ApplicationInitial Application Date: f r 16 C)s
Application # L %✓ v� l
COUNTY OF HARNETT LAND USE APPLICATION
Cent)I Permitting 102 E. Front Street, Lillington, NC 27546 Phone: (910) 893-4759 Fax: (910) 893-2793
LANDOWNER: `,1r - Mailing Address:
City: State: NLL Zip:^ --77 hone #: �'-�- :te`' �W
APPLICANT: S'cP l��t:rtiw, Q1;'V1k,r•( :VYIC . Mailinq A reS�C 1W'Cwti Q3,yyAc% I 1?, "1 /U kat, -h
City: f er cftk State: Zip: l5u l Phon� 4fA � SOS
PROPERTY
Address: _
Parcel: C
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Flood Plain: % Panel: Waters
DIRECTIONS TO THE PROPERTY FROM LILLINGTON:
Lot #: a. o Lot Si;
Deed Book/Page: Plat Book/Page:
PROPOSED USE:
0,1"'Sg. Family Dwelling (Size r) # of Bedrooms 3 # Baths a Basement (w/wo bath) Garage Deck JLe'
❑ Multi -Family Dwelling No. Units No. Bedrooms/Unit
❑ Manufactured Home (Size x__) # of Bedrooms Garage Deck
Number of persons per household��_
❑ Business Sq. Ft. Retail Space Type
Type
❑ Industry Sq. Ft.
❑ Church Seating Capacity Kitchen
❑ Home Occupation (Size x_) # Rooms Use
Additional Information:
❑ Accessory Building (Size—x ) Use
❑ Addition to Existing Building (Size x )
❑ Other
Use
Additional Information:
Water Supply: County (_) Well (No. dwellings Other
Sewage Supply: (V'rNew Septic Tank (_) Existing Septic Tank County Sewer (_) Other
Erosion & Sedimentation Control Plan Required? YES aNO
Property owner of this tract of land own land that contains a manu d hom in ebur h�ed feet (500') of tract listed above? YES NO
Structures on this tract of land: Single family dwellings a ct es Other (specify)
Required Residential Property Line Setbacks: Minimum Actual
Front 35 3_
Rear 25 It _
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Side 10 (Zb yQ8
Corner 20
43__
Nearest Building 10
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.
Signatur of Ow or O is A nt Date
** is application expires 6 months from the initial date if no permits have been issued**
A RECORDED SURVEY PLAT AND RECORDED DEED ARE REQUIRED WHEN APPLYING FOR A LAND USE APPLICATION
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SITE PIAN APPROVAL
DISTRICA—I—P3 L USE
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Application Number: I �04 I
Harnett County Planning Department
PO Box 65, Lillington, NC 27546
910-893-7527
Environmental Health New Septic Systems Test
nvironmental Health Code 800
• Place "property flags" in each corner of 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
1 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
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.
Building Inspections
• 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.
911 Addressin
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 fo dress conf' ation. This must be called in even if you have contacted E911 for verbal
confirmation a
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Applicant Signature: --- -- Date: Jly U
03/05