DOCUMENTS Initial Application Date: \1I Lo l t.$ Application# V lJCO�Lt'3 8"1
CU#
COUNTY OF HARNETT RESIDENTIAL LAND USE APPUCATION
Central Permitting 108 E Front Street,Lillington,NC 27546 Phone:(910)893-7525 ext:2 Fax:(910)893-2793 www.hamett.org/permits
"A RECORDED SURVEY MAP,RECORDED DEED(OR OFFER TO PURCHASE)&SITE PLAN AREREQUIRED WHEN SUBMITTING A LAND USE APPLICATION"'
LANDOWNER: .� F �Sgen"rf A` clot':) 7 Mailing(Address: -1 / I/Apt47 Y/�L(,
City: u VQ✓/na spate: Zip:Jc SNContect Nb:919'ken"ork2S EmaJic 0
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APPLICA/NT1*::�/ Icuss a !- 7(-0 Mailing Address: Z�3 it aY WeiQ 4Y.c nn /1 11//��''
City: 6216 teOSIJn0 State: PC Zipz?1 '( Contact N¢(Q( I)(Dio- I I Email: OIC/14SL d,1 Ci.J10 ."/ P9r•% y4
*Please fill out applicant information d different than landow/ner'� / n\ebsx+n"(4 rolrtkem.(1( ?0. C✓,_. V"'
CONTACT NAME APPLYING IN OFFICE: vl/ �e75s4 iPG QYr•( Phone#(9/t) O�10 "1/3/
PROPERTY LOCATION:Subdivisio¢ /pe eSCY✓Pi J{'�� Lot#: Jo Lot Size: •nCI
State Road## /� State Road Name: ) 1.1 r3 fad ` r /!Maa/p'Bo_ook/&PagOO I D / I tat
Parcel:0q ��//��T�.y�ww VLDULS Di b' )- PIN: U204S ^ lj(-0 --IIW't �
Zoningl\ryy Flood Zone:K WatersheJ'-IF1 Deed Book&Page$ �/ 1'54 Power Company:
*New structures with Progress Energy as service provider need to supply premise number from Progress Energy.
PROPOSED USE:
Monolithic
❑ SFD:(Size x )#Bedrooms: #Baths:_Basement(w/wo bath): Garage: Deck:_Crawl Space:_Slab:_Slab:_
(Is the bonus room finished?( )yes (_)no w/a closet?( )yes ( )no(if yes add in with#bedrooms)
❑ Med:(Size x )#Bedrooms #Baths_Basement(w/wo bath) Garage:_Site Built Deck: On Frame Off Frame
(Is the second floor finished?( )yes ( )no Any other site built additions?( )yes ( )no
U Manufactured Home: SW OW TW(Size x )Si Bedrooms: Garage: (site built? )Deck (site built? )
❑ Duplex'.(Size x )No.Buildings: _ No.Bedrooms Per Unit:
U Home Occupation:#Roams: II,^, Use: --T Hours ofoOperation:eP #Employees:
Addition/Accessory/Other:(Size /V x31 )Use: 1 n G rQ�f CV U cp.•On rvi t F)) Closets in addition?( )yes ( )no
Water Supply: County Existing Well New Well(#of dwellings using well )*Must have operable water before final
Sewage Supply: New Septic Tank(Complete Checklist) Existing Septic Tank(Complete Checklist) 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?( )yes (_)no
Does the property contain any easements whether underground^o-�r overhead(_)yes ( )no
\
Structures(existing or proposed):Single family dwellings: `P..j5 - Manufactured Homes: Other(specify)' p�/'1 Gfl
Required Residential Property Line Setbacks:tComments:
� (�� 1� 1
Front Minimum Actual Lt.ft' JC t9 `9 Oe✓V,rc al
Rear 1�"1 p b .\ V \O` er—— len
Closest Side 1Se '7 \ `' ISWI t anon
�
Sideslreet/comer lot
Nearest Building
on same lot
F de,Yer L f Lke Afolmalion Vane t ol2 ,;,, ,
APPLICATION CONTINUES ON BACK
SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINGTON: 1 urn Lek] µ,,y 4 +1 Al l U r r) Lehi On Tt)
°Ansi,tn Ltsk RlQ 7 rn Cr on 6///05fl Le 4 on-/07ro,Ay rec/
If permits are grant,• I a• -- •conform to all ordinances and I /of the State of North Carolina regulating such work and the specifications of plans submitted.
I hereby state that fo -•oing sta.-ments are accurate .•c r tot best of my knowledge. Permit subject to revocation if false information is provided.
� , . 41e18
afore of 0 0 aj is 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 applications.'"
