DOCUMENTS ifit
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COUNTY OF HARNETT RESIDE NTIAL LAND USE APPLICATION CL:
Central Permining 108 E Front Street,Ellington, NC 27.546 Phone:(91C)293-7525 eel 2 Far(910)893--2793 n.✓wnamed or
'A RECORD."D ?/permits
SURVOY IIAP,RECOROEp DEED(OR OFFER TO PuRgimsEt Sll E FLAN ARE REQUIRED WHEN SUBMITTING A LAND USE RPPLICATION"
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Maying Address- Cc--5
City. v,
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APPLICANT': .v': �L.ej 1 flA5A.IMailing Andress Q
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CONTACT NAE APPLYING IN OFFICE:r/r'( ta)[2( ) M. 04/2phone it C7/(1
PROPERTY LOCATION: Subdivision' I h Z—.-• ei
q C� _Lot a .-1 lot Size-
Stare Road x 13"b State Road Name-
Sten- DC heap Book & Page, a Ol to 1( .
raiaal 0 % Dirt oiap o7 PIN ogb4S- S-7 - t-Fa34rism
Zoning/MN 3ldlood Zone- /�, Watershed:LYLL9e
Deed Book&Pa J3T ll •
—
J 13 a43ewerCompany`.
'New structures wi(n Progress Energy as service provider need to supply premise number
Isom Progress Energy.
PROPOSED USE:
VSFS((SizerI2 x��
T Bedrooms'.q Berths y3asemenl(w/wo being Monolithic
) Garage Geek:_CraM Spaces Slab'VSlab.
(Is the bonus room finished?(dyes ( )no w/a closet?
U yes ( )no pl yes add in wpm xi bedrooms)
0 Mon(Dye )k Bedrooms IL Barns Basementw/wo Cath.)_)_Garages _Site Bar Deck:_ On Frame Off Frame
(Is the second floor finished?( )yes Lu no Any Omer site (]w0 atltliiidns? )yes f J no
O Manufactured Home'._SW OW TW(Size x )%BedroomsGara
—Garage (site built? 1 Deck- (site owIIP )
D Duplex: (Size x )No. Buildings: No.Bedrooms Per Unrt_
O Home Occupation k Rooms Use'
Hours of Operation tEmplOyeer._
• AddiioruAccessory/Other: (Size x )Use.
/� — --- — _ Ctosds in adonis!?/ 'yes U Fo
Water Supply V — wiry Existing Well _New Well fit of dwellings using well (-Must have operable water before final
Sewage Supply: New Sept Tank(Complete Cnecklisf) Existing Septic Tank(Complete CneckLafl Counry Sewer
Does owner of this tract of land, own land tnal contains a manufactured home wlcJr,five hundred feel(5DD) of Its listed above?( )yes
Does the (�o
p'oper'y contain any easements whether underground or overread f 1 yes U no
Structures(existing or Or Ingle family dwellings t Marlutacture Homes.
Other;specify): _
Requfrcd Residential Properly Liss Setbacks: Comments:
Front MinimumeS Actual
Rear ogC J
loses)Side �U
Sioeslreeucomer lot ,DCO
Nearresl Building .4//7//
D m lot YYY
Pence-Mai Land Use Appncason P_
ce 1 of 2
APPLICATION CONTINUES ON BACK 03/11
SPF�C abg DIREC110 NS TO THE PROPERTY FROM LIL LIN GTON:
If permits are granted I agree to conform to all ordinances and I. s of the Sate of North Carolina regulating such work and the speofcations of plans submitted.
I hereby state that for-!. g state .nts are accurate and the best of my knowledge. Permit subject to revocation if false information is provided.
9nature of Dwner or•ees Age _ -
-
oar
"it Is the owner/applicants responsibility to provide the county with any applicable information about the subject pro
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.^p property,including but not limited
'This application expires 6 months from the initial date if permits have not been issued^
Residential Land Use Apphption
Page 2 0f 2
03/11
CUMBERLAND HOMES, INC.
