DOCUMENTS SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: ue44 north On 5 MG.,n 5'4 --kuu .✓d
t ElerneN- 5+, Cont-:nu.e 5•1(415k4 nolo MC - (910 A11& attain 54,
i..rn tec+ nr -o I-tame } Central 2d� 0. 3 Turn 2;r3h}
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 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.
ar/Cs. cjevo 3-67-
Signature of OwnerOwner's Agent Date
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"`It is the owner/applicants responsibility to provide thevcounty 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 employee%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"
Residnnlial Land Use Application Page 2of 2 D3l11
NOT FOR LEGAL USE .
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NAME: /`-16•n-a 22O1"CrO APPLICATION it:
*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 I CONFIRMATION#
Environmental Health New Septic SvstemCode 800
• All property irons must be made visible. Place "pink property flags" on 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 grade 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,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 Environmental 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.
Environmental Health Existing Tank Inspections Code 800
• Follow above instructions for placing flags and card on property.
• Prepare for inspection by removing soil over outlet end of tank as diagram indicates, and lift lid straight up (if
possible)and then put lid back in place. (Unless inspection is for a septic tank in a mobile home park)
• DO NOT LEAVE LIDS OFF OF SEPTIC TANK
• After uncovering outlet end call the voice permitting system at 910-893-7525 option 1 & select notification permit
if multiple permits, then use code BOO for Environmental Health inspection. Please note confirmation number
oiven 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 type(s): can be ranked in order of preference,must choose one.
{_} Accepted {_} Innovative t1 Conventional tI Any
{_I Alternative I1 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:
(_IYES (_} NO Does the site contain any Jurisdictional Wetlands?
{_}YES ( 1 NO Do you plan to have an_rneation system now or in the future?
IYES (_I NO Does or will the building contain any drains?Please explain.
{ }YE.S 11 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?
I_}YES I-1 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 (_1 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 That I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The Site Accessible So That 1CAA CompleteCSite Evaluation Can Be PTe�rforrmmled. 1 3
PROPERTYWNERS OR OtWNERS LEGoALREPRESENTATIVESGNATURE(REQUIRED) DATE'
10/10
B3536 - P227
•
/ ). For Registration Kimberly S. Hargrove
•
Register of Deeds
/,, Harnett County, NC
�"� Electronically Recorded •
•
-�1 NE r OUNTY TAX ID a 2017 Aug 24 02:38 PM NC Rev Stamp:S 12000
•
0662 0016 Book: 3535 Page'.227 - 230 Fee:8 26.00
0 Instrument Number: 2017012722
yt'-)111 SB
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`-'10(77�A QLINA GENERAL WARRANTY DEED .
Excise Tera f120.00 v •
•
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Pacer Identifier No.L70662001 ( ofi _>__> l � Couob'co the day of 20
Ma'UBox to: Grant=19S3 Honmt els C 27501
Thi,instrument was propend by: l�E . „ethIaw.304 B.lone Street.Raleigh.NC 27601
Brief description'bathe fides: / ,
ThBS DEED mode this 22 day GS 20ZM�1,4 /'.
GRANTOR ;;,,/ GRANTEE GRANTEE
AI86lTM.M'D3.IA11S.DNMARR1EgANDMARVII�C. tit ROM*RO BRDWlAA1�17DRt.
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JURDMAN,UNMARBWD $��p00"'(ff000 AS A MARRIED COUPLE
52s7 SL Harald Terrace \ Rod
Staw%FL34997 7.---\
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Eater in appropriate bio&for each party: a address,and,reyptoprLas ,sc\-g corporation orprinez* .
Thedmigntlon 0»mmadGrown=DadWeb ehSah
bdesaid pinks, \7egeeendadgs,'Mahan includej
Anther, P
SHns, mNteo
e seise as required by want ! 1
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WITNESS/3TH,the the Grantor, ahntor,tbra' rbleconsd �
enpaid by dmOretegihe r w h gllrabyadmowledgd,hes
and by them promote dominat,bargain,selmodconveyredotheGot in fee simple, aseG lot gemmed afield Monied
in the City ofAam,Township,Hai County,Nwlb Camila and more prteaterly ' Fell
Sealtabd Rabbit A -tM` ''C /'
The property MW tonJ'd_Wf mot tie prior y redden,of t4 Orator. C/2
Tho property hereinabove deathbed MIS Expired byGrantor b'indrment rewarded hi Book 296/pa8� ¥` 0
ill...\ J/\
Aap,howkgda above aer4kdpropatyurewded intoe .P�. ,J, ,
submitted electronically by "Merman & Henan Attorneys at taw" [[// �� J`
in compliance with Horth Carolina statutes governing recordable documents_7 / ' Jti�
and the tern of the submitter agreement with the Harnett County Register of/De�.S
NC BrAsswdadoo Fonallo.301974 Restate 1977,2002 �/` ' A
Printed byApemmwmr theNCBa Association-1931-Chicago TOM thorn=Company l,..-
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B3535 - P228
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1 eferyi 7O BOLD the Are:aidlot orparcel ofhedand eltpivilamm and appwatemnommuetohda nlheGwmet
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., trhhbeEtaetee,that Omer laaebedoflheprembm infix ample,bnfierightto=secrete mein
,.,. w marketable and 5eeamebarolall ent�6tanmaambaG[tmrwill warrant and defmdenetlespinet
the , fall parsers whomeoeva,ama than the following exception=
21717 A1W �
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INI, W*E .belirwaahas duly executed tlefacpohpg.softhedrymtd year first above wham.