"This application expires 6 months from the initial date if permits have not been issued"
Resdenflal lnrc Use Aoolicalion Grana 2ofJ
S 7f 34' 44.0000' E 101'-15/i71• 33' 48.0000' E 531-8 7/8'
15' STREETSCAPE BU� FER
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TROPHY RIDGE
CUMBERLAND HOMES, INC.
THE SALEM IV WI 3RD CAR GARAGE
LOT * 20
SCALE.
RESERVE
:V '•40
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NTE# 11-6-4)401 Harnett County aallDepartment of Public Health 2 4 9 2 7
PERMIT # a4 -& I }a elation Perm
New Installation Septic Tank I� Nitrifiation Line 0 Repair ❑ Expansion
, PROPERTY LOCATION: !rcYsa tt,d� Ln�+11r', a./ . Yt 14/A1
Name: (owner) C�snlyrlr s� +\ow.uyilnc- SUBDIVISION 't" 'e- llv-,.s.}v_ LOT # 2 —
System Installer: Te S ao.%.ac Registration #
Basement with plumbing: 0 Garage Q.i 1 Bedrooms -3
Type of Water Supply: D Communityublic ❑ Well Distance from well N 1t feet
System Type: a.SY /aasS.,ys ♦ Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must coma Beath Department 6 months prior to expiration for permit renewal.
This system has been instilled in mnpeaae with aMlimal.Nand Carolina General Smmm.Mks br Sewage lnaaent ad Dispirit.and all maidens a the Improvement Permit ad fmmda Mdwbroa
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PERMIT CONDITIONS: "a-U('oR 1' (LA as Co:�
I. Performance: System shall perform in accordance with Rule .1961.
II. Monitoring As required by Rule .1961.
III. Maintenance: As required by Rule .1961.Other.
Subsurface system operator required! Yes 0 No ❑
If yes,see attached sheet for additional operation conditions, maintenance and reporting.
IY. Operation:
Y. Other.
❑ D-Box 0 Pump ❑ Alarm 0 N2OLine ❑ PWR Line
Following are the specifications for the sewage dieI system on the above captioned pm
Type of system: ❑ Conventional ther Ctikl f.L.'nmlris - Septic Tank IC)X, gallons Pump Tank 'CtFD gallons
Subsurface No. of 3 exact length width of depth of
Drainage Field ditches of each ditch feet ditdies 3 leer ditdies r9c2i#xZ inches
Trend Drain Required: Linear feet
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Authorized State Agent _ Date 0'11oa/ao(e
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. B3596 - P134
•
y,./^N• For Registration Kimberly S. Hargrove
/' � Register of Deeds
Hamett County. NC
(H COUNTY TAX Ina Electronically Recorded
\ 95..-91211.‘ 2018 Apr 1310:52 AM NC Rev Stamp:$ 622.00
04-137391 Book: Page:134 - 136 Fee:E 28.00
J Instrument Number 2018005020
I 6,7).n....
1
Prepared Qy n41 to: Matthews,Attorney, 1103 W Cumberland St.,Dunn,NC 28334
Mail to: Grgnt e��j¢examination or tax advice given)
EXCISE TAXczyr2: EBB
Parcel ID No.: (0 i10
---pq
NOR OI&IA GENERAL WARRANTY DEED
r\/r-.\.
THIS DEED, m .-a-Ld' .A r of March, 2018, by and between
CUMBERLAND HO 'C orporation whose address is P.O. Box
727,Dunn, NC 28335,here c9H'ed GRANTOR, and ROBERT J. ACKLEY
and wife, SHERRY A. AC Y,of 49yroipeliy,Ridge,Fuquay Varina,NC
27526, hereinafter called GRANTEE. 7 it
2
The designation Grantor and e*an\eecsAd herein shall include said
parties,their heirs, successors and assi diha1t'' elude singular, plural,
masculine or feminine as required by contt ki7)
WITNESS ? —�
I
�C,?�.
That the Grantor, for a valuable considerat r . : y the Grantee, the
receipt of which is hereby acknowledged,has and by epi. 'c is does grant,
bargain, sell and convey unto the Grantee in fee simp - : rbaf.¢ditain lot or parcel
of land situated in Hector's Creek Township, Harnett , . arolina and
more particularly described as follows: 1/'/
BEING all of Lot 20 of The Reserve Subdivision as shown on plat,naY�orje Book
2016,Page 161 and 162 and reified in Map Book 2016,Page 209,Hans pun
This lot is conveyed subject to the Restrictive Covenants for recorded in Book ,k1
• and Book 3495,Page 111,Harnett County Registry.
gecordabk document'end the terms ofthr tebmltter agreement with the Harnett Count'Reehter of Deeds ��
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83596 - P135
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/_AI or a portion of that property herein conveyed does not include the
\_ residence of a Grantor. (N.C. Gen. Stat. §105-317.2).