THE AVALON WITH SCREEN PORCH
LOT * 7 THE RESERVE
SCALE: 1"■40'
S 1° 37' 44.0000' W 260'-2 7/8"
2
i9 NJ
2b.
F o
Lam/ f
s. 20-0
SITE PLAN
APPROVAL
DISTRICT A kUSE 51�
.1REf1ROOMS
is H1 1
nin A motto!
R=50'-0"
AL=76'-1 9/16"
RESERVE DRIVE
NAME: �y n.., kcua tJC ��0ne•6` APPLICA HON d:
This application to he filled out when apphing for aseptic system inspection.`
County Health Department Application for Improvement Permit and/or Authorization to Construct
IF THE INFORMATION IN THIS APPLICATION IS FALSIFIER CHANGED OR THE SITE IS ALTERED_THEN'flit IhlI'IkOVLMENT
PERMIT OR AID HORITATION TO CONSTRUCT SHALL I3EC01E INVALID The ntil is -lid for other 60 mouths or r nJ, t expiration
depending upon documentation uborned_ twmplete sae plan 60 moths,complete plat=tdtnow expiration)
910-893-7525 option I CONFIRMATION d
❑ Environmental Health New Septic System Code 8 00 --- - _-
• All property irons must be made v isible. Place "pork p roperty flags" o n each corner i 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 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
evaluation to be performed. Inspectors should be able to walk freely around site. Do not grade property.
• A//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 En vironmental 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.
E Environmental Health Existing Tank Inspections Cod e SOD
• 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 Of
possible) and then close back down. (Unless inspection is for a septic tank in a mobile home park)
• After uncovenng 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 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 tvpetsi can be ranked in order or preference. must choose one
{ } Accepted { } Innovative {'Conventional �] Any
{ } Alternative { t Other
The applicant shall notify the local health deparvnent upon submittal of this application if any of the following apply to the property in
question. lithe answer is`yes",applicant must attach supporting documentation
{_}YES {<NO Does the site contain any Jurisdictional Wetlands'
{ }YES { h'NO Do you plan to have an P j wctem now or in the future?
✓_)YES ( <NO Does or will the building contain any raitur Please explain.
(YES r ONO Are there any existing wells,springs,waterlines of Wastewater Systems on this pro pool2
tt—}YES l<NO Is any wastewater going to be generated on the she other than domestic sewage'
{ IVES { t NO Is the site subject to approval by any other Public.=.eenc7'
{_}YES NO Are there any Easements or Right of Ways on this propenyl
i
{_}YES { }NO Does the site contain any existing scare{ cable,phone or undc-eround electric Imes:
If yes please call ND Cuts at 6O0-633x949 to locate the lines. This is a free service
I Have Read This Application And Certify Thai The Information Provided Herein Is l rue,Complete And Correct Authorised County And
Stam ORCiats Are Granted Right Of Envy re Conduct Necessan Inspections'I o Determine Compliance With Applicable Laws And Rules.
I Understand That I Am Solely Responsible F or The Proper Identification And Labeling Of All Propertt Lints And Corners And Making
The Site Accessible Su That A Complete She Evaluation Can Be Performed.
PROPERTY WNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE h.-)
ro-n..ien C.ieckps.
Harnett County
102 EAST FRONT ST
P 0 BOX 65
LILLINGTON NC 27546
DATE: 12/14/17 RECEIPT # : 0000011247
TIME: 11 : 39 : 03 CASHIER: JBROCK
APPLICATION NBR: 17-50042921
LOCATION ADDR: 128 RESERVE DR
REFERENCE: NEW TANK
ITEM DESCRIPTION PAID
SOIL EVAL/NEW SEPTIC TANK 750 . 00
TOTAL AMOUNT PAID: 750 . 00
PAYMENT TYPE: ESCROW