DOCUMENTS Initial Application Date: la)f W I IP App1 icabon N ' S OC)Lia-7
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 1pja E.Front S`eet,.LilliigFon,NC 27506 Phone:(910)893-7525 est:2 Fax:(910)593-2793 www.hamamorypemnits
"A RECORDED SURVEY MAP,RECORDED DEED jOR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN SUBMITTING A LAND USE APPLICATION'
Gladbel Go zalez
LANDOWNER:
Malang Address:178 Leo county line rd
\city.
broadway I IStato n__ Dix 5O5 Contact No: 325-262-7869
IEmail:
LOCANT,:Clyde Patterr ; mato;Add :4271 Leaflet ch rd
City: Broadway State:NC I z 27505 919-258-5538
"PleaseNI an aspirant a different If Goofed No: Email:
iiMmetipij' landowner
CONTACT NAME APPLYIN$IN OFFICE,GIarlbol l lonzitlez Phone a325-262-7689
PROPERTY LOCATION:Subdivision: I Lot It Lot ISize': to•a a
State Hoed h0 I //Sta�te Cil
N1a�me: �(k • •1•4 — "an
�l �iT Map Book 8 Page:hL TILS
Parcel: /by�ey�Y�S�I4 Ci' IDOL ! PIN: �I Gk-I�n VJJ -5U 0 O •600
2onegAan ePtPd 201je{ *atert/had: ITT Deed Book A Page: t`fP Power Company':
'New structures with Progms'Energy as tervice 1 need to supply premise number _ fromrely
Prog Energy.
PROPOSED USE:
I
U SED:(Size_x Monolithic
Ya Bedraml�:_a Baths: ' Basement(w/wo bath):_Garage:_Deck:_Crawl Space:_Slab:_Slab:_
I(Is the bone,room Misled?L.)yes (J no w/a closet?( )yes ( )no(U yes add in wNr 0 bedrooms)
II
L3 Mod:(Size x yI#Bedraart N Baths.Basement(wMn bath) Garage: Site Built Deck:_ Co Frame_Off Frame_
'(tame^••,_„rJrr flow anitted? )yea ( )no Any other site Oda additions?( )yes ( )no
M Manufactured Home: W✓.S _DW_TW(Mize t4 x70 )a Bedrooms: 2 Garage: (site built? )Deck: (sae bout?_)
❑ Duplex:(Size_xT )No.Buildings: I No.Bedrooms Per Unit:
LIHome Occupation:#R4iis: I UsE: Hours of Operation: #Employees:_
❑ Addition/Accessory/Other'(Size 'x )Ube. Closets Si addition?( )yes U no
Water Supply: ✓ County Existing Well _New Well(N of dwellings using well )'Must have operable water before Bnel
Sewage Supply: ✓ New Septic Tank(rmplete(4heck$st) Existing Septic Tank(Complete Checklist) County Sewer
Does owner of ms tract of lantd,own land diet contain*a n- nulactoed Noire within five hundred feet(500')of tract listed above?( )yes (_)no
Doesthe property contain any easements w
hether ungergrpund or overhead U yes U no /
Structures(existing or proposed):Single family dwelllr s: Manufactured Homes: I Pry�°i(spotty)',
Required Residential Property Line Seso1scks:: Comments: tS.l<_�k�
Front Minimum 3S Actual '.. c+
Rear a S ',1+aS t
Closest Side �„
Sidestreeucorner lot `—:�—
r T '
Nearest Building _h:
on same tat
. -r_it:l.l it •a' �' APPLICATION CONTINUES II
ON BACK
SPECIFIC DIRECTIONS TO TE PROPESTY FROM hAUNOTON: from lillington take 27 ivy go anoint( 15 miles turn right an 24/27 hwy
anoint(8 miles pass watell tank props lty is to the right.
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If permits ere granted I agree•conform It all Miro .::and laws of the State of North Carolina regulating such work and are specifications of plans submitted.
I hereby stale that f. ,. t• ts ane :.. m : : • cured to 'i best of my knowledge. Permit subject to revocation If false Infometbn i mcnIded.
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Standar. . • Ipr Owners Rgen� Date
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"It k tie ownerlapplkanfwponslbt�b pro county with any applicable Information about time subject property,Including but not orated
to;boundary Inlormati$house on, ad or overhead easements,etc.The county or its employees are not responsible for any
or Information that Is contained within ties.applk.tions
"This ap4uMation*Spires d months from the Initial date If pennlb hays not been bawd
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FFEICE rSpCEN�
SITE PLAN APPROVAL �, '' ^, ``��
DISTRICT R A�6Y.USE�d.__
*BEDROOMSI
�a(e 1 r Zoning m Valor
GRAPHIC SCALE f'-200'
0 200 400 600
Al.. Al2-a e C�
NAME. t1
APPLICATION fr:
`This application to be filled out when applying for a septic system inspection.*
Co a t Health D. •ailment A 1 i lication for Im•rovemeut 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
0 Envlronmant p Health New Se me Code 8 00 CONFIRMATION M
• All property Irons m made isible Place' ink roperty must be dearlyflaggedM p Peen flags'o n each corner iron of lot. All property
• Place approximately every 50 feet between corners,
"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.
