LAND USEinitial Application Date: 6 Application # �`c�-�J ='�► .'
COUNTY OF HARNETT LAND USE APPLICATION
Central Permitting 102 E. Front Street, Lillington, NC 27546 Phone: (910) 8934759 Fax: (910) 893-2793
LANDOWNER:"rs?�) 1 rT (L1jt'aS 64 fing Address:
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City: �L�lt'11t r 1��� State:_ Zip: Phone #:
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APPLICANT: /4 -< Mailing Address: / Q (1 tVOdCI /L -?
City: (�� I�wrj (� State: Zip: S Phone #: (_ SSo2 — �_79D
PROPERT L CATION: SR #: ` SR Name: La 1;2
Parcel: J a C) f 05 '3 PIl
i r r
Zoning. Subdivision:
Fl d Plain: k7PROPERTY
Panel:^ Watershed:
D CTI NS T FRO LI LLINGTON:
rYl 1,0 < C� ` i r"n t 'ck+ i rl`f� Viii ri Q r�ir
Lot #: �— Lot 5
Deed BooklPage. O% , Plat Book/Page:
/,
PROPOSED USE: -7
Sg Family Dwelling (Sizex/ # of Bedrooms # Baths , Basement (w/wo bath) Garagaa
❑ Multi -Family Dwelling No. Units No. Bedrooms/Unit
❑ Manufactured Home (8ize x____) #of Bedrooms Garage Deck �+n
Comments: r
Number of persons per household
-Business Sq. Ft. Retail Space Type
❑ Industry Sq. Ft.
❑ Home Occupation
❑ Accessory Building
Type
(Size x_� # Rooms Use
(Size xJ) Use
❑ Addition to Existing Building (Size x_-) Use
❑ Other
Water Supply: lC5) County U Well (No. dwellings ) (__) Other
Sewage Supply: New Septic Tank (J Existing Septic Tank County Sewer Other
Erosion & Sedimentation Control Plan Required? YES NO
Structures on this tract of land: Single family dwellings toyManufactured homes'"—` Other (specify)
Property owner of this tract of land own land that contains as manufactured home w/in five hundred feet (500') of tract listed above? YES NO
Required Property Line Setbacks: Minimum
Front,-
Actual
Minimum Actual
Rear
'25/
Side 1IrL
Carver a�f i
Nearest Building_
If permits are granted I agree to conform to all ordinances and the laws of the State of North Carolina regulating such work and the specifications or plans submitted. I
hereby swear that the foregoing statements are accurate and correct to the best of my knowledge.
Signature of Appiica t Date
**This application expires 6 months from the date issued if no permits have been issued**
A RECORDED SURVEY PLAT AND RECORDED DEED ARE REQUIRED WHEN APPLYING FOR A LAND USE PERMIT
Certificate of Approval of the Design and construction 0 orroere.
I hereby cerify that all streets and other requiurad
improvements have been installed in on acceptable
manner and according to Harnett County specifications and
standards in the Subdivision or that
guarantees of the installation of the required
Improvements in an amount and manner satisfactory to the
Planning Department of Harnett County hogs been
received, and that the filing fee for the plat has been paid.
o nett County,, ub,dyvision+Administrator
Date`
THE LOT(S) ON THIS PLAT HAVE BEEN EVALUATED BY A PRIVATE
CONSULTANT. BASED ON THIS REVIEW, IT APPEARS THAT LOT(S) ON
THIS PLAT MEET APPROPRIATE REGULATIONS. NOTE THAT FINAL
APPROVAL FOR EACH LOT REQUIRES ISSUANCE OF THE APPROPRIATE
HARNETT COUNTY HEALTH DEPARTMENT PERMITS FOR SPECIFIC USE
AND SITING IN ACCORDANCE WITH REGULATIONS IN FORCE AT THE
TIME OF PERMITTING. THIS CERff TIO DOLS NOT REPRESENT
APPROVED OR A PE'RMIM, R ANY S W�
DATE ENVIRONMENTAL HEALTH
NORTH CAROLINA —HARNETT COUNTY
FILED DATE L �. TIME
,�.
MAP NUMBER (n
REGISTER OF DEEDS
JSIMBERLY S. HARGROVE
A96 -t: DEPUTY REGISTER OF DEEDS
DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
PROPOSED SUBDIVISION ROAD
Application Number: :!�W /Jv`Ti�
Harnett County Planning Department
PO Box 65, Lillington, NC 27546
910-893-7527
Environmental Health New Se tic S est
Environmental Health Code 800
• Place "property flags" in ea lot. All property lines must be clearly flagged approximately every 50 feet
between corners.
• Place "house corner flags" at each corner of where the house/manufactured home will sit. Use additional flagging to
outline driveways, garages, decks, out buildings, swimming pools, etc.
• Place flags at locations as developed on site plan by Customer Service Technician and you.
• Place Environmental Health "orange" card in location that is easily viewed from road.
• 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. No grading of property should be
done.
• After preparing proposed site call the voice permitting system at 910-893-7527 and give code 800 for Environmental
Health confirmation. Please note confirmation number given at end of recording for proof of request.
• To hear results, call IVR again. Once approved, proceed to Central Permitting for permits
Environmental Health Existing Tank Inspections
Environmental Health Code 800
• Place Environmental Health "orange" card in location that is easily viewed from road.
• Prepare for inspection by removing soil over door as diagram indicates. Loosen trap door cover. (Unless inspection is
for a septic tank in a mobile home park)
• After preparing trapdoor call the voice permitting system at 910-893-7527 and give code 800 for Environmental Health
confirmation. Please note confirmation number given at end of recording for proof of request.
• To hear results, call IVR again. Once approved, proceed to Central Permitting for permits
Health and Sanitation Inspections
Health and Sanitation Plan Review 826
• After submitting plans for food and lodging, call the voice permitting system at 910-893-7527 and give code 826 for
Health and Sanitation confirmation. Please note confirmation number given at end of recording for proof of request.
• To hear results, call IVR again. Once approved, proceed to Central Permitting for permits
-1 Fire Marshal Inspections
Fire Marshall Plan Review Code 804
• Call the voice permitting system at 910-893-7527 and give code 804 for plan review. Please note confirmation number
given at end of recording for proof of request.
• To hear results, call IVR again. Once approved, proceed to Central Permitting for permits
• Pick up Fire Marshal's letter and place on job site until work is completed.
Public Utilities
• Place stake with "orange" tape/name thirty feet (30) from the center of the road at the location you wish to have water
tap installed.
• Allow four to six weeks after application for water/sewer taps. Call Utilities at 893-7575 for technical assistance.
uildin In ections
Call the voice permitting system at 910-893-7527 to schedule inspections. Please note confirmation number given at
end of recording for proof of request.
• For new housing/set up permits must meet E 911 / Addressing guidelines prior to calling for final inspection.
To hear results of inspections, call IVR again.
E911 Addressing
Addressing Confirmation Code 814
• Address numbers shall be mounted on the house, 3 inches high (5" for commercial).
• Numbers must be a contrasting color from house, must be clearly visible night and day at entrance of driveway if home
is 100 ft or more from road, or if mailbox is on opposite side of road.
• Once you purchase permits and footing inspection has been approved call the voice permitting system at 910-893-7527
and give code 814 for address confirmation. This must be called in even if you have contacted E911 for verbal
confirmation
Applicant Signature: Date:
03/05