/ > ✓{\� �ZU�/K/L�l�rti+ (SEAL)
(path.Name)„.," ri\/„ �C�> ALBERT M. L.uMs i
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Tele: \/ / MARVIN C.BAMAN
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SEAL-STAMP Sane ofNmtlrlA5Emial-Comixro -/-i \
ondaalped 'y Peblio and Stem afawaid, certify that
.!-•\ rnmuvnaoa J I Eta'f- Al- Z73/9 ,N in C cCo raiegoil ti paamnEyappeared
,C i thavraott-saedaew tame this by and acknowledged �keeguingleene na for the purposes therein i
w..e.at at
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� ,_..,.t eyrme.npaaAto.xa a reseed Witness ray hand and seal -?d day of AG(�ua-1- 20%f. I
a ij�[��,eyam i �rr�''��/�Ptthlix C oq,,- -�.�_
SEAL-STAMP Sme orNie6�sii�a-Comely ofI,--�
I, the oodasigned Nday Pbfe of the '—illpli I Stab afamaid, catty that
40C-n d--e-.+1-6r-A+-.e.0 `✓ pasmaliyaamebefoream •
this days acknowledged that he tithe of ,j a
Naucanlsaa onpnioMlmhed'labtrdy gReSJm pemeahb
(stole through the inapplicable),aid lhabyamlprityA* r he signed the
foregoing i.smiaum Waannwwib beWB'ulb actamNaSIatempaaml,
dtb day of 20
My CatwNaionapia; R�.ter)
Notary PuMte1 ,J
SEAL-STAMP Siam ofNalhCattsffia-Cm * K./y Of �
I,the tmdesipedNolsyPublic ofthe County and SUB admaseid,ea*that <117.-----.``� 1
wma m swop a emy haand Notarial sseal,this say of \'r 204.
MyCommission Exphet /2 E
NC BrAssociatimpanNo.3O 1976,Revised 1977,2002 P ”
Printed by Agreement with tteNC Ba Assoc loon-1981-Chicago The bnmance Company �\ -
B3535 - P229
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ernehemrrt7h'nStumm'Milt cafi6cJemauirngj tthe(Mend*wandh hemokenar.99lcwn
�wrOa§rftnesdha1eof.
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neem the co
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NC Bar Anocistiow Form No.3 O 1976,Reviled O 1977,2002 / �
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Printed by Agll
rsment with the NCer Acocis ion-1921-(Lingo 791e bananas Cai a.y 1`
83535 - P230
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'�EGIBIMNCyiat an existing iron pipe corner with J.O.McLeod located within the right of way of State
'aR�,\\,,,5�5�d//gg oint being located 1065 feet northwest of N.C.Highway 8210}and runs thence
thtduKt�t way of said State Road 81403 North 65 degrees 23 minutes West 152.0 feet to an
existing I pe wi Chester Brown on the northern right of way of said road;thence along the •
Brown lige yoR(y$de minutes West 245.5 feet to an existing iron pipe corner with McLeod in
the Brown I�'.",,`r -,,�,�''d'a`'.�/,�th cLeod line South 73 degrees 02 minutes East 359.8 feet to an existing
iron pipe cotoe ;t( hyrrce an h(4ne with McLeod South 38 degrees 17 minutes West 253.4 feet to the
point of REGINrg T 3nrfcprdalg 1.321 acres,according to a survey by C.W. Russum,RIS,dated 8-26-
78 entitled"Propthy pfnafnd Carol k Trasti".
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HARNETT COUNTY CASH RECEIPTS
REPRINT
maa CUSTOMER RECEIPT ama
Oper: JBROCK Type: CP Drawer: 1
Date: 3/89/l8 52 Receipt no: 281519
Year Humber Amount
2818 58843500
1983 HARNETT CENTRAL RD
ANGIER, NC 27581
B4 BP - ENV HEALTH FEES
EXT TANK $188.88
MARIA ROMERO
Tender etail
CP CREDdIT CARD $100.08
Total tendered $188.08
Total payment 5188.80
Trans date: 3/09/18 Time: 18:88:38
+a THANK YOU FOR YOUR PAYMENT **