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DOCUMENTS Initial Application Date: (..3-1 I l I I ❑ Application# 1. O.5 rel S I t4.- D14. I CU# COUNTY OF HARNETT RESIDENTIAL LAND USE APPLICATION ' Central Permitting 108 E.Front Street,Lillington,NC 27545 Phone:(910)893-7525 ext:2 Fax:(910)1893-2793 www.hamett.org/permhs "A RECORDED SURVEY MAP,RECORDED pDEED(OR OFFER TO PURCHASE)&SITE PLAN ARE REQUIRED WHEN N{SUBMITTING A LAND USE APPLICATION" LANII(11VN,E,R�:_ -(11Ar 4 i O.Pa»Jtlun Manmg Address: '3(<5 (cn LL / /�-f.-t w4 City: erPeF S State 4-1C ZIp:,27S.1IContact No:%-S(n8�'i3a7 Email:,air04J$OT(G LD AA l APPLICANT*:5_i tat.- �s ,L Ma��i//in Address. tips p Cagle_ k-o.ke Q 6- City City: I .()f�'1� State:TUC ZieD19i Contact No:/(/ "SCOO /jO7 Email: ifs'-'Ad.CQri 'Plmaefl out applicant Information HEMerem man bndoemerr �]V� O �j CONTACT NAME APPLYING IN OFFICE: Skit- /IN((eAri1 �(1 D Phone k %p-geo&'Z 3a7 p PROPERTY LOCATION:t&SeLbies: 33-5/ JifW"`S 1.1et5Cd 4 (tF+K : t1Aks� Lot#: Iii Lot Size: ' O S (� State Road it �I-17( 1 State Road Name: 6P r5 (n ,tur)nae.\ 1Ll Map'Book&Page:, f7((F/ -Jf O Parcel: ©x 1 I �t Yr C)V ia. & PIN: IL ID '-.^,// IS' �I4I, 0 17) "�"' Zoningl?c\2D Flood Zone: 7i- _Watershed: eed Book&Page:24Na / '1S- Power Company: (}aide �r^^�y *New structures with Progress Energy as service provider need to supply premise number from Progress Energy. PROPOSED USE: ,yMonolindc Er SFD:(Size Lf 0 x 40 )#Bedrooms#BSths'JiBasemenl(w/wo bath):"/Garage:_Deck:_Crawl Space: Slab:_Slab:_ (._ cies (la the bonus room finished? yes (_J no wi a closet?U yes no(if yes add In with#bedrooms) ❑ Mod:(Size x )#Bedrooms_#Baths_Basement(wMo bath)_Garage: Site Built Deck:_ On Frame_Off Frame_ (Is the second floor finished?( I yes (_)no My other site built additions?(i yes (_)no ❑ Manufactured Home:_SW DW_TW(Sae x )/t Bedrooms:_Garage: (site built?_)Deck: (site built?_] ❑ Duplex:(Sae x )No.Buildings: No.Bedrooms Per Unit: ❑ Home Occupation:#Rooms: Use: Hours of Operation: *Employees:_ ❑ Addlon/Acrossory/Other(Size_x 1 Use: Closets in addition?(i yes ( )no Water Supply: &unty _Existing Well —New Well(#ofdwel#ngs using well )*Must have operable water before final Sewage Supply: ....71tiew Septic Tank(Complete Checklist) _Existing Septic Tank(Complete Check#st) , 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?L yes ( )no / Does the properly contain any easements whether underground or overhead 4 5 s (_)no Structures(existing o proposed): ngle family dwellings: / Manufactured Homes: Other(speciy): Required Residential Property Live Setbacks: Comments: Front Minimum Actual f° Rear >CZZW`I Closest Side C 3u Sidestreet/corner lot Nearest Building on same lot Residential Land Use Application Page 1 of 2 03/11 APPLICATION CONTINUES ON BACK SPECIFIC DIRECTIONS TO THE PROPERTY FROM LILLINOTON: /dull Sittig ,gym r If permits are granted I agree . co ••all ordl cec and laws of the State of North Carolina regulating such work and g espsciinfC do^s of�fe providelans d.I hereby state lb- •- oin -•: -are occur: . d correct to the beet of my knowledge. Pernik subject revocation Signatu er or I, Ps Agent Data Mt Is the owner/applicants tenons •IINy to provide the county with any applicable Information about the subject property.Including but not limited to:boundary information,house location, underground or overhead mining Information Mateasements,Me etc.cThe in these applications,"lyees ere not responsible for any incorrect "this application expires 6 months from the Initial date If permits have not been blued" Residential Land Use Application Page 2 of 2 03/11 in 9 tag 777 I; !hill rn rn g6aPp $ Y Y SITE LAN APPROVAL C mutat r-- -kTh Una asEosOoms rii.) I I ‘ \ ,i c-siL I I P R 3 0 ii§ L8 8 o o •1 m a I 01;241 g31 DU' wi s IGA g IIZ H sr 8 o1 IT' 'ISe Y rk 3ipo _ L,. 1667 20I BB'62� 8 ',I 0 c 9P a m b"_ S n T 3JO k615 • u 4 ; I a r, w nvd.O9 aH SOVOHSSOHO SA311V8 [ea I-#USON { o o NAME: APPLICATION#: `This application to be filled out when applying for a septic system inspection.* County Health Department ADDlication for Imnrovement Permit and/or Authorization to Construct IF THE INFORMATION IN THIS APPLICATION IS FALSIFIED,CHANGED,OR WE 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 1 CONFIRMATION# ra'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 comer 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 ynderarowth 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 dews after confirmation.