DOCUMENTS Initial Application Date: u\`l 4 I% Application ft S[ Y.tt 3 1 /
1
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COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION
Central Permitting 108 E.Front Street,Lillington,NC 275413 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.hamehtt.org/permifs
^A RECORDED SURVEY MAP,R11ECORDED DEED(01111 OFFERpTO PURCHASE)8817E PLAN ARE REQUIRED WHEN SUBMITTING A LAND USEAPPLICATION"
LANDOWNER: �reC lute (ott4ro H0,0 dao
Pe Mailing
ZSd mi �,
Meiling Address:
City: RRciro,J Stater( ap: 2:37d Contact No: ,10 -yYV-Ybi Email: She un(+Prerrun pre/trite)nt.raw)
APPLICANT*: Mailing Address:
City: State:_Zip: Contact No: Email:
*Please fill out applicant information If different than landovmar
CONTACT NAME APPLYING IN OFFICE: S b 4 to 6-nrd4er
Phone it 9lu -982 y(9Z
PROPERTY LOCATION:Subdivision: sum r+e Allff tr Lot F: 31 Lot Size: , S.3
State Road k rr�YZ3 State Road Name: BeIU4 4?l 1 u l L App Map Book 8 Page:i'a CIlO / L{-1 (
Parcel:fl -1 SI.D/ kt>Sq S4� PIN: Cf SID/ — .1 a -35ss. 0
Zoning:R A-tOM Flood Zone: X Watershet >PDeed Book 8 Page: 3499 / 319 Power Company': 62„4 t4 E M'
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
2. S —Monoli�ic
M
SED:(Size 30 x 3 S 3#Bedrooms:y a Baths:_BasemeM(w/wo bath): Garage:_Deck:_Crawl Space:_Slab: Slab:'
(Is the bonus room finished?( )yes (J no w/a closet?(J yea (J no(if yes add in with Y bedrooms)
❑ Mad:(Size x t t Bedrooms k Baths_Basement(w/wo bath)_Garage: Site Built Deck:_ On Frame_Off Frame_
(Is the second floor finished?(J yes U no Any other site built additions?( )yes (J no
❑ Manufactured Home:_SW DW_TW(Size x )0 Bedrooms:_Garage: (site built?___)Deck: (site built?_j
❑ Duplex:(Size_x 1 No.Buildings: No.Bedrooms Per Unit:
❑ Home Occupation:it Rooms' Use: Hours of Operation: /Employees:_
❑ Addition/Accessory/Other:(Size x 1 Use: Closets In addition?(J yes (J no
Water Supply: J County _Existing Well _New Well(I atdwelligs using well )•Must haven
operable water before final
Sewage Supply: , New Septic Tank(Complete Check//si) _Existing Septic Tank(Complete Checkllse —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?( 1 yes J no
Does the property contain any easements whether underground or overhead(J yes (J no
Structures(existing or proposed):Single family dwellings: J anufactured Homes: Other(specify):
?TO pexec'
Required Residential Properly Line Setbacks: Comments:
Front Minimum 35 Actual 36.i
Rear 2 S 34
Closest Side I o 101
SldestreeUcomer lot
Nearest Building
on same lot
ADP! If1ATIe1N f:f1NTINI IFA AN RACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINIO�TON: Ii z� � o n p' N ' 1. 0 n
r�Millun u.e�el. R') fur .7 Mile> . 16,1‘i onSumner-114 or. fi'11,{ or
peas}n-10 Lcnc , 01 (o+ on le14 C [orner /
It permits are granted I agree to conform to all ordinances and laws of the Slate 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 it false information is provided.
, Waco, 714- Y�Io�IS
Signature of Owner or Owner's Agent Date
"'Nis the owner/applicants responsibility to provide the county with any applicable Information aboutthe subject property,Including but not limited
to:boundary Information,house location,underground or overhead easements,etc.The county or Its employees m not responslbN for any
Incorrect or missing Information that la contained within these application."'
