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Cenbal Permittin COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION Cil,._—._.
g :09 E Front Street,Lillington, NC 275OE Phone (910)S93-7525 es°2 Fac(910)C93-27g3 .,;Kamen org/permr
^A RECORDED SURVEY VAP RFOORDED DEED(OR OFFER To PURCHASE)e SITE PIAN AR[REQUIRED WREN SUBMIT1 INC A)ANO USE APPLICATIDN^
LANDOWNER:_ C V /1‘1/40-4 lryI r ll. ,. M.hog Adss.dro
City: // C� ��QC f
--__ Slab A Zip: Contact No:_ _ --'}—�^--- Email
APPLICANT': !i e i /j�r' .Mailing Adorers Inv 7 —�—. ----
Plea
/40-02/17 SIa1 o'vner paB iSContac G �J �5+++Qa(aMMML-5(5 ---
Pexsefill oW applicant lots:mall ftdn tthan iz(sooner
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CONTACT NAME APPLYING IN OFFICE.fu/CY(Plit aR
-�� Phone# ?//J -S9g-
PROPERTY LOCATION: Subdlvisiorr "Ice
_Lot C I of Size_. (:)(0
Stale Road
-9� 2— Slate Road Name-
YarceLy�. �} b_w_p ��� •12_45(
/-� 1_S � Map Rook B Page
PIN: IJ�D q 1.1 • U
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Zoning /'I } J0lood Zone: /S, Walsrshed.SDe
ed Book&Page-S31;-4 342 Power Company''
'New simetures with Progress Energy as service provider need to supply premise number
-- -.— _from P,-ogress Energy.
PROPOSED USE:
einoSED (Size I ec i '{51 z Bedrooms:,9 It$pts:Z_➢asement(wlwo barn '. Is.--DeckCreed Slab-. o�ic
_Garage. Cwl Spate_ Slap tee" Slab:
(Is the bonus room finished'Les ( )no w/a closet?LE yes
( )no(if yes add in with kbedrooms)
O Mat(Site J z Bedrooms k Baths _ Basement(w/wo baro
)—_Garage') Son Buill Deck On Frame
(Is the sewnd floor finished'f ) yes Oft Frame
Uno Any utner site bull atldl;ions?( I yes ( no
❑ Manufactured Home: SW DW TN(Size x
)C 8etlmpm>._G arage' (sile buill9 ) Deck' (sile owllc_ )
❑ Duplex(Sae x )No. Buildings:_
No. Bedrooms Per Unit
O Home Occupation k Rooms'.
Use Hours of Operation'
_
---- ?F mpinYees• _
• AoditiO Acessory/otner: (Sizex ) use_
J ,er Supply / unty Existing Wel: ( -New Well oftl llicgs g _Jn..
wHl 'Mus(have operable b 1 final
Sewage Supply 7New SepfcTank GomplI Checklist) t.g Septic Tank(Complete Checkllsl) CoSever
Does owner of this tract of land. oval land that contains a manufactured home within five Hundred led(SOY) of)rad listed above
Does the property conlarr.anyU yes ( V)na
easements Wtefner underground or overhead( )yes
Structures(existing or Single family dwellings' �� o0
_Manufactured Homes diner :a _
Pacify;
Required Resideodxl Property Lice Setbacks: Comments:
Front Minimum_ Actual --
Rear cq.S
Closest Side /0 - --
SideslreeVmmer lot IIX/O - -- --
Nearest Building 4/cd/079
or same lot
R esidertle:Lane Use appuri:,on
of 2
o3n1
APPLICATION CONTINUES ON OACK
SPCC DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
If permits are grantedI re
agree to conform to all ordinances and I. e of the State of North Carolina regulating such work and Ine specifications of plans submitted_
I hereby state that fo Is are accurate and.orre ,the hest est of my knowl-etl
9e. Penni)subject to revocation i(false information a provided.
- ignature of Owner or eYs Age -D
It is the owner/applicants 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
Pace 2 of 2
03/11
CUMBERLAND HOM S, INC.
THE KINSLEV W/ 3RD AR GARAGE
LOT * 12 THE R SERVE
SCALE: r•4 '
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DISTRICT OA ' USE sr�
*BEDROOMS
Toning .m Armor
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N 71” 42' 53.0000 W 100'-0"
TROPHY RIDGE
NAME: C1Mjyj- 1 nr,16-2' APPLICATION k:
`This application to be filled out when applying for a Bepfie system inspection.'
County Health Department Application for Improvement Permit and/or Authorization to Construct
IF TILE➢1FORMATION LN THIS APPLICATION IS FALSIFIED,CHANGED. OR TUE SITE 1S AL PELLETAL-NEN ME IMPROVEMENT
PERMIT OR AUTHORIZATION TO CONSTRUCT SHALL BCOME INVALID. The liis idlid isrhhr 60 monies or is,tuna expiration
depending upon documental bmitted. (complete she plan-60ms
mom ,coml oa snout p
pia- out es .aion)
910-893-7525 option I CONFIRMATION d
❑ Environmental Health New Septic System Code 8 00 — - - _ --• All property irons must be made visible. Place"pink p roperty flags' o n each corner ron 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 a1 /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. 525.00 return trip fee may be incurred
for failure to uncover outlet Fd, 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 vuonmental 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 permits0 .
Environmental Health Existing Tank Inspections Cod e B00
• 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-B93-7525 option 1 & select notification permit if
multiple permits,then use code BOO for Environmental Health ins pection. 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 pvpe(y. can he ranked in order of preference,must choose one.
{_} Accepted 1I Innovative (�•C nventional {_l 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
questionif the answer is'Nes', applicant must attach supporting documentation.
{ }YES { C Does the site contain any ha-radiational Wetlands'
{ }YES {�NQ Do you plan to have an urio=r'on sin now or in the future°
(.4NO Does or will the building contain any drains? Please explain._ _
I_IYES r /f NO .Are there any existing wells.springs, waterlines or Wastewater Systems on this property°
{_}YES r 1-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 A deny')
{YES {_-]'NO Are there any Easements or Richt of Ways on this property?
( }YES {�'NO Does the site contain any existing water.cable_phone tar underground electric lines?
If yes please call No Cuts at 800-652-4949 to locate the lines. This is a free service
I Have Read This Application And Certifi That The Information Provided Herein Is True,Complete And Correct Authorised County And
Smit 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 Or All Prnpert. Lines And Corners And Making
The Site Accessible So That A Complete Site Evaluation Can Be Performed.
Z_a -- 12-
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12
PROPERTY OWNS• OR OWNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE
E.riaalto G,ed➢st
•
Harnett County
102 EAST FRONT ST
P 0 BOX 65
LILLINGTON NC 27546
DATE: 12/14/17 RECEIPT # : 0000011245
TIME: 11: 38 :43 CASHIER: JBROCK
APPLICATION NBR: 17-50042923
LOCATION ADDR: 72 TROPHY RDG
REFERENCE: NEW TANK
ITEM DESCRIPTION PAID
SOIL EVAL/NEW SEPTIC TANK 750 . 00
TOTAL AMOUNT PAID: 750 . 00
PAYMENT TYPE: ESCROW