DOCUMENTS nAlzl Application Dale 1 c)-I_0I I
--� ApplicationF1 r--) Q _
Carlon Peimnn COUNTY OF HARNETT RESIDENTIAL LA ND USE APPLICATION CU.
g 1DB E. FEDTI Street Lllino;on NC 27Ezs Phone: (PID)E93-7°25 ex)2 Fa: (910) &P327E3
ku ,
'A RECORDED SURVEY VAP RECORDED DEED IDR OFFER TO PURCHASE,&EIIE PLAN;RE REO'U!REO WHEN SUBMITTING A LAND USE APPLIClT ^org/peil5
LANDOWNERE APPL¢AIONIDN
City /r S __Zip Con— Taring Am e _ GJD--
�_ sai we __ _EE mail_
APPLICANT': _ / Lt'''.
aw_1� <- ///� Mailing FbgrEes /%__
'twain fill 14/J/J !/L ZiG fL�
City fill �Sale Contact NO 91/O _
our appagmiMor'neGon tlOMcrenl than lan]o.ner /Z�Y EmaE: n
�/(` L / " fin � 5�r 7CY4�o0.[Orti
CONTACT NAME APPLYING IN OFFICE:,____ E d^ //
cT P.none Vair e ° S9/
PROPERTY LOCATION- SubdivIsiorF '. 3r 1 o
State 3oatl' Lot= S� Lot SIZE /
State Road Name eir io.An•L�p - fiC
rarref �- p c�r-o1 P\a.l 'I S 1� le�^e�noe& Pade
Zonln Wham]
FIN • — 3IX G, o��
9/24 r )(Flood Zone._X_Watershed
--,oYQDeee Book aRage: 3�� 1p 4—� p
'New structures avth Progress Energy as seam - wer Company'
provider neat to supply premse rurtmer
from Progress Eneryy.
PROPOSED USEt '1
5( ETD (Sze �a�I , :Brooms: 1
Baths. 9Baaement(W/WD bath): Garage_=peck. Monplilhic
(Is the bonus room finished,( ;yes C adddi Space Slab. Slab.
UnD w/atlosel]U yes
Lunn (If yes in wan t bedrooms)
O Mad (Sae +_c Sr beomoms X E
.webs Basement (wAvd baro) Garaoe.
(is the second Door finished, Site Built Deck On Frame OH FramE
LJ yes U no Am pc-.er site buil) apdiGonsv( ;yes
__, no
L Manufactured Home SVy
OVv Tn'(Sue '__=3egmams
D G m9e _
(site built9LDecKIslle bunt, I
Duplex:(Size x_)No. Buildings._
No. 3edrdams Per LOW
O Home Occupation t Rooms:
Use Hours
Opxaeon
NAeam �6mplpyEes_—
D AtleAOsSD /Diner (Size xJ Use
/
Imams .d rtlo, J yes a no
Water Supply lV/
ppy /clnunry Existing M l NewWll ly llings .g well
Sewage Supply New SepticTank (a,mpl Check/op /_Masi have P bl ter before final
Emoting Septic Tank.
'Complete
?lelChao/Jan]
C :ly Sewer
/Dues owner NCI and ow` nd Mal contains e D name wn:n five r ne^ -J(50 ) of ad,Ives above �yes rY/n
no
gDues ine property roman any easements wether uno_goun_or ov mead ( )ya ,Structures(existing (prW �Singlefamy tlwJlings__A_______vanrsctu=tl Homer
Other epeaity)
Requ'red Residential Property Line Setbacks-
S communis
Mini :
' .Dr4 mum_ Actual��)
Rear 025/\ ��--
Closest Side /V a-
,
Sioestreel/comer ml a0 -l3�
Nearest Building >
on same lot —
ReslDant,aI L and Us=Appi,cal'dn
Rasa 1 cl 2
APPLICATION CONTINUES ON BACK U311
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 1 3
If permits are granted I agree to conform to all ordinances and laws of the State of North Carolina regulating such work and the spedfications of plans submitted.
I hereby state that foregoing statements are accurate and correct to the best of my knowledge. Permit subject to revocation if false information is provided.
ILi19 It�
Sign reof or or Owner's Agent Date
'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 application."'
"This application expires 6 months from the initial date if permits have not been issued"
Resdenlial Land Use Application Page 2 of 2 03/11
CUMBERLAND HOMES, INC.
LOT * 54 NEILLS CREEK FARMS
39 MOUNTAIN LAUREL PLACE ANGIER, NC 27501
THE OAKLAND IIA WITH 3RD CAR GARAGE
SCALE: 1" • 80' '
SITE PLAN APPROVAL 00 a
DISTRICT- ' L1I. USE''[ k
#BEDROOMS Lf
Date • ••`_
N l
ir
p 6b •ir
., 'Q'. ' L
P.
,
NAME: W axn sb s \f—v`lN. NOn.s&' APPLICATION#:
"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 System Code 8 00
• All property Irons must be made v Isible. 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 undergrowth to allow the soil
evaluation to be performed. Inspectors should be able to walk freely around site. Do not wade 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. mar*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 and 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 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 use code 800 for Environmental Health ins pection. Please note confirmation number
elven at end of recordlnq for proof of request.
• Use Click2Gov or IVR to hear results. Once approved, proceed to Central Permitting for remaining permits.
PIIS
If applying for authorization to construct please indicate desired system type(s): can be ranked in order of preference,must choose one.
{ ) Accepted {_}Innovative {V1Conventional {_} 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 ( a
V]NO Does the site contain any Jurisdictional Wetlands?
{_}YES {V(/NO Do you plan to have an irrigationnLsystem now or in the future?
(_}YES ( ✓}NNO Does or will the building contain any drains?Please explain.
(_}YES { VINO Are there any existing wells,springs,waterlines or Wastewater Systems on this property?
{_}YES {_v1'O Is any wastewater going to be generated on the site other than domestic sewage?
{_}YES Isar NO Is the site subject to approval by any other Public Agency?
{ }YES {_}NO Are there any Easements or Right of Ways on this property?
(_}YES �Ir}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 Officials Are Granted Right Of Entry To Conduct Necessary Inspections To Determine Compliance With Applicable Laws And Rules.
I Understand Tbat I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site Accessible So That A Complete Site Evalrtion Can Be Performed.
PROPERTY OWNERS NERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE It1
E-Health Checklist of 3 12110
Harnett County
102 EAST FRONT ST
P 0 BOX 65
LILLINGTON NC 27546
DATE: 12/22/17 RECEIPT #: 0000011255
TIME: 16: 07 :20 CASHIER: JBROCK
APPLICATION NBA: 17-50042994
LOCATION ADDR: 91749 TECH 2
REFERENCE: NEW TANK
ITEM DESCRIPTION PAID
SOIL EVAL/NEW SEPTIC TANK 750 . 00
TOTAL AMOUNT PAID: 750 . 00
PAYMENT TYPE: ESCROW