DOCUMENTS Initial Application Date: 12/8/20171 SO O r l 94
Application# ��) r-F-OL—I
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street,Lillington,NC 27548 Phone:(910)893-7525 ex1:2 Fax:(910)893-2793 www.hamett.org/permits
^A RECORDEDRDySURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED MEN SUBMITTING A LAND USE APPLICATION"
LANDOWNER: r"'1\ bCCC) S Mailing Address:P O Box 99188
City: Raleigh State:NC Zip:27824 Contact No: 910101-5505 Email: patsy.grhomes@gmail.com
APPLICANT*:Gary Robinson Homes,LLC Mailing Address:6200 Ramsey Street,Suite 200
City: Fayetteville State'NC Zip: Contact Contact No: 910-401-5505 Email: patsy.grhomes@gmail.com
'Please fill out applicant information if different than landowner
CONTACT NAME APPLYING IN OFFICE:Patsy O'Ouinn Phone*910-401-5505 Ext 221
PROPERTY LOCATION:Subdivision: Gate WeLot#.36 Lot Size: .62 acres
State Road# 1434 State Road Name'. Lemuel Black rRoad Map Book 8 Page Ox:CI / LIS
Parcel0526-20-0165.000 PIN: 0105250100095038
Zoning;((�jr—Flood Zone: X Watershed:t" n' Deed Book 8 Page3 b !R 1 I Power Company': South River
'New structures with Progress Energy as service provider need to supply premise number "F� from Progress Energy.
PROPOSED USE:
4?11 44 4 ° Slab /
SFD:(Size x )#Betlmoms. #Baths.�Basement(wAvo bathp. Garage: `� co
Deck: Crawl Space: Slab: Slab:
(Is the bonus room finished?( )yes ( )no w/a closet?( )yes ( I no(if yes add in with#bedrooms)
❑ Mod:(Size_x_)it 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 yea ( 1 no
❑ Manufactured Home:_SW_DW_TW(Size x )#Bedrooms: Garage: (site built? 1 Deck: (site built? I
U 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: ( County _Existing Well _New Well(5 or tlwellings 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
Doe the property contain any easements whether underground or overhead( )yes U )no
Structures(existing or proposed): Single family dwellings: Manufactured Homes: Other(specify):
Required Residential Property Line Setbacks: Comments:
Front Minimum 35 Actual 77
Rear 25 26.4
Closest Side 10 21
SidestreeVcomer lot 20 34
Nearest Building
on same lot
R i .. ial Land lfrrAlit'.. con I .. .rf o 53 1 :
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 210 Southto SRI 1125 Lemuel Black Road. Gate West Subdivision is
on the right. Tumrigt onto Gatewest Drive,turn right onto Remington Hill Drive. Lot 38 is on the right.
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 plana submitted.
I hereby state that foregoing s ments are accurate and carred to the beet of my knowledge. Permit subject to revocation If false information is provided.
12/8/2017
Sign of r or Owner's Agent Data
"'It Is the owner/applicants responsibility to provide the county with any applicable Information about the subject properly,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 a months from the initial date If permits have not been Issued'
nu el l enc Use Apoian.n
THIS SURVEY IS
AN
L ORIN
SIT l POPO CDH PARCELS OF LANDF AND DOESTNOP CREATE AE
P-PATIO NEW SWEET OR CHANGE AN EXISTING STREET.
I SW=SIDEWALK
DW-GONG DRWexAr PRELIMINARY
EB-ELECTRIC BOX
SCO-CLEANOUT
SHAWN T. RUMBERGER, PLS L-4909 DATE
TP-TELEPHONE PEDESTAL
WM-WATER METER
THIS MAP IS ONLY INTENDED FOR THE PARTIES
AC AIR CONDITIONING UNIT j AND PURPOSES SHOWN. THIS MAP IS NOT FOR
BOGBACK OF CURB / RECORDATION. NO TITLE REPORT PROVIDED.
EDP-EDGE OF PAVEMENT / NOTE: SEPTIC AREA SCALED IN FROM
• Q IRON PIPE FOUND / \h INFORMATION PROVIDED BY BUILDER
i O IRON PIPE SETS
o NAIL SET
VICINITY MAP (NTS) 4/
Z, LINE BEARING DISTANCE
/ L7 S 15'56'51"' W 38.56"
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O / L8 S 23'38'25" E 74.93'
G // CURVE CHORD BEARING CHORD RADIUS ARC
(6\,P ftIz/ * C6 S 6632'02" E 30.32' 335.00' 30.33'
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07 S 76100151" E 79.99' 335.00' 80.18'
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SETBACKS TO BE ABANDONED
FRONT 35' °'
SIDE 10' �. m
REAR 25' �=I .3
SIDE STREET 20'
IMPERVIOUS AREA
HOUSE 2.315 SOFT.