�7 T roe hereinabove described was acquired byGrantor byinstrument
'�/ � property r'tY 4
B Page 533 , Harnett County Registry.
lTO HOLD the aforesaid lot or parcel of land and all
priviIbges/�n0ces thereto belonging to the Grantee in fee simple.
/ it .\
Anilt. with the Grantee, that Grantor is seized of the
premises in s mf4p ras the right to convey the same in fee simple, that title is
marketable and& of all encumbrances,and that Grantor will warrant and
defend the title : • _, -.,/".>"wfi�lilaims of all persons whomsoever except for the
exceptions herein: /-7,-----em,
. i U
Title to the proper urgbove described is subject to the following
exceptions: V )
I
I. General utility eas 9f4ecord.
2. Easements, restrictio4afid rightly{ of record.
3. Such facts as an environmental dy}on the subject property by an
environmental engineer w d ve /1
4. Such facts as would be disco yfr current survey of the real property
described herein.
5. 2018 ad valorem taxes which are of,..,--- o . 1
5.
IN WITNESS WHEREOF,the GrantOACtvgepgr set its hand and seal,the
day and year first above written. L\ <\/"
CUMBERLAND H '•'W41 .
A NC Corporation //7\
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By ),.....-0.
I . y &orris, Vice
< 2,-,-------,
�hi45
B3596 - P136
�lj i CAROLINA
OF HARNETT
j��I, ynn A. Matthews, a Notary Public, do hereby certify that Danny E.Norris
• :I. . : -, before me this day and acknowledged that he is Vice-President
o Qtr. Homes Inc., a North Carolina Corporation, and that he as Vice-
Predicts? _ aut rized to do so executed the foregoing on behalf of the
corpo a •
Witness my ��i�d notarial seal,this the of March, 2018.
-��.
����1� otary Public
My Commission E •'3.} 1; ,,,,,.,n„
\ .,____ �.� .MATTE•' ,
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09109/11 Application#
Harnett County Central Permitting
ction w to be filled out PO Box 85 Lillington NC 27548
Each sebeb
M whomever blow work 910 893 7525 Fax 910 893 2793 www hamad org/permlts
Must be owner or licensed
contractor Address company Application for Residential Building and Trades Permit
name 8 phone must match �]
Owners Name J3c 4 e•�h e/.�y Akin! Date -I4-18
Site Address �+9 Tr oto hy ✓Y119,se, J Phone
Directions to job site from LlllingtonJ 1 - •• •• 5 2n° r - .
1Zrn ox , Turn I4I•0.,6 Chris-Flan Gtfk1 � juin (I on/ro 1zrdIin3 ta'
en1-o jo-vo9AY Adit
Subdivision the 'Atsronres Lot 70
Description of Proposed Work nyr o(••! Swi nun) pN-Q #of Bedrooms
Heated SF Unheated SF Finished Bonus Room'+ Crawl Space Slab
((' General Contractor Information
Card ardin4 -}am,lyi Ps--if o (900 roe I
Building Contractors Corhpany Name Telephone ff /
Z3 b3 I (LOoo0 A- c El -PRsbc✓o uy. mcIlssc ..L c&.rol, nq}am,lIII1r.-
Address Email Address
7CC1p 8
License#
Electrical Contractor information
Description of Work C1nt,oService Size 30 Amps T-Pole _Yes GNo
unser, €1cc--ric C'un.1,anj ( 9r1) 91s- ac4l
Electrical Contractor s Company Name J Telephone
Zchu,lon "hC x-1591 5cotjw,scncJeciric,C?fi-pfcLi• n ,
Address Email Address
a3se ( ,
License#
MechanicallHVAC Contractor Information
Description of Work
Mechanical Contractor s Company Name Telephone
Address Email Address
License#
Plumbing Contractor Information
Description of Work #Baths
Plumbing Contractors Company Name Telephone
Address Email Address
License#
Insulation Contractor Information
Insulation Contractors Company Name&Address Telephone
*NOTE General Contractor must fill out and sign the second page of this application
I hereby certify that I have the authority to make necessary application that the application is correct
and that-the construction will conform to the regulations in the Building Electrical Plumbing and
Mechanical codes and the Hamett County Zoning Ordinance I state the information on the above
contractors is correct as known to me and that by sinning below I have obtained all subcontractors