• If property is thickly wooded,Environmental Health requires that you clean out the undergrowth to allow the soil
• evaluafion loft to ttoo b performed.
- Inspectors should be able to walk freely around site.po not Grade Dfnatlty.
• hi_ _ within 10 business diva after confirmation. $25.00 return trio fee may be incurred
• After preparing proposed site call the voice permitting system at 910-893-7525 option 1 torschedule and use code
800 (after selecting notification permit if multiple permits exist)for En vironmental Health inspection. Please note
conflretio number given at end ofo r roof f reouest
• Use Click2Gov or IVR to verify results. Once approved,proceed to Central Permitting for permits.
❑ Environmental Health Ex'sti Tank Inspect ons Cod e 800
• Follow above instructions for placing flags and card on property.
• Prepare for inspection by removing soil over over outlet end as diagram indicates, and lift lid straight up(if
possible)and then close back down.(Unless inspection is for a septic tank in a mobile home park)
• After uncovering outlet end call the voice permitting system at 910-893-7525 option 1 &select notification permit if
multiple pe rlts, then u se code 800 for Environmental Health ins pection. please note c onflrmation 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 ystem type(s): can be ranked in order of preference,must choose one.
(_} Accepted I_) Innovative
( Conventional {_) Any
(_} Alternative I ) Other _
T e applicant
ftt s shall notify
ti is the le ocal health department upon submittal of this application if any of the following apply to the property in
✓/ y applicant must attach supporting documentation.
!_}YES ) NO Does the site contain any Jurisdictional Wetlands?
(_I YES ( ) N�Q Do you plan to have an itriatliettyaLcm now or in the future?
{—}YES (Z(Na Does or will the building contain any yaigsf Please explain.
IJYES I i I NO Are there any existing wells,springs,waterlines or Wastewater Systems on this property?
(_)YES {_(NO. Is any wastewater going to be generated on the site other than domestic sewage?
(_:YES ( NO Is the site subject to approval by any other Public Agency?
{_}YES { Are there any Easements or Right of Ways on this property?
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{_}YES (_, 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 Omei s Arc Granted Right Or Entry To Conduct Necessary inspections To Determine Compliance With Applicable Laws And Rules.
I Understand I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The She 4te sible Se That A Com. nation Can Re`Performed.
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PROPERT 1WNERS OR OW .. it . . •,3a TIVE SIGNATURE(REQUIRED) DA ' In
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/ /o «c..v ynet./CM
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ee B 04 W carom etc .1.,9 Car
//�t // [[ )) //r� _OFFER TO PURCHAS CT
PTL La.r . VO 2 - .9r%ata. W10 O/ i{ ! /
hrtby offers m purchase nod CL L. -age;
o. V W—�.,. M 4 Y..m .,.atm...
upon acceptance of rid alter, apes to sell and comer. all of that plot. Pim q parcel of lana dmaed below, together with W
located suit= and suchgym'®n
puma property R Y Med below Oa w a p5 p.,pe.y am collectively referred to u "0e Romer), in
accordance with the Standard Ar'ai on
aw m the REVERSE SIDE HEREOF adage=sit Safford{pen and ma
I. MEAL PROPERTY: Located in the My ComComma@4 . ma MAn 40.
State of North Cartga,being known as and more pertkuldy described u:
San Adds
up)Dsap:kn m ?'>- +L. Dsgrf�eA t99 Psk7"a '71i' atm
t. PERSONAL PROPERTY: orf/
S. PURCHASE PRICE: The Price i Latpfg.e iLen e a inlLllitway s Solite:
(a)i 1Otpppa Au may pad by ns./W:1--'00 fros w�-1�.,ir
(tab:bank,certified,or;moral chat)
with the&Anne/tumama,a.m be held in mem by S�lL, agnn
'mil the tale Y dad, at whk.dei It dH be credited to Boyer, In MU this mum is otherwise annired anal is
otrdmad b amnia,with the Standard Provision the ER
REVERSE SIDE HEOF;
(b)b qq1h .M ib.rhorny:pdon of the maid Mapai Slam a m sadobtiptima a Sita themartinmartinant martinim securedw
red by a deed a t
tb on the Pmny:
(C)$ .by a�promissory one immd by a pad..,, deed a um on the Property wish interne prior to default ult the rate a
/0 pa amumpayablerfahwa: /a ';Mrt Tb D-�r7T _, 16',
Et�y?imi tauitiam and/or pmddr fl shall be: a /'
Amanda'.or- riga if any,dream be: Agra /r�G+.fc I`�
(d)I err W the balance of the pitcher pint ie m at ddog.
1. mNDrnONS.(Sus N/A in inch blank a penitents 1(a)and dab)dna k not a mnedea to this contraa.)
