COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION Central Permitting 108 E.Front Street,Lillington,NC 27546 Phone:(910)893-]525 ext:2 Fax:(910)893-2793 wwa.hamett.orglpermits "A RECORDED SURVEY MAP.RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION" LANDOWNER: RO�,Ve7 (-0 (, 'I W� xsMlai�ling Address: City: IIli./L\t•- 41 Cr Mailing �-7SdSM4PN/o:c'/(0-590-L75(omail'. '' o 41 i APPLICANT*: ! S'�e.1 lr I I i�V'ySs M^ailing Adddrress: ` 7 �w04 to co 11 I N S (— City:Li lI//xA1 f J/ State: ipa'-r (ktact No:710 c ! P' Od—.snail'. 'Please fill out applica information if different than landowner I Co �j( ('� CONTACT NAME APPLYING IN OFFICE: '1U--ie LO /I i '40c. Phone# �� —A(y / /7— C�d'f o PROPERTY LOCATION:Subdivision: C/qn TOt I Ads- L/✓ y/� Lot#: /_A Lot Size !' 32 ,AC- State Road I State Road Name: ✓ O e Con L S $J C / L�`! �x Map Book 8 Page.a U(0' (] Parcel OLD SON���7f6 bL PIN: CX.D 31 �J`I�IL t� 7041• 6o0 /J C Zoning QP.3b Flood Zone/° WatersheE:]y� Deed Book B Pegp/o17 / Lle).3 Power Company': SOL( j (C/lye r C� nic 'New structures with Progress Energy as service provider need to supply premise number from Progress Energy. PROPOSED US���E�:: SED:(Siztp/��x 4? )4 Bedrooms: 24 Baths:�asement w/wo bath � monolithic( )_Garage: Deck: Crawl Space'. ✓Slab: Slab: (Is the bonus room finished?(_)yes ( )no w/a closet?( )yes ( )no(if yes add in with#bedrooms) ❑ Mod:(Size_ _)4 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 1#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? -U yes (_)no Water Supply: /VCounty Existing Well New Well(#of dwellings using well )'Must have operable water before final Sewage Supply. /"y 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 (_)no Structures(existing or proposed):Single family dwellings:: anufactured Homes:IA�� Other(specify): O wr+� N Required Residential Property Line Setbacks:ac4/ Comments: Front Minimum �3 S /Actual L O Rear tit S r 35* 11 Closest Side 20 / T-1•5 SidestreeVcorner lot Nearest Building b# on same lot Resident al Land Use Application Page 1 of 2 03/11 APPLICATION CONTINUES ON BACK SPECIFIC DIRECTIO TO THE PROPERTY FROM LILLINGTON: (OO / 2 ! 740 WR1rJ C._. t . ` • .A ...i .¢!f 0 � 4 u age) ttt©//IA/s LAI r_ i , ��� � 0J i O is _,e.) If permits are granted I agree to conform to all ordinances and laws of e State of North Carolina regulating such work and the specifications of plans submitted. I hereby state that forstat ents area ate n cor to st of my knowledge. Permit subject to revocation if false information is provided. SI tureo Owner or ner's Agent Date "'It is the owner/applicants responsibility to pcovlde the county with any applicable information about the subject prpperty,including but not limited to:boundary Information,house location„underground or overhead easements,etc.The county arts 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 - a44iiti OV I• 0. çyQV C14 b . ba . = •-'• .. v,z.(1x el 0 `•a - o n 0 ' . N. R S. / 'fitti 'QV ' - •: ti of / ? • �� � ; qui /• / �' i t ��� / bin�o a j / \ / ° ,4 • pCr rer ti ° !; ( waszoan \-0 v a a< �yD vdang S 1 �I A 13 lofsiaek \ % c ar os ,�� aura if r, Q �cakI w I _ q+ I Iitl, 0Co .. O kti 'Fad y I rj b + • a �\ d I io aa a.: h a', , I ,' CSI 2 �M y '.y 4I '�il, y rc _ 20 Side line setback o 8. b � I ' .35' fronto ' I �� 41 h .J Setback I , in I. I h See orerreas7'IF' • 04-- row ,, itti Area a -:i la. —: a"_ 5'E."}'"iv�, ... W Summary b _ _ _ _ • t I ��+ . ' ; ',. fl _ f N 0—M8-010-074-857.BP r1 allo —-208.-(12•-- t. MVV Old Properly Line f V IN C I SethfrLnl I # SITE PLAN APPROVALPR � DISTRICT a " �`' USES_ *BEDROOMS ca 1 Data ol11111 m... 4 II 4.a aF 1i; !!!1R BG kii as jE, 11 151, 1 1e111i� Ili iii�Pii� visl� i1 1ir iire 1° Ii, dilluil 4y i C I 1 O i NW ti 1!' • •;3,3. 11 v i21 ! ��:5a9E ; : 41100h ,, © 111 1 1 1 ,��a� ti! 1! 41? VP,' 'phi ja a Ino ! o .q 1 1"' i 11 Ilr 1 �1 Ili 1 i 1 ! 1 II ! 0; 01 •I I �1 I 1R I$i Ráh Ill 1 �e "IiiF ������ � I I ly 3 `lir �./ -47-71;14P-4-724. '. "111 .} C q t N 1! _"` - _ 1u1 III l!1 o 'ti I * e O 4•aa 1 I -C-. j i1l ill! .-t 4 f r fill1i1 �i1 1d31� Q ,it i il• I I U , 1I,1 3 11 q' 10 1 1 9 I el sr 111111 I I fir/ ii;litii llii 1. 'i it 1111 ",1t1 ii 1 k! 1 �1i ,r d 111 1111 e2 �[[li < e yl 8 Lin 11 1 1 i 1-il1;1, ,hf 0 I J 1{11111 11) II + 11 4iii� 711.111111111111 �'i � ve s 'yb,- f1} 11+j r1 11 �: 1 1 ,� e�,15 :::e ,.c_ jll 1 ;1 811 11 ( : - 5,� 5; t; 111 , 111 E III 1�I i;r !I,1! Illi. i ,1 �' Mig ,e4 !'!P! ! !!!i 1i 111Jlli!RJ X41.1 ;* 1it ii : tt M �i � ii: i Jl ! ,�: ,% P1 '*•...,. a1 NAME: p_oci/-VQs/) co III t(p S APPLICATION ft: *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 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 al/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. • 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 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 8 select notification permit if multiple permits, then use code BOO 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,must choose one. l—} Accepted I—} Innovative A Conventional (_) Any { 1 Alternative l—} 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 DOCUMENTATION: I_}YES {NO Does the site contain any Jurisdictional Wetlands? I—IYES Ike(NO Do you plan to have an iftigan system now or in the future? 1—}YES NO Does or will the building contain any drains?Please explain. k 2 YES 1_l NO Are there any existing wells,springs. waterlines or Wastewater Systems on this property? I—IYES Qrf NO Is any wastewater going to be generated on the site other than domestic sewage? 1 }YES 1744 NO Is the site subject to approval by any other Public Agency? OYES 1—I NO Arc there any Easements or Right of Ways on this property? YES I_} NO Does the site contain any existi wa_er,cable,phone or undergrouttrcetectnc 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 Slate Officials Are Granted Right Of Entry To Conduct Necessary Inspections To Determine Compliance With Applicable Laws And Rales. I Understand That I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making The S' A essibl So Th mplete S'te Ey a ' n Be Pe formed. /0- /U-/7 PROPERTY OWN OR OWNE EG REPRESENTATIVE SIGNATURE(REQUIRED) DATE 10/10