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NAME: APPLICATION#:
*This application to be filled out when applying for a septic system inspection.`
County Health Department ADDlication for Improvemeut 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#
UEnvironmental Healh New Septic Svst m Code 8 00
• AU property Irons must be made v lslblee Place"pink p roperty flags"o n 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.
• If property Is thickly wooded, Environmental Health requires that you clean out the underorowih to allow the soil
evaluation to be performed. Inspectors should be able to walk freely around site.po not tirade property
• Au lots to be addressed within 10 business days after confirmation.$25.00 return trio fee may be Incurred
for failure to uncover outlet ltd.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 En vironmental Health inspection. Please note
confirmation number elven at end of recordina for proof of reaues6
• Use Click2Gov or IVR to verify results. Once approved, proceed to Central Permitting for permits.
❑ Environmental Health Existing Tank Irmoectlons 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 8 select notification permit If
multiple permits,then u se code 800 for Environmental Health ins pection. please note confirmation number
given at end of recording for proof of moues*.
• Use Click2Gov or IVR to hear results. Once approved,proceed to Central Permitting for remaining permits.
SEPTIC
If applying for authorization to constmet please indicate desired system type(s): can be ranked in order of preference,must choose one.
L} Accepted (_} Innovative I✓) Conventional (_I Any
(—) Alternative { ) 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.
(_}YES {✓}NO Does the site contain any Jurisdictional Wetlands?
(_)YES {Y}NO Do you plan to have an jab/Sioux=now or in the future?
(_}YES {k}NO Does or will the building contain any lbajg6?Please explain.
I }YES It)NO Are there any existing wells,springs,waterlines or Wastewater Systems on this property?
(_)YES (i} NO Is any wastewater going to be generated on the site other than domestic sewage?
(_}YES Le) NO Is the site subject to approval by any other Public Agency?
1_}YES {e)NO Are there any Easements or Right of Ways on this properly?
(_)YES Lel NO Does the site contain any existing water,cable,phone or underground electric lines?
If yes please call No Cuts at 800-632-0949 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 Created Right Of Entry To Conduct Necessary Inspections To Determine Compliance With Applicable Laws And Rules.
I Understand That I Mn Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site Accessible So That A Complete Site Evaluation Can Be Performed.
4.1" 12/19/2017
PROPERTY OW OR ERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE
&Health Check ist 1 of 3 1W10
Vacant Lot Purchase Contract
Buyer, Rim offers to purchase from
Seller, Albatross
the following parcel of land:
Subdivision, _GW ,City, Bunnlevel
County,Harnett Lot number 36 Deed Book 3389
Page 0771 Purchase Price$ 34,000.00 Earnest Money
Deposit$ 0 Balance Due at Closing$ 34,000.00
Property must be zoned with no restrictions for Residential use.
Seller will pay for deed preparation, title research and revenue stamps. Buyer will
pay all other closing costs. Closing will occur on or before_ gc days
The deed will be made to HJM
Special Conditions:_ single family dwelling •
Seller will provide public water access and private or public sewer to the vacant lot.
All earnest monies become non refundable if closing does not occur on or before the
contract closing date.
Buyer and Seller agree and confirm all terms and conditions in the contract.
Buyer: Hank Morris Date: December 2017
Title: President 919345.0514
Phone: Fax:
Buyer's Mailing Address: PO Box 99188, Raleigh, NC 27624 _
Seller: Albatross Investments 1.1 C Date: December 2017
Title: Phone: 910.853.2287 Fax:
Seller's Mailing Address: 627 Little Bridge Rd., Fayetteville, NC 28311
HARNETT COUNTY CASH RECEIPTS
*** CUSTOMER RECEIPT aya
Date: /
12/119/17 52 RCK eceipt p
eiptno:e: CP 191909
Year Number
2017 50042959 Amount
91749 TECH 2
LLILLINGTON, NC 27546
BP - ENV HEALTH FEES
NEW TANK $758.08
GARY ROBINSON
Tender detail
CN CHECK ppyMEN 13161 $750,00
Total tendered
Total payment $750,00
4750,00
Trans date: 12/19/17 Time: 10:19:55
sa THANK YOU FOR YOUR PAYMENT **