(e)Te Byermut beabk toobtainafine mmf®mt mm bade .effective dumb thdate deleting.
bra loan in thepindpei mom of$ foe item a leashes so imam
nm net msmd %per annum,with mrpe landiwue pans=mad %a the ken mom Buyer airs to m his bat
efforts to a such mmimmt and to die Seller immediately spm nide of the lender's Yabu.If Lam it to pay any lm Ming ma tits m
ate it IoIos;
(b) The Bonk ma be able to area the unpaid piedpd Mama of the mating m darned b paregraph 5(b) above lee the remainder of the
lac mi.at an Sats rate not mea=d %pan aa.lad(at derdh ypam)
with nip ken ananimm ad/or&mot parka m to mad %of the m bane.(See Ssdad Arta No.S).U each aamptlm
requires the bier's appeal,amoral mem be grand mar hfae
nt to
dart such appeal and to advise Seller hnmedbrh upon his .loan. prion c bsom c
receipt of the isdeYs a.ddam. U Seller to pay any m etsumPpm cora.rhos c®
ane as When
h) Tse ma be no raaiaim. ea®em. ming or orb governmental madams that wW prom the =mask me of the real property for
pimm
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5. ASSESS/4M Seller Inas that dereme m Special r®m. ebbe o
per n{ coa l:med. for pi
sidewalk, paving. a. tawas
other upmmner atm or adjoining the Property,inceptor Dams:
(hen Mae erste idevmodm a each e®ms,if any.Te get
for payment or proration of any ahem indicated Is to be m forth In pm/raft I below.)
6. OTTER PROVISIONS AND COraarnoNL
(a)AA of the Laded Prmtioo m the REVERSE SIDE HEREOF an t dsemd and shag apply to this Mermen:. cosep the kBadg numbered
Standard A .iMo.n all bedekmd: (lfm a art mbeddred,nese TSae".)
We-,ws�'P� ,'e ..pis salad' "6 liar sq doe _
ems.64,410seti).. -Vet '"" � ;a„yt. {7
ca" rs.des, w 1S ?,so 1,
--:'t"-as. Liss, x r r..._ 3a., rt. :, ant - -
I THERE 8A!RNE ANY ADDPNDA TO TIS CONTRACT,INDICATE ABOVE AND ATTACH HERETO.
7.beim ING /tall parties aper to executed aa
sany aall dmyaand pap= dosing with dandwhinier der of Mk on
dappeeed by
Theddi a h made to GLai aaLyt -A
s. POSSESSION: Pmeaun shall be del ed Cat r d.esinl
In the even that t Ruhas gpomace that I not Mag.delivered at ig.thee Saber mass to pay to Berl the suesa S ✓j j7 per day from
and includig die date of Ming mad deluding de date that paean is m be delivered as Wove as be.
I. COUNTERPARTS: Tis offer shall beam a binding contract am sired by both Bayer and Sega.h is m be apedlu
counterparts with a aged n being by each parry beam and the reraw gm.If P-1-/6
Date of Defer /� S l�iIf �'' / •
1. -Wvui.r,OAti�B.� a!% ..sf4F yia. ...stat
Date:a`(SAO Application#
PROCEDURES AND GUIDELINES FOR MANUFACTURED HOME INSPECTIONS
(��-y. RA-20R&RA-20M Certification Criteria
I, " '` - L ,Q''�ty���yn�nd� erstand that because I'm located in a RA-20R or RA-20M
Zoning District an Is t iSlaceWnanufactured home in this district I must meet the following criteria,
verified by zoning inspection approval,before I will be issued a certificate of occupancy for this home.
1. The home must have a pitched roof, far a manufactured home,whether A-shaped or rounded,
which has a minimum rise(measured at the center of the home)of twelve (12) inches for every
seven (7) feet of total width of the home. (Example: A home measuring fourteen (14 ft.) in
width must have a twenty four(24)inch rise as measured from the center of the rooRine to the
baseline of the roof.) (See Illustrations Below.)
ar Minimum ,_-- A-Shaped 24°Minimum "I,iv Rounded
Roof Pitch Mu --:—.1g4ii, , Roof Pkeh Rise
r t f
fx _ I.. ..
t*40470+7
pL 1 �R
i r `
14'In Width "p'tP' *►
_ yr a-- 1721F—y_.
K*;' is -:7:. Tb�72B0t .
Note: Most Rounded Roofs Will Not Meet The Roof Pitch `
Requirement As Illustrated. The Measurement From The Peak Of
The Roof To The Base Line Of The Roof Must Be 12" For Every 7' Of
Total Width Of The Home. (Ex: 14'Wide Home=24" Roof Rise)
Continued
2. The home must be underpinned,consisting of a brick curtain wall or have galvanized metal
sheeting,ABS or PBC plastic color skirting with interlocking edges,installed around the
perimeter of the home. Skirting shall be consistent in appearance, in good condition,
continuous,permanent,and unpierced except for ventilation and access.
3. The homes moving apparatus must be removed,underpinned,or landscaped. (See examples
below.)
iE. 4 `
l lir
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IPS"-
4. The home must have been constructed after July 1"1976.
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Signature of Property Owner/Agent Date
• By signing this form the owner/agent is stating that they have read and understand the
information on this form.