$25.00 return trip fee may be incurred for failure to uncover outlet lid,mark house corners and property lines.etc. once lot confirmed ready. • After preparing proposed site call the voice permitting system at 910-893-7525 option 1 to schedule and use code 800 (after selecting notification permit if multiple permits exist) for Environmental Health inspection. Please note confirmation number aiven at end of recordina for Proof of request. • Use Click2Gov or IVR to verify results. Once approved,proceed to Central Permitting for perm Its. ❑ Environmental Health Existing Tank Inspections Code 800 • Follow above instructions for placing flags and card on property. • Prepare for inspection by removing soil over outlet end of tank as diagram indicates, and lift lid straight up (if possible)and then put lid back In place. (Unless inspection is for a septic tank In a mobile home park) • DO NOT LEAVE UDS OFF OF SEPTIC TANK • After uncovering outlet end call the voice permitting system at 910-893-7525 option 1 & select notification permit if multiple permits, then use code 800 for Environmental Health inspection. Please note confirmation number given at end of recording for Proof of request. • Use CIIck2Gov or IVR to hear results.Once approved, proceed to Central Permitting for remaining permits. SEPTIC If appy$ng for authorization to construct please indicate desired system type(s): can be ranked in order of preference,must choose one. {_I/ Accepted (_} Innovative (_)Conventional (_)Any {_) 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 theans er is"yes",applicant MUST ATTACH SUPPORTING DOCUMENTATION: {_}YES { Does the site contain any Jurisdictional Wetlands? (_)YES ( )/I y70 Do you plan to have an ji:ligation system now or in the future? {_)YES l �1)40 Does or will the building contain any jag?Please explain. I_}YES { //NO Are there any existing wells,springs,waterlines or Wastewater Systems on this property? {_}YES {_A NO Is any wastewater going to be generated on the site other than domestic sewage? {_)YES (Z{ . O Is the site subject to approval by any other Public Agency? (_{YES [ 47MO 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 800-6324949 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 G . Right Of Entry To Conduct Necessary Inspections To Determine Compliance With Applicable Laws And Rules. I Und Tha Solely Responsible For The Proper Identification And Labeling Of All Property Lines And Corners And Making ons Iete Site Evaluation Can Be Performed, R ERTY 0 RS OR HERS LEGAL REPRESENTATIVE SIGNATURE(REQUIRED)ksi DATE 10/10 B3606 - P645 For Registration Kimberly S. Hargrove Register of Deeds Harnett County, NC Electronically Recorded HARNETT COUNTY TAX ID # 2018 May 18 02:13 PM NC Rev Stamp: $ 90.00 071610 0133 02 Book: 3606 Pagef545 - 546 Fee:5 26.00 071610 0133 03 Instrument Number: 2018007010 071610 0096 01 05-18-2018 BY: CW NORTH CAROLINA GENERAL WARRANTY DEED Excise Tax$ 90.00 PIN No.: Lot 4-071610 0133 02; Lot 5-071610 0133 03; (0.93 acre)Lot-071610 0096 Ol Mail after recording to Dwight W. Snow,Attorney at Law,P.O.Box 397,Dunn NC 28335 This instrument was prepared by Dwight W.Snow,Attorney at Law,P.O.Box 397,Dunn NC 28335 Brief Description for the index Lots 4 &5 Map Book 2016,Page 348 and 0.93 acre Lot Map Book 2016,Page 337 THIS DEED made this the 18th day of May, 2018 by and between GRANTOR GRANTEE OLIVER J. ENNIS and wife, - S-MARK PROPERTIES,LLC VICKIE WOOD ENNIS a N.C.Limited Liability Company 416 Chic Ennis Road 365 Cottle Lake Dr. Benson,NC 27504 Coats,N.C. 27521 The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include singular,plural,masculine, feminine or neuter as required by context. WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged,has and by these presents does grant,bargain,sell and convey unto the Grantee in fee simple, all that certain lot or parcel of land situated in the Grove Township,Harnett County,North Carolina and more particularly described as follows: BEING all of Lots 4 composed of 0.83 acre and Lot S composed of 0.87 acre as shown on that map entitled "Minor Subdivision Map For Oliver J.Ennis and Wife, Heide Wood Ennis"recorded on NORTH CAROLINA GENERAL WARRANTY