"TTN application expires 6 months from the Initial date It permits have not been Issued"
NAME: Ptt(gton (aeon Home) t kPAoby}Iual APPLICATION it:
*This application to be Riled 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#
gnv/ronmental Health New Septic System Code 800
• All Drowns 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 undmarowth 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.$26.00 return trip tee 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
• peg sbl ) and tEhe
p�OFIld F bac
ckkIInnpiece. (Unless inspection is for a septic tank In a mobile home park)
O 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 800 for Environmental Health inspection. Please note confirmation number
given at end of recordina 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 III Conventional {_}Any
{_I 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 I X)NO Does the site contain any Jurisdictional Wetlands?
{_}YES (k)NO Do you plan to have an irrigation systeww now or in the future?
{_)YES ( )1.1 NO Does or will the building contain any kpg?Please explain.
1_t YES I 1 }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?
(_}YES (1) NO Is the site subject to approval by any other Public Agency?
{_)YES { X} NO Are there any Easements or Right of Ways on this property?
(_)YES (X}} 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 Roles
I Understand That I Am Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making
The She Accessible So'ppt A Coro ate Site Evaluation Can Be Performed.
0.94
PROPERTY OWNERS OR OWNERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED) DATE
10/10
THIS MAP IS NOT INTENDED FOR
RECORDATION,SALES,CONVEYANCES
OR TO BE ATTACHED TO A DEED AS AN
EXHIBIT.
Notes: 31 Ntta'
I. Acreage computed by DMD method
2.All Distances Are Ground Distances 0.53 ACRES
' 3.Property is Subject Mali Easements of Record. .DB 3499,PG 319
4.Adjoining Property Information Per Harnett County PH 2010,PG 411
Tax Records.
5.This plot plan was drawn from a physical survey
6.Property is zoned RA-20M.
• FUTURE
DEVELOPMENT 3I�CS ERB
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PHASE 3 003"19 is ti PB 2010,PG 411
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CHORD=S 890023S"F.
0 60 120 tau LENGTH=34.36' PLOT PLAN FOR:
—�—m PRECISION CUSTOM HOMES AND RENOVATIONS,LLC
NORTH ttpttntfggg SITE ADDRESS:23 BEAUTIFUL LANE ,
HARNETTTHCAROLINA COUNTY � � CARO ttt COUNTY Of: HARNEIT
I certify that this plat was drawn under my supervision from 4OQ;FESS/O 'I'q % DATE:TOWNSHIP OF:JOHNSONVILLE
a physical survey.This map does not conform to Gs 47-30 as g0 'I.yl, 1. DATE: 4192018
amended and is not intended for recardmian,nor should a Q- SEAL SCALE 1"-60
copy of this map he unsched to a deed as an exhibit to be = TERRY C. FAIRCLOTH,PLS
rerorded per GS 89C-26 - L-5185�L _
• yo J"� �= 2017 FALLOW RUN
i ",•SUR•,"��� FAYETTEVIIIF NC 28312
', ?y • • c,l-, PHONE#:(910)-494-7444
Tory abdan License No:L-5185 4'tttsl Pi000. EMAIL: fairctothswveying®yahoo.com
WEBSITE:tenycfairclothpls.com
SOUTHEASTERN SOIL& ENVIRONMENTAL ASSOC.,INC.
PROPOSED SUBSURFACE WASTE DISPOSAL SYSTEM DETAIL SHEET
SUBDIVISION:Su m at 1: Y` LOT 31
INITIAL SYSTEM:APPROVED 25%RECUCTION REPAIR At Qrc ved 2.5 A 12 ed..0}'°"
DISTRIBUTION: jer ia\ DISTRIBUTION Ser;al
BENCHMARK: 100.0_ LOCATION EIC X04- 31 ( 2c ad
NO. BEDROOMS: L/ LIAR ) 3 c,
LINE FLAG COLOR ELEVATION LENGTH
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y 8 to 3 .(12. 70
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BYR .C, Ruiner DATE OS /o2 / 200
TYPICAL PROFILE THERE SHALL BE NO GRADING
0 -40 L-5 4'r1 60-An CUTTING,LOGGING OR OTHER SOIL
ex 2 ') 4 0 DISTURBANCE IN SEPTIC AREA
ANY DISTU RBANCEMA Y CAUSE A SITE
TO BECOME UNSUITABLE
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