permission to obtain these permits and if amt changes occur including listed contractors site plan
number of bedrooms building and trade plans Environmental Health permit changes or proposed use
changes I certify it is my responsibility to notify the Harnett County Central Permitting Department of
any and all changes
EXPIRED PERMIT FEES-6 onths to 2 years permit re-issue fee is$150 00 After 2 years re-issue fee
is urrent fee sch dul
` 0 1� 18
i ture of Owner/ ra /Officer(s)of Corporation
Date
Affidavit for Worker's Compensation NC GS 87.14
The unde gned applicant being the
General Contractor Owner Officer/Agent of the Contractor or Owner
Do hereby confirm under penalties of perjury that the person(s) firm(s)or corporaton(s)performing the work
set forth in the permit
Has three(3)or more employees and has obtained workers compensation insurance to cover them
Has one(1)or more subcontractors(s)and has obtained workers compensation insurance to cover
them
Has one(i)or more subcontractors(s)who has their own policy of workers compensation insurance
covering themselves
_Has no more than two(2)employees and no subcontractors
While working on the project for which this permit is sought it is understood that the Central Permitting
Department issuing the permit may require certificates of coverage of workers compensation insurance pnor
to issuance of the permit and at any time dunng the permitted work from any person firm or corporation
carrying out the work
Company or Namev-�///�11� �cu()aro/rn -�dlYi,�� C}�o� ' Pa.�� ,I
Sign w/Title / Il- -eNitt- I�Z n)u--VSs Date 7-kr( k
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call: (910) 893-7525 Fax: (910) 893-2793
Application Number 18-50043813 Date 4/16/18
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - -
Application type description CP SWIMMING POOL
Subdivision Name
Property Zoning UNZONED
Owner Contractor
ACKLEY ROBERT & SHERRY CAROLINA FAMILY POOL & PATIO
49 TROPHY RIDGE 2303 NORWOOD AVE
FUQUAY-VARINA NC 27526 GOLDSBORO NC 27534
(919) 523-2725 (919) 580-1111
Applicant
LEGARD MELISSA
2303 NORWOOD AVE
GOLDSBORO NC 27534
(919) 610-7131
--- Structure Information 000 000 16X34 INGROUND POOL
Flood Zone FLOOD ZONE X
Other struct info PROPOSED USE POOL
SEPTIC - EXISTING? NA
Permit RESIDENTIAL BUILDING PERMIT
Additional desc .
Phone Access Code . 1238740
Issue Date . . . 4/16/18 Valuation . . . . 0
Expiration Date . 4/16/19
Permit LAND USE PERMIT
Additional desc .
Phone Access Code . 1238765
Issue Date . . . . 4/16/18 Valuation . . 0
Expiration Date . 10/13/18
Permit RESIDENTIAL ELECTRICAL PERMIT
Additional desc . POOL
Phone Access Code 1238757
Issue Date . . . 4/16/18 Valuation . . . . 0
Expiration Date . . 4/16/19
Special Notes and Comments
T/S: 04/16/2018 02 :27 PM JBROCK
THE RESERVE - 49 TROPHY RIDGE
HARNETT COUNTY CENTRAL PERMITTING
P.O. BOX 65
LILLINGTON, NC 27546
For Inspections Call: (910) 893-7525 Fax: (910) 893-2793
Page 2
Application Number 18-50043813 Date 4/16/18
Property Address 91749 TECH 2
PARCEL NUMBER - - - - - - -
Application description . . CP SWIMMING POOL
Subdivision Name
Property Zoning UNZONED
Required Inspections
Phone Insp
Seq Insp# Code Description Initials Date
Permit type . . . . RESIDENTIAL BUILDING PERMIT
999 131 R131 ONE TRADE FINAL
Permit type . . . . LAND USE PERMIT
999 818 Z818 PZ*ZONING INSPECTION /_/_
Permit type . . . . RESIDENTIAL ELECTRICAL PERMIT
999 205 E205 R*ELEC UNDER SLAB / /_
999 215 E215 R*ELEC. UND. POOL _/_/_
999 213 E213 R*ELECTRICAL UNDERGROUND
999 131 R131 ONE TRADE FINAL _/_/_
HARNETT COUNTY CASH RECEIPTS
mem CUSTOMER RECEIPT mmw
Open JBROCK Type: CP Drawer: I
Date: 4/16/16 52 Receipt no: 324056
Year Number Amount
2018 50043813
91749 TECH 2
LILLINGTON, NC 27546
Al BP - PERMIT FEES 8125.80
POOL
CAROLINA FAMILY
Tender detail
CK CHECK PAYMEN 2124 $125.00
Total tendered $125.00
Total payment $125.00
Trans date: 4/16/18 Time: 14:35:20
mm THANK YOU FOR YOUR PAYMENT **