DEED Excise Tax $ 90.00 PIN No.: Lot 4-071610 0133 02; Lot 5-071610 0133 03; (0.93 acre) Lot- 071610 0096 01 Mail after recording to Dwight W. Snow,Attorney at Law, P.O. Box 397,Dunn NC 28335 This instrument was prepared by Dwight W. Snow,Attorney at Law, P.O. Box 397, Dunn NC 28335 Brief Description for the index Lots 4& 5 Map Book 2016, Page 348 and 0.93 acre Lot Map Book 2016, Page 337 THIS DEED made this the 18th day of May, 2018 by and between GRANTOR GRANTEE OLIVER J. ENNIS and wife, - S-MARK PROPERTIES, LLC VICKIE WOOD ENNIS a N.C. Limited Liability Company 416 Chic Ennis Road 365 Cottle Lake Dr. Benson, NC 27504 Coats,N.C. 27521 The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include singular, plural, masculine, feminine or neuter as required by context. WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has and by these presents does grant,bargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of land situated in the Grove Township, Harnett County, North Carolina and more particularly described as follows: BEING all of Lots 4 composed of 0.83 acre and Lot 5 composed of 0.87 acre as shown on that man The property hereinabove described was acquired by Grantor by instrument recorded in Book 2728,Page 177, Harnett County Registry. Maps showing the above described property lots are recorded in Map Book 2016, Page 348 and Map Book 2016, Page 337, Harnett County Registry. All or a portion of the property herein conveyed does not include the primary residence of a Grantor. (NC. Gen. Stat. §105-317.2). TO HAVE AND TO HOLD the aforesaid lots or parcels of land and all privileges and appurtenances thereto belonging to the Grantee in fee simple. And the Grantor covenants with the Grantee,that Grantor is seized of the premises in fee simple,has the right to convey the same in fee simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the lawful claims of all persons whomsoever except for the exceptions hereinafter stated. Title to the property hereinabove described is subject to the following exceptions: 1. General utility easements of record. 2. Roadways and rights-of-way of record and those visible by inspection of the premises. 3. Such facts as an environmental study on the subject property by an environmental engineer would reveal. 4. Such facts that would be revealed by a recent as built survey on the subject tract by a registered land surveyor. 5. Such facts that are revealed by those surveys which are recorded in Map Book 2016, Page 348, and Map Book 2016, Page 337, Harnett County Registry. 6. 2018 ad valorem taxes which are not yet due and payable and which will be the responsibility of the Grantee to pay when they become due. IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal, or if corporate, has caused this instrument to be signed in its corporate name by its duly authorized officers and its seal to be hereunto affixed by authority of its Board of Directors, the day and year first above written. (SEAL) Oliver J. Ennis r• ULteW WPM &144(i0 (SEAL) Vickie Wood Ennis SEAL-STAMP NORTH CAROLINA County of Harnett LAVF''• Rj., I, Notary Public, certify that Oliver J. Ennis and wife, Vickie Wood Ennis, y •,Grantors,personally appeared before me this day and acknowledged the execution of the foregoing instrument. pUELle a44itness my hand and official stamp or seal,this the for day of May, 2018. s` rro0� '`. 7--) 1 I A 08108111 Application# Hamed County Central Permitting Gown below to bend out PO Boz es onion NC 2754 hyaline/sr pmtow to nark 883 7626 Fax 010 593 2793 view Semen sr8/Psrnras otiose crow or licensed maracas Address company Application for Residential Braiding'and Trades Paine( name a Done must match Owners Name S-/Ylo^{<�J�o.Ptzun Li-C. Date �, - /X See Address -3a51 ICJ its (% c-srcdpJ (ari Phone 95-S!G„C-F3i7 DireCtionsio pb site from Lllhngton al em b u --._ , . - Aa 9'UwL k ci L. a -rt. ,m 'ad /7, ‘a,,, ran , _A °%Y Z- 27:1'-4 Subdmeon 110.-..... . tat Lot Description of Proposed Work kk..c.J g ,_ - sen #of Bedrooms ..-- Heated Heated SF (1c-A Unheated SF9 O Finished Bonus Room9 rCrawl Space _Slab C---- General Contractor Infomraro -/YLiifk ,. 9(c-s{6k-93o7 Building Contractonrs pony Name Telephone nIr Address Email Address License# Elancel Contractor Infoabor( Description of Work Service Size Amps T-Pole _Yes_No 2uFat skoz- e tee„ anni, ?eq.-lin-995%7 Electncal Contactor s Company Name Telephone Sly . t.-ii 72ci <r ,2_,J Address Emad Address I orad U License# 9Slt�Yl rpbon of Work / 52e/r j �`i 1< it'ae bract )dlc¢J3 Z-2cfb 9(o zS—IS-- 0Y(5 Mechanical CorThttrrs Conosany NameTelephone 72-0-2) LAsnn s( oi- 6e 47 Address Email Address 115U2— License# Valplumbing Contractor Informatto0 DescriptionsIof Work c r1 N Rut-6 #Baths It c9\ bPlumbing Contractor ompany e /� Telephone 3/ -mil SnSro(rz- wav . (ale: o ode_ Address ( Emad Address License# ontractor Information 7A-4r:441-y - A �C _ 9 20- 77a--gra Insulation Contractors Company Name ft Address' Tele ne *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 Hamed County Zoning Ordinance I state the information on the above contractors is correct as known to me and that jasiameakinfaS pennusron to obtain these(*armee and if my changes occur including listed contractors site plan number of bedrooms budding and trade plans Environmental Health permit changes or proposed use charges I certify it is my responsibility to notify the Hamed County Central Permitting Department of any and all changes EXPI D PE: FEES•0 Months to 2 years permit re-issue fee is 3150 00 After 2 years re-issue fee la 85 .6L'-0 • r rc— tonere of • :ctorl s)of Corporation Date Affidavit for Worker's Compensation NC G S 87-14 The und/erygned appl cam being the General Contractor _Owner _OfhcerlAgent of the Contractor or Owner Do hereby confirm under penalties of penury that the person(s) firms)or carporation(s)performing the work set forth in the permit _Has three(3)or more employees and has obtained workers compensation insurance to cover them _4/1-las one(1)or more subcontractors(s)and has obtained workers compensation insurance to cover them/ one(1)or more subcontractors(s)who has their own policy of workers compensation insurance covenng themselves Has no more than two(2)employees and no suborn utiwtuwa 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 during the matted work from any person firm or corporation carrying out the work ��vv11 / Company or Nab i7-/?e-/cIe1?"-.4 '- C- c' �%I Sign w/rrtle' �i[� c. Date A— Jit 1 „ LIEN AGENT INFORMATION Effective April 1,2013 ere--; a3 i. In accordance with North Carolina General Assembly Session Law 2012-158, ' Inspection Departments are not allowed to issue any permit where the project cost is$30,000 or more unless the application is for improvements to an existing dwelling that the applicant uses as a residence OR the property owner has designated a lien agent and provided the inspections office with the information below: Name of Lien Agent 1-1%.\tipActrfS \LI .S ucPc'ct C-1ntP "'ltC Mailing address of Agent \ W. 1,140,mak e . 5u,c, 5©7 Physical address of Agent cl \rj, \,Neo e) 6{-• Su `1/2-c- ;07 ,c also Telephone \- %R - AG- `1384 Fax 1 Q\e - - S(ola Email c-IulQrUc tc. coin The information will be attached to the permit record and a copy provided to the applicant. The applicant is required to post a copy on the construction site. Excerpt from North Carolina G.S. 160A-417: "(Effective April 1,2013)No permit shall be issued pursuant to subdivision(1)of subsection(a)of this section where the cost of the work is thirty thousand dollars($30,000)or more,other than for improvements to an existing single-family residential dwelling unit as defined in G.S. number, tht the applicant uses as a residence,unless the name,physical and mailing address,telephone facsimile number,and electronic mail address of the lien agent designated by the owner pursuant to G.S. 44A-11.1(a) is conspicuously set forth in the permit or in an attachment thereto.The building permit may contain the lien agent's electronic mail address.The lien agent information for each permit issued pursuant to this subsection shall be maintained by the inspection department in the same manner and in the same location in which it maintains its record of building permits issued" HARNETT COUNTY CASs REECEIPTS aw. CUSTOMER RECEIPT *** Oper: :MUCK Type: CP Drawer: 1 Date: 6/11/18 52 Receipt no: 385488 Year Bumper Amount 2018 50044224 91749 TECH 2 LILLINGTON, NC 27546 B4 NP - ENV NEA-in FEES NEW TANK 6756.08 5 MARK PROP lender detail CP CREDIT CARD $750.90 Total tendered 3759.00 Total payment 3750.90 Trans date: 6/11/36 Time: 12:21:21 ** THANK YOU FOR YOUR